Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima 739-8528, Japan; Department of Microbiology and Immunology, Faculty of Pharmacy, Kafrelsheikh University, Kafr El-Sheikh 33516, Egypt.
Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University, Higashi-Hiroshima 739-8528, Japan.
Infect Genet Evol. 2020 Jan;77:104065. doi: 10.1016/j.meegid.2019.104065. Epub 2019 Oct 18.
A total of 65 non-replicate Gram-negative bacterial strains were recovered from clinical specimens between April and September 2014 at a University Hospital in Egypt. This collection was screened by PCR for carbapenemase-encoding genes, 16S rRNA methylases, and colistin resistance genes (mcr-1-mcr-8). Twenty-two strains (22/65, 33.8%) were positive for carbapenemase-encoding genes [13 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 Pseudomonas aeruginosa (three VIM-2, four VIM-24) strains]. The 16S rRNA methylase RmtC was detected in 12 NDM-1-producers for the first time in Egypt; no mcr genes were detected. A self-transmissible A/C plasmid was found to carry bla in all NDM-1-producing strains. NDM-5 and OXA-181 were located on an untypeable and IncX3 plasmid, respectively. Additionally, Enterobacterial repetitive intergenic consensus (ERIC)-PCR revealed five clonally related P. stuartii isolates collected over a 1.5-month period. Thirteen carbapenemase-producing strains were isolated from burn patients who are at a high risk of developing infections and require special medical care. To our knowledge, this is the first report of NDM-1-producing-P. stuartii strains in an African burn unit, NDM-1- and RmtC-positive non-lactose fermenting E. coli globally, VIM-24-producing P. aeruginosa in Africa, and 16S RMTase rmtC-NDM-1-producers in Egypt. This work highlights the detection of different carbapenemase-producing bacterial strains within an Egyptian teaching hospital compromising the effectiveness of carbapenems and urgently asking the Egyptian medical authorities for implementation of antimicrobial surveillance plans and infection control policies to early detect and to effectively halt the rapid spread of these superbugs.
2014 年 4 月至 9 月期间，埃及一家大学医院从临床标本中分离出 65 株非复制革兰氏阴性细菌。该菌丛经 PCR 方法检测产碳青霉烯酶基因、16S rRNA 甲基化酶和多粘菌素耐药基因（mcr-1-mcr-8）。22 株（22/65，33.8%）产碳青霉烯酶基因阳性[13 株产 NDM-1（4 株大肠埃希菌、2 株肺炎克雷伯菌和 7 株斯氏普罗威登斯菌），2 株大肠埃希菌同时携带 NDM-5 和 OXA-181，7 株铜绿假单胞菌（3 株 VIM-2，4 株 VIM-24）]。首次在埃及发现 12 株产 NDM-1 的大肠埃希菌中携带 16S rRNA 甲基化酶 RmtC，未检测到 mcr 基因。所有产 NDM-1 的菌株均携带bla 可移动 A/C 质粒。NDM-5 和 OXA-181 分别位于无法分型和 IncX3 质粒上。此外，肠杆菌重复基因间一致序列（ERIC）-PCR 显示，在 1.5 个月的时间内从烧伤患者中分离出 5 株克隆相关的斯氏普罗威登斯菌。13 株产碳青霉烯酶的菌株分离自烧伤患者，这些患者发生感染的风险很高，需要特殊的医疗护理。据我们所知，这是首次在非洲烧伤病房中发现产 NDM-1 的斯氏普罗威登斯菌，也是首次在全球范围内发现产 NDM-1 和 RmtC 的非乳糖发酵大肠埃希菌、非洲产 VIM-24 的铜绿假单胞菌以及埃及的 16S RMTase rmtC-NDM-1 产菌。这项工作突出了在埃及教学医院中检测到不同的产碳青霉烯酶的细菌菌株，这些菌株危及碳青霉烯类药物的有效性，并紧急要求埃及医疗当局实施抗菌药物监测计划和感染控制政策，以尽早发现并有效阻止这些超级细菌的快速传播。
