Phenotypic and Genotypic Characterization of ESBL-, AmpC-, and Carbapenemase-Producing &lt;b&gt;&lt;i&gt;Klebsiella pneumoniae&lt;/i&gt;&lt;/b&gt; and &lt;b&gt;&lt;i&gt;Escherichia coli&lt;/i&gt;&lt;/b&gt; Isolates

Kazemian, Hossein; Heidari, Hamid; Ghanavati, Roya; Ghafourian, Sobhan; Yazdani, Fateme; Sadeghifard, Nourkhoda; Valadbeigi, Hasan; Maleki, Afshin; Pakzad, Iraj

doi:10.1159/000500311

Cited by 56 publications

(43 citation statements)

References 28 publications

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“…Several studies have reported that AmpC producer in K. pneumoniae ranged from 7.8% to 43%. [37][38][39] Similar to a previous study, resistance to carbapenem among Enterobacter spp. was high.…”

Section: Discussionsupporting

confidence: 78%

Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae

Alizadeh¹,

Rezaee²,

Kafil³

et al. 2020

IDR

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Background: Carbapenem-resistant Enterobacteriaceae (CRE) is a major concern leading to morbidity and mortality in the world. CRE often is becoming a cause of therapeutic failure in both hospital and community-acquired infections. Aim: This study aimed to investigate the resistance mechanisms of CRE by phenotypic and molecular methods. Materials and Methods: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Antimicrobial susceptibility testing was carried out using phenotypic methods. The carbapenem resistance mechanisms including efflux pump hyperexpression, AmpC overproduction, carbapenemase genes, and deficiency in OmpK35 and OmpK36 were determined by phenotypic and molecular methods, respectively. Results: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Amikacin was found to be the most effective drug against CRE isolates. All isolates were resistant to imipenem and meropenem by the micro-broth dilution. AmpC overproduction was observed in all Enterobacter spp. and three K. pneumoniae isolates. No efflux pump activity was found. Carba NP test and Modified Hodge Test could find carbapenemase in 59 (98%) isolates and 57 (95%) isolates, respectively. The most common carbapenemase gene was bla OXA-48-like (72.8%) followed by bla NDM (50.8%), bla IMP (18.6%), bla VIM (11.8%), and bla KPC (6.7%). The ompK35 and ompK36 genes were not detected in 10 and 7 K. pneumoniae isolates, respectively. Conclusion: The amikacin is considered as a very efficient antibiotic for the treatment of CRE isolates in our region. Carbapenemase production and overproduction of AmpC are the main carbapenem resistance mechanisms in CRE isolates. Finally, Carba NP test is a rapid and reliable test for early detection of carbapenemase-producing isolates.

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Section: Discussionsupporting

confidence: 78%

Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae

Alizadeh¹,

Rezaee²,

Kafil³

et al. 2020

IDR

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“…The relation between ERIC patterns and β-lactam resistance encoding genes profiles was studied where 42 different resistance gene profiles were distributed among 34 ERIC patterns that represent all tested K. pneumoniae isolates. Similar results were reported by Kazemian et al [51] Our results indicated the significance and convenience of ERIC-PCR and β-lactam resistance encoding genes profiles in differentiating isolates based on genetic relatedness. The diversity in our isolates represented a problem in the treatment of K. pneumoniae infections.…”

Section: Plos Onesupporting

confidence: 91%

“…Similar results were reported by Kazemian et al . [ 51 ] Our results indicated the significance and convenience of ERIC-PCR and β-lactam resistance encoding genes profiles in differentiating isolates based on genetic relatedness. The diversity in our isolates represented a problem in the treatment of K .…”

Section: Discussionmentioning

confidence: 73%

Characterization of β-lactam resistance in K. pneumoniae associated with ready-to-eat processed meat in Egypt

