Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia

Introduction: Infections due to carbapenemase‑producing Enterobacteriaceae have been increasingly reported worldwide and are causing significant health concerns. In this study, we investigated the occurrence of New Delhi Metallo‑beta‑lactamase (NDM) carbapenemase‑producing Enterobacteriaceae (CPE)...

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Main Authors:	Yahya Mohsen, Saleh Mahdi, Hamzah, Hairul Aini, Mustafa Mahmoud, Mohammed Imad Al-Deen
Format:	Article
Language:	English
Published:	JSS University Sri Shivrathreeshwara Nagar, 2018
Subjects:	QR Microbiology
Online Access:	http://irep.iium.edu.my/63741/ http://irep.iium.edu.my/63741/ http://irep.iium.edu.my/63741/ http://irep.iium.edu.my/63741/1/Saleh%20Mahdi%20IntJHealthAlliedSci7117-1817684_050256.pdf

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spelling	iium-637412018-05-21T05:20:44Z http://irep.iium.edu.my/63741/ Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia Yahya Mohsen, Saleh Mahdi Hamzah, Hairul Aini Mustafa Mahmoud, Mohammed Imad Al-Deen QR Microbiology Introduction: Infections due to carbapenemase‑producing Enterobacteriaceae have been increasingly reported worldwide and are causing significant health concerns. In this study, we investigated the occurrence of New Delhi Metallo‑beta‑lactamase (NDM) carbapenemase‑producing Enterobacteriaceae (CPE) in Enterobacteriaceae isolates from Hospital Tengku Ampuan Afzan (HTAA) and verified the presence of associated carbapenemases genes. MATERIALS AND METHODS: Standard antimicrobial susceptibility testing was performed to analyze the isolates’ susