학술논문
Detection of NDM Variants ( bla NDM-1 , bla NDM-2 , bla NDM-3 ) from Carbapenem-Resistant Escherichia coli and Klebsiella pneumoniae : First Report from Nepal.
Document Type
Academic Journal
Author
Thapa A; Department of Microbiology, Golden Gate International College, Kathmandu, Nepal.; Upreti MK; Department of Microbiology, Golden Gate International College, Kathmandu, Nepal.; Bimali NK; Department of Microbiology, Golden Gate International College, Kathmandu, Nepal.; Shrestha B; Kathmandu Model Hospital, Kathmandu, Nepal.; Sah AK; Annapurna Neurological Institute and Allied Sciences, Kathmandu, Nepal.; Nepal K; Department of Microbiology, Golden Gate International College, Kathmandu, Nepal.; Dhungel B; Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.; Adhikari S; Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.; Adhikari N; Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.; Lekhak B; Department of Microbiology, Golden Gate International College, Kathmandu, Nepal.; Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.; Rijal KR; Central Department of Microbiology, Tribhuvan University, Kathmandu, Nepal.
Source
Publisher: Dove Medical Press Country of Publication: New Zealand NLM ID: 101550216 Publication Model: eCollection Cited Medium: Print ISSN: 1178-6973 (Print) Linking ISSN: 11786973 NLM ISO Abbreviation: Infect Drug Resist Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
1178-6973
Abstract
Background: Increasing burden of carbapenem resistance among Enterobacterales is attributable to their ability to produce carbapenemase enzymes like metallo-beta-lactamase (MBL), Klebsiella pneumoniae carbapenemase (KPC), and OXA-type. This study aimed to determine the prevalence of carbapenemases and MBL genes (( bla NDM-1, bla NDM-1 and bla NDM-3 ) among E. coli and K. pneumoniae isolates.
Methods: A total of 2474 urine samples collected during the study period (July-December 2017) were processed at the microbiology laboratory of Kathmandu Model Hospital, Kathmandu. Isolates of E. coli and K. pneumoniae were processed for antimicrobial susceptibility testing (AST) by disc diffusion method. Carbapenem-resistant isolates were subjected to Modified Hodge Test (MHT) for phenotypic confirmation, and inhibitor-based combined disc tests for the differentiation of carbapenemase (MBL and KPC). MBL-producing isolates were screened for NDM genes by polymerase chain reaction (PCR).
Results: Of the total urine samples processed, 19.5% (483/2474) showed the bacterial growth. E. coli (72.6%; 351/483) was the predominant isolate followed by K. pneumoniae (12.6%; 61/483). In AST, 4.4% (18/412) isolates of E. coli (15/351) and K. pneumonia (3/61) showed resistance towards carbapenems, while 1.7% (7/412) of the isolates was confirmed as carbapenem-resistant in MHT. In this study, all (3/3) the isolates of K. pneumoniae were KPC-producers, whereas 66.7% (10/15), 20% (3/15) and 13.3% (2/15) of the E. coli isolates were MBL, KPC and MBL/KPC (both)-producers, respectively. In PCR assay, 80% (8/10), 90% (9/10) and 100% (10/10) of the isolates were positive for blaNDM-1 , bla NDM-2 and bla NDM-3, respectively.
Conclusion: Presence of NDM genes among carbapenemase-producing isolates is indicative of potential spread of drug-resistant variants. This study recommends the implementation of molecular diagnostic facilities in clinical settings for proper infection control, which can optimize the treatment therapies, and curb the emergence and spread of drug-resistant pathogens.
Competing Interests: The authors report no conflicts of interest in relation to this work.
(© 2022 Thapa et al.)
Methods: A total of 2474 urine samples collected during the study period (July-December 2017) were processed at the microbiology laboratory of Kathmandu Model Hospital, Kathmandu. Isolates of E. coli and K. pneumoniae were processed for antimicrobial susceptibility testing (AST) by disc diffusion method. Carbapenem-resistant isolates were subjected to Modified Hodge Test (MHT) for phenotypic confirmation, and inhibitor-based combined disc tests for the differentiation of carbapenemase (MBL and KPC). MBL-producing isolates were screened for NDM genes by polymerase chain reaction (PCR).
Results: Of the total urine samples processed, 19.5% (483/2474) showed the bacterial growth. E. coli (72.6%; 351/483) was the predominant isolate followed by K. pneumoniae (12.6%; 61/483). In AST, 4.4% (18/412) isolates of E. coli (15/351) and K. pneumonia (3/61) showed resistance towards carbapenems, while 1.7% (7/412) of the isolates was confirmed as carbapenem-resistant in MHT. In this study, all (3/3) the isolates of K. pneumoniae were KPC-producers, whereas 66.7% (10/15), 20% (3/15) and 13.3% (2/15) of the E. coli isolates were MBL, KPC and MBL/KPC (both)-producers, respectively. In PCR assay, 80% (8/10), 90% (9/10) and 100% (10/10) of the isolates were positive for bla
Conclusion: Presence of NDM genes among carbapenemase-producing isolates is indicative of potential spread of drug-resistant variants. This study recommends the implementation of molecular diagnostic facilities in clinical settings for proper infection control, which can optimize the treatment therapies, and curb the emergence and spread of drug-resistant pathogens.
Competing Interests: The authors report no conflicts of interest in relation to this work.
(© 2022 Thapa et al.)