Prevalence and molecular characterization of Enterobacteriaceae producing NDM-1 carbapenemase at a military hospital in Pakistan and evaluation of two chromogenic media

Day, Kathryn M.; Ali, Shamshad; Mirza, Irfan Ali; Sidjabat, Hanna E.; Silvey, Anna; Lanyon, Clare; Cummings, Stephen; Abbasi, Shahid Ahmed; Raza, Muhammad W.; Paterson, David L.; Perry, John D.

doi:10.1016/j.diagmicrobio.2012.11.006

Cited by 53 publications

(34 citation statements)

References 16 publications

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“…In comparison to other geographical regions, such as the United Kingdom, China, and the Indian subcontinent (21,(36)(37)(38)(39), there are relatively few reports of NDM-producing Enterobacteriaceae from Australia. In the majority of the cases preceding 2014, patients had a history of travel to high-incidence countries (32).…”

Section: Resultsmentioning

confidence: 99%

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Wailan

Paterson

Kennedy

et al. 2016

Antimicrob Agents Chemother

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e bla NDM has been reported in different Enterobacteriaceae species and on numerous plasmid replicon types (Inc). Plasmid replicon typing, in combination with genomic characteristics of the bacterial host (e.g., sequence typing), is used to infer the spread of antimicrobial resistance determinants between genetically unrelated bacterial hosts. The genetic context of bla NDM is heterogeneous. In this study, we genomically characterized 12 NDM-producing Enterobacteriaceae isolated in Australia between 2012 and 2014: Escherichia coli (n ‫؍‬ 6), Klebsiella pneumoniae (n ‫؍‬ 3), Enterobacter cloacae (n ‫؍‬ 2) and Providencia rettgeri (n ‫؍‬ 1). We describe their bla NDM genetic contexts within Tn125, providing insights into the acquisition of bla NDM into Enterobacteriaceae. IncFII-type (n ‫؍‬ 7) and IncX3 (n ‫؍‬ 4) plasmids were the most common plasmid types found. The IncHI1B (n ‫؍‬ 1) plasmid was also identified. Five different bla NDM genetic contexts were identified, indicating four particular plasmids with specific bla NDM genetic contexts (NGCs), three of which were IncFII plasmids (FII-A to -C). Of note, the bla NDM genetic context of P. rettgeri was not conjugative. Epidemiological links between our NDM-producing Enterobacteriaceae were established by their acquisition of these five particular plasmid types. The combination of different molecular and genetic characterization methods allowed us to provide insight into the spread of plasmids transmitting bla NDM .

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Section: Resultsmentioning

confidence: 99%

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Wailan

Paterson

Kennedy

et al. 2016

Antimicrob Agents Chemother

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“…Of the 13 studies mentioned, 9 showed an almost exclusive presence of KPC producers (80,139,141,(150)(151)(152)(153)(154)(155)(156), while 2 revealed the exclusive presence of NDM producers (157,158). Only two studies were done at institutions where KPC and VIM producers were reported to coexist (140,159), and only one study was performed with OXA-48-producing isolates (160).…”

Section: Screening Methods To Detect Fecal Carriage Of Cposmentioning

confidence: 99%

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

et al. 2016

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SUMMARYCarbapenemases have become a significant mechanism for broad-spectrum β-lactam resistance inEnterobacteriaceaeand other Gram-negative bacteria such asPseudomonasandAcinetobacterspp. Intestinal carriage of carbapenemase-producing organisms (CPOs) is an important source of transmission. Isolation of carriers is one strategy that can be used to limit the spread of these bacteria. In this review, we critically examine the clinical performance, advantages, and disadvantages of methods available for the detection of intestinal carriage of CPOs. Culture-based methods (Centers for Disease Control and Prevention [CDC] protocols, chromogenic media, specialized agars, and double-disk synergy tests) for detecting carriage of CPOs are convenient due to their ready availability and low cost, but their limited sensitivity and long turnaround time may not always be optimal for infection control practices. Contemporary nucleic acid amplification techniques (NAATs) such as real-time PCR, hybridization assays, loop-mediated isothermal amplification (LAMP), or a combined culture and NAAT approach may provide fast results and/or added sensitivity and specificity compared with culture-based methods. Infection control practitioners and clinical microbiologists should be aware of the strengths and limitations of available methods to determine the most suitable approach for their medical facility to fit their infection control needs.

