Spreading of NDMI-Producing Klebsiella Pneumoniaein Different Wards at Assiut University Hospital

Eman Ramadan Mohamed^1, , Hamada Mohamed Halby², Mamdouh Yones Ali¹, Rehab Mahmoud Abd El-Baky³ and Nancy G F M Waly⁴

¹Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Assiut71515, Egypt

²Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt

³Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia, 61519, Deraya University, Minia 11566, Egypt

⁴Department of Microbiology and Immunology, Faculty of Pharmacy, Minia University, Minia, Egypt

Cite this paper:
Eman Ramadan Mohamed, Hamada Mohamed Halby, Mamdouh Yones Ali, Rehab Mahmoud Abd El-Baky and Nancy G F M Waly. Spreading of NDMI-Producing Klebsiella Pneumoniaein Different Wards at Assiut University Hospital. American Journal of Infectious Diseases and Microbiology. 2020; 8(1):24-28. doi: 10.12691/ajidm-8-1-4

Abstract

Spreading of NDMI-producing klebsiella pneumoniaehas become a great trouble in many Egyptian hospitalized patients. Localizing the source of these isolates is an important step to prevent their spread in this country. This study included 33 NDMI-producing klebsiella pneumoniae that collected from different clinical specimens of patients admitted to different wards at Assiut University Hospitals in Egypt and confirmed to produce blaNDM1 gene by polymerase chain reaction. Isolates were typed by Enterobacterial Repetitive Intergenic Consensus (ERIC). Respiratory samples (51%) were the predominant samples and chestdepartment was the major ward (48.48%) that isolates recovered. ERIC gel profile showed that several identical isolates were found especially in chest ward and between different medical wards of this hospital suggested clonal transmission of NDMI-producing K. pneumoniae. Also, there are differences in the number and size of ERIC-PCR profiles indicated the genetic diversity among NDMI-producing K. pneumoniae isolates. The results of this study may help in tracing and controlling NDM-1-producing K. pneumoniae outbreak by applying effective infection control measures especially in the chest ward of this hospital.

Keywords:
carbapenem-resistant Klebsiella pneumoniae bla NDM1 ERIC

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References:

