The emergence of carbapenemase blaNDM genotype among carbapenem-resistant Enterobacteriaceae isolates from Egyptian cancer patients

Tawfick, Mahmoud M.; Alshareef, Walaa A.; Bendary, Hager A.; Elmahalawy, Hadir; Abdulall, Abeer K.

doi:10.1007/s10096-020-03839-2

Cited by 32 publications

(34 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…35 As reported in other previous studies in Egypt, our study also concluded that the predominant species among the isolated CRE was MDR K. pneumoniae, which represents a frightening causative agent of different types of infections among hospitalized pediatric cancer patients. [35][36][37][38] It was reported that class D carbapenemases (bla OXA-48 = 58%) are predominant in K. pneumoniae followed by the bla NDM-1 gene, in several studies conducted in different countries notably in the Mediterranean region including Spain, France, Turkey, Tunisia and Egypt. 20,21 Furthermore, the majority (41.8%) of the K. pneumoniae isolates in the current study harbored one or more carbapenem resistance determinants (Figure 2) that agreed with previously reported studies.…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Egyptian Pediatric Cancer Patients Including a Strain with a Rare Gene-Combination of β-Lactamases

Osama¹,

El-Mahallawy²,

Mansour³

et al. 2021

IDR

View full text Add to dashboard Cite

Purpose Healthcare-associated infections caused by multi-drug-resistant (MDR) pathogens are a global threat. We aim to assess the clonal relatedness among carbapenemase-producing Klebsiella pneumoniae (CPKP) strains infecting Egyptian pediatric cancer patients. Materials and Methods Identification and antimicrobial susceptibility testing of 149 Gram-negative isolates obtained from pediatric cancer patients were performed by VITEK 2. Genes encoding carbapenemases and extended-spectrum β-lactamases were detected by PCR and verified by DNA sequencing of representative samples. The transferability of the plasmids harboring bla OXA-48 , from representative clinical samples, was evaluated by performing a conjugation experiment followed by PCR and MIC shift determination. Clonal relationships among the bla OXA-48 -harboring K. pneumoniae isolates were determined by enterobacterial repetitive intergenic consensus (ERIC)-PCR and pulsed-field gel electrophoresis (PFGE). Results Carbapenem resistance was observed in 59% of the isolates. The most prevalent species was K. pneumoniae (45.6%) and 57% of them were isolated from ICU. Fifty-nine % of the K. pneumoniae isolates were carbapenemase-producers and bla OXA-48 was detected in (58%) of them. One isolate co-harbored bla OXA-48, bla NDM-1 , and bla IMP-1 genes for the first time in Egypt. PCR and meropenem MIC shift confirmed the success of the transferability of representative plasmids to E. coli K12. ERIC and PFGE identified 93% and 100% of the K. pneumoniae with a similarity coefficient ≥85%, respectively, including strains with indistinguishable patterns, suggesting possible clonal dissemination. Conclusion Our findings underline the dissemination of diverse clones of MDR CPKP among Egyptian pediatric cancer patients. Hence, routine molecular characterizations followed by strict implementation of infection control measures are crucial to tackling this threat.

show abstract

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Egyptian Pediatric Cancer Patients Including a Strain with a Rare Gene-Combination of β-Lactamases

Osama¹,

El-Mahallawy²,

Mansour³

et al. 2021

IDR

View full text Add to dashboard Cite

show abstract

“…This genotypic carbapenem resistance prevalence corroborates with earlier studies conducted in the East African region [18,25,38] and elsewhere [27,39] that reported levels ranging from 25% to 40%. Contrary, this frequency is signi cantly lower than carbapenem genotypic levels reported by studies in Tunisia (76.7%) [40], South Africa (68% and 86%) [33,34] , Egypt (89.6%) [37], Turkey (49.5%) [41]. KPC, VIM, NDM, OXA-48 and IMP are the commonest carbapenemases worldwide [42].…”

