High prevalence of VIM-4 and NDM-1 metallo-β-lactamase among carbapenem-resistant Enterobacteriaceae

Abstract

The purpose of this study was to identify the mechanisms leading to carbapenem resistance among multidrug-resistant Enterobacteriaceae isolates recovered from hospitalized patients with nosocomial infections in Mubarak Al Kabeer Hospital, Kuwait. Fourteen carbapenem-resistant Enterobacteriaceae isolates were obtained from inpatients in different wards and intensive care units between April 2009 and February 2011. Antibiotic susceptibilities were determined using the E-test method. Genes encoding b-lactamases were characterized by specific PCR amplification, sequencing and conjugation assays. All isolates were identified as metallo-blactamase (MBL) producers using phenotypic and molecular methods. Eleven of the 14 isolates produced VIM-4 (six Klebsiella pneumoniae, three Escherichia coli, one Enterobacter cloacae and one Klebsiella oxytoca). Three K. pneumoniae isolates produced the MBL NDM-1 and coproduced the plasmid-encoded AmpC CMY-4. The VIM-4-producing isolates co-produced extended-spectrum b-lactamases including CTX-M-15 and some SHV derivatives. The VIM-4 gene was not transferable by conjugation studies of six selected strains. We demonstrated here the emergence of VIM-4-and NDM-1-producing isolates in the largest teaching hospital in Kuwait.

Molecular Characterization of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae in the Countries of the Gulf Cooperation Council: Dominance of OXA-48 and NDM Producers

“…No isolate was found to produce the KPC, VIM, or IMP betalactamase, although these carbapenemases have been previously detected in Saudi Arabia and Kuwait (2,(22)(23)(24). For 17 isolates, no carbapenemase activity or carbapenemase genes were identified, suggesting a noncarbapenemase-related resistance mechanism.…”

Carbapenem Resistance among Enterobacter Species in a Tertiary Care Hospital in Central India

“…Lascols et al and Castanheira et al also reported carriage of bla NDM-1 among E. cloacae [33, 34]. Emergence of bla NDM-1 producing E. cloacae clinical isolates was reported from Singapore [35], China [36], Australia [37], United States [38], Kuwait [39], Turkey [40], and Canada [41]. MBLs other than NDM-1 also have been reported by various authors in E. cloacae : bla IMP-1 from Turkey [42], bla IMP-8 from Taiwan [43], bla VIM1-4 from Italy [44–46], bla VIM-2 from Korea [47], and bla VIM-12 from Greece [48].…”

Isolation of Salmonella enterica Serovar Kentucky Strain ST 198 and Its H 2 S-Negative Variant from a Patient: Implications for Diagnosis

“…Both the 915 and 917 isolates were identified as Salmonella enterica serotype Kentucky (antigens 8,20:i,z 6 ) in an agglutination test according to the Kauffmann-White scheme by using commercial antisera (Murex, Dartford, the United Kingdom; Statens Serum Institut, Copenhagen, Denmark; and Denka Seiken, Tokyo, Japan). The clonal relationship between the two isolates was evaluated by pulsed-field gel electrophoresis (PFGE) using restriction enzyme XbaI as described previously (1). The two isolates appeared very similar ( Fig.…”