The Inc FII Plasmid and its Contribution in the Transmission of blaNDM-1 and blaKPC-2 in Klebsiella pneumoniae in Egypt

Abstract

The emergence of bla KPC-2 and bla NDM-1 producing Klebsiella pneumoniae represents a great problem in many Egyptian hospitals. One hundred and twenty-six K. pneumoniae isolates from patients admitted to Assiut University Hospital were identified by an API20E kit. Carbapenemase-producing K. pneumoniae (CPKP) was detected by the modified carbapenem inactivation method (mCIM), the EDTA-modified carbapenem inactivation method (eCIM), and an E-test. Based on the polymerase chain reaction, all isolates were negative for bla-VIM-1 and bla-IMP-1 , fifteen of these isolates were positive for both bla KPC-2 and bla NDM-1 , two isolates were positive for bla KPC-2 only, and twenty-eight isolates were positive for bla-NDM-1 only. Although one isolate was positive for the string test, all CPKP isolates were negative for capsular genes. Only 71.1% of CPKP transferred their plasmids to their corresponding transconjugants (E. coli J53). The resistance patterns of the clinical isolates and their transconjugates were similar, except for 12 isolates, which showed differences with their transconjugates in the resistance profile of four antibiotics. Molecular typing of the plasmids based on replicon typing showed that Inc FIIK and FII plasmids predominated in isolates and their transconjugants carrying bla KPC-2 and/or bla NDM-1 . Conjugative Inc FII plasmids play an important role in the spread of CPKP, and their recognition is essential to limit their spread.

Landscape of Multidrug-Resistant Gram-Negative Infections in Egypt: Survey and Literature Review

“…28 CRE Figure 8 Summary of the prevalence (%) of carbapenemase and ESBL genes in K. pneumoniae. Notes: Data from references 40,[55][56][57][58][59][60][61][62]70,80,[94][95][96][97][98][99] . a % of carbapenemase-resistant/-producing K. pneumoniae; b % of MDR K. pneumoniae; c % of ESBL-producing/third-generation cephalosporin-resistant K. pneumoniae; d % of ertapenem non-susceptible K. pneumoniae.…”

Antibiotics and Environment

“…The study by Sukmawinata et al [10] demonstrated that the IncI1 plasmid was associated with the transmission of the gene bla CTX-M-2 in extended spectrum β-lactamase-producing E. coli, in thoroughbred racehorses in Japan. The study of Mohamed et al [11] reported that conjugative Inc FII plasmids had an important role in the spread of carbapenemase-producing Klebsiella pneumoniae in Egypt. Conjugative plasmids play an important role in the spread of antibiotic resistance, and their recognition is essential to limit their diffusion.…”

Determination of incompatibility group plasmids and copy number of the bla NDM-1 gene in carbapenem-resistant Klebsiella pneumoniae strains recovered from different hospitals in Kerman, Iran

“…Ramadan Mohamed et al reported that IncFIIK and FII plasmids play an important role in the dissemination of bla NDM-1 and bla KPC-2 among clinical strains of K. pneumoniae [1]. In our previous study, ST268 was reported in different hospitals in Kerman, Iran, as a new NDM-positive clone [17].…”

“…Risk factors that might increase nosocomial infections by K. pneumoniae include diabetes, long-term hospitalization, chronic obstructive pulmonary disease (COPD), transplantation, dialysis, neutropenia, excessive alcohol consumption and general weakness [1, 2]. The increase of carbapenem-resistant strains and the spread of plasmids carrying carbapenemase genes in K.…”

“… Klebsiella pneumoniae is a common pathogen implicated in different infections such as pneumonia, bacteraemia, meningitis, metastatic liver abscesses, the infection of wounds and soft tissues, and catheter-associated urinary tract infections [1]. Risk factors that might increase nosocomial infections by K.…”