Seroepidemiology, Antimicrobial Susceptibility and Virulence Characteristics of Clinical Klebsiella pneumoniae Isolates in Mansoura University Hospitals

2021 ◽  
Vol 30 (1) ◽  
pp. 9-18
Author(s):  
Aya H. Elasmer ◽  
Mohammed Y. Ibrahim ◽  
Dina E. Rizk
Keyword(s):  
Genetic Diversity ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Genetic Relatedness ◽  
Diffusion Method ◽  
Serum Resistance ◽  
Beta Lactam ◽  
University Hospitals ◽  
Disk Diffusion Method ◽  
Pathogenic Potential

Background: Klebsiella pneumoniae is one of the crucial causes of nosocomial and community-acquired infections that can result in various infections in human. Objectives: The present study aim to investigate the prevalence of capsular serotypes, antimicrobial susceptibility and virulence characteristics of K. pneumoniae isolated from different Mansoura University Hospitals. Methodology: K. pneumoniae isolates were collected from different clinical sources at Mansoura University Hospitals. The antimicrobial susceptibility to 14 different antibiotics was determined by disk diffusion method. The capsular serotypes were assessed by quelling test. Serum resistance, haemagglutination, biofilm, lipase, protease and lecithinase enzymes production were assessed phenotypically. Moreover, four virulence genes (rmpA, fimH, kfuBC and wabG) were detected by PCR. The genetic relatedness among isolates was investigated using ERIC-PCR molecular typing. Results: Seventy-three isolates were confirmed as K. pneumoniae. The vast majority of isolates demonstrated MDR patterns (72.6%) including a high resistance rate to the beta-lactam antibiotics (ampicillin: 98.6%, amoxicillin-clavulanic acid: 97.26 %, piperacillin: 97.26 %, amoxicillin: 93.15% and cefotaxime: 94.52%). K1 and K2 were the main serotypes found among the isolates, K1 serotype was the predominant (79.45%). It was found that serum resistance was the highest detected virulence factor among isolates (95.9%) and lipase was the lowest detected factor (19.2%). Haemagglutination was detected in 63% of the isolates especially from rectal swab (83.3%) and sputum (72.7%). The biofilm formation was detected mainly among urine and blood isolates. rmpA, fimH, kfuBC and wabG genes were harbored by 20.5%, 92%, 66% and 94.5% of isolates, respectively. ERIC- PCR showed high genetic diversity (100%, typability, Simpson’s index of diversity= 1). Conclusion: The current study revealed the high antibiotic resistance levels, pathogenic potential, and genetic diversity among K. pneumoniae isolated from different clinical sources which is considered a serious health problem that necessitates interventions to control its spread.

scholarly journals Detection of OqxAB and QepA Efflux Pumps and Their Association with Antibiotic Resistance in Klebsiella pneumoniae Isolated From Urinary Tract Infection

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Manijeh Dehnamaki ◽  
Maryam Ghane ◽  
Laleh Babaeekhou
Keyword(s):  
Urinary Tract Infection ◽  
Antibiotic Resistance ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Efflux Pump ◽  
Efflux Pumps ◽  
Diffusion Method ◽  
Beta Lactam ◽  
Disk Diffusion Method

Background: The emergence and spread of drug resistance among Klebsiella pneumoniae clinical isolates have limited the treatment options for these bacteria. Efflux pumps are considered as one of the key mechanisms of antibiotic resistance in K. pneumoniae isolates. Objectives: The present study aimed to detect oqxA, oqxB, and qepA efflux genes in K. pneumoniae isolated from urinary tract infection (UTI) and survey their association with antibiotic resistance. Methods: In total, 100 K. pneumoniae isolates were obtained from urine samples, and an antimicrobial susceptibility test was conducted using the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) instructions. Polymerase chain reaction (PCR) was done for the detection of efflux pump genes including, oqxA, oqxB, and qepA, and their association was statistically analyzed with resistance to antibiotics. Results: The highest rate of resistance was obtained against trimethoprim-sulfamethoxazole (72%), amikacin (70%), levofloxacin (68%), gentamicin (56%), ceftazidime (56%), and ceftriaxone (51%), and the lowest resistance was against imipenem (10%). Thirty one percent of isolates were multidrug resistant (MDR). Molecular distribution test showed that 57% and 56% of isolates carried the oqxA and oqxB genes, respectively. Also, the frequency of qepA genes was 21%. The presence of oqxA/oqxB and qepA efflux genes were significantly associated with fluoroquinolone and beta-lactam resistance phenotypes (P < 0.05). Conclusions: The high frequency of efflux genes showed that this resistance mechanism is the main way, along with other resistance mechanisms in K. pneumoniae isolates. It is necessary to adopt appropriate treatment to reduce the incidence of resistance.

