Occurrence and Characterization of Carbapenemase-Producing <i>Enterobacteriaceae</i> in a Tunisian Hospital

Helal, Rania Ben; Dziri, Raoudha; Chedly, Meriem; Klibi, Naouel; Barguellil, Farouk; Asli, Mohamed Selim El; Moussa, Mohamed Ben

doi:10.1089/mdr.2018.0013

Cited by 17 publications

(17 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Of note, there were a number of mismatches between the results of a previous screening for carbapenemase genes using a commercial PCR assay [28] and the present screening using in-house multiplex PCRs [27]. For the genes bla OXA-48 and bla VIM , the numbers of missed samples and additional detections were in a similar range for both platforms, while considerably more detections of bla NDM were observed with the commercial system.…”

Section: Discussionmentioning

confidence: 71%

“…Of note, 107 out of 197 assessed Enterobacteriaceae had been subjected to the “Hyplex ® Superbug ID system” (amPLEX Diagnostics, Gars-Bahnhof, Germany), targeting the carbapemase genes bla VIM , bla IMP , bla NDM-1 , bla OXA-48 , and bla KPC , in a previous assessment [28]. From those 107 strains, the ampPLEX assay had detected bla OXA-48 in 76 strains, bla NDM-1 in 7 strains, bla OXA-48 and bla NDM-1 in 4 strains, and bla OXA-48 and bla VIM in 4 strains, while no carbapenemase had been detected in 16 strains.…”

Section: Resultsmentioning

confidence: 99%

“…From those 107 strains, the ampPLEX assay had detected bla OXA-48 in 76 strains, bla NDM-1 in 7 strains, bla OXA-48 and bla NDM-1 in 4 strains, and bla OXA-48 and bla VIM in 4 strains, while no carbapenemase had been detected in 16 strains. Matches and mismatches of the results of the in-house PCRs [27] as applied in the present study and the results of the commercial assay from the previous assessment [28] are shown in Table 2 for the carbapenemase genes bla VIM , bla NDM , and bla OXA -48 which were included in both assays (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…The applied in-house PCR approach detected carbapenemases in 170/197 (86.3%) strains, while the resistance mechanism against carbapenems remained unresolved for the remaining 13.7% of cases. The addition of results from a previous study with a commercial carbapenemase PCR [28] reduced the number of strains without detected carbapenemase genes to 12/197 (6.1%).…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Screening for carbapenemases in ertapenem-resistant Enterobacteriaceae collected at a Tunisian hospital between 2014 and 2018

Kollenda

Frickmann

Helal

et al. 2019

EuJMI

Self Cite

View full text Add to dashboard Cite

Background Carbapenem-resistance is frequently detected in Enterobacteriaceae isolated from patients in Tunisia. The study was performed to identify frequent carbapenemases in Tunisian isolates. Methods Between May 2014 and January 2018, 197 ertapenem-resistant Enterobacteriaceae were isolated at the microbiological department of the Military Hospital of Tunis. The strains were phenotypically characterized and then subjected to in-house polymerase chain reaction (PCR) targeting the carbapenemase genes bla IMP , bla VIM , bla NDM , bla SPM , bla AIM , bla DIM ,bla GIM , bla SIM , bla KPC , bla BIC , and bla OXA-48 . Results The assessed 197 ertapenem-resistant Enterobacteriaceae from Tunis comprised 170 Klebsiella pneumoniae , 19 Enterobacter cloacae , 6 Escherichia coli , 1 Citrobacter sedlakii , and 1 Enterobacter asburiae. Thereby, 55 out of 197 isolates (27.9%) were from blood cultures, suggesting a systemic disease. The carbapenemase gene bla OXA-48 quantitatively dominated by far with 153 detections, followed by bla NDM with 14 detections, which were distributed about the whole study interval. In contrast, bla BIC and bla VIM were only infrequently identified in 5 and 3 cases, respectively, while the other carbapenamases were not observed. Conclusions The carbapenemase gene bla OXA-48 was identified in the vast majority of ertapenem-resistant Tunisian Enterobacteriaceae while all other assessed carbapenemases were much less abundant. In a quantitatively relevant minority of isolates, the applied PCR-based screening approach did not identify any carbapenemases.

show abstract

Section: Discussionmentioning

confidence: 71%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Screening for carbapenemases in ertapenem-resistant Enterobacteriaceae collected at a Tunisian hospital between 2014 and 2018

Kollenda

Frickmann

Helal

et al. 2019

EuJMI

Self Cite

View full text Add to dashboard Cite

show abstract

“…Some require DNA extraction from a rectal swab specimen before amplification, such as the PCR-based Amplidiag CARBA þ MCR assay (Mobidiag, Paris, France) 24 or the Check-Direct CPE assay (Check-Points, Wageningen, the Netherlands), 25 whereas others do not require DNA extraction, such as Hyplex SuperBug ID (Amplex Biosystems GmbH, Giessen, Germany). 26 Others are fully automated, such as CRE ELITe MGB kits on InGenius platform (Elitech, Les Ulis, France) 27 and Gen-eXpert Carba-R assay (Cepheid, Sunnyvale, CA). 28,29 Most of these assays target the big 5 carbapenemases: KPC, OXA-48 like, NDM, VIM, and IMP, representing >99% of the carbapenemases produced by Enterobacteriaceae in countries such as France.…”

mentioning

confidence: 99%

Evaluation of the BD MAX Check-Points CPO Assay for the Detection of Carbapenemase Producers Directly from Rectal Swabs

