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Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt

Received: 15 November 2016     Accepted: 30 November 2016     Published: 3 January 2017
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Abstract

Multidrug-resistant Gram-negative organisms have emerged as a major threat to hospitalized patients, and are associated with serious morbidity and mortality. This study aimed to characterize carbapenem resistance genes among Gram-negative bacilli isolated from clinical samples from patients in the intensive care unit of Cairo University Hospital. A total of 211 samples were collected from patients showing clinical evidence of infection. Bacteria were isolated and identified by conventional microbiological methods. Acinetobacter baumannii isolates were furtherly characterized by polymerase chain reaction (PCR), using primers specific for blaOXA-51-like genes. The Kirby Bauer disc diffusion method was used to determine susceptibility patterns of isolates, and carbapenem resistance was further examined by a modified Hodge test. Positive isolates were tested for the presence of blaKPC, blaOXA-48, and blaNDM-like genes by PCR. NDM gene types were determined by direct sequencing. From the 211 samples, 229 Gram-negative bacilli were isolated. Fifty isolates (21.2%) were resistant to carbapenem. PCR analysis showed that none of the 50 isolates carried blaKPC-like genes, while 24 (48%) isolates carried blaOXA-48-like genes, 8 (16%) carried blaNDM-1, and five isolates (10%) carried both blaNDM-1 and blaOXA-48-like genes. These results indicate that continuous surveillance of these multidrug-resistant pathogens is urgently required. And that is very important is to activate the antimicrobial stewardship programs of which the most important is restriction of the big gun antibiotics like carbapenems, colistin, tigecyclin and vancomycin and restricting their prescription to privileged specialties.

Published in American Journal of Internal Medicine (Volume 5, Issue 1)
DOI 10.11648/j.ajim.20170501.11
Page(s) 1-6
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2017. Published by Science Publishing Group

Keywords

Carbapenem Resistance, Gram-negative Bacilli, blaOXA-48, blaNDM-1

References
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    Maha Assem, Mohamed-Naguib Abdalla Wifi, Rasha Elsherif, Ahmed Saad, Dalia Kadry Ismail, et al. (2017). Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt. American Journal of Internal Medicine, 5(1), 1-6. https://doi.org/10.11648/j.ajim.20170501.11

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    ACS Style

    Maha Assem; Mohamed-Naguib Abdalla Wifi; Rasha Elsherif; Ahmed Saad; Dalia Kadry Ismail, et al. Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt. Am. J. Intern. Med. 2017, 5(1), 1-6. doi: 10.11648/j.ajim.20170501.11

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    AMA Style

    Maha Assem, Mohamed-Naguib Abdalla Wifi, Rasha Elsherif, Ahmed Saad, Dalia Kadry Ismail, et al. Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt. Am J Intern Med. 2017;5(1):1-6. doi: 10.11648/j.ajim.20170501.11

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  • @article{10.11648/j.ajim.20170501.11,
      author = {Maha Assem and Mohamed-Naguib Abdalla Wifi and Rasha Elsherif and Ahmed Saad and Dalia Kadry Ismail and Ahmed Hasanin and Rasha Bassyouni and Mohamed Saeed Hussein Gomaa},
      title = {Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt},
      journal = {American Journal of Internal Medicine},
      volume = {5},
      number = {1},
      pages = {1-6},
      doi = {10.11648/j.ajim.20170501.11},
      url = {https://doi.org/10.11648/j.ajim.20170501.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajim.20170501.11},
      abstract = {Multidrug-resistant Gram-negative organisms have emerged as a major threat to hospitalized patients, and are associated with serious morbidity and mortality. This study aimed to characterize carbapenem resistance genes among Gram-negative bacilli isolated from clinical samples from patients in the intensive care unit of Cairo University Hospital. A total of 211 samples were collected from patients showing clinical evidence of infection. Bacteria were isolated and identified by conventional microbiological methods. Acinetobacter baumannii isolates were furtherly characterized by polymerase chain reaction (PCR), using primers specific for blaOXA-51-like genes. The Kirby Bauer disc diffusion method was used to determine susceptibility patterns of isolates, and carbapenem resistance was further examined by a modified Hodge test. Positive isolates were tested for the presence of blaKPC, blaOXA-48, and blaNDM-like genes by PCR. NDM gene types were determined by direct sequencing. From the 211 samples, 229 Gram-negative bacilli were isolated. Fifty isolates (21.2%) were resistant to carbapenem. PCR analysis showed that none of the 50 isolates carried blaKPC-like genes, while 24 (48%) isolates carried blaOXA-48-like genes, 8 (16%) carried blaNDM-1, and five isolates (10%) carried both blaNDM-1 and blaOXA-48-like genes. These results indicate that continuous surveillance of these multidrug-resistant pathogens is urgently required. And that is very important is to activate the antimicrobial stewardship programs of which the most important is restriction of the big gun antibiotics like carbapenems, colistin, tigecyclin and vancomycin and restricting their prescription to privileged specialties.},
     year = {2017}
    }
    

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  • TY  - JOUR
    T1  - Emergence of Gram-Negative Bacilli with Concomitant blaNDM-1- and blaOXA-48-Like Genes in Egypt
    AU  - Maha Assem
    AU  - Mohamed-Naguib Abdalla Wifi
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    AU  - Rasha Bassyouni
    AU  - Mohamed Saeed Hussein Gomaa
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    JF  - American Journal of Internal Medicine
    JO  - American Journal of Internal Medicine
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    PB  - Science Publishing Group
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    AB  - Multidrug-resistant Gram-negative organisms have emerged as a major threat to hospitalized patients, and are associated with serious morbidity and mortality. This study aimed to characterize carbapenem resistance genes among Gram-negative bacilli isolated from clinical samples from patients in the intensive care unit of Cairo University Hospital. A total of 211 samples were collected from patients showing clinical evidence of infection. Bacteria were isolated and identified by conventional microbiological methods. Acinetobacter baumannii isolates were furtherly characterized by polymerase chain reaction (PCR), using primers specific for blaOXA-51-like genes. The Kirby Bauer disc diffusion method was used to determine susceptibility patterns of isolates, and carbapenem resistance was further examined by a modified Hodge test. Positive isolates were tested for the presence of blaKPC, blaOXA-48, and blaNDM-like genes by PCR. NDM gene types were determined by direct sequencing. From the 211 samples, 229 Gram-negative bacilli were isolated. Fifty isolates (21.2%) were resistant to carbapenem. PCR analysis showed that none of the 50 isolates carried blaKPC-like genes, while 24 (48%) isolates carried blaOXA-48-like genes, 8 (16%) carried blaNDM-1, and five isolates (10%) carried both blaNDM-1 and blaOXA-48-like genes. These results indicate that continuous surveillance of these multidrug-resistant pathogens is urgently required. And that is very important is to activate the antimicrobial stewardship programs of which the most important is restriction of the big gun antibiotics like carbapenems, colistin, tigecyclin and vancomycin and restricting their prescription to privileged specialties.
    VL  - 5
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Author Information
  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Anesthesiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

  • Medical Microbiology and Immunology Department, Faculty of Medicine, Fayoum University, Fayoum, Egypt

  • Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt

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