scholarly journals Detection Of Hypermucoviscous Klebsiella Pneumoniae And Phenotypic Comparison Of Their Virulence Factors With Classical Strains Among Patients Visiting Tertiary Care Hospital

2021 ◽  
Author(s):  
Tika Bahadur Thapa ◽  
Sujina Maharjan ◽  
Nisha Giri ◽  
Manisha Sapkota ◽  
Ojaswee Shrestha ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Virulence Factors ◽  
Tertiary Care ◽  
Test Method ◽  
Diffusion Method ◽  
Serum Resistance ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Disk Diffusion Method ◽  
String Test

Abstract Background: Klebsiella pneumoniae which are commonly recognized in laboratory are termed as classical K. pneumoniae (cKP). A new strain of K. pneumoniae named hypermucoviscous K. pneumoniae (hmvKP) emerging with a distinctive feature than classical strains. Our study aimed to determine the prevalence of hypermucoviscous K. pneumoniae in our hospital and their phenotypic comparison with the classical strains.Methods : This laboratory-based cross-sectional study done from February to July 2018, in the Department of Microbiology, Manmohan Memorial Teaching Hospital, Kathmandu, Nepal. One hundred and five clinical non-duplicative isolates of K. pneumoniae proceeded for the study. Hypermucoviscosity of isolated K. pneumoniae were tested by standard String test. Antibiotic susceptibility was determined by the Kirby-Bauer disk diffusion method according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Further β-lactamases (ESBL, MBL, and KPC) were detected by the phenotypic combination disk test method. Serum resistance and biofilm production were determined to assess their virulence.Results: A total of one hundred five non-repetitive pure and microbiologically identified K. pneumoniae were taken for study. Among the isolated K. pneumoniae, 29 (27.6%) were hypermucoviscous K. pneumoniae (hmvKP) and 76(72.4%) were classical K. pneumoniae (cKP) determined by string test. The majority of K. pneumoniae were resistant to ceftazidime (80%) and cefotaxime (78%) whereas all the isolates were found susceptible to polymyxin b and colistin. Extended spectrum beta lactamase (ESBLs) production, Metallo-beta lactamase (MBL), Klebsiella pneumoniae carbapenemase (KPC) production, biofilm, and serum resistance were compared among classical and hypermucoviscos strains and the hypermucoviscous strains revealed significantly higher expression of virulence than classical strainsConclusion: The expression of virulence factors and antimicrobial resistance was found significantly higher among the hypermucoviscous strains when phenotypically compared. The prevalence of these hypermucoviscous strains in hospital settings may increase the risk of morbidity and mortality. Therefore, timely diagnosis and appropriate treatment strategies are crucial.

MrkD Gene as a Regulator of Biofilm Formation with Correlation to Antibiotic Resistance among Clinical Klebsiella pneumoniae Isolates from Menoufia University Hospitals

2020 ◽  
Vol 29 (3) ◽  
pp. 137-144
Author(s):  
Asmaa M. Elbrolosy ◽  
Naira A. Eissa ◽  
Nahed A. Al-Rajhy ◽  
Esraa El-Sayed A. El-Mahdy ◽  
Rasha G. Mostafa
Keyword(s):  
Antibiotic Resistance ◽  
Klebsiella Pneumoniae ◽  
Biofilm Formation ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
University Hospitals ◽  
Pcr Assay ◽  
Disk Diffusion Method ◽  
Microbiological Methods

