Emergence of New Delhi metallo beta lactamase blaNDM-1 and Oxacillinases blaOXA-48 producing  Klebsiella pneumoniae  in an Egyptian hospital

Shawky, A.; Tolba, Sahar; Hamouda, Hayam M.

doi:10.21608/ejm.2019.12395.1096

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…Among studied isolates, blaNDM-1 was the most prevalent (96.2%) followed by blaOXA-48 (63.5%), however, bla KPC , bla VIM , and bla IMP genes were not identified in any of the studied isolates. Similar findings were reported in recent studies from different institutions in Egypt, where Shawky et al found that 75% of their isolates carried blaNDM, followed by blaOXA-48 (59%) 27 . Additionally, El Defrawy et al reported that blaNDM was prevalent (84%), followed by blaOXA-48 (6%), with only 2% of isolates carrying blaKPC 6 .…”

Section: Discussionsupporting

confidence: 90%

Dissemination of NDM-1 and OXA-48 Co-producing Carbapenem-resistant Enterobacterales at Two Tertiary Hospitals in Egypt

ElFeky,

Awad,

Mowafy

et al. 2024

Egyptian Journal of Medical Microbiology

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Background. The global incidence of carbapenem-resistant Enterobacterales (CRE) is increasing, posing a major treatment challenge and serious infection control concern.Objective. We aimed to characterize carbapenemases both genotypically and phenotypically among CRE isolated from two tertiary hospitals in Egypt, and to detect the genetic relatedness among studied isolates. Methodology. A total of 107 nonduplicate CRE strains isolated from different clinical specimens of hospitalized patients were assessed for presence of carbapenemases genes using multiplex PCR. Onehundred isolates were also assessed for the presence of carbapenemases using MASTDISCS Combi Carba Plus kit. Molecular typing of the isolates was done by Enterobacterial Repetitive Intergenic Consensus region PCR (ERIC-PCR). Results. Klebsiella pneumoniae (K. pneumoniae) represented most of the studied isolates (n=85; 79.4%). The most prevalent carbapenemase gene among our isolates was blaNDM-1 (n=103; 96.2%) followed by blaOXA-48 (n=68; 63.5%). Among them, 64 isolates (59.8%) carried more than one gene as blaNDM-1 and blaOXA-48 genes. blaKPC, blaVIM and blaIMP were not detected in the isolates. The sensitivity of the Carba Plus kit for the detection of MBL was much better than respectively), however, the negative predictive value was poor for the detection of both (19.05% and 39.36%, respectively). The constructed dendrogram for each genus from each hospital revealed significant genetic diversity among the investigated isolates. Conclusions. The study highlights the wide dissemination of diverse clones of CRE isolates that co-harbor blaOXA-48 and blaNDM-1 genes among our hospitals as well as low accuracy of detection using phenotypic techniques like Carba plus kit.

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Section: Discussionsupporting

confidence: 90%

Dissemination of NDM-1 and OXA-48 Co-producing Carbapenem-resistant Enterobacterales at Two Tertiary Hospitals in Egypt

ElFeky,

Awad,

Mowafy

et al. 2024

Egyptian Journal of Medical Microbiology

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“…Low incidence rate of bla IMP and absence of bla VIM genes in this study were also reported by others [20,23,24] confirming that both genes are not prevalent in our geographical region [24]. In addition, bla VIM genes are uncommon among Enterobacterales [30].…”

Section: Discussionsupporting

confidence: 89%

Susceptibility of carbapenem-resistant Enterobacterales isolates to new antibiotics from a tertiary care hospital, Egypt: A matter of hope

