Dissemination of ST101 blaOXA-48 producing Klebsiella pneumoniae at tertiary care setting

Abstract

Introduction: The worldwide dissemination of the acquired carbapenemases in Gram-negative bacteria is a strongly expressed demand for the emergence of post antibiotic era. The aim of this study was to test the production of carbapenemase by Klebsiella pneumoniae strains isolated from hospitalized cancer patients and to investigate the genetic relationship of carbapenemase producing carbapenem resistant K. pneumoniae using multilocus sequence typing (MLST).
 Methodology: Antibiotic susceptibility testing and phenotypic testing for extended spectrum b-lactamases (ESBL) and carbapenemases production were performed. PCR amplification of ESBL and carbapenemase genes was performed. MLST was done to detect the genetic relatedness of the isolates.
 Results: Our data showed all strains were sensitive to colistin. Carba NP test was positive in thirty-one carbapenem resistant K. pneumoniae isolates and 26 out of 34 K. pneumoniae isolates were metallo-beta-lactamases (MBL) positive. All carbapenemase-positive isolates were ESBL CTX-M-1-like positive. blaOXA-48 gene was detected in 25 isolates (80.65%) and 21 isolates (67.75%) produced blaNDM-1 like enzyme. VIM and KPC genes were not identified in this study. Association of blaOXA-48 like and blaNDM-1 like was found in 15 (48.39%) isolates, while the coproduction of OXA-48-like and IMP-1 was revealed in only one K. pneumoniae isolate. MLST revealed ten distinct sequence types (STs).
 Conclusion: Here we have documented the coexistence of NDM-type and OXA-48-like, and the coproduction of OXA-48-like and IMP in carbapenem resistant K. pneumoniae in patients with cancer. The dominant clone of the OXA-48-like-producing K. pneumoniae isolates from Egypt was ST101 epidemic clone belonging to clonal complex 101, an association that has been reported worldwide. The second most frequent ST was ST383.ST11 was assigned to OXA-48-producing K. pneumoniae.

Emergence of colistin resistance in multidrug-resistant Klebsiella pneumoniae and Escherichia coli strains isolated from cancer patients

“…Colistin-resistant K. pneumoniae isolates in our collection belong to various clones, as assessed by multilocus sequence typing, suggesting considerable genetic diversity present in the same hospital. Of these, ST101 is a major drug-resistant strain, not only in Egypt, but also worldwide [33, 34]. Strikingly, we seem to have found the first mcr-1 positive ST11 strain in Egypt.…”

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.…”

Detection of Carbapenem-Resistance Genes in Klebsiella Species Recovered from Selected Environmental Niches in the Eastern Cape Province, South Africa

“…Among the various members of CRE, CRKP have received the most attention because they have the greatest potential to contribute to the overall problem of AR [ 37 , 38 ]. In a study conducted in Egypt, ElMahallawy et al [ 39 ] reported the detection of OXA-48-like positive CRE in clinical isolates, which emphasized the prevalence of CRE in sub-Sahara Africa and this calls for more studies to be carried out in the region. In South Africa, reports on the presence of ARGs (specifically carbapenemase-producing genes) in isolates from different environmental niches are scarce, however, various studies on the high occurrence of ESBL have been previously reported [ 40 , 41 , 42 ].…”