Section: Discussionmentioning

confidence: 77%

“…For example, prevalence of carbapenem resistance in Tanzania was 24% [25], Nigeria 15.2%, 27.4% and 36.8%) [26][27][28], India 31.77% [29]. Contrary, this frequency is higher than carbapenem resistance levels reported in countries like Ghana (7.2%) [30], Morocco 5.99% [31], and Ethiopia 2.73%, [32] with similar healthcare settings but lower than the incidences above 50% reported in South Africa, Egypt and Tunisia [33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 97%

Carbapenem resistance profiles of Pathogenic Escherichia coli in Uganda

Ssekatawa

Byarugaba

Nakavuma

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Escherichia coli has been implicated as one of the main etiological agents of diarrhea, urinary tract infections, meningitis and septicemia worldwide. The ability to cause diseases is potentiated by presence of virulence factors. The virulence factors influence the capacity of E. coli to infect and colonize different body systems. Thus, pathogenic E. coli are grouped into DEC strains that are mainly clustered in phylogenetic group B1 and A; ExPEC belonging to A, B2 and D. Coexistence of virulence and beta-lactamase encoding genes complicates treatment outcomes. Therefore, this study aimed at presenting the CR profiles among pathogenic E. coli. Methods: This was a retrospective cross-sectional study involving use of archived E. coli clinical isolates collected in 2019 from four Ugandan tertiary hospitals. The isolates were subjected to antibiotics sensitivity assays to determine phenotypic resistance. Four sets of multiplex PCR were performed to detect CR genes, DEC pathotypes virulent genes, ExPEC PAI and the E. coli phylogenetic groups. Results:Antibiotic susceptibility revealed that all the 421 E. coli isolates used were MDR as they exhibited 100% resistance to more than one of the first-line antibiotics. The study registered phenotypic and genotypic CR prevalence of 22.8% and 33.0% respectively. The most predominant gene was blaOXA-48 with genotypic frequency of 33.0%, then blaVIM(21.0%), blaIMP(16.5%), blaKPC(14.8%) and blaNDM(14.8%). Spearman’s correlation revealed that presence of CR genes was highly associated with phenotypic resistance. Furthermore, of 421 MDR E. coli isolates, 19.7% harboured DEC virulent genes, where EPEC recorded significantly higher prevalence (10.8%) followed by S-ETEC(3.1%), STEC(2.9%), EIEC (2.0%) and L-ETEC(2.0%). Genetic analysis characterized 46.1% of the isolates as ExPEC and only PAI IV536(33.0%) and PAI IICFT073(13.1%) were detected. Phylogenetic group B2 was predominantly detected (41.1%), followed by A(30.2%), B1(21.6%), and D(7.1%). Furthermore, 38.6% and 23.1% of the DEC and ExPEC respectively expressed phenotypic resistance.Conclusion: Our results exhibited significant level of CR carriage among the MDR DEC and ExPEC clinical isolates belonging to phylogenetic groups B1 and B2 respectively. Virulence and CR genetic factors are mainly located on mobile elements. Thus, constitutes a great threat to the healthcare system as it promotes horizontal gene transfer.

show abstract

“…This genotypic carbapenem resistance prevalence corroborates with earlier studies conducted in the East African region [29,42,43] and elsewhere [31,44] that reported levels ranging from 25% to 40%. Contrary, this frequency is significantly lower than carbapenem genotypic levels reported by studies in Tunisia (76.7%) [45], South Africa (68% and 86%) [37,38] , Egypt (89.6%) [41], Turkey (49.5%) [46]. KPC, VIM, NDM, OXA-48 and IMP are the commonest carbapenemases worldwide [47].…”

