scholarly journals Phenotypic and genotypic methods for detection of metallo beta lactamases among carbapenem resistant Enterobacteriaceae clinical isolates in Alexandria Main University Hospital

2016 ◽  
Vol 10 (1) ◽  
pp. 32-40 ◽  
Author(s):  
F El Ghazzawy Iman ◽  
A Meheissen Marwa ◽  
A Younis Doaa
Keyword(s):  
Clinical Isolates ◽  
University Hospital ◽  
Beta Lactamases ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

scholarly journals Evaluation of Different Methods for Detection of Metallo-beta-Lactamases in Pseudomonas aeruginosa Clinical Isolates

2010 ◽  
Vol 59 (1) ◽  
pp. 45-48 ◽  
Author(s):  
TOMASZ BOGIEL ◽  
ALEKSANDER DEPTUŁA ◽  
EUGENIA GOSPODAREK
Keyword(s):  
Clinical Laboratory ◽  
Bacterial Species ◽  
Inhibition Zone ◽  
Clinical Isolates ◽  
University Hospital ◽  
Pcr Assay ◽  
Beta Lactamases ◽  
Carbapenem Resistant ◽  
Phenotypic Methods ◽  
Positive Results

Metallo-beta-lactamases (MBLs) produced by Pseudomnonas aeruginosa are a serious threat due to their ability to be transmitted between the same as well as different bacterial species. Different methods are applied in the clinical laboratory to detect MBLs. The aim of this study was to compare 4 phenotypic methods and a PCR assay for their ability to detect MBLs in clinical isolates of carbapenem-resistant P. aeruginosa strains. The study embraced a total of 70 carbapenem-resistant P. aeruginosa strains isolated in The Department of Microbiology of Dr. A. Jurasz University Hospital in Bydgoszcz. The highest percentage (42.9%) of the strains were isolated from Intensive Care Unit patients, mainly from urine samples (31.4%). Methods used in this study were: double-disc synergy tests in two combinations: using ceftazidime with 2-mercaptopropionic acid and imipenem with EDTA, differences in inhibition zone diameters between discs with imipenem/EDTA and imipenem, Etest MBL (AB Biodisk) and molecular amplification of bla(IMP) and bla(VIM) genes responsible for producing MBLs, using PCR assay. The lowest percentage (1.4%) of positive results in detection of MBLs was obtained using PCR assay, the highest (72.9%) by double-disc synergy tests with imipenem and EDTA, but the specificity of this method may be low.

Characterization of Carbapenem-Resistant Enterobacteriaceae Clinical Isolates in Al Thawra University Hospital, Sana'a, Yemen

2020 ◽  
Vol 26 (3) ◽  
pp. 211-217 ◽  
Author(s):  
Sameer Ahmed Alsharapy ◽  
Alima Gharout-Sait ◽  
Anaelle Muggeo ◽  
Thomas Guillard ◽  
Pascal Cholley ◽  
...  
Keyword(s):  
Clinical Isolates ◽  
University Hospital ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

scholarly journals Multi-institute analysis of carbapenem resistance reveals remarkable diversity, unexplained mechanisms, and limited clonal outbreaks

2017 ◽  
Vol 114 (5) ◽  
pp. 1135-1140 ◽  
Author(s):  
Gustavo C. Cerqueira ◽  
Ashlee M. Earl ◽  
Christoph M. Ernst ◽  
Yonatan H. Grad ◽  
John P. Dekker ◽  
...  
Keyword(s):  
Carbapenem Resistance ◽  
Resistance Mechanisms ◽  
Phylogeographic Structure ◽  
Aggressive Approach ◽  
Beta Lactamases ◽  
Carbapenem Resistant ◽  
Local Transmission ◽  
California Hospital ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
The Continuum

Carbapenem-resistant Enterobacteriaceae (CRE) are among the most severe threats to the antibiotic era. Multiple different species can exhibit resistance due to many different mechanisms, and many different mobile elements are capable of transferring resistance between lineages. We prospectively sampled CRE from hospitalized patients from three Boston-area hospitals, together with a collection of CRE from a single California hospital, to define the frequency and characteristics of outbreaks and determine whether there is evidence for transfer of strains within and between hospitals and the frequency with which resistance is transferred between lineages or species. We found eight species exhibiting resistance, with the majority of our sample being the sequence type 258 (ST258) lineage ofKlebsiella pneumoniae. There was very little evidence of extensive hospital outbreaks, but a great deal of variation in resistance mechanisms and the genomic backgrounds carrying these mechanisms. Local transmission was evident in clear phylogeographic structure between the samples from the two coasts. The most common resistance mechanisms were KPC (K. pneumoniaecarbapenemases) beta-lactamases encoded byblaKPC2,blaKPC3, andblaKPC4, which were transferred between strains and species by seven distinct subgroups of the Tn4401element. We also found evidence for previously unrecognized resistance mechanisms that produced resistance when transformed into a susceptible genomic background. The extensive variation, together with evidence of transmission beyond limited clonal outbreaks, points to multiple unsampled transmission chains throughout the continuum of care, including asymptomatic carriage and transmission of CRE. This finding suggests that to control this threat, we need an aggressive approach to surveillance and isolation.

scholarly journals Colistin heteroresistance in carbapenem-resistant Acinetobacter baumannii clinical isolates from a Thai university hospital

