High Carbapenem Resistance in Clinical Gram-Negative Pathogens Isolated in Egypt

• Published in: Microbial drug resistance (Larchmont, N.Y.) Vol. 23; no. 7; p. 838
• Main Authors: Khalifa, Hazim O, Soliman, Ahmed M, Ahmed, Ashraf M, Shimamoto, Toshi, Hara, Toshinori, Ikeda, Mitsuyasu, Kuroo, Yuta, Kayama, Shizuo, Sugai, Motoyuki, Shimamoto, Tadashi
• Format: Journal Article
• Language: English
• Published: United States 01-10-2017
• Subjects: Anti-Bacterial Agents - pharmacology; beta-Lactam Resistance - genetics; beta-Lactamases - genetics; beta-Lactamases - metabolism; Carbapenems - pharmacology; Egypt - epidemiology; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Escherichia coli - classification; Escherichia coli - drug effects; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - drug therapy; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Gene Expression; Hospitals; Humans; Integrons; Microbial Sensitivity Tests; Morganella morganii - classification; Morganella morganii - drug effects; Morganella morganii - genetics; Morganella morganii - isolation & purification; Phylogeny; Pseudomonas aeruginosa - classification; Pseudomonas aeruginosa - drug effects; Pseudomonas aeruginosa - genetics; Pseudomonas aeruginosa - isolation & purification; Pseudomonas Infections - drug therapy; Pseudomonas Infections - epidemiology; Pseudomonas Infections - microbiology; Serratia Infections - drug therapy; Serratia Infections - epidemiology; Serratia Infections - microbiology; Serratia marcescens - classification; Serratia marcescens - drug effects; Serratia marcescens - genetics; Serratia marcescens - isolation & purification; Pseudomonas aeruginosa; carbapenemases; Escherichia coli; Klebsiella pneumoniae; Egypt; Serratia marcescens
• ISSN: 1931-8448
• DOI: 10.1089/mdr.2015.0339

The emergence and spread of carbapenem-resistant gram-negative bacteria poses a serious threat to human health worldwide. Currently, little is known about the molecular mechanisms underlying carbapenem resistance and their prevalence among gram-negative bacteria in Egypt. In this study, we analyzed carbapenemase production in gram-negative bacteria isolated from hospitalized patients in Egypt in 2014. All isolates were subjected to phenotypic and genotypic susceptibility testing for carbapenem resistance. Our results indicated a high level of carbapenem-resistant gram-negative bacteria in Egypt, with 50.8% of the isolates harboring at least one carbapenem resistance gene. OXA-48-like and NDM-1 were the most prevalent carbapenemases, being detected in 49.2%, and 47.7% of carbapenemase-positive isolates, respectively, whereas Verona integron-encoded metallo-β-lactamase (VIM) was detected in only 26.2% of carbapenemase-positive isolates. This study reports for the first time carbapenemase-producing Serratia marcescens, Morganella morganii, and bla
-producing Pseudomonas aeruginosa in Egypt. It is also the first demonstration of the coexistence of different carbapenemases, being detected in 21.5% of carbapenemase-positive isolates. Effective antibiotic supervision, regional surveillance, and early detection of carbapenemase producers are imperative to prevent their future spread to epidemic levels.