Section: Extraintestinal Pathogenic Escherichia Coli (Expec)mentioning

confidence: 80%

“…For example, prevalence of carbapenem resistance in Tanzania was 24% [29], Nigeria 15.2%, 27.4% and 36.8%) [30][31][32], India 31.77% [33]. Contrary, this frequency is higher than carbapenem resistance levels reported in countries like Ghana (7.2%) [34], Morocco 5.99% [35], and Ethiopia 2.73%, [36] with similar healthcare settings but lower than the incidences above 50% reported in South Africa, Egypt and Tunisia [37][38][39][40][41].…”

Section: Extraintestinal Pathogenic Escherichia Coli (Expec)mentioning

confidence: 97%

Carbapenem Resistance Profiles of Pathogenic Escherichia coli in Uganda

Ssekatawa

Byarugaba

Nakavuma

et al. 2021

EJBIO

View full text Add to dashboard Cite

Escherichia coli has been implicated as one of the main etiological agents of diarrhea, urinary tract infections, meningitis and septicemia worldwide. The ability to cause diseases is potentiated by presence of virulence factors. The virulence factors influence the capacity of E. coli to infect and colonize different body systems. Thus, pathogenic E. coli are grouped into DEC strains that are mainly clustered in phylogenetic group B1 and A; ExPEC belonging to A, B2 and D. Coexistence of virulence and beta-lactamase encoding genes complicates treatment outcomes. Therefore, this study aimed at presenting the carbapenem resistance (CR) profiles among pathogenic E. coli. This was a retrospective cross-sectional study involving use of 421 archived E. coli clinical isolates collected in 2019 from four Uganda tertiary hospitals. The isolates were subjected to antibiotics sensitivity assays to determine phenotypic resistance. Four sets of multiplex PCR were performed to detect CR genes, DEC pathotypes virulence genes, ExPEC PAI and the E. coli phylogenetic groups. Antibiotic susceptibility revealed that all the 421 E. coli isolates used were MDR as they exhibited 100% resistance to more than one of the first-line antibiotics. The study registered phenotypic and genotypic CR prevalence of 22.8% and 33.0% respectively. The most predominant gene was blaOXA-48 with genotypic frequency of 33.0%, then blaVIM (21.0%), blaIMP (16.5%), blaKPC (14.8%) and blaNDM (14.8%). Spearman’s correlation revealed that presence of CR genes was highly associated with phenotypic resistance. Furthermore, of 421 MDR E. coli isolates, 19.7% harboured DEC virulence genes, where EPEC recorded significantly higher prevalence (10.8%) followed by S-ETEC (3.1%), STEC (2.9%), EIEC (2.0%) and L-ETEC (2.0%). Genetic analysis characterized 46.1% of the isolates as ExPEC and only PAI IV536 (33.0%) and PAI IICFT073 (13.1%) were detected. Phylogenetic group B2 was predominantly detected (41.1%), followed by A (30.2%), B1(21.6%), and D (7.1%). Furthermore, 38.6% and 23.1% of the DEC and ExPEC respectively expressed phenotypic resistance. Our results exhibited significant level of CR carriage among the MDR DEC and ExPEC clinical isolates belonging to phylogenetic groups B1 and B2 respectively. Virulence and CR genetic factors are mainly located on mobile elements. Thus, constitutes a great threat to the healthcare system as this promotes horizontal gene transfer.

show abstract

The emergence of carbapenemase blaNDM genotype among carbapenem-resistant Enterobacteriaceae isolates from Egyptian cancer patients

Cited by 32 publications

References 45 publications

Molecular Characterization of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Egyptian Pediatric Cancer Patients Including a Strain with a Rare Gene-Combination of β-Lactamases

Molecular Characterization of Carbapenemase-Producing Klebsiella pneumoniae Isolated from Egyptian Pediatric Cancer Patients Including a Strain with a Rare Gene-Combination of β-Lactamases

Carbapenem resistance profiles of Pathogenic Escherichia coli in Uganda

Carbapenem Resistance Profiles of Pathogenic Escherichia coli in Uganda

Contact Info

Product

Resources

About