Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study | ||
| Microbes and Infectious Diseases | ||
| Article 15, Volume 2, Issue 2, May 2021, Pages 295-307 PDF (397.53 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/mid.2021.59593.1113 | ||
| Authors | ||
| Doaa Abo-Alella* 1; Mahmoud Mohamad Malek2; Mai Mohamad Malek3 | ||
| 1Medical Microbiology & Immunology Department, Faculty of Medicine,Zagazig University, Zagazig, Egypt | ||
| 2Urology Department, Faculty of Medicine, Zagazig university, Zagazig, Egypt. | ||
| 3Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt | ||
| Abstract | ||
| Background: Gram Negative bacilli (GNB) are the most common causes of urinary tract infections (UTIs). There is a worrying level of antimicrobial resistance emerging in UTIs pathogens. Metallo-β-lactamases (MBLs) are rapidly spreading β-lactamases with no available FDA approved inhibitor conferring resistance to most β-lactam antibiotics including carbapenems. We aimed to determine prevalence and antimicrobial resistance patterns of Gram-negative uropathogens in our tertiary care hospital, and to characterize MBLs production among them. Methods: A hundred and forty-three urine samples were collected from the Urology Department. Uropathogens were isolated on Cystiene Lactose Electrolyte Deficient agar and Mac-Conkey’s agar. GNB were identified by conventional methods. Antimicrobial susceptibility was evaluated by disc diffusion method. Carbapenems resistant Gram-negative bacilli (CRGNB) were tested for MBLs production both phenotypically and genotypically. Results: Eighty-five GNB (75.9%) were isolated from 112 positive cultures. Escherichia coli (49.4%) was the most prevalent isolate. Most of GNB showed high resistance patterns to various antimicrobials. Twenty-nine GNB isolates were resistant to at least one carbapenem (28.2% for imipenem, 30.6% for meropenem). Twenty-three isolates (79.3%) were phenotypically positive for MBL activity by combined disc test (CDT). Twenty-two isolates (75.9%) were positive for one or more of MBL genes (blaIMP, blaVIM and/or blaNDM). Conclusions: Our study emphasized on the alarming rates of resistance to most of the common antimicrobials particularly carbapenems among GNB uropathogens, which represent a public health threat. CRGNB isolates in our hospital are phenotypically and genotypically associated with MBLs production so an effective strategy to combat these strains is mandatory. | ||
| Keywords | ||
| Gram-negative bacilli; Cabapenemases; NDM; VIM; IMP | ||
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