Background: Klebsiella pneumoniae (K. pneumoniae) is a common pathogen involved in a diverse array of life-threatening infections. Increasing frequent acquisition of antibiotic resistance by K. pneumoniae has given rise to multidrug-resistant pathogen mostly at the hospital level. Objectives: To assess the prevalence and antibiotic resistance pattern of the clinical K. pneumoniae isolates at Menoufia University Hospitals (MUHs) as well as to explore the role of mrkD gene as a regulator of biofilm formation. Methodology: A total of 340 different clinical samples were obtained from 270 patients who were admitted to MUHs and those from Outpatient clinics during the period from April 2018 to September 2019. 84 K. pneumoniae isolates were identified by the standard microbiological methods and vitek-2 system. The antimicrobial resistance pattern was determined by disk diffusion method. The biofilm-forming ability of all K. pneumoniae isolates was demonstrated phenotypically by the modified Congo red agar method (MCRA) and PCR assay verified the presence of mrkD gene as a genetic determinant of biofilm formation. Results: Klebsiella spp. represented 34.7% of the collected isolates and the predominant spp. was K. pneumoniae (91.3%). The highest resistance rates were for ceftriaxone (69%) followed by aztreonam (67.9%), 66.7% for each of piperacillin and ceftazidime, while the least resistance rate was for fosfomycin (8.3%). Biofilm production was detected among 83.3% of the isolates by MCRA method. A highly significant statistical difference was noted between biofilm- and non- biofilm - producing K. pneumoniae isolates regarding resistance to cefepieme and amikacin (P <0.001) and similarly regarding resistance to aztreonam, imipenem, meropenem, ertapenem and tobramycin (P<0.05). Conventional PCR assay showed that, 92% of the isolates harbored mrkD gene with a highly significant association with biofilm formation. Conclusion: The increasing prevalence and remarkable ability to acquire antibiotic resistance among K. pneumoniae isolates together with biofilm formation should alert even more regarding the hazard of this pathogen in hospital settings.

scholarly journals Evolution of In Vitro Antimicrobial Susceptibility of Equine Clinical Isolates in France between 2016 and 2019

Animals ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 812 ◽  
Author(s):  
Albertine Léon ◽  
Sophie Castagnet ◽  
Karine Maillard ◽  
Romain Paillot ◽  
Jean-Christophe Giard
Keyword(s):  
Escherichia Coli ◽  
Staphylococcus Aureus ◽  
Antimicrobial Resistance ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Veterinary Antibiotics ◽  
Disk Diffusion Method ◽  
Animal Exposure

The present study described the evolution of antimicrobial resistance in equine pathogens isolated from 2016 to 2019. A collection of 7806 bacterial isolates were analysed for their in vitro antimicrobial susceptibility using the disk diffusion method. The most frequently isolated pathogens were group C Streptococci (27.0%), Escherichia coli (18.0%), Staphylococcus aureus (6.2%), Pseudomonas aeruginosa (3.4%), Klebsiella pneumoniae (2.3%) and Enterobacter spp. (2.1%). The majority of these pathogens were isolated from the genital tract (45.1%, n = 3522). With the implementation of two French national plans (named ECOANTIBIO 1 and 2) in 2012–2016 and 2017–2021, respectively, and a reduction in animal exposure to veterinary antibiotics, our study showed decreases in the resistance of group C Streptococci, Klebsiella pneumoniae and Escherichia coli against five classes, four classes and one class of antimicrobials tested, respectively. However, Staphylococcus aureus, Escherichia coli and Enterobacter spp. presented an increased resistance against all the tested classes, excepted for two fifths of E. coli. Moreover, the percentages of multi-drug resistant strains of Staphylococcus aureus and Enterobacter spp. also increased from 24.5% to 37.4% and from 26.3% to 51.7%, respectively. The data reported here are relevant to equine practitioners and will help to improve knowledge related to antimicrobial resistance in common equine pathogens.

scholarly journals Investigation of the presence of NDM-1, VIM-1 and OXA-1 genes in MDR strains of Klebsiella pneumoniae isolated from clinical specimens