[1]	Decré D, Verdet C, Emirian A, Le Gourrierec T, Petit J-C, Offenstadt G, et al. Emerging severe and fatal infections due to Klebsiella pneumoniae in two university hospitals in France. Journal of clinical microbiology. 2011; 49: 3012-4.
[2]	Foglia E, Meier MD, Elward A. Ventilator-associated pneumonia in neonatal and pediatric intensive care unit patients. Clinical microbiology reviews. 2007;20:409-25.
[3]	Yan J, Pu S, Jia X, Xu X, Yang S, Shi J, et al. Multidrug resistance mechanisms of carbapenem resistant Klebsiella pneumoniae strains isolated in Chongqing, China. Annals of laboratory medicine. 2017; 37: 398-407.
[4]	Miriagou V, Cornaglia G, Edelstein M, Galani I, Giske C, Gniadkowski M, et al. Acquired carbapenemases in Gram-negative bacterial pathogens: detection and surveillance issues. Clinical microbiology and infection. 2010; 16: 112-22.
[5]	Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-β-lactamase gene, bla NDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrobial agents and chemotherapy. 2009; 53: 5046-54.
[6]	Khan AU, Maryam L, Zarrilli R. Structure, genetics and worldwide spread of New Delhi metallo-β-lactamase (NDM): a threat to public health. BMC microbiology. 2017; 17: 101.
[7]	El-Sweify M, Gomaa N, El-Maraghy N, Mohamed H. Phenotypic Detection of Carbapenem Resistance among Klebsiella pneumoniae in Suez Canal University Hospitals, Ismailiya, Egypt. International Journal of Current Microbiology and Applied Sciences. 2015; 4: 10-8.
[8]	Gamal D, Fernández-Martínez M, Salem D, El-Defrawy I, Montes LÁ, Ocampo-Sosa AA, et al. Carbapenem-resistant Klebsiella pneumoniae isolates from Egypt containing blaNDM-1 on IncR plasmids and its association with rmtF. International Journal of Infectious Diseases. 2016; 43: 17-20.
[9]	Morsi SS. Comparative Evaluation of Phenotypic and Genotypic Methods for Detection of Carbapenemases in Clinically Significant Klebsiella pneumoniae Isolates. The Egyptian Journal of Medical Microbiology. 2016; 38: 1-8.
[10]	Christian NA, Roye-Green K, Smikle M. Molecular epidemiology of multidrug resistant extended spectrum beta-lactamase producing Klebsiella pneumoniae at a Jamaican hospital, 2000-2004. BMC microbiology. 2010; 10: 27.
[11]	Seifi K, Kazemian H, Heidari H, Rezagholizadeh F, Saee Y, Shirvani F, et al. Evaluation of biofilm formation among Klebsiella pneumoniae isolates and molecular characterization by ERIC-PCR. Jundishapur journal of microbiology. 2016; 9.
[12]	Zhang S, Yang G, Ye Q, Wu Q, Zhang J, Huang Y. Phenotypic and genotypic characterization of Klebsiella pneumoniae isolated from retail foods in China. Frontiers in microbiology. 2018; 9: 289.
[13]	Hedges A. Estimating the precision of serial dilutions and viable bacterial counts. International journal of food microbiology. 2002; 76: 207-14.
[14]	Madeo M, Barlow G. Reducing blood-culture contamination rates by the use of a 2% chlorhexidine solution applicator in acute admission units. Journal of Hospital Infection. 2008; 69: 307-9.
[15]	Shin YM, Oh Y-M, Kim MN, Shim TS, Lim C-M, Lee SD, et al. Usefulness of quantitative endotracheal aspirate cultures in intensive care unit patients with suspected pneumonia. Journal of Korean medical science. 2011; 26: 865-9.
[16]	Pierce VM, Simner PJ, Lonsway DR, Roe-Carpenter DE, Johnson JK, Brasso WB, et al. Modified carbapenem inactivation method for phenotypic detection of carbapenemase production among Enterobacteriaceae. Journal of clinical microbiology. 2017; 55: 2321-33.
[17]	Sfeir M, Hayden J, Fauntleroy K, Mazur C, Johnson J, Simner P, et al. EDTA-modified carbapenem inactivation method: a phenotypic method for detecting metallo-β-lactamase-producing Enterobacteriaceae. Journal of clinical microbiology. 2019; 57: e01757-18.
[18]	Poirel L, Dortet L, Bernabeu S, Nordmann P. Genetic features of blaNDM-1-positive Enterobacteriaceae. Antimicrobial agents and chemotherapy. 2011; 55: 5403-7.
[19]	Versalovic J, Koeuth T, Lupski R. Distribution of repetitive DNA sequences in eubacteria and application to finerpriting of bacterial enomes. Nucleic acids research. 1991; 19: 6823-31.
[20]	Pitout JD, Nordmann P, Poirel L. Carbapenemase-producing Klebsiella pneumoniae, a key pathogen set for global nosocomial dominance. Antimicrobial agents and chemotherapy. 2015; 59: 5873-84.
[21]	Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing Enterobacteriaceae. Emerging infectious diseases. 2011; 17: 1791.
[22]	Patel G, Huprikar S, Factor SH, Jenkins SG, Calfee DP. Outcomes of carbapenem-resistant Klebsiella pneumoniae infection and the impact of antimicrobial and adjunctive therapies. Infection Control & Hospital Epidemiology. 2008; 29: 1099-106.
[23]	Nordmann P, Poirel L, Walsh TR, Livermore DM. The emerging NDM carbapenemases. Trends in microbiology. 2011; 19: 588-95.
[24]	Mohamed ER, Aly SA, Halby HM, Ahmed SH, Zakaria AM, El-Asheer OM. Epidemiological typing of multidrug-resistant Klebsiella pneumoniae, which causes paediatric ventilator-associated pneumonia in Egypt. Journal of medical microbiology. 2017; 66: 628-34.
[25]	Sydnor ER, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clinical microbiology reviews. 2011; 24: 141-73.
[26]	Wang X, Chen G, Wu X, Wang L, Cai J, Chan EW, et al. Increased prevalence of carbapenem resistant Enterobacteriaceae in hospital setting due to cross-species transmission of the blaNDM-1 element and clonal spread of progenitor resistant strains. Frontiers in microbiology. 2015; 6: 595.
[27]	Yu F, Ying Q, Chen C, Li T, Ding B, Liu Y, et al. Outbreak of pulmonary infection caused by Klebsiella pneumoniae isolates harbouring blaIMP-4 and blaDHA-1 in a neonatal intensive care unit in China. Journal of medical microbiology. 2012; 61: 984-9.
[28]	Huang X, Cheng X, Sun P, Tang C, Ni F, Liu G. Characteristics of NDM-1-producing Klebsiella pneumoniae ST234 and ST1412 isolates spread in a neonatal unit. BMC microbiology. 2018; 18: 186.
[29]	Ramadan Mohamed E, Ali MY, Waly NG, Halby HM, Abd El-Baky RM. The Inc FII Plasmid and its Contribution in the Transmission of blaNDM-1 and blaKPC-2 in Klebsiella pneumoniae in Egypt. Antibiotics. 2019; 8: 266.