ElMahallawy Hadir, Zafer Mai Mahmoud, Al-Agamy Mohamed, Amin Magdy Aly, Mersal Mai Muhammed, Booq Rayan Yousef, Alyamani Essam, Radwan Samah
National Cancer Institute, Cairo University, Cairo, Egypt.
Ahram Canadian University, Giza, Egypt.
J Infect Dev Ctries. 2018 Jun 30;12(6):422-428. doi: 10.3855/jidc.9789.
The worldwide dissemination of the acquired carbapenemases in Gram-negative bacteria is a strongly expressed demand for the emergence of post antibiotic era. The aim of this study was to test the production of carbapenemase by Klebsiella pneumoniae strains isolated from hospitalized cancer patients and to investigate the genetic relationship of carbapenemase producing carbapenem resistant K. pneumoniae using multilocus sequence typing (MLST).
Antibiotic susceptibility testing and phenotypic testing for extended spectrum b-lactamases (ESBL) and carbapenemases production were performed. PCR amplification of ESBL and carbapenemase genes was performed. MLST was done to detect the genetic relatedness of the isolates.
Our data showed all strains were sensitive to colistin. Carba NP test was positive in thirty-one carbapenem resistant K. pneumoniae isolates and 26 out of 34 K. pneumoniae isolates were metallo-beta-lactamases (MBL) positive. All carbapenemase-positive isolates were ESBL CTX-M-1-like positive. blaOXA-48 gene was detected in 25 isolates (80.65%) and 21 isolates (67.75%) produced blaNDM-1 like enzyme. VIM and KPC genes were not identified in this study. Association of blaOXA-48 like and blaNDM-1 like was found in 15 (48.39%) isolates, while the coproduction of OXA-48-like and IMP-1 was revealed in only one K. pneumoniae isolate. MLST revealed ten distinct sequence types (STs).
Here we have documented the coexistence of NDM-type and OXA-48-like, and the coproduction of OXA-48-like and IMP in carbapenem resistant K. pneumoniae in patients with cancer. The dominant clone of the OXA-48-like-producing K. pneumoniae isolates from Egypt was ST101 epidemic clone belonging to clonal complex 101, an association that has been reported worldwide. The second most frequent ST was ST383.ST11 was assigned to OXA-48-producing K. pneumoniae.
革兰氏阴性菌中获得性碳青霉烯酶在全球范围内的传播，强烈预示着后抗生素时代的到来。本研究旨在检测从住院癌症患者中分离出的肺炎克雷伯菌菌株的碳青霉烯酶产生情况，并使用多位点序列分型（MLST）研究产碳青霉烯酶的耐碳青霉烯肺炎克雷伯菌的遗传关系。
进行抗生素敏感性测试以及超广谱β-内酰胺酶（ESBL）和碳青霉烯酶产生的表型测试。对ESBL和碳青霉烯酶基因进行PCR扩增。采用MLST检测分离株的遗传相关性。
我们的数据显示所有菌株对黏菌素敏感。在31株耐碳青霉烯肺炎克雷伯菌分离株中，Carba NP试验呈阳性，34株肺炎克雷伯菌分离株中有26株金属β-内酰胺酶（MBL）呈阳性。所有产碳青霉烯酶的分离株ESBL CTX-M-1样均呈阳性。在25株分离株（80.65%）中检测到blaOXA-48基因，21株分离株（67.75%）产生blaNDM-1样酶。本研究未鉴定出VIM和KPC基因。在15株（48.39%）分离株中发现blaOXA-48样和blaNDM-1样相关，而仅在1株肺炎克雷伯菌分离株中发现OXA-48样和IMP-1的共同产生。MLST显示有十种不同的序列类型（STs）。
在此我们记录了癌症患者耐碳青霉烯肺炎克雷伯菌中NDM型和OXA-48样的共存，以及OXA-48样和IMP的共同产生。埃及产OXA-48样肺炎克雷伯菌分离株的优势克隆是属于克隆复合体101的ST101流行克隆，这种关联在全球范围内均有报道。第二常见的ST是ST383。ST11被归为产OXA-48的肺炎克雷伯菌。
