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.

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

2021 ◽  
Author(s):  
Hana S. Elbadawi ◽  
Kamal M. Elhag ◽  
Elsheikh Mahgoub ◽  
Hisham N Altayb ◽  
Ayman Ahmed ◽  
...  
Keyword(s):  
Nosocomial Infections ◽  
Carbapenem Resistance ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Relative Distribution ◽  
Health Coverage ◽  
Health Security ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene

Abstract Background: Antimicrobial resistance (AMR) poses a complex threat to global health security and universal health coverage. Over recent decades, there has been an increase globally in reports of nosocomial infections caused by carbapenem-resistant Gram-negative bacilli (GNB). We aimed to explore the molecular characterization and detection of genes associated with carbapenem producing Gram negative bacteria isolated from hospitalized patients in Soba University Hospital (SUH) in Khartoum State, Sudan. Results: A total of 206 GNB clinical specimens were collected between October 2016 and February 2017 from hospitalized patients in SUH. Of 206 carbapenem resistance isolates, 171 (83%) were confirmed as phenotypically resistant and 121 (58.7%) isolates harboured one or more carbapenemase genes. New Delhi metallo-β-lactamase (NDM) types were the most predominant genes, blaNDM 107(52%). Others included blaIMP 7 (3.4%), blaOXA-48 5(2.4%) and blaVIM 2 (0.9%) Co-resistance genes with NDM producing GNB were detected in 87 (81.3%) of all blaNDM producing isolates. NDM1 was the most frequent subtype observed in 75 (70 %) blaNDM producing isolates.Conclusions: The frequency of carbapenemase producing bacilli was found to be high in SUH. 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.

Detection and Characterisation of Carbapenem Resistant Gram-negative Bacilli Isolates Recovered From Hospitalised Patients at Soba University Hospital, Sudan

2020 ◽  
Author(s):  
Hana S. Elbadawi ◽  
Kamal M. Elhag ◽  
Elsheikh Mahgoub ◽  
Hisham N Altayb ◽  
Francine Ntoumi ◽  
...  
Keyword(s):  
Nosocomial Infections ◽  
Carbapenem Resistance ◽  
University Hospital ◽  
Relative Distribution ◽  
Genotypic Resistance ◽  
Health Security ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Hospitalised Patients ◽  
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). This study aimed to detect and characterize carbapenem resistance Gram negative bacteria isolated from hospitalized patients in Soba University Hospital (SUH) in Khartoum State, Sudan Results: A total of 206 GNB isolates from different clinical specimens were obtained from hospitalised patients between October 2016 to February 2017. Of 206 isolates, 171 (83%) were confirmed resistant phenotypically and 121 (58.7%) isolates were positive for the presence of one or more carbapenemase genes. New Delhi metallo-β-lactamase (NDM) types were the most predominant genes, blaNDM 107(52%). Others included blaIMP 7 (3.4%), blaOXA-48 5(2.4%), blaVIM 2 (0.9%) 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 < 0.001). NDM1 was the most frequent subtype observed in 75 (70 %) isolates which clusters to the Indian lineage.Conclusions: The frequency of carbapenemase producing bacilli was found to be improperly high in SUH. 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.

scholarly journals Detection and characterization of carbapenem resistant Gram‐negative bacilli isolates recovered from hospitalized patients at Soba University Hospital, Sudan

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hana S. Elbadawi ◽  
Kamal M. Elhag ◽  
Elsheikh Mahgoub ◽  
Hisham N. Altayb ◽  
Francine Ntoumi ◽  
...  
Keyword(s):  
Nosocomial Infections ◽  
Carbapenem Resistance ◽  
Close Correlation ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Relative Distribution ◽  
Health Coverage ◽  
Health Security ◽  
Gram Negative ◽  
Carbapenemase Gene

Abstract Background Antimicrobial resistance (AMR) poses a complex threat to global health security and universal health coverage. Recently, nosocomial infections with carbapenemase-producing Gram-negative bacilli (GNB) is increasing worldwide. We report the molecular characterization and detection of genes associated with carbapenemase producing Gram negative bacteria isolated from hospitalized patients at Soba University Hospital (SUH) in Khartoum State, Sudan. Results Between October 2016 and February 2017, a total of 206 GNB clinical specimens were collected from hospitalized patients in SUH. Of 206 carbapenem resistance isolates, 171 (83 %) were confirmed as phenotypically resistant and 121 (58.7 %) isolates harboured one or more carbapenemase genes. New Delhi metallo-β-lactamase (NDM) types were the most predominant genes, blaNDM 107(52 %), followed by blaIMP 7 (3.4 %), blaOXA-48 5(2.4 %) and blaVIM 2 (0.9 %). Co-resistance genes with NDM producing GNB were detected in 87 (81.3 %) of all blaNDM producing isolates. NDM-1 was the most frequent subtype observed in 75 (70 %) blaNDM producing isolates. The highest percentage of resistance was recorded in ampicillin (98 %), cephalexin (93.5 %) amoxicillin clavulanic acid (90 %), cefotaxime (89.7 %), ceftriaxone (88.4 %), ceftazidime (84.2 %), sulfamethoxazole-trimethoprim (78.4 %) and nitrofurantoin (75.2 %), aztreonam (66 %) and temocillin (64 %). A close correlation between phenotypic and carbapenemase genes detection in all GNB was observed. Conclusions The frequency of carbapenemase producing bacilli was found to be high in SUH. 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.

