Emergence of Multidrug-resistant Carbapenemases and MCR-1 Producing Pseudomonas aeruginosa in Egypt

Pseudomonas aeruginosa is an expedient Gram-negative bacterium, which is characterized by its ability to acquire antimicrobial resistance. In this study, 56 unrepeatable carbapenem-resistant P. aeruginosa isolates were gathered from various clinical sources from hospitals in Cairo and Mansoura universities. The isolates exhibited diminished susceptibility towards carbapenems, quinolones, aminoglycosides and chloramphenicol by using disc diffusion method. Carbapenemase production was confirmed among the isolates, where all the 56 P. aeruginosa isolates harboured carbapenemase genes including blaVIM (43 isolates), blaKPC (38 isolates), blaNDM-1 (17 isolates), blaIMP (16 isolates) and blaOXA-48 (15 isolates). Among the isolates, 13 carried only one carbapenemase gene, while 43 isolates carried multiple carbapenemase genes. MCR-1 production was confirmed in 10 of the tested isolates by detecting the mcr-1 gene encoding for the colistin resistance. Enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR) evaluation showed that the tested isolates were unrelated to each other. Therefore, this study rises the danger of emergence of MDR P. aeruginosa resistant to carbapenems coupled with other antimicrobials including colistin, which is regarded as the last reservoir for the management of infections caused by MDR Gram-negative pathogens. Early inspection of resistance patterns in MDR organisms is an important tool to control and prevent infections via limiting the spread of these pathogens

In-vitro investigation of biofilm-specific resistance and virulence of biofilm-forming uropathogenic Escherichia coli

Uropathogenic Escherichia coli (UPEC) is the primary etiologic agent of urinary tract infections (UTIs). This study aimed to investigate the difference in antimicrobial susceptibility of UPEC isolates in the planktonic and biofilm states. Important virulence factors were also evaluated. The minimum inhibitory concentrations (MICs) were determined and recorded as 0.5-64 μg/ ml for amikacin, 0.5-64 μg/ ml for cefotaxime, 0.25-64 μg/ ml for cefepime, 0.25-16 μg/ ml for meropenem, and 0.125-32 μg/ ml for ciprofloxacin. Biofilm-specific resistance was assessed using the minimum biofilm eradication concentration (MBEC). The obtained results for MBEC were: 8-512 μg/ ml for amikacin, 32-512 μg/ ml for cefotaxime, 8-512 μg/ ml for cefepime, 4-256 μg/ ml for meropenem, and 4-128 μg/ ml for ciprofloxacin. The virulence factors were evaluated using suitable phenotypic techniques. Our findings revealed a significant enhancement in the antimicrobial resistance after biofilm formation. The MBEC values were higher than the MIC values by 2-128 folds for amikacin, 2-256 folds for cefotaxime, 2-64 folds for cefepime, 8-128 folds for meropenem, and 4-128 folds for ciprofloxacin. The swimming and swarming motilities demonstrated a significant positive correlation (rs = 0.506, P< 0.001). Protease production analysis revealed a large variation, with the weak biofilm-producing isolates EW2 and EW15 displaying the largest zone diameters of 39 mm and 33 mm; respectively. We have also evaluated the distribution and levels of siderophore production, which were significantly associated with meropenem resistance. Finally, this study underscores the importance of considering biofilm formation in UPEC treatment and emphasizes the need for therapeutics targeting these biofilms

Co-existence of NDM-1 and OXA-48 genes in Carbapenem Resistant Klebsiella pneumoniae clinical isolates in Kafrelsheikh, Egypt

Background: The noteworthy spread of carbapenem-resistant K. pneumoniae (CR-KP) isolates represents a significant safety threat. Objective: Determination of the carbapenemase genes incidence among CR-KP clinical isolates in Kafrelsheikh, Egypt. Methods: A total of 230 K. pneumoniae isolates were recovered from four hospitals in Kafrelsheikh, Egypt. Susceptibility testing was conducted using Kirby-Bauer method and automated-Vitek2 system. CR-KP isolates were tested using modified Hodge test (MHT) and combined disk synergy test. PCR and DNA sequencing were conducted for CR-KP isolates to recognize the included carbapenemase-genes. Results: Out of 230 K. pneumoniae isolates, 50 isolates presented resistance to carbapenem (meropenem). All 50 CR-KP isolates were multidrug-resistant (MDR). Genes like blaNDM-1 and blaOXA-48 were the only detected genes among CR-KP with an incidence of 70.0% and 52.0%, respectively. Up to 74.0% of the tested isolates carried at least one of the two recorded genes, among them 48.0% co-harbored both blaNDM-1 and blaOXA-48 genes. The accession-numbers of sequenced blaNDM-1 and blaOXA-48 genes were MG594615 and MG594616, respectively. Conclusion: This study reported a high incidence of MDR profile with the emergence of blaNDM-1 and blaOXA-48 genes co-existence in CR-KP isolates in Kafrelsheikh, Egypt. Hence, more restrictions should be applied against the spread of such serious pathogens

Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children in Delta, Egypt

Background: The ability of Shigella to invade, colonize, and kill host cells is affected by many virulence factors. The study aimed to confirm the identification and assess the presence of 12 virulence genes of the recovered Shigella spp. and 6 common antibiotic resistance genes particularly in S.flexneri &nbsp;isolates recovered &nbsp;&nbsp;from delta area –Egypt. &nbsp;Methods:&nbsp; A total of 62 Shigella isolates were collected from different hospitals.&nbsp; The detection of genes specific for the genus, serotypes, major virulence genes and genes encoding antibiotics resistance was performed by PCR. Results:&nbsp; A total of 62 (6.7%) isolates were positive for Shigella spp. virulence genes namely ipaH &amp; virA &amp; sigA &amp; icsA &amp; sen genes were detected in all species while sat &amp; sepA were not detected in S.boydii&nbsp; . on the other hand, pic was not detected in the tested species isolates. The tested isolates also harboured all except blaCTXM antibiotic resistance gene. &nbsp;Conclusions: This study provide information about the prevalence of MDR character and the distribution of virulence &amp; antibiotic resistance genes for effective control policies within this geographic region. Keywords:&nbsp; Shigella, pathogenesis, virulence genes, resistance genes

Additional file 1 of Genetic diversity of macrolides resistant Staphylococcus aureus clinical isolates and the potential synergistic effect of vitamins, C and K3

Additional file 1