First reported nosocomial outbreak of harboring and in a neonatal intensive care unit in Cairo, Egypt.

INTRODUCTION

is a significant hospital-acquired pathogen, and many outbreaks of infection have been reported in neonates. We report a sudden breakout of harboring the and metallo-β-lactamase (MBL) genes that occurred from March to August 2015 in the neonatal intensive care unit of Cairo University Hospital, Cairo, Egypt.

METHODS

During the study period, 40 nonduplicate clinical isolates of were collected from blood culture samples. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to identify each isolate. Then, minimum inhibitory concentrations of different antibiotics were assessed by the Vitek 2 compact system. Screening of the MBL genes , , , , and as well as the carbapenemase genes KPC, NDM, OXA-48, SME-1, and SME-2 were evaluated. Pulsed field gel electrophoresis was preformed to detect the genetic relationship of the isolates.

RESULTS

Analysis showed that 37.5% of the clinical isolates were resistant to meropenem (minimum inhibitory concentrations ≥ 2 µg/mL), and and were the most prevalent MBL genes (42.5% and 37.5%, respectively). None of the other investigated genes were observed. Pulsed field gel electrophoresis typing revealed two discrete clones; 33/40 (82.5%) were pulsotype A and 7/40 (17.5%) were pulsotype B.

CONCLUSION

Here, we report for the first time the detection of MBL-producing isolates, particularly IMP-4 and VIM-2 recovered from inpatients with bacteremias from the intensive care unit at Cairo University Hospital.