scholarly journals Prevalence and Molecular Characterization of Carbapenem resistance Gram negative bacilli among hospitalized patients in Khartoum state

2019 ◽  
Author(s):  
Hana Salaheldin Elbadawi ◽  
Kamal Elhag ◽  
Elsheikh Mahgoub ◽  
Hisham N Altayb ◽  
Muzamil Mahdi Abdel Hamid
Keyword(s):  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
University Hospital ◽  
P Value ◽  
Genotypic Resistance ◽  
Cross Sectional ◽  
Gram Negative ◽  
Endemic Diseases ◽  
Carbapenemase Gene

Abstract Background Carbapenems are broad-spectrum β-lactam antibiotics widely prescribed for the treatment of multidrug-resistant gram negative bacilli in systemic infections. In the past ten years the Carbapenem resistance among gram-negative bacilli is rapidly expanding across nosocomial infection isolates. This study was conducted to determine the prevalence and to characterize Carbapenem resistance genes among Gram negative bacilli (GNB) isolated from patients treated in hospitals in Khartoum state, Sudan.Methods A cross-sectional laboratory based study was conducted over six months at the microbiology department in Soba University Hospital and Institute of Endemic Diseases, University of Khartoum. 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 those encoding the NDM-, VIM-, and IMP -type Metallo-beta-lactamases, the class A KPC-type carbapenemases, and the class D OXA-48 enzyme. In addition to CTXM, TEM and SHV. DNA sequencing and bioinformatics analysis were used to detect genes subtypes.Results Of 206 isolates, 171 (83%) positive phenotypically and 121 (70.7%) from 171 isolates were confirmed for present one or more carbapenemase gene. NDM-types were the most predominant genes, blaNDM 107(88.4%), followed by blaIMP 7 (5.7%), blaOXA-48 5(4.1%), blaVIM 2 (1.6%) and blaKPC 0 (0%). Co- resistance genes with NDM producing Gram-negative bacilli were detected in 87 (81.3%) of all NDM positive isolates. Correlation between phenotypic and genotypic resistance was observed (P- value < 0.001). Carbapenemase genes were mostly detected in the K. pneumoniae 70 (42.6%), followed by P. aeruginosa 33 (20%), A. baumannii 30 (18.2%) and E. coli with 18 strains (10.9%). NDM-1 was detected in 75 isolates (70%), other subtypes of NDM were identified by sequencing were NDM- 5 and NDM-6.Conclusions The prevalence of carbapenemase producing bacilli was fond to be high in Khartoum hospitals. NDM was found to be the most prevalent carbapenemase genes among clinical isolates and belong to Indian lineage. For prevention infection control and regular surveillance must be enhanced.

scholarly journals Genome-Wide Identification of Carbapenem-Resistant Gram- Negative Bacterial (CR-GNB) Isolates Retrieved From Hospitalized Patients in Bihar, India

2021 ◽  
Author(s):  
Namrata Kumari ◽  
Mukesh Kumar ◽  
Amit Katiyar ◽  
Abhay Kumar ◽  
Pallavi Priya ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Cross Sectional ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Genome Wide ◽  
Synergy Test ◽  
Global Threat

Abstract Carbapenemase-producing clinical isolates are becoming more common over the world, posing a severe public health danger, particularly in developing nations like India. Carbapenem-resistant Gram-negative bacterial (CR-GNB) infection has become a fast-expending global threat with limited antibiotic choice and significant mortality. The aim of this study was to highlight the carbapenem-resistance among clinical isolates of hospital admitted patients in Bihar, India. A cross-sectional study was conducted with 101 clinical isolates of E. coli, K. pneumoniae, A. baumannii, and P. aeruginosa. All GNB isolates were tested for their antimicrobial susceptibility using double disc synergy test / modified hodge test (DDST/MHT) and subsequently confirmed carbapenemase-producing isolates were evaluated for carbapenem-resistance genes using whole-genome sequencing (genotypically) method. The overall percentage of carbapenem-resistance among GNB was (17/101) 16.83%. The AMR analysis demonstrates a significantly high prevalence of blaCTX−M followed by blaSHV, blaTEM, blaOXA and blaNDM β-lactams carbapenem-resistance genes among clinical isolates of GNB. Co-occurrence of carbapenemase-encoding genes with blaNDM was found in 70.6% of carbapenemase-producing isolates. Our study highlights the mechanism of carbapenem-resistance to curb the overwhelming threat posed by emergence of drug-resistance in India.

