International Journal of Applied Microbiology and Biotechnology Research
ISSN: 2053-1818
Vol. 7(6), pp. 86-94, July, 2019
doi.org/10.33500/ijambr.2019.07.011

Emergence of carbapenem resistant enterobacteriacae coharboring New Delhi metallo-beta-lactamase (NDM-1) and Klebsiella pneumoniae carbapenemase (KPC) isolated from a tertiary hospital in Egypt

Raghda Hager*¹, Shimaa Ahmed Abdel Salam² and Nagwa M Abo El Magd²

¹Department of Medical Microbiology and Immunology, Faculty of Medicine, Misr University for Science and Technology, Egypt.
²Department of Medical Microbiology and Immunology, Faculty of Medicine, Ain Shams University, Egypt.

*To whom correspondence should be addressed. E-mail: rody_hager@yahoo.com.

Received 18 April, 2019; Received in revised form 31 May, 2019; Accepted 07 June, 2019.

Keywords:
Enterobacteriaceae, Carbapenem resistance, Modified Hodge test, Imipenem-EDTA CDT.

Carbapenem-resistant Enterobacteriaceae (CRE) is considered a significant problem in the healthcare facility. Resistance to carbapenems in Enterobacteriaceae is mediated by different mechanisms; one of them is due to the production of carbapenemases. This study was aimed to detect the prevalence of blaKPC and MβLs encoding genes (blaVIM and blaNDM-1) production among CRE isolates isolated from Egypt Children’s Hospital. Additionally, isolates were evaluated via phenotypic methods of detection. One hundred Enterobacteriaceae isolates were isolated from different clinical samples and screened for carbapenem resistance with imipenem 10 µg and meropenem 10 µg discs. The resistant isolates were tested for antibiotic susceptibility, modified Hodge test (MHT) and imipenem-ethylene diamine tetra-acetic acid (EDTA) combined disc diffusion (IPM-EDTA CDT). Finally, conventional polymerase chain reaction (PCR) was done to detect carbapenemase genes (blaVIM, blaKPC and blaNDM-1). Thirty isolates were initially identified as carbapenem resistant based on resistance to imipenem 10 µg and meropenem 10 µg discs. Klebsiella pneumoniae (K. Pneumoniae) was the most common isolated species (73.33%) followed by Escherichia coli (E.coli) (26.67%). The majority of carbapenem resistant isolates (66.7%) were collected from blood cultures. BlaVIM gene was the most detected gene among the carbapenem resistant isolates. It was found in 27 isolates (90%). blaNDM-1 genes were found in 7 isolates (23.3%) while blaKPC was found in 3 isolates only (10%). Carbapenem resistance among Enterobacteriaceae is widely spreading and mostly caused by blaVIM gene. More attention is needed to control the spread of carbapenem resistance among Enterobacteriaceae in Egypt.

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