Girlich

Oueslati

Bernabeu

et al. 2020

The Journal of Molecular Diagnostics

View full text Add to dashboard Cite

A novel real-time multiplex PCR assay, BD MAX Check-Points CPO, was evaluated to detect carbapenemase-producing organisms in clinical settings on the BD MAX system. A total of 175 wellcharacterized isolates (including 123 carbapenemase producers) and 128 rectal swab specimens (including 83 positives) of patients considered at high risk for carriage of carbapenemase producers were included. Bacterial suspensions were used to spike true-negative rectal swabs to mimic a clinical sample. Sample (50 mL), containing either the spiked or the patient's sample, was processed. The BD MAX Check-Points CPO assay detected carbapenemases KPC, VIM/IMP, NDM, and OXA-48elike producers with a high sensitivity and specificity of 97.1% and 98.8%, respectively. Rare variants of the IMP type (IMP-11, IMP-13, and IMP-14) and one rare and distantly related OXA-48 variant (OXA-535) remained undetected. With patients' rectal swabs, sensitivity and specificity were 92.8% and 97.8%, respectively. Failure of detection was due to weak inoculum. The time to result was short: approximately. 2.5 hours for 12 samples (including extraction and PCR). The automated sample-in results-out platform is an efficient, quick, and easy-to-use tool for the detection of the main five carbapenemases. The lack of distinction between producers of VIM and IMP may be limiting in countries where these enzymes are widespread, as in Asia, but not in France, where IMP producers are extremely rare. (J Mol Diagn 2020, 22: 294e300; https://doi.The global spread of carbapenemase-producing organisms (CPOs; Enterobacteriaceae Pseudomonas and Acinetobacter species) is a major public health issue worldwide. 1e5 The most clinically relevant carbapenemases belong to several Ambler classes of b-lactamases that differ by amino acid sequence, structural features, and biochemical properties: class A (KPC type), class B, i-e metallo-b-lactamases (eg, IMP, VIM, and NDM types) or carbapenem-hydrolyzing class D ß-lactamases, such as OXA-48 like in Enterobacteriaceae and OXA-23, OXA-40, OXA-58, and OXA-143 in Acinetobacter species. 1e5 The geographic distribution of carbapenemase-producing Enterobacterales (CPEs) is variable, but the same five main determinants are usually found at variable prevalence. KPC producers have spread most extensively throughout the world,

show abstract

High Prevalence of blaNDM Among Carbapenem Non-Susceptible Klebsiella pneumoniae in a Tunisian Hospital First Report of blaNDM-9, blaKPC-20, and blaKPC-26 Genes

et al. 2023

View full text Add to dashboard Cite

Fifty-four carbapenem non-susceptible Klebsiella pneumoniae (CNSKP) isolates were collected from a Tunisian hospital over a period of 13 consecutive months. Carbapenemase production and the prevalence of carbapenemase-encoding genes were investigated using combined-disk test (CDT), modified Carba NP (mCarba NP) test, and UV-spectrophotometry method complemented by PCR experiments and sequencing. Carbapenemase production was detected by the mCarba NP test and CDT in 92.59% and 96.29% of the 54 CNSKP isolates, respectively; while imipenem hydrolysis was detected using UVspectrophotometry in the crude extracts of 44 isolates. bla NDM, bla OXA-48-like , and bla KPC carbapenemase-encoding genes were found in 48, 31, and 22 isolates, respectively. Remarkably, bla NDM-9, bla KPC-20 , and bla KPC-26 genes were reported. The co-occurrence of carbapenemase-encoding genes in a single isolate was detected in 62.96% of the isolates. The analysis of clonal relationships between the isolates by pulsed field gel electrophoresis revealed that the majority of them were genetically unrelated. Our investigation provides molecular data on enzymatic mechanism of carbapenem non-susceptibility among 54 CNSKP showing the dominance of bla NDM, and comprises the first identification of bla NDM-9, bla KPC-20 , and bla KPC-26 genes in a Tunisia hospital.

show abstract

Occurrence and Characterization of Carbapenemase-Producing Enterobacteriaceae in a Tunisian Hospital

Cited by 17 publications

References 32 publications

Screening for carbapenemases in ertapenem-resistant Enterobacteriaceae collected at a Tunisian hospital between 2014 and 2018

Screening for carbapenemases in ertapenem-resistant Enterobacteriaceae collected at a Tunisian hospital between 2014 and 2018

Evaluation of the BD MAX Check-Points CPO Assay for the Detection of Carbapenemase Producers Directly from Rectal Swabs

High Prevalence of blaNDM Among Carbapenem Non-Susceptible Klebsiella pneumoniae in a Tunisian Hospital First Report of blaNDM-9, blaKPC-20, and blaKPC-26 Genes

Contact Info

Product

Resources

About