scholarly journals Carbapenemase Genes among Multidrug Resistant Gram Negative Clinical Isolates from a Tertiary Hospital in Mwanza, Tanzania

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Martha F. Mushi ◽  
Stephen E. Mshana ◽  
Can Imirzalioglu ◽  
Freddie Bwanga
Keyword(s):  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Tertiary Hospital ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Class D ◽  
Carbapenemase Gene ◽  
Systemic Infections

The burden of antimicrobial resistance (AMR) is rapidly growing across antibiotic classes, with increased detection of isolates resistant to carbapenems. Data on the prevalence of carbapenem resistance in developing countries is limited; therefore, in this study, we determined the prevalence of carbapenemase genes among multidrug resistant gram negative bacteria (MDR-GNB) isolated from clinical specimens in a tertiary hospital in Mwanza, Tanzania. A total of 227 MDR-GNB isolates were analyzed for carbapenem resistance genes. For each isolate, five different PCR assays were performed, allowing for the detection of the major carbapenemase genes, including those encoding the VIM-, IMP-, and NDM-type metallo-beta-lactamases, the class A KPC-type carbapenemases, and the class D OXA-48 enzyme. Of 227 isolates, 80 (35%) were positive for one or more carbapenemase gene. IMP-types were the most predominant gene followed by VIM, in 49 (21.59%) and 28 (12%) isolates, respectively. Carbapenemase genes were most detected inK. pneumoniae24 (11%), followed byP. aeruginosa23 (10%), andE. coliwith 19 isolates (8%). We have demonstrated for the first time a high prevalence of MDR-GNB clinical isolates having carbapenem resistance genes in Tanzania. We recommend routine testing for carbapenem resistance among the MDR-GNB particularly in systemic infections.

scholarly journals Correlation between the Antibiotic Resistance Genes and Susceptibility to Antibiotics among the Carbapenem-Resistant Gram-Negative Pathogens

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 255
Author(s):  
Salma M. Abdelaziz ◽  
Khaled M. Aboshanab ◽  
Ibrahim S. Yahia ◽  
Mahmoud A. Yassien ◽  
Nadia A. Hassouna
Keyword(s):  
Antibiotic Resistance ◽  
Resistance Genes ◽  
Efflux Pump ◽  
Antibiotic Resistance Genes ◽  
Multiple Drug ◽  
P Value ◽  
Multidrug Efflux ◽  
Multidrug Efflux Pump ◽  
Gram Negative ◽  
Carbapenem Resistant

In this study, the correlation between the antibiotic resistance genes and antibiotic susceptibility among the carbapenem-resistant Gram-negative pathogens (CRGNPs) recovered from patients diagnosed with acute pneumonia in Egypt was found. A total of 194 isolates including Klebsiella pneumoniae (89; 46%), Escherichia coli (47; 24%) and Pseudomonas aeruginosa (58; 30%) were recovered. Of these, 34 (18%) isolates were multiple drug resistant (MDR) and carbapenem resistant. For the K. pneumoniae MDR isolates (n = 22), blaNDM (14; 64%) was the most prevalent carbapenemase, followed by blaOXA-48 (11; 50%) and blaVIM (4; 18%). A significant association (p value < 0.05) was observed between the multidrug efflux pump (AcrA) and resistance to β-lactams and the aminoglycoside acetyl transferase gene (aac-6’-Ib) gene and resistance to ciprofloxacin, azithromycin and β-lactams (except for aztreonam). For P. aeruginosa, a significant association was noticed between the presence of the blaSHV gene and the multidrug efflux pump (MexA) and resistance to fluoroquinolones, amikacin, tobramycin, co-trimoxazole and β-lactams and between the aac-6’-Ib gene and resistance to aminoglycosides. All P. aeruginosa isolates (100%) harbored the MexAB-OprM multidrug efflux pump while 86% of the K. pneumoniae isolates harbored the AcrAB-TolC pump. Our results are of great medical importance for the guidance of healthcare practitioners for effective antibiotic prescription.

scholarly journals Investigation of Carbapenemase Genes in Carbapenem Resistant Enterobacterales Isolates: First KPC Report From Dokuz Eylul University Hospital

2021 ◽  
Author(s):  
Şeyda Şilan Okalin ◽  
Ayşe Nur Sarı Kaygısız ◽  
Mahmut Cem Ergon ◽  
İbrahim Mehmet Ali Öktem
Keyword(s):  
Treatment Options ◽  
Carbapenem Resistance ◽  
Tracheal Aspirate ◽  
University Hospital ◽  
Chain Reaction ◽  
Specific Primers ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
Polymerase Chain

