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Abstract

Purpose. The purpose of this study was to investigate New Delhi metallo-β-lactamase (NDM) production among Gram-negative bacilli.

Methodology. Antibiogram-resistotyping and detection of New Delhi metallo-β-lactamase (NDM) in clinical isolates of Klebsiella pneumoniae, Acinetobacter baumannii and Pseudomonas aeruginosa and comparative evaluation of the diagnostic performance of three phenotypic methods for NDM detection, with PCR considered as the gold standard, were performed. Minimum inhibitory concentration (MIC) of antibiotics against NDM-positive strains using E-tests and clonal relationship analysis using enterobacterial repetitive intergenic consensus (ERIC)-PCR in these strains were determined.

Results. The most effective antibiotics against strains of the species K. pneumoniae were Colistin, Chloramphenicol and Tigecycline; against P. aeruginosa were Fosfomycin and Polymyxins, and against A. baumannii were Polymyxins, Ampicillin/Sulbactam and Minocycline. Overall, 66, 31 and 40 different resistotypes were observed among K. pneumoniae, A. baumannii and P. aeruginosa strains, respectively. The bla NDM-1 gene was detected in 28 (8.5 %) strains of the bacteria investigated. The sensitivities and specificities of the Meropenem-EDTA combined disk test, the meropenem-dipicolinic acid combined disk test and the modified Hodge test methods for NDM detection were 96.43, 55.15; 96.43, 54.85; and 89.29, 35.15, respectively. Additionally, in spite of the low positive predictive values of these tests, their negative predictive values were high. ERIC-PCR results revealed two main clusters in NDM-positive strains of each of the species P. aeruginosa and A. baumannii, and ten main clusters in K. pneumoniae. In all the NDM-positive strains maximum MIC rates (>256) were observed for all beta-lactam antibiotics.

Conclusion. There were high levels of antibiotic resistance and a high frequency of multi-drug resistance and extensive-drug resistance profiles, as well as highly prevalent bla NDM-1 genes in the bacteria investigated.

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2017-04-21
2019-10-20
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References

