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Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae
BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) is a major concern leading to morbidity and mortality in the world. CRE often is becoming a cause of therapeutic failure in both hospital and community-acquired infections. AIM: This study aimed to investigate the resistance mechanisms of CRE...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229782/ https://www.ncbi.nlm.nih.gov/pubmed/32494169 http://dx.doi.org/10.2147/IDR.S244357 |
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author | Alizadeh, Naser Ahangarzadeh Rezaee, Mohammad Samadi Kafil, Hossein Hasani, Alka Soroush Barhaghi, Mohammad Hossein Milani, Morteza Yeganeh Sefidan, Fatemeh Memar, Mohammad Yousef Lalehzadeh, Aidin Ghotaslou, Reza |
author_facet | Alizadeh, Naser Ahangarzadeh Rezaee, Mohammad Samadi Kafil, Hossein Hasani, Alka Soroush Barhaghi, Mohammad Hossein Milani, Morteza Yeganeh Sefidan, Fatemeh Memar, Mohammad Yousef Lalehzadeh, Aidin Ghotaslou, Reza |
author_sort | Alizadeh, Naser |
collection | PubMed |
description | BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) is a major concern leading to morbidity and mortality in the world. CRE often is becoming a cause of therapeutic failure in both hospital and community-acquired infections. AIM: This study aimed to investigate the resistance mechanisms of CRE by phenotypic and molecular methods. MATERIALS AND METHODS: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Antimicrobial susceptibility testing was carried out using phenotypic methods. The carbapenem resistance mechanisms including efflux pump hyperexpression, AmpC overproduction, carbapenemase genes, and deficiency in OmpK35 and OmpK36 were determined by phenotypic and molecular methods, respectively. RESULTS: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Amikacin was found to be the most effective drug against CRE isolates. All isolates were resistant to imipenem and meropenem by the micro-broth dilution. AmpC overproduction was observed in all Enterobacter spp. and three K. pneumoniae isolates. No efflux pump activity was found. Carba NP test and Modified Hodge Test could find carbapenemase in 59 (98%) isolates and 57 (95%) isolates, respectively. The most common carbapenemase gene was bla(OXA-48-like) (72.8%) followed by bla(NDM) (50.8%), bla(IMP) (18.6%), bla(VIM) (11.8%), and bla(KPC) (6.7%). The ompK35 and ompK36 genes were not detected in 10 and 7 K. pneumoniae isolates, respectively. CONCLUSION: The amikacin is considered as a very efficient antibiotic for the treatment of CRE isolates in our region. Carbapenemase production and overproduction of AmpC are the main carbapenem resistance mechanisms in CRE isolates. Finally, Carba NP test is a rapid and reliable test for early detection of carbapenemase-producing isolates. |
format | Online Article Text |
id | pubmed-7229782 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-72297822020-06-02 Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae Alizadeh, Naser Ahangarzadeh Rezaee, Mohammad Samadi Kafil, Hossein Hasani, Alka Soroush Barhaghi, Mohammad Hossein Milani, Morteza Yeganeh Sefidan, Fatemeh Memar, Mohammad Yousef Lalehzadeh, Aidin Ghotaslou, Reza Infect Drug Resist Original Research BACKGROUND: Carbapenem-resistant Enterobacteriaceae (CRE) is a major concern leading to morbidity and mortality in the world. CRE often is becoming a cause of therapeutic failure in both hospital and community-acquired infections. AIM: This study aimed to investigate the resistance mechanisms of CRE by phenotypic and molecular methods. MATERIALS AND METHODS: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Antimicrobial susceptibility testing was carried out using phenotypic methods. The carbapenem resistance mechanisms including efflux pump hyperexpression, AmpC overproduction, carbapenemase genes, and deficiency in OmpK35 and OmpK36 were determined by phenotypic and molecular methods, respectively. RESULTS: Sixty CRE (50 Klebsiella pneumoniae, 6 Escherichia coli, and 4 Enterobacter spp.) were isolated from October 2018 to June 2019. Amikacin was found to be the most effective drug against CRE isolates. All isolates were resistant to imipenem and meropenem by the micro-broth dilution. AmpC overproduction was observed in all Enterobacter spp. and three K. pneumoniae isolates. No efflux pump activity was found. Carba NP test and Modified Hodge Test could find carbapenemase in 59 (98%) isolates and 57 (95%) isolates, respectively. The most common carbapenemase gene was bla(OXA-48-like) (72.8%) followed by bla(NDM) (50.8%), bla(IMP) (18.6%), bla(VIM) (11.8%), and bla(KPC) (6.7%). The ompK35 and ompK36 genes were not detected in 10 and 7 K. pneumoniae isolates, respectively. CONCLUSION: The amikacin is considered as a very efficient antibiotic for the treatment of CRE isolates in our region. Carbapenemase production and overproduction of AmpC are the main carbapenem resistance mechanisms in CRE isolates. Finally, Carba NP test is a rapid and reliable test for early detection of carbapenemase-producing isolates. Dove 2020-05-12 /pmc/articles/PMC7229782/ /pubmed/32494169 http://dx.doi.org/10.2147/IDR.S244357 Text en © 2020 Alizadeh et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Alizadeh, Naser Ahangarzadeh Rezaee, Mohammad Samadi Kafil, Hossein Hasani, Alka Soroush Barhaghi, Mohammad Hossein Milani, Morteza Yeganeh Sefidan, Fatemeh Memar, Mohammad Yousef Lalehzadeh, Aidin Ghotaslou, Reza Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae |
title | Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae |
title_full | Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae |
title_fullStr | Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae |
title_full_unstemmed | Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae |
title_short | Evaluation of Resistance Mechanisms in Carbapenem-Resistant Enterobacteriaceae |
title_sort | evaluation of resistance mechanisms in carbapenem-resistant enterobacteriaceae |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229782/ https://www.ncbi.nlm.nih.gov/pubmed/32494169 http://dx.doi.org/10.2147/IDR.S244357 |
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