Detection of OXA-48 Gene in Carbapenem-Resistant and from Urine Samples.

INTRODUCTION

Resistance to carbapenem in Gram-negative bacteria is attributable to their ability to produce carbapenemase enzymes. The main objective of this study was to detect the presence of genes in carbapenem-resistant uropathogenic and isolated from urine samples from patients attending Alka Hospital, Jawalakhel, Lalitpur, Nepal.

METHODS

A total of 1013 mid-stream urine samples were collected from patients with suspected urinary tract infection (UTI) between April and September 2018. The identified isolates underwent antibiotic susceptibility testing using the modified Kirby-Bauer disc-diffusion method. Phenotypic carbapenemase production was confirmed by the modified Hodge test, and the gene was detected using conventional polymerase chain reaction.

RESULTS

Out of 1013 urine samples, 15.2% (154/1013) had bacterial growth. Among the isolates, 91.5% (141/154) were Gram-negative bacteria, and was the most common bacterial isolate (62.9%; 97/154), followed by 15.6% (24/154). Among 121 bacterial isolates (97 isolates and 24 isolates), 70.3% (52/121) were multidrug-resistant and 29.7% (22/121) were multidrug-resistant . In addition, 9.1% (11/121) were carbapenem resistant (both imipenem and meropenem resistant). Development of multidrug resistance and development of carbapenem resistance were significantly associated (<0.05). Of the 11 carbapenem-resistant isolates, only seven were carbapenemase producers; of these, 28.6% (2/7) were , 72.4% (5/7) were and 42.8% (3/7) had the gene. Of the three bacterial isolates with the gene, 33.3% (1/3) were and 66.7% (2/3) were

CONCLUSION

One in ten isolates of and were carbapenem resistant. Among carbapenem-resistant isolates, one-third of and two-thirds of had the gene. OXA-48 serves as a potential agent to map the distribution of resistance among clinical isolates.