Antibiotics and Antibiotic Resistance

Biography

Biography: Tadashi Shimamoto

Abstract

Twenty-six carbapenem-resistant Gram-negative bacterial isolates were recovered from clinical samples between April 2014 and September 2014 at Tanta University Teaching Hospital, Egypt. Carbapenemase production was detected phenotypically using Modified Hodge Test (MHT) and Carbapenem Inactivation Method (CIM) in 22 isolates. Molecular characterization identified the presence of thirteen NDM-1-producers (four Escherichia coli, two Klebsiella pneumoniae, and seven Providencia stuartii), two E. coli co-carrying NDM-5 and OXA-181, and seven VIM-producing Pseudomonas aeruginosa (three VIM-2, three VIM-24, and one VIM-28). For the other four isolates, no carbapenemase activity and no carbapenemase gene was detected, suggesting non-carbapenemase related resistance. The 16S rDNA methylase gene, rmtC was detected in twelve isolates (four E. coli, two K. pneumoniae, and six P. stuartii). The PCR mapping of the bla_NDM gene showed that it was surrounded by a complete or truncated copy of insertion sequence ISAba125 and followed by a bleomycin resistance gene ble_MBL, mediating resistance to bleomycin. ERIC-PCR analysis identified the presence of five clonally related P. stuartii isolates collected over a 1.5-month period. Each isolate, except one producing NDM-1 and the plasmid-mediated quinolone resistance gene qnrA, harbored NDM-1, and CMY β-lactamases and the 16S rDNA methylase gene, rmtC. To the best of our knowledge, this is the first report of an outbreak due to NDM-1-producing P. stuartii. Furthermore, ERIC-PCR analysis identified the presence of a clonal relationship between NDM-5-producing E. coli, VIM-2-producing P. aeruginosa, and VIM-24-producing P. aeruginosa. This work highlights the dissemination of different types of carbapenemases within a University Teaching Hospital in Egypt.