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

<h4>Background</h4>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 inve...

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Autores principales:	Sayran Hamad Haji, Safaa Toma Hanna Aka, Fattma A Ali
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/48bd6d0a7c594a2fb2197b81051ee8b8
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spelling	oai:doaj.org-article:48bd6d0a7c594a2fb2197b81051ee8b82021-12-02T20:04:36ZPrevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.1932-620310.1371/journal.pone.0259005https://doaj.org/article/48bd6d0a7c594a2fb2197b81051ee8b82021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0259005https://doaj.org/toc/1932-6203<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusion</h4>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.Sayran Hamad HajiSafaa Toma Hanna AkaFattma A AliPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 11, p e0259005 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sayran Hamad Haji Safaa Toma Hanna Aka Fattma A Ali Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.
description	<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusion</h4>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.
format	article
author	Sayran Hamad Haji Safaa Toma Hanna Aka Fattma A Ali
author_facet	Sayran Hamad Haji Safaa Toma Hanna Aka Fattma A Ali
author_sort	Sayran Hamad Haji
title	Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.
title_short	Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.
title_full	Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.
title_fullStr	Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.
title_full_unstemmed	Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli.
title_sort	prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant gram-negative bacilli.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/48bd6d0a7c594a2fb2197b81051ee8b8
work_keys_str_mv	AT sayranhamadhaji prevalenceandcharacterisationofcarbapenemaseencodinggenesinmultidrugresistantgramnegativebacilli AT safaatomahannaaka prevalenceandcharacterisationofcarbapenemaseencodinggenesinmultidrugresistantgramnegativebacilli AT fattmaaali prevalenceandcharacterisationofcarbapenemaseencodinggenesinmultidrugresistantgramnegativebacilli
_version_	1718375538009047040

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

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