Objective: In recent years, increasing carbapenem resistance of Enterobacterales bacteria limits treatment options, considerably. The main mechanism of this resistance is the production of carbapenemase enzymes. The aim of this study is to determine carbapenemase gene types in Enterobacterales isolates from our hospitalized patients and assess the clonal associations of the isolates with KPC gene. Method: A total of 48 clinical Enterobacterales isolates resistant to at least one carbapeneme and received between January 2019 and March 2019 were included in the study. Sample types were consisted of urine, blood, tracheal aspirate, wound and sputum. Of these isolates, three were Escherichia coli while 45 were Klebsiella pneumoniae. Types of carbapenemases were investigated by polymerase chain reaction, using specific primers for VIM, IMP, NDM, KPC and OXA-48 genes. PFGE was performed to determine the clonal associations between blaKPC positive K. pnemoniae isolates. Results: According to the results, blaOXA-48 (n=2) and blaKPC (n=1) were found to be present among E. coli isolates. Regarding 45 K. pneumoniae isolates; only blaOXA-48 and only blaNDM were present in 30 and two isolates, respectively. Seven K. pneumoniae isolates were found positive for both blaOXA-48 and blaNDM. Remaining K. pneumoniae isolates (n=6) harboured only blaKPC. None of the isolates were positive for blaIMP and blaVIM. PFGE analysis showed four isolates had the same pulsotype (A), while two had different pulsotypes (B-C). Conclusion: To our knowledge, this is the first report of KPC gene isolated in Dokuz Eylul University Hospital.

Determination of carbapenemase genes in clinical isolates using Cepheid Xpert Carba-R

2021 ◽  
pp. 16-19
Author(s):  
N. I. Gabrielyan ◽  
V. G. Kormilitsyna ◽  
V. K. Zaletaeva ◽  
A. V. Krotevich ◽  
I. A. Miloserdov ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Infection Control ◽  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Critical Issue ◽  
Sensitivity Study ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Carbapenem Resistant

Detection of carbapenem resistance genes is a critical issue for hospitals due to possible recommendations for infection control and targeted therapy. The Cepheid Xpert instrument, a Carba-R test for the detection and differentiation of five common carbapenemase genes, was tested from September 2020 to February 2021. As part of the approbation, 20 tests were provided. This review presents the results of the approbation of a relatively regular sensitivity study on Siemens WalkAway‑96 plus. Cepheid Xpert Carba-R analysis has been shown to be an accurate and fast tool for detecting colonization by carbapenem-resistant gram-negative bacteria, which can help limit the spread of these organisms in hospitals.

Integration of the blaNDM-1 carbapenemase gene into a novel SXT/R391 integrative and conjugative element in Proteus vulgaris

2020 ◽  
Vol 75 (6) ◽  
pp. 1439-1442
Author(s):  
Ling-Han Kong ◽  
Rong Xiang ◽  
Yu-Long Wang ◽  
Shun-Kang Wu ◽  
Chang-Wei Lei ◽  
...  
Keyword(s):  
Resistance Gene ◽  
Resistance Genes ◽  
Bioinformatics Analysis ◽  
Carbapenem Resistance ◽  
Resistance Determinant ◽  
Proteus Vulgaris ◽  
Genetic Environment ◽  
Carbapenem Resistant ◽  
Carbapenemase Gene ◽  
Integrative And Conjugative Element

Abstract Objectives To characterize the genetic environment of the carbapenem resistance determinant in Proteus vulgaris of swine origin. Methods The carbapenem-resistant P. vulgaris strain BC22 was isolated from a faecal swab from a diseased pig with diarrhoea in Sichuan Province of China in 2018. The presence of carbapenemase genes was screened by PCR. WGS and bioinformatics analysis were performed to analyse the genetic environment of the carbapenem resistance determinant. Results P. vulgaris strain BC22 was found to harbour the carbapenemase gene blaNDM-1. WGS data revealed that blaNDM-1 was located in a truncated ISAba125 composite transposon. The carbapenem resistance gene blaNDM-1 and 20 other resistance genes, including the multiresistance gene cfr and the bifunctional aminoglycoside/quinolone resistance gene aac(6′)-lb-cr, were located in a novel SXT/R391 integrative and conjugative element (ICE). This new SXT/R391 ICE of 148.7 kb was chromosomally located, and could be transferred to Escherichia coli. Conclusions Here, we report a carbapenemase gene, blaNDM-1, integrated into an SXT/R391 ICE. Our study highlights that this SXT/R391 ICE may facilitate the dissemination of clinically important resistance genes such as blaNDM-1, cfr and aac(6′)-lb-cr.

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