Molecular characterization of multidrug-resistance in Gram-negative bacteria from the Peshawar teaching hospital, Pakistan

Masseron, Amandine; Poirel, Laurent; Ali, Basim; Syed, Muhammad Ali; Nordmann, Patrice

doi:10.1016/j.nmni.2019.100605

Cited by 22 publications

(17 citation statements)

References 34 publications

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“…The most common carbapenemase gene was bla NDM 83% (44/53) followed by bla OXA-48 75% (40/53), bla VIM 49% (26/53) and bla IMP 43% (23/53), while the gene bla KPC was least frequent (4/53) ( Table 5 ). Interestingly, bla NDM was the most commonly detected carbapenemase and bla OXA-48 was second, which is consistent with other reports [ 12 , 16 , 19 , 37 ]. In addition, similar to previous analyses, the two genes bla OXA-48 and bla NDM were commonly detected with a high predominance of bla OXA-48 [ 23 , 26 ].…”

Section: Discussionsupporting

confidence: 92%

“…The most prevalent bacteria were Klebsiella sp., A. baumanii, followed by E. coli and P. aeruginosa, which is similar to data from recent studies conducted in other countries [4,23,26,29,38]. Comparable to previous reports [14,38], the KPC gene was the least detected among carbapenemase-producing bacteria, even in some studies none of bla KPC was detected [28,37]. A probable explanation for the low detection rate of the KPC gene among carbapenemase-producing isolates might be that these isolates contain other class A carbapenemases (other than KPC), for example GES, Sme, NMC-A and IMI.…”

Section: Plos Onesupporting

confidence: 88%

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Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli

2021

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Background Emerging worldwide in the past decade, there has been a significant increase in multidrug-resistant bacteria from serious nosocomial infections, especially carbapenemase-producing Gram-negative bacilli that have emerged worldwide. The objective of this study is to investigate carbapenem resistance in Gram-negative bacilli bacteria using phenotypic detection, antimicrobial resistance profiles and genotypic characterisation methods. Methods 200 Gram-negative bacilli isolates were collected from different clinical specimens. All clinical samples were exposed to isolation and identification of significant pathogens applying bacteriological examination and an automated Vitek-2 system. The isolates were subjected to susceptibility tests by the Vitek-2 automated system and those isolates that were resistant to beta-lactam drugs, including carbapenems, third-generation cephalosporines or cefoxitin, were selected for phenotyping using Carba plus disc system assay for detection of carbapenemase-producing isolates. These isolates were further confirmed by molecular detection. PCR was used for the detection carbapenem-resistant genes (OXA-48, IMP, NDM, VIM, and KPC). Results 110 (55%) of 200 Gram-negative bacilli were identified as beta-lactam-resistant isolates. The frequency of carbapenem-resistant isolates was calculated to be 30.9% (n = 34/110). A collection totalling 65/110 (59%) isolates were identified as carbapenemase producers by phenotypic method. Moreover, among the 65 carbapenemase-producing Gram-negative isolates with a positive phenotype-based result, 30 (46%), 20 (30%) and 18 (27%) isolates were positive for OXA-48, KPC and MBL enzymes, respectively, as well as the production of 27% of AmpC with porin loss. Tigecycline was the most effective antibiotic that affected 70% of MDR isolates, but high rates of resistance were detected to other tested antimicrobials. Of interest, a high incidence of MDR, XDR and PDR profiles were observed among all carbapenemase-producing isolates. 36% (24/65) of the tested isolates were MDR to 3 to 5 antimicrobial classes. 29% (17/65) of the recovered isolates were XDR to 6 to 7 antimicrobial classes. Alarmingly, 24% (16/65) of isolates displayed PDR to all the tested 8 antimicrobial classes. Genotype assay, including 53 phenotypically confirmed carbapenemase-producing isolates of Gram-negative bacilli, found 51(96%) isolates were harbouring one or more genes. The most common carbapenemase gene was bla NDM 83% (44/53) followed by bla OXA-48 75% (40/53), bla VIM 49% (26/53) and bla IMP 43% (23/53), while the gene bla KPC was least frequent 7% (4/53). 92% (46/51) of isolates were involved in the production of more than one carbapenemase gene. Conclusion This study demonstrated the emergence of carbapenemase-producing Gram-negative pathogens implicated in healthcare-related infections. Accurate identification of carbapenem-resistant bacterial pathogens is essential for patient treatment, as well as the development of appropriate contamination control measures to limit the rapid spread of pathogens. Tigecycline exhibited potent antimicrobial activity against MDR, XDR and PDR-producing strains that establish a threatening alert which indicates the complex therapy of infections caused by these pathogens.

