背景和目的:碳青霉烯耐药性的全球传播以及由此导致的死亡率增加迫使世界卫生组织(WHO)将碳青霉烯耐药性肠杆菌科(CRE)作为全球优先病原体。我们的研究旨在确定埃及革兰氏阴性医院分离株中碳青霉烯酶编码基因和主要质粒不相容组的患病率。材料和方法:这项横断面研究在曼苏拉大学医院进行了12个月,2019年1月至12月。对所有分离株进行碳青霉烯抗性测试。通过常规聚合酶链反应(PCR)筛选所选择的分离株是否存在碳青霉烯酶基因,即blaKPC,blaIMP,BlaVIM,和blaNDM-1.使用商业PBRT试剂盒进行基于PCR的质粒复制子分型。结果:在150个分离株中,只有30例(20.0%)表现出耐碳青霉烯。肺炎克雷伯菌是所有分离细菌中耐药性最强的,blaNDM是主要的碳青霉烯酶基因,而最普遍的质粒复制子是F复制子组合(FIA,FIB,和FII)和A/C。仅在肺炎克雷伯菌中检测到质粒,大肠杆菌,阴沟肠杆菌,还有铜绿假单胞菌.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上显著的关联,包括blaNDM,IncA/C,IncX结论:我们的研究表明,在我们的地区,质粒介导的碳青霉烯耐药细菌的数量惊人地上升。抗性基因和质粒的共存凸显了有针对性的抗生素监测计划以及在地方和国际层面开发替代治疗方案的重要性。根据我们的结果,我们建议对更多的肠杆菌科细菌进行大规模研究,测试其他碳青霉烯酶编码基因,并将复制子分型方法与其他质粒检测方法进行了比较。我们还建议制定一项国家行动计划,以控制埃及抗生素的不合理使用。
Background and Objectives: The global spread of carbapenem resistance and the resulting increase in mortality forced the World Health Organization (WHO) to claim carbapenem-resistant enterobacteriaceae (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. Material and Methods: 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 blaKPC, blaIMP, blaVIM, and blaNDM-1. PCR-based plasmid
replicon typing was performed using the commercial PBRT kit. Results: Out of 150 isolates, only 30 (20.0%) demonstrated carbapenem resistance. Klebsiella pneumoniae was the most resistant of all isolated bacteria, and blaNDM 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 Klebsiella pneumoniae, Escherichia coli, Enterobacter cloacae, and Pseudomonas aeruginosa. Remarkably, we found a statistically significant association between carbapenemase genes and plasmid replicons, including blaNDM, IncA/C, and IncX. Conclusions: 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 Enterobacteriaceae 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.