Badran

Malek²,

Ateya³

et al. 2022

J Infect Dev Ctries

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Introduction: Carbapenem-resistant Enterobacterales (CRE) are particularly worrisome pathogens because of their resistance to last-resort antibiotics, significant morbidity, and mortality. With limited treatment options, new therapeutic choices have become available for the management of CRE infections. Data regarding the efficacy of these novel agents are still limited particularly in a low-middle-income country like Egypt. This study aims to assess the prevalence of different carbapenemase genes among CRE isolates and the susceptibility of these isolates to novel antibiotics for improving antibiotic policy and infection control strategies in Egypt. Methodology: In this cross-sectional study, 260 Enterobacterales were recovered from patients admitted to intensive care units between January and June 2021. Susceptibility testing was conducted using Kirby-Bauer method. Molecular detection of five carbapenemase genes, namely blaKPC, blaIMP, blaVIM, blaNDM, blaOXA-48 was done using polymerase chain reaction (PCR). Results: Of the 260 Enterobacterales, 34.6% were found to be carbapenems resistant. All of the CRE isolates were multi-drug resistant exhibiting resistance to most antibiotics. All isolates harbored one or more carbapenemases genes. The most prevalent was blaNDM (84.4%), followed by blaOXA-48 (73.3%), blaKPC (13.3%), blaIMP (2.2%), while blaVIM gene wasn’t detected. Among 62.2% of the CRE isolates, two or more carbapenemase genes co-existed. For the new antibiotics tested, 100% of CRE resisted ceftolozane/tazobactam, 86.7% resisted ceftazidime/avibactam, 51.1% were resistant to eravacyclin, and 42.2% were resistant to cefiderocol. Conclusions: A high percentage of resistance to carbapenems among Enterobacterales isolates was revealed. blaNDM was found to be the most predominant carbapenemase gene. A high rate of CRE resistance to novel agents signifies a major threat.

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“…Similarly, a study in Cairo reported that the genes bla NDM-1 and bla OXA-48 were the most predominant, and none of their isolates carried bla IMP nor bla KPC genes. However, bla VIM was amplified at a low incidence (2.3%) among their isolates 37 . Similar results were encountered with other studies in Egypt, Saudi Arabia, and Turkey 25, 26, 35, 38- 41 .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Phenotypic Testing by mCIM with eCIM for Determination of the type of Carbapenemase Produced by Carbapenem-resistant Enterobacterales

Aboulela

Jabbar

Hammouda

et al. 2023

Egyptian Journal of Medical Microbiology

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Background: Carbapenemase-producing Enterobacterales are increasingly spreading in healthcare facilities. Identifying the type of carbapenemase can help epidemiologic surveillance and proper selection of antimicrobials. Objective: This study assessed the sensitivity and specificity of carbapenem inactivation method (mCIM with eCIM) for identification of carbapenemase-production. Methodology: The study involved 150 isolates of Enterobacterales. Carbapenem-resistant isolates by Kirby Bauer method were further tested for carbapenemase production phenotypically by mCIM with eCIM, and genotypically by multiplex PCR using specific primers for bla KPC , bla OXA-48 , bla NDM-1 , bla VIM , and bla IMP. Results: Resistance to carbapenem was observed in 53/150 isolates. Phenotypically, 28/53 isolates produced metallo-β-lactamase, 16/53 produced serine carbapenemase, 5/53 isolates gave inconclusive results, and 4/53 were negative by mCIM with eCIM test. Genotypically, 30 isolates carried bla NDM-1 , and 41 isolates carried bla . Both genes co-existed in 18 Metallo-β-lactamase producers. The 9 isolates with negative or inconclusive results carried carbapenemase-encoding genes. For mCIM with eCIM test the sensitivity and specificity of detecting Metallo-β-lactamase production were higher (87% and 91%) than for serine carbapenemase detection (34% and 83%), respectively. Conclusion: It was concluded that the mCIM with eCIM test does not always lead to true conclusions about the existence and the type of carbapenemase produced by Enterobacterales.

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Emergence of New Delhi metallo beta lactamase blaNDM-1 and Oxacillinases blaOXA-48 producing Klebsiella pneumoniae in an Egyptian hospital

Cited by 4 publications

References 39 publications

Dissemination of NDM-1 and OXA-48 Co-producing Carbapenem-resistant Enterobacterales at Two Tertiary Hospitals in Egypt

Dissemination of NDM-1 and OXA-48 Co-producing Carbapenem-resistant Enterobacterales at Two Tertiary Hospitals in Egypt

Susceptibility of carbapenem-resistant Enterobacterales isolates to new antibiotics from a tertiary care hospital, Egypt: A matter of hope

Assessment of Phenotypic Testing by mCIM with eCIM for Determination of the type of Carbapenemase Produced by Carbapenem-resistant Enterobacterales

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