Faculty of Medicine, Mansoura University, Mansoura City 35516, Egypt.
Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura City 35516, Egypt.
Medicina (Kaunas). 2023 Feb 1;59(2):285. doi: 10.3390/medicina59020285.
The global spread of carbapenem resistance and the resulting increase in mortality forced the World Health Organization (WHO) to claim carbapenem-resistant (CRE) as global priority pathogens. Our study aimed to determine the prevalence of carbapenemase-encoding genes and major plasmid incompatibility groups among Gram-negative hospital-based isolates in Egypt. : This cross-sectional study was carried out at Mansoura University Hospitals over 12 months, from January to December 2019. All the isolates were tested for carbapenem resistance. The selected isolates were screened by conventional polymerase chain reaction (PCR) for the presence of carbapenemase genes, namely , , , and . PCR-based plasmid replicon typing was performed using the commercial PBRT kit. : Out of 150 isolates, only 30 (20.0%) demonstrated carbapenem resistance. was the most resistant of all isolated bacteria, and was the predominant carbapenemases gene, while the most prevalent plasmid replicons were the F replicon combination (FIA, FIB, and FII) and A/C. Plasmids were detected only in , , and Pseudomonas . Remarkably, we found a statistically significant association between carbapenemase genes and plasmid replicons, including , IncA/C, and IncX. : Our study demonstrated an alarming rise of plasmid-mediated carbapenem-resistant bacteria in our locality. The coexistence of resistance genes and plasmids highlights the importance of a targeted antibiotic surveillance program and the development of alternative therapeutic options at the local and international levels. Based on our results, we suggest a large-scale study with more isolates, testing other carbapenemase-encoding genes, and comparing the replicon typing method with other plasmid detection methods. We also recommend a national action plan to control the irrational use of antibiotics in Egypt.
碳青霉烯类耐药性的全球传播及其导致的死亡率上升迫使世界卫生组织（WHO）将耐碳青霉烯类（CRE）列为全球优先病原体。我们的研究旨在确定埃及医院分离的革兰氏阴性菌中产碳青霉烯酶基因和主要质粒不相容群的流行率。
这是一项在曼苏拉大学医院进行的横断面研究，时间为 2019 年 1 月至 12 月，共 12 个月。所有分离株均进行了碳青霉烯类耐药性检测。选择的分离株通过常规聚合酶链反应（PCR）筛选是否存在碳青霉烯酶基因，即、、、。采用商业 PBRT 试剂盒进行基于 PCR 的质粒复制子分型。
在 150 株分离株中，只有 30 株（20.0%）表现出碳青霉烯类耐药性。是所有分离菌中最耐药的，是主要的碳青霉烯酶基因，而最常见的质粒复制子是 F 复制子组合（FIA、FIB 和 FII）和 A/C。质粒仅在、、和假单胞菌中检测到。值得注意的是，我们发现碳青霉烯酶基因和质粒复制子之间存在统计学显著关联，包括、IncA/C 和 IncX。
我们的研究表明，质粒介导的碳青霉烯类耐药菌在我们当地急剧增加。耐药基因和质粒的共存突出了在地方和国际层面上制定有针对性的抗生素监测计划和开发替代治疗方案的重要性。根据我们的结果，我们建议进行一项大规模的研究，使用更多的分离株，检测其他产碳青霉烯酶基因，并将复制子分型方法与其他质粒检测方法进行比较。我们还建议在埃及制定一项国家行动计划，以控制抗生素的不合理使用。