2020 ◽  
Vol 36 (7) ◽  
Author(s):  
Khin Thet Thet ◽  
Kamonwan Lunha ◽  
Arpasiri Srisrattakarn ◽  
Aroonlug Lulitanond ◽  
Ratree Tavichakorntrakool ◽  
...  
Keyword(s):  
Acinetobacter Baumannii ◽  
Clinical Isolates ◽  
University Hospital ◽  
Carbapenem Resistant ◽  
Thai University

scholarly journals The Clinical and Molecular Epidemiology of Noncarbapenemase-Producing Carbapenem-Resistant Enterobacteriaceae: A Case-Case-Control Matched Analysis

2020 ◽  
Vol 7 (8) ◽  
Author(s):  
Ruth Bouganim ◽  
Liana Dykman ◽  
Omar Fakeh ◽  
Yair Motro ◽  
Rivka Oren ◽  
...  
Keyword(s):  
Medical Center ◽  
Carbapenem Resistance ◽  
Case Control ◽  
Beta Lactamases ◽  
Carbapenem Resistant ◽  
Asymptomatic Carriage ◽  
Skin Ulcers ◽  
Chronic Skin ◽  
Multivariable Regression Models ◽  
Carbapenem Resistant Enterobacteriaceae

Abstract Background Risk factors and outcomes associated with carbapenem-resistant Enterobacteriaceae (CRE) acquisitions are derived primarily from cohorts consisting of carbapenemase-producing (CP) strains. Worldwide epidemiology of non-CP-CRE is evolving, but controlled epidemiological analyses are lacking. Methods A matched case-case-control investigation was conducted at Shamir (Assaf Harofeh) Medical Center, Israel, on November 2014–December 2016. Noncarbapenemase-producing CRE (as defined by the US Clinical and Laboratory Standards Institute Standards) carriers were matched to patients with non-CRE Enterobacterales and to uninfected controls (1:1:1 ratio). Matched and nonmatched multivariable regression models were constructed to analyze predictors for acquisition and the independent impact of carriage on multiple outcomes, respectively. Representative isolates were whole genome sequenced and analyzed for resistome and phylogeny. Results Noncarbapenemase-producing CRE carriers (n = 109) were matched to the 2 comparative groups (overall n = 327). Recent exposure to antibiotics (but not specifically to carbapenems), prior intensive care unit admission, and chronic skin ulcers were all independent predictors for non-CP-CRE acquisition. Acquisitions were almost exclusively associated with asymptomatic carriage (n = 104), and despite strong associations per univariable analyses, none were independently associated with worse outcomes. Genomic analyses of 13 representative isolates revealed polyclonality, confirmed the absence of carbapenemases, but confirmed the coexistence of multiple other genes contributing to carbapenem-resistance phenotype (multiple beta-lactamases and efflux pumps). Conclusions Noncarbapenemase-producing CRE acquisitions are primarily associated with asymptomatic carriage, specifically among prone populations with extensive recent exposures to antibiotics. The prevalent mode of acquisition is “emergence of resistance” (not “patient-to-patient transmission”), and therefore the role of stewardship interventions in reducing the spread of these therapeutically challenging pathogens should be further explored.

scholarly journals Detection and Characterization of Carbapenem resistant Gram-negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan

2020 ◽  
Author(s):  
Hana S. Elbadawi ◽  
Kamal M. Elhag ◽  
Elsheikh Mahgoub ◽  
Hisham N Altayb ◽  
Francine Ntoumi ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Nosocomial Infections ◽  
Carbapenem Resistance ◽  
Clinical Isolates ◽  
University Hospital ◽  
P Value ◽  
Relative Distribution ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene

Abstract Background:Antimicrobial resistance (AMR) poses a threat to global health security. Whilst over the past decade, there has been an increase in reports of nosocomial infections globally caused by carbapenem resistant Gram-negative bacilli (GNB), data from Africa have been scanty. We performed a study of carbapenem resistance genes among GNB isolated from patients treated in hospitals in Khartoum state, Sudan.Methods:A cross-sectional study was conducted at Soba University Hospital (SUH) and Institute of Endemic Diseases, University of Khartoum for the period October 2016 to February 2017. A total of 206 GNB isolates from different clinical specimens were analyzed for carbapenem resistance genes using phenotypic tests and affirmed by genes detection. Multiplex PCR was performed for each strain to detect the carbapenemase genes, including the blaNDM, blaVIM, blaIMP, blaKPC, and blaOXA-48. In addition to blaCTXM, blaTEM and blaSHV. DNA sequencing and bioinformatics analysis were used to detect genes subtypes.Findings:Of 206 isolates, 171 (83%) were confirmed resistant phenotypically and 121 (58.7%) isolates were positive for the presence of one or more carbapenemase gene. New Delhi metallo-β-lactamase (NDM) types were the most predominant genes, blaNDM 107(88.4%). Others included blaIMP 7 (5.7%), blaOXA-48 5(4.1%), blaVIM 2 (1.6%) and blaKPC 0 (0%). Co- resistance genes with NDM producing GNB were detected in 87 (81.3%) of all blaNDM positive isolates. A significant association between phenotypic and genotypic resistance was observed (P- value < 0.001). NDM-1 was the most sub type was observed in 75 isolates (70 %), other subtypes were NDM- 5 and NDM-6. Infections due to Carbapenem resistant GNB are increasing at SUH, with the blaNDM being the prevalent genes among clinical isolates and belong to the Indian lineage.Conclusions:The frequency of carbapenemase producing bacilli was found to be improperly high in Khartoum hospitals. NDM was found to be the most prevalent carbapenemase gene among clinical isolates. Close surveillance across all hospitals in Sudan is required. The relative distribution of Carbapenemase genes among GNB in nosocomial infections in Africa needs to be defined.

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