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“…These approaches have been applied with or without initial broth enrichment, which causes an additional delay, while its performance still remains controversial (12,13). Several chromogenic media, such as CHROMagar KPC and Colorex KPC (CHROMagar, Paris, France) (11,(14)(15)(16), Brilliance CRE (Oxoid, Basingstoke, United Kingdom) (14,17), and chromID Carba (bioMérieux, Marcy l'Etoile, France) (16,18), have also been used for the active screening of carbapenem-resistant Enterobacteriaceae (CRE) or CPE. In addition, the specific culture medium Supercarba was developed and evaluated for the detection of CPE (14,19), while the nonspecific chromogenic medium chromID extended-spectrum ␤-lactamase (ESBL) (bioMérieux) has been applied for CRE detection (16,20).…”

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A Combined Disk Test for Direct Differentiation of Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

et al. 2013

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dCarbapenemase-producing Enterobacteriaceae (CPE) are rapidly spreading worldwide. Early detection of fecal CPE carriers is essential for effective infection control. Here, we evaluated the performance of a meropenem combined disk test (CDT) for rapidly differentiating CPE isolates directly from rectal swabs. The screening method was applied for 189 rectal swabs from hospitalized patients at high risk for CPE carriage. Swabs were suspended in 1 ml saline and cultured for confluent growth onto a MacConkey agar plate with a meropenem (MER) disk alone, a MER disk plus phenyl boronic acid (PBA), a MER disk plus EDTA, and a MER disk plus PBA and EDTA. An inhibition zone of <25 mm around the MER disk alone indicated carriage of carbapenemresistant organisms. Furthermore, >5-mm differences in the inhibition zone between MER disks without and with the inhibitors (PBA, EDTA, or both) were considered positive results for detecting Klebsiella pneumoniae carbapenemase (KPC), metallo-␤-lactamase (MBL), or both carbapenemases, respectively. For comparison, rectal suspensions were tested using MacConkey plates with ertapenem (MacERT) disks and PCR (PCR-S) for carbapenemase genes. Of the 189 samples, 97 were genotypically confirmed as CPE positive by one of the three protocols tested. The CDT, MacERT disks, and PCR-S assays exhibited sensitivities of 94.8%, 96.9%, and 94.8% and specificities of 100%, 98.9%, and 100%, respectively, for detecting CPE-positive swabs. Moreover, the CDT correctly differentiated the production of KPC, MBL, or both carbapenemases in 78 of the 97 (80.4%) CPE-positive rectal swabs. Our results demonstrate that the CDT may provide a simple and inexpensive method for detecting and differentiating the carbapenemase type within a single day without requiring further testing and additional delay, supporting the timely implementation of infection control measures.

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Prevalence and molecular characterization of Enterobacteriaceae producing NDM-1 carbapenemase at a military hospital in Pakistan and evaluation of two chromogenic media

Cited by 53 publications

References 16 publications

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

A Combined Disk Test for Direct Differentiation of Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

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Prevalence and molecular characterization of Enterobacteriaceae producing NDM-1 carbapenemase at a military hospital in Pakistan and evaluation of two chromogenic media

Cited by 53 publications

References 16 publications

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla NDM Genetic Contexts

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla NDM Genetic Contexts

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

A Combined Disk Test for Direct Differentiation of Carbapenemase-Producing Enterobacteriaceae in Surveillance Rectal Swabs

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Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts

Genomic Characteristics of NDM-Producing Enterobacteriaceae Isolates in Australia and Their bla _NDM Genetic Contexts