Molecular Investigation of Metallo-β-lactamase Encoding Gene in Nosocomial Carbapenem-Resistant Enterobacteriaceae in Iraqi Hospitals

Yıl 2018, Sayı: 2, 239 - 243, 19.08.2018

Ahmed S. K. Al-khafajı Shaymaa Fadhel Abbas Albaayıt Omyma S. Ibraheem Hawraa H. Abdul-ılah

Öz

In recent years, there has been an increasing
amount of evidence that nosocomial carbapenem-resistant Enterobacteriaceae pose
a major puplic health threat. This study aims to uncover the association of
multidrug-resistance related genes with increasing the rate of acquired
hospital infections by Enterobacteriaceae pathogens. Enterobacteriaceae species
(n=57) were detected in clinical specimens (n=45) obtained from patients with
infected wounds and burns in 3 Iraqi hospitals. Carbapenem-resistant
Enterobacteriaceae bacteria were investigated by antibacterial susceptibility tests.  The Molecular investigation by PCR analysis
showed that Klebsiella
pneumonia isolates
(n=5) and Escherichia coli isolates (n=3) are carrying
metallo-β-lactamase encoding gene (bla_IMP).
It can be concluded that the expression of bla_IMP is considered among the main
reasons of dominating resistance strains of Enterobacteriaceae pathogens and
thus spreading nosocomial infection in Iraqi clinical centers. However, further
molecular investigation is needed to overcome this resistance on molecular
bases when treating.

Anahtar Kelimeler

blaIMP, Enterobacteriaceae, Nosocomial infection, Metallo-β-lactamase

Kaynakça

• Carattoli A. Resistance plasmid families in Enterobacteriaceae. Antimicrobial agents and chemotherapy. 2009;53(6):2227-38. Huang XZ, Frye JG, Chahine MA, Glenn LM, Ake JA, Su W, et al. Characteristics of plasmids in multi-drug-resistant Enterobacteriaceae isolated during prospective surveillance of a newly opened hospital in Iraq. PloS one. 2012;7(7):e40360. Church D, Elsayed S, Reid O, Winston B, Lindsay R. Burn wound infections. Clinical microbiology reviews. 2006;19(2):403-34. Guarner F. The intestinal flora in inflammatory bowel disease: normal or abnormal? Current opinion in gastroenterology. 2005;21(4):414-8. Azzopardi EA, Azzopardi E, Camilleri L, Villapalos J, Boyce DE, Dziewulski P, et al. Gram negative wound infection in hospitalised adult burn patients--systematic review and metanalysis. PloS one. 2014;9(4):e95042. Finley PJ, Norton R, Austin C, Mitchell A, Zank S, Durham P. Unprecedented Silver Resistance in Clinically Isolated Enterobacteriaceae: Major Implications for Burn and Wound Management. Antimicrobial agents and chemotherapy. 2015;59(8):4734-41. Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infection control and hospital epidemiology. 2008;29(12):1099-106. Borer A, Saidel-Odes L, Riesenberg K, Eskira S, Peled N, Nativ R, et al. Attributable mortality rate for carbapenem-resistant Klebsiella pneumoniae bacteremia. Infection control and hospital epidemiology. 2009;30(10):972-6. Tischendorf J, de Avila RA, Safdar N. Risk of infection following colonization with carbapenem-resistant Enterobactericeae: A systematic review. American journal of infection control. 2016;44(5):539-43. Yang YJ, Wu PJ, Livermore DM. Biochemical characterization of a beta-lactamase that hydrolyzes penems and carbapenems from two Serratia marcescens isolates. Antimicrobial agents and chemotherapy. 1990;34(5):755-8. Pitout JD, Nordmann P, Poirel L. Carbapenemase-Producing Klebsiella pneumoniae, a Key Pathogen Set for Global Nosocomial Dominance. Antimicrobial agents and chemotherapy. 2015;59(10):5873-84. Donald HM, Scaife W, Amyes SG, Young HK. Sequence analysis of ARI-1, a novel OXA beta-lactamase, responsible for imipenem resistance in Acinetobacter baumannii 6B92. Antimicrobial agents and chemotherapy. 2000;44(1):196-9. Evans BA, Amyes SG. OXA beta-lactamases. Clinical microbiology reviews. 2014;27(2):241-63. Sidjabat HE, Townell N, Nimmo GR, George NM, Robson J, Vohra R, et al. Dominance of IMP-4-producing enterobacter cloacae among carbapenemase-producing Enterobacteriaceae in Australia. Antimicrobial agents and chemotherapy. 2015;59(7):4059-66. Nordmann P, Dortet L, Poirel L. Carbapenem resistance in Enterobacteriaceae: here is the storm! Trends in molecular medicine. 2012;18(5):263-72. Senda K, Arakawa Y, Ichiyama S, Nakashima K, Ito H, Ohsuka S, et al. PCR detection of metallo-beta-lactamase gene (blaIMP) in gram-negative rods resistant to broad-spectrum beta-lactams. Journal of clinical microbiology. 1996;34(12):2909-13. Hariharan P, Bharani T, Franklyne JS, Biswas P, Solanki SS, Paul-Satyaseela M. Antibiotic susceptibility pattern of Enterobacteriaceae and non-fermenter Gram-negative clinical isolates of microbial resource orchid. Journal of natural science, biology, and medicine. 2015;6(1):198-201. Madec JY, Haenni M, Nordmann P, Poirel L. Extended-spectrum beta-lactamase/AmpC- and carbapenemase-producing Enterobacteriaceae in animals: a threat for humans? Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 2017;23(11):826-33. Meletis G. Carbapenem resistance: overview of the problem and future perspectives. Therapeutic advances in infectious disease. 2016;3(1):15-21. Rood IGH, Li Q. Review: Molecular detection of extended spectrum-beta-lactamase- and carbapenemase-producing Enterobacteriaceae in a clinical setting. Diagnostic microbiology and infectious disease. 2017;89(3):245-50.