High Prevalence of New Delhi Metallo-β-Lactamase-1 (NDM-1) Producers among Carbapenem-Resistant Enterobacteriaceae in Kuwait

Autor: Wafaa Jamal, Vincent O. Rotimi, M. John Albert
Rok vydání: 2016
Předmět:
Male
Bacterial Diseases
0301 basic medicine
Imipenem
Physiology
Klebsiella pneumoniae
lcsh:Medicine
Carbapenem-resistant enterobacteriaceae
Urine
Pathology and Laboratory Medicine
Klebsiella Pneumoniae
Geographical Locations
chemistry.chemical_compound
0302 clinical medicine
Drug Resistance
Multiple
Bacterial
Klebsiella
Ampicillin
Prevalence
Medicine and Health Sciences
030212 general & internal medicine
lcsh:Science
Aged
80 and over
Multidisciplinary
biology
Enterobacteriaceae Infections
Hematology
Middle Aged
Anti-Bacterial Agents
Bacterial Pathogens
Body Fluids
Infectious Diseases
Blood
Kuwait
Medical Microbiology
Enterobacter Infections
Female
Pathogens
Anatomy
Ertapenem
Research Article
medicine.drug
Adult
DNA
Bacterial
Asia
Cefepime
030106 microbiology
Microbial Sensitivity Tests
Microbiology
Meropenem
beta-Lactamases
03 medical and health sciences
Signs and Symptoms
Enterobacteriaceae
Diagnostic Medicine
Sepsis
Escherichia coli
medicine
Humans
Microbial Pathogens
Aged
Bacteria
business.industry
lcsh:R
Organisms
Infant
Biology and Life Sciences
Escherichia Coli Infections
biology.organism_classification
Carbapenems
chemistry
People and Places
Colistin
lcsh:Q
business
Zdroj: PLoS ONE
PLoS ONE, Vol 11, Iss 3, p e0152638 (2016)
ISSN: 1932-6203
Popis: The aim of the study was to determine the prevalence of New Delhi metallo-β lactamase-1 (NDM-1) producing Enterobacteriaceae in Kuwait over a one year period. Consecutive Enterobacteriaceae isolates with reduced susceptibility to carbapenems were collected from four government hospitals in Kuwait from January-December 2014. Their susceptibility to 18 antibiotics was performed by determining the minimum inhibitory concentration. Isolates resistant to carbapenems were tested by PCR for resistant genes. Finger printing of the positive isolates was done by DiversiLab®. Clinical data of patients harboring NDM-1 positive isolates were analyzed. A total of 764 clinically significant Enterobacteriaceae isolates were studied. Of these, 61 (8%) were carbapenem-resistant. Twenty one out of these 61 (34.4%) were NDM-1-producers. All patients positive for NDM-1-carrying bacteria were hospitalized. About half were females (11/21 [52.3%]), average age was 53.3 years and the majority were Kuwaitis (14/21 [66.6%]). Six patients (28.5%) gave a history of travel or healthcare contact in an endemic area. Mortality rate was relatively high (28.6%). The predominant organism was Klebsiella pneumoniae (14 [66.6%]) followed by E. coli (4 [19%]). All NDM-1-positive isolates were resistant to meropenem, ertapenem, cefotaxime, cefoxitin and ampicillin, while 95.2% were resistant to imipenem, cefepime, and piperacillin-tazobactam. They were multidrug resistant including resistance to tigecycline, but 90% remained susceptible to colistin. About two-thirds of isolates (61.9%) co-produced-extended spectrum β-lactamases. During the study period, an outbreak of NDM-1 positive K. pneumoniae occurred in one hospital involving 3 patients confirmed by DiversiLab® analysis. In conclusion, NDM-1-producing Enterobacteriaceae is a growing healthcare problem with increasing prevalence in Kuwait, especially in hospitalized patients, leaving few therapeutic options. A high prevalence of NDM-1 necessitates the implementation of strict infection control to prevent the spread of these organisms.
Databáze: OpenAIRE
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