Abdel-Rhman

2020

PLoS ONE

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K. pneumoniae was known as a nosocomial infection that causes human diseases. It is considered as one of the food-borne pathogens as it causes septicemia and diarrhea in humans. This study aims to characterize K. pneumoniae strains isolated from ready to eat processed meat phenotypically and genetically. Three hundred and fifty ready to eat processed meat (Luncheon-meat) samples were collected. Forty-four (12.6%) K. pneumoniae strains were isolated and bio-typed, where the majority were identified to belong to biotype B1. K1 and K2 serotypes were detected and strains were classified as hypermucoviscous K. pneumoniae (HVKP) and classic K. pneumoniae (CKP) (26 and 18 isolates, respectively). The isolates were resistant to several classes of β-lactam antibiotics, ceftazidim and cefotaxime (95.5%), cefoxitin (93.2%), ertapenem (90.9%) and amoxicillin-clavulanic acid (86.4%). They were classified as extended spectrum β-lactamases (ESBLs), AmpC or carbapenemase-producers phenotypically. Eighteen β-lactamase genes were investigated by PCR. The most prominent genes were SHV (63.6%), TEM (52.2%), CTX-M15 (50%), AMPC (47.7%), CIT-M (45.5%) and VIM (43.2%). Co-detection of β-lactam resistance genes revealed 42 gene profiles. Twenty-four isolates had the complete efflux system (AcrAB-ToƖC). Besides, Integrons (I, II, III) were detected in 20 isolates. Molecular typing by ERIC-PCR showed high genetic diversity between isolates as 34 different patterns were identified. Overall, this study confirmed the hazards posed by the presence of multiple resistance genes in the same isolate and this should not be undervalued. Besides, the horizontal transfer of plasmid harboring resistance genes between isolates in food represents potential health risks for consumers in Egypt and so the control and inhibition plans are necessary.

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“…Reuland et al [28] described in their study pAmpC (bla CMY , bla MOX , bla FOX , bla DHA , bla ACT , bla MIR , and bla ACC ) in community strains in Amsterdam. Ribeiro et al [15] and Kazemian et al [29] identified bla DHA bla CMY and bla CIT pAmpC in Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis in different types of nosocomial infections in Portugal and Iran, respectively.…”

Section: Resultsmentioning

confidence: 99%

Conjugative plasmidic AmpC detected in Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae human clinical isolates from Portugal

et al. 2020

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AmpC is a type of β-lactamase enzyme produced by bacteria; these enzymes are classified in Class C and Group 1, and these confer resistance to cephamycin. Enterobacterales producing AmpC are reported worldwide and have great clinical importance due to therapeutic restriction and epidemiological importance once the easy dissemination by plasmidic genes to other bacteria is a real threat. These genes are naturally found in some enterobacteria as Enterobacter cloacae, Morganella morganii, and Citrobacter freundii, but other species have demonstrated similar resistance phenotype of AmpC production. Genes carried in plasmids have been described in these species conferring resistance to cefoxitin and causing therapeutic failure in some bacterial infections. This work detected and described five clinical strains of Escherichia coli, Proteus mirabilis, and Klebsiella pneumoniae that presented plasmid ampC (pAmpC) isolated from the north of Portugal collected in 2009. AmpC production was confirmed by inhibition of the enzyme by cloxacillin and boronic acid in agar diffusion tests. Also, PCR (polymerase chain reaction) was performed for the detection of gene universal to AmpC, bla ampC , and others to AmpC group: bla ACC , bla CIT , bla CMY , bla DHA , and bla EBC. The conjugation in liquid medium for 24 h was realized to determine if gene is localized in chromosome or plasmid. The isolates and their conjugants showed phenotypic characteristics and bla CMY and bla CIT were detected by PCR corroborating the AmpC characteristics observed in these bacteria. Confirmation of transfer of plasmid containing genes encoding AmpC is of high epidemiological relevance to the hospital studied and demonstrated the importance of AmpC surveillance and studies in hospital and community environments in order to choose the appropriate therapy for bacterial infections.

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Phenotypic and Genotypic Characterization of ESBL-, AmpC-, and Carbapenemase-Producing <b><i>Klebsiella pneumoniae</i></b> and <b><i>Escherichia coli</i></b> Isolates

Cited by 56 publications

References 28 publications

<p>Evaluation of Resistance Mechanisms in Carbapenem-Resistant <em>Enterobacteriaceae</em></p>

<p>Evaluation of Resistance Mechanisms in Carbapenem-Resistant <em>Enterobacteriaceae</em></p>

Characterization of β-lactam resistance in K. pneumoniae associated with ready-to-eat processed meat in Egypt

Conjugative plasmidic AmpC detected in Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae human clinical isolates from Portugal

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