Emerging New Delhi metallo-β-lactamase-1-type-producing Gram-negative bacteria isolated from Cairo University Pediatric Hospital, Cairo, Egypt.

New Delhi metallo-β-lactamase (NDM) compromises the efficacy of almost all β-lactam antibiotics, including carbapenems. This study aimed to screen for the bla gene and NDM-1-type carbapenemase production among Gram-negative bacteria in Cairo University Pediatric Hospital (Cairo, Egypt). Among 382 Gram-negative clinical isolates collected over the period October 2013 to May 2014, 100 clinical isolates showing reduced carbapenem (imipenem and meropenem) susceptibility were included in this study. Initial phenotypic screening for NDM enzyme production was performed by Etest for metallo-β-lactamases (EMBL). Genotypic detection of the bla gene was done by TaqMan real-time PCR. Metallo-β-lactamase production was detected in 23% of the isolates by EMBL, whereas 24% of the isolates were found to be positive for the bla gene by real-time PCR. The EMBL sensitivity was 79.2%, specificity was 94.7%, positive predictive value was 82.6%, negative predictive value was 93.5% and overall accuracy was 91.0%. Seventeen (70.8%) of bla-positive cases were hospital-acquired in origin, whilst 7 cases (29.2%) were community-acquired. Eleven isolates (45.8%) harbouring bla were found in critical care units. In conclusion, the high prevalence of bla carbapenemase gene among Gram-negative bacteria, with its great potential for spread in intensive care units, warrants the attention of a nationwide surveillance programme to contain its spread.