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Section: Discussionsupporting

confidence: 92%

Section: Plos Onesupporting

confidence: 88%

Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli

2021

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“…Even so, in a study, the coexistence of bla NDM-1 with other ESBL genes was identified [ 21 ]. In 2019, a study from Peshawar, Pakistan resembled our findings by reporting a 16% bla NDM-1 prevalence in Gram-negative bacteria [ 22 ]. Nevertheless, some other studies have reported different patterns of prevalence for bla NDM-1 in Pakistan, i.e., 41% in 2013 and 6.8% in 2018 [ 23 , 24 ].…”

Section: Discussionsupporting

confidence: 69%

First Report of blaNDM-1 Bearing IncX3 Plasmid in Clinically Isolated ST11 Klebsiella pneumoniae from Pakistan

et al. 2021

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The New Delhi Metallo-β-lactamase (NDM) is among the most threatening forms of carbapenemases produced by K. pneumoniae, well-known to cause severe worldwide infections. The molecular epidemiology of blaNDM-1-harboring K. pneumoniae is not well elucidated in Pakistan. Herein, we aim to determine the antibiotics-resistance profile, genes type, molecular type, and plasmid analysis of 125 clinically isolated K. pneumoniae strains from urine samples during July 2018 to January 2019 in Pakistan. A total of 34 (27.2%) K. pneumoniae isolates were carbapenemases producers, and 23 (18.4%) harbored the blaNDM-1 gene. The other carbapenemases encoding genes, i.e., blaIMP-1 (7.2%), blaVIM-1 (3.2%), and blaOXA-48 (2.4%) were also detected. The Multi Locus Sequence Typing (MLST) results revealed that all blaNDM-1-harboring isolates were ST11. The other sequence types detected were ST1, ST37, and ST105. The cluster analysis of Xbal Pulsed Field Gel Electrophoresis (PFGE) revealed variation amongst the clusters of the identical sequence type isolates. The blaNDM-1 gene in all of the isolates was located on a 45-kb IncX3 plasmid, successfully transconjugated. For the first time, blaNDM-1-bearing IncX3 plasmids were identified from Pakistan, and this might be a new primary vehicle for disseminating blaNDM-1 in Enterobacteriaceae as it has a high rate of transferability.

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“…Asocierea genelor de rezistență la carbapenem NDM, împreună cu β-lactamază cu spectru extins CTX-M-15 și 16S rRNA metilaze, a fost frecventă, explicând modelul de multidrogrezistență observat. Toate izolatele au rămas sensibile la colistin [17].…”

Section: Rezutate șI Discuțiiunclassified

Antimicrobial resistance. Characteristic of resistance to antimicrobial preparations of Gram-negative bacteria

Bucov¹,

Burduniuc²,

Bălan³

et al. 2021

SPEMM

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The scope is the literature review on the resistance of Gramnegative bacteria to antimicrobial preparations is presented. 131 different materials were analyzed, including WHO documents and scientifi c publications. Bacterial resistance remains a significant threat and a leading cause of death worldwide. Resistant bacteria proliferate by natural selection when drug-sensitive ones are removed by antibiotics. These organisms can be spread to all health care facilities as well in community, which requires increased attention to infection control measures and the administration of β-lactamcontaining medicines in an effort to control the selection of other even more harmful pathogens. Several strategies for combating and controlling Gram-negative resistant bacteria have been reported, such as the development of antimicrobial auxiliaries, structural modifi cation of existing antibiotics, research and study of chemical structures with new mechanisms of action. In addition to new therapy, an effective infection control system, along with the prudent use of antimicrobials, is extremely important.

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Molecular characterization of multidrug-resistance in Gram-negative bacteria from the Peshawar teaching hospital, Pakistan

Cited by 22 publications

References 34 publications

Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli

Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli

First Report of blaNDM-1 Bearing IncX3 Plasmid in Clinically Isolated ST11 Klebsiella pneumoniae from Pakistan

Antimicrobial resistance. Characteristic of resistance to antimicrobial preparations of Gram-negative bacteria

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