2019 ◽  
Author(s):  
Melika Taleb ◽  
Farzaneh Hosseini
Keyword(s):  
Klebsiella Pneumoniae ◽  
Opportunistic Pathogen ◽  
New Drugs ◽  
Diffusion Method ◽  
Klebsiella Pneumonia ◽  
Beta Lactam ◽  
Biochemical Tests ◽  
Disk Diffusion Method ◽  
Enzyme Gene

Abstract Background:Klebsiella pneumoniae has emerged as a significant opportunistic pathogen responsible for nosocomial infections. This bacteria is frequently resistant to multiple classes of antibiotics such as the family of beta-lactam antibiotics. The aim of this study was the molecular evaluation of resistant strains of Klebsiella pneumonia isolation of multiple resistant drugs from clinical specimens.Methods:60 clinical isolates of Klebsiella pneumoniae were isolated and identified by staining and biochemical tests during fall season from a laboratory in Tehran. Antimicrobial susceptibility testing was carried out using a disk diffusion method with CLSI standards. All isolates were examined by PCR test for the presence of NDM-1, VIM-1, and OXA-1 genes.Results:The highest resistance in the strains was related to antibiotic ampicillin (90%), followed by the highest resistance to ciprofloxacin (70%), cefixime (66.66%), trimethoprim-sulfamethoxazole (65%), piperacillin (50%). Also, most susceptibilities were to ampicillin antibiotics (85%), gentamicin (70%), piperacillin-tazobactam (60%) and amikacin (56.66%). Out of the 60 isolated strains, 3 isolates (5%) had the VIM-1 enzyme gene, 2 isolates (3.3%) had the OXA-1 enzyme gene and no isolates were found with the NDM-1 enzyme gene. Conclusion:The high levels of antibiotic resistance among the organisms that cause clinical infections suggest that the mechanisms involved in the development of resistance and the evaluation of antimicrobial activity of new drugs in vitro can help the process of effective treatment of these infections.

scholarly journals Predominance of PVL-negative community-associated methicillin-resistant Staphylococcus aureus sequence type 8 in newly diagnosed HIV-infected adults, Tanzania

2021 ◽  
Author(s):  
Joel Manyahi ◽  
Sabrina J. Moyo ◽  
Said Aboud ◽  
Nina Langeland ◽  
Bjørn Blomberg
Keyword(s):  
Staphylococcus Aureus ◽  
Hiv Infection ◽  
Diffusion Method ◽  
Molecular Characteristics ◽  
People Living With Hiv ◽  
Newly Diagnosed ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Methicillin Resistant ◽  
Inducible Clindamycin Resistance

AbstractDifficult-to-treat infections caused by methicillin-resistant Staphylococcus aureus (MRSA) are of concern in people living with HIV infection as they are more vulnerable to infection. We aimed to identify molecular characteristics of MRSA colonizing newly diagnosed HIV-infected adults in Tanzania. Individuals newly diagnosed with HIV infection were recruited in Dar es Salaam, Tanzania, from April 2017 to May 2018, as part of the randomized clinical trial CoTrimResist (ClinicalTrials.gov identifier: NCT03087890). Nasal/nasopharyngeal isolates of Staphylococcus aureus were susceptibility tested by disk diffusion method, and cefoxitin-resistant isolates were characterized by short-reads whole genome sequencing. Four percent (22/537) of patients carried MRSA in the nose/nasopharynx. MRSA isolates were frequently resistant towards gentamicin (95%), ciprofloxacin (91%), and erythromycin (82%) but less often towards trimethoprim-sulfamethoxazole (9%). Seventy-three percent had inducible clindamycin resistance. Erythromycin-resistant isolates harbored ermC (15/18) and LmrS (3/18) resistance genes. Ciprofloxacin resistance was mediated by mutations of the quinolone resistance-determining region (QRDR) sequence in the gyrA (S84L) and parC (S80Y) genes. All isolates belonged to the CC8 and ST8-SCCmecIV MRSA clone. Ninety-five percent of the MRSA isolates were spa-type t1476, and one exhibited spa-type t064. All isolates were negative for Panton-Valentine leucocidin (PVL) and arginine catabolic mobile element (ACME) type 1. All ST8-SCCmecIV-spa-t1476 MRSA clones from Tanzania were unrelated to the globally successful USA300 clone. Carriage of ST8 MRSA (non-USA300) was common among newly diagnosed HIV-infected adults in Tanzania. Frequent co-resistance to non-beta lactam antibiotics limits therapeutic options when infection occurs.

