The First Egyptian Report Showing the Co-Existence of blaNDM-25, blaOXA-23, blaOXA-181, and blaGES-1 Among Carbapenem-Resistant K. pneumoniae Clinical Isolates Genotyped by BOX-PCR
| Autor: | Shaker S Althobaiti, Fatma I Abou-Elazm, Mohamed M. Shohayeb, Mohamed F. El-Badawy, Shaymaa W. El-Far |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pharmacology Carbapenem resistant medicine.drug_class 030106 microbiology Antibiotics K pneumoniae Sulbactam Biology Tazobactam Microbiology 03 medical and health sciences 0302 clinical medicine Infectious Diseases Clavulanic acid medicine Pharmacology (medical) 030212 general & internal medicine Inhibitory effect Mercaptopropionic acid medicine.drug |
| Zdroj: | Infection and Drug Resistance. 13:1237-1250 |
| ISSN: | 1178-6973 |
| DOI: | 10.2147/idr.s244064 |
| Popis: | Background and Objective The emergence of carbapenem-resistant K. pneumoniae (CRKP) continues to escalate and is alarming because of the emergence of pan drug-resistant strains. The objective of this study was to investigate the existence of 12 carbapenemase genes among CRKP clinical isolates. Methods Ninety-six Klebsiella spp. clinical isolates were collected. The isolates were identified phenotypically and genotypically. These isolates were screened for susceptibility to 24 different antibiotics. The modified Hodge test (MHT) and the Carba Nordmann/Poirel (NP) test were used to phenotypically screen carbapenem-resistant strains for carbapenemase production. Phenotypic characterization of carbapenemases was performed using the combined disk synergy test (CDST). Additionally, the presence of 12 carbapenemase genes in CRKP isolates was investigated. The DNA sequence of blaNDM and blaGES genes was determined. The BOX-PCR technique was used to determine the clonal relationship between CRKP isolates. Results All carbapenem-resistant isolates were related to K. pneumoniae. Susceptibility testing showed that 19.79% (19/96) of the collected isolates were carbapenem-resistant. Of the CRKP isolates, 68.42% (13/19) tested positive for the MHT and Carba NP test. CDST showed that 42.11% (8/19), 63.16% (12/19), 47.37% (9/19), and 73.68% (14/19) of the CRKP isolates tested positive for the inhibitory effect of clavulanic acid, sulbactam, phenylboronic acid, and tazobactam, respectively, while 84.21% (16/19) and 68.42% (13/16) tested positive for the inhibitory effect of EDTA and mercaptopropionic acid, respectively. It was found that 10.53% (2/19) of the isolates tested positive for the inhibitory effect of sodium chloride. Molecular investigation of carbapenemases showed that 26.32% (5/19), 73.68% (14/19), 21.05% (4/19), 10.53% (2/19), and 5.26% (1/19) of the isolates tested positive for blaNDM, blaOXA-48, blaOXA-181, blaOXA-51, and blaOXA-23, respectively. None of the isolates tested positive for blaOXA-40 and blaOXA-58. Two allelic variants of blaNDM (blaNDM-1 and blaNDM-25) were detected. BOX-PCR revealed high clonal relatedness between CRKP isolates. Conclusion MHT was more sensitive than Carba NP test for evaluating carbapenemase production and class D carbapenemase genes were the most prevalent of the 12 carbapenemase genes that were evaluated. |
| Databáze: | OpenAIRE |
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