  1. Nielsen JB, Hansen F, Littauer P, Schønning K, Hammerum AM. An NDM-1-producing Escherichia coli obtained in Denmark has a genetic profile similar to an NDM-1-producing E. coli isolate from the UK. J Antimicrob Chemother 2012;67:2049–2051 [CrossRef][PubMed]
    [Google Scholar]
  2. Giske CG, Gezelius L, Samuelsen Ø, Warner M, Sundsfjord A et al. A sensitive and specific phenotypic assay for detection of metallo-β-lactamases and KPC in Klebsiella pneumoniae with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillin. Clin Microbiol Infect 2011;17:552–556 [CrossRef][PubMed]
    [Google Scholar]
  3. Gomila M, del Carmen Gallegos M, Fernández-Baca V, Pareja A, Pascual M et al. Genetic diversity of clinical Pseudomonas aeruginosa isolates in a public hospital in Spain. BMC Microbiol 2013;13:138–143 [CrossRef][PubMed]
    [Google Scholar]
  4. Mulet X, Cabot G, Ocampo-Sosa AA, Domínguez MA, Zamorano L et al. Biological markers of Pseudomonas aeruginosa epidemic high-risk clones. Antimicrob Agents Chemother 2013;57:5527–5535 [CrossRef][PubMed]
    [Google Scholar]
  5. Chung DR, Song J-H, Kim SH, Thamlikitkul V, Huang S-G et al. High prevalence of multidrug-resistant nonfermenters in hospital-acquired pneumonia in Asia. Am J Respir Crit Care Med 2011;184:1409–1417 [CrossRef]
    [Google Scholar]
  6. Bhatt P, Tandel K, Shete V, Rathi KR. Burden of extensively drug-resistant and pandrug-resistant Gram-negative bacteria at a tertiary-care centre. New Microbes New Infect 2015;8:166–170 [CrossRef][PubMed]
    [Google Scholar]
  7. Li B, Yi Y, Wang Q, Woo PC, Tan L et al. Analysis of drug resistance determinants in Klebsiella pneumoniae isolates from a tertiary-care hospital in Beijing, China. PLoS One 2012;7:e42280 [CrossRef][PubMed]
    [Google Scholar]
  8. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 2012;18:268–281 [CrossRef][PubMed]
    [Google Scholar]
  9. Mahon CR, Lehman DC, Manuselis GJ Jr. Textbook of Diagnostic Microbiology Maryland Hieghts, Missouri: Elsevier Health Sciences; 2014; pp.249–303
    [Google Scholar]
  10. Clinical and Laboratory Standards Institute (CLSI) Performance Standards for Antimicrobial Susceptibility Testing; 24th Informational Supplement. CLSI M100-S24 Wayne, PA: Clinical and Laboratory Standards Institute; 2014; pp.98–110
    [Google Scholar]
  11. Peleg AY, Seifert H, Paterson DL. Acinetobacter baumannii: emergence of a successful pathogen. Clin Microbiol Rev 2008;21:538–582 [CrossRef][PubMed]
    [Google Scholar]
  12. Chu H, Zhao L, Wang M, Liu Y, Gui T et al. Sulbactam-based therapy for Acinetobacter baumannii infection: a systematic review and meta-analysis. Braz J Infect Dis 2013;17:389–394 [CrossRef]
    [Google Scholar]
  13. Adibhesami H, Douraghi M, Rahbar M, Abdollahi A. Minocycline activity against clinical isolates of multidrug-resistant Acinetobacter baumannii. Clin Microbiol Infect 2015;21:e79e80 [CrossRef]
    [Google Scholar]
  14. Ritchie DJ, Garavaglia-Wilson A. A review of intravenous minocycline for treatment of multidrug-resistant Acinetobacter infections. Clin Infect Dis 2014;59:S374–S380 [CrossRef]
    [Google Scholar]
  15. Miriagou V, Cornaglia G, Edelstein M, Galani I, Giske CG et al. Acquired carbapenemases in Gram-negative bacterial pathogens: detection and surveillance issues. Clin Microbiol Infect 2010;16:112–122 [CrossRef][PubMed]
    [Google Scholar]
  16. Carmeli Y, Akova M, Cornaglia G, Daikos GL, Garau J et al. Controlling the spread of carbapenemase-producing Gram-negatives: therapeutic approach and infection control. Clin Microbiol Infect 2010;16:102–111 [CrossRef][PubMed]
    [Google Scholar]
  17. Leão ACQ, Menezes PR, Oliveira MS, Levin AS. Acinetobacter spp. are associated with a higher mortality in intensive care patients with bacteremia: a survival analysis. BMC Infect Dis 2016;16:386–370 [CrossRef]
    [Google Scholar]
  18. Shahcheraghi F, Nobari S, Rahmati Ghezelgeh F, Nasiri S, Owlia P et al. First report of New Delhi metallo-beta-lactamase-1-producing Klebsiella pneumoniae in Iran. Microb Drug Resist 2013;19:30–36 [CrossRef][PubMed]
    [Google Scholar]
  19. Pasteran F, Veliz O, Faccone D, Guerriero L, Rapoport M et al. A simple test for the detection of KPC and metallo-β-lactamase carbapenemase-producing Pseudomonas aeruginosa isolates with the use of meropenem disks supplemented with aminophenylboronic acid, dipicolinic acid and cloxacillin. Clin Microbiol Infect 2011;17:1438–1441 [CrossRef][PubMed]
    [Google Scholar]
  20. Yong D, Toleman MA, Giske CG, Cho HS, Sundman K et al. Characterization of a new metallo-β-lactamase gene, blaNDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother 2009;53:5046–5054 [CrossRef][PubMed]
    [Google Scholar]
  21. Fazeli H, Norouzi-Barough M, Ahadi AM, Shokri D, Solgi H. Detection of New Delhi Metallo-Beta-Lactamase-1 (NDM-1) in carbapenem- resistant Klebsiella pneumoniae isolated from a university hospital in Iran. Hippokratia 2015;19:205–209[PubMed]
    [Google Scholar]
  22. Neonakis IK, Spandidos DA, Petinaki E. Minocycline a solution for multidrug-resistant Acinetobacter baumannii?. Future Microbiol 2014;9:299–305 [CrossRef][PubMed]
    [Google Scholar]
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