scholarly journals Streptococcal Throat Carriage among Primary School Children Living in Uyo, Southern Nigeria

2021 ◽  
Vol 11 (01) ◽  
pp. e28-e34
Author(s):  
Kevin B. Edem ◽  
Enobong E. Ikpeme ◽  
Mkpouto U. Akpan
Keyword(s):  
Primary School ◽  
School Children ◽  
Antimicrobial Susceptibility ◽  
Group A Streptococcus ◽  
Latex Agglutination ◽  
Sub Saharan Africa ◽  
Primary School Children ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Cross Sectional

AbstractSurveillance of the carrier state for β-hemolytic streptococcal (BHS) throat infections remains essential for disease control. Recent published works from Sub-Saharan Africa have suggested a changing epidemiology in the burden of BHS throat infections. The objective of the present study was therefore to determine the prevalence and pattern of BHS throat carriage in school-aged children in Uyo, Akwa Ibom State. This was a prospective cross-sectional study of 276 primary school children in Uyo. Subjects were recruited by multistage random sampling. Obtained throat swabs were cultured on 5% sheep blood agar. Lancefield grouping on positive cultures was done by using the Oxoid Streptococcal Grouping Latex Agglutination Kit, United Kingdom. Antimicrobial susceptibility testing was done with the disk diffusion method. Associations were tested with Fischer's exact test. The prevalence of BHS carriage was 3.3%. Group C Streptococcus was identified in 89% of isolates and Group G Streptococcus in 11%. Younger age and larger household size were associated with asymptomatic streptococcal throat infections. Antimicrobial susceptibility was highest with cefuroxime and clindamycin (89% of isolates each), while 78% of isolates were susceptible to penicillin. None of the tested isolates was susceptible to co-trimoxazole. The prevalence of streptococcal throat carriage in the study area was low. There were no Group A Streptococcus isolates suggesting an evolving epidemiology of BHS disease in the study area.

scholarly journals Phenotypic Antimicrobial Susceptibility of Escherichia coli from Raw Meats, Ready-to-Eat Meats, and Their Related Samples in One Health Context

2021 ◽  
Vol 9 (2) ◽  
pp. 326
Author(s):  
Frederick Adzitey ◽  
Nurul Huda ◽  
Amir Husni Mohd Shariff
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Resistance Index ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Disk Diffusion Method ◽  
E Coli ◽  
The Usa ◽  
Raw Meats

Meat is an important food source that can provide a significant amount of protein for human development. The occurrence of bacteria that are resistant to antimicrobials in meat poses a public health risk. This study evaluated the occurrence and antimicrobial resistance of E. coli (Escherichia coli) isolated from raw meats, ready-to-eat (RTE) meats and their related samples in Ghana. E. coli was isolated using the USA-FDA Bacteriological Analytical Manual and phenotypic antimicrobial susceptibility test was performed by the disk diffusion method. Of the 200 examined meats and their related samples, 38% were positive for E. coli. Notably, E. coli was highest in raw beef (80%) and lowest in RTE pork (0%). The 45 E. coli isolates were resistant ≥ 50% to amoxicillin, trimethoprim and tetracycline. They were susceptible to azithromycin (87.1%), chloramphenicol (81.3%), imipenem (74.8%), gentamicin (72.0%) and ciprofloxacin (69.5%). A relatively high intermediate resistance of 33.0% was observed for ceftriaxone. E. coli from raw meats, RTE meats, hands of meat sellers and working tools showed some differences and similarities in their phenotypic antimicrobial resistance patterns. Half (51.1%) of the E. coli isolates exhibited multidrug resistance. The E. coli isolates showed twenty-two different resistant patterns, with a multiple antibiotic resistance index of 0.0 to 0.7. The resistant pattern amoxicillin (A, n = 6 isolates) and amoxicillin-trimethoprim (A-TM, n = 6 isolates) were the most common. This study documents that raw meats, RTE meats and their related samples in Ghana are potential sources of antimicrobial-resistant E. coli and pose a risk for the transfer of resistant bacteria to the food chain, environment and humans.

scholarly journals Otodectic and bacterial etiology of feline otitis externa in Tripoli, Libya

2021 ◽  
Vol 10 (4) ◽  
pp. 377-383
Author(s):  
Murad A. Hiblu ◽  
Omar M. Ellraiss ◽  
Elfurgani S. Karim ◽  
Rabia A. Elmishri ◽  
Enass M. Duro ◽  
...  
Keyword(s):  
Antimicrobial Susceptibility ◽  
Otitis Externa ◽  
Diffusion Method ◽  
Bacterial Isolates ◽  
Disk Diffusion Method ◽  
Parasite Detection ◽  
Common Etiology ◽  
Etiological Agents ◽  
Staphylococcus Spp ◽  
Otodectes Cynotis

Background: Feline otitis externa is a dermatological disorder with a multifactorial complex etiology.Aim: This study aimed to investigate the prevalence of different etiological agents, particularly the parasitic and bacterial, responsible for the cases of feline otitis externa in Tripoli, Libya, and to assess the antimicrobial susceptibility of the bacterial isolates from those cases.Methods: Cerumen and otic discharges of the suspected cats were collected for parasite detection and bacterial culture. Kirby–Bauer’s disk diffusion method was used for antimicrobial susceptibility testing.Results: The results showed that otodectic mites and bacterial causes were equally the most prevalent in those cases, with a prevalence of 47.1% each. Otodectes cynotis infestation was more frequently bilateral and severe. Staphylococcus spp. were the most prevalent among bacterial causes (75%), followed by Proteus spp. (16.6%) and Pseudomonas spp. (8.4%). Norfloxacin and gentamicin were the most effective antimicrobials against bacterial isolates, as they were effective against 83.3% and 70.8% of isolates, respectively.Conclusion: Otodectes cynotis infestation and staphylococcal infections constituted the most common etiology of feline otitis externa in Tripoli, Libya, and norfloxacin represented a cogent antibacterial for the treatment of otitis externa.

scholarly journals Phenotypic detection of Carbapenamase among Klebsiella pneumoniae isolated from clinical samples using modified Hodged test

2020 ◽  
Vol 13 (3) ◽  
pp. 135-140
Author(s):  
HauwaYakubu ◽  
Mahmud Yerima Iliyasu ◽  
Asma’u Salisu ◽  
Abdulmumin Ibrahim Sulaiman ◽  
Fatima Tahir ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Susceptibility Testing ◽  
University Teaching ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Beta Lactam ◽  
Beta Lactamases ◽  
Beta Lactam Antibiotics ◽  
Microbiological Techniques ◽  
Tract Infections

Carbapenemases are microbial enzymes that confer resistance to virtually all available beta-lactam antibiotics and the most frequent carbapenemases are the Klebsiella pneumoniae Carbapenamase (KPC). Detection of carbapenemases is a significant infection control strategy as the enzymes are often associated with extensive antimicrobial resistance, therapeutic failures and mortality associated with infectious diseases. A total of 400 clinical samples were collected from different groups of patients in Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria and 118 K. pneumoniae were isolated using standard microbiological techniques. The isolates were subjected to antibiotic susceptibility testing by Kirby-Bauer disc diffusion method, then screened for Carbapenamase production using modified Hodge test. The results indicated that the isolates were resistant to Ampicillin (61.9%), Ceftriaxone (50.8%) and Ceftazidime (50.8%), then Ciprofloxacin (54.2%), but predominantly sensitive to Imipenem (66.9%), Eterpenem (60.2%) and Meropenem (65.3%). It was found that 38 (32.2%) of the isolates phenotypically shows the presence of Carbapenamase, with highest frequency of (40.7%) among patients, mainly adult females with cases of Urinary Tract Infections (UTIs) and the least from wound (11.8%).This study revealed that the isolates produced other beta-lactamases than KPC or variants of Carbapenamase that cannot be detected by modified Hodge test, thus shows low resistance to carbapenems. Therefore further studies is needed to genotypically confirm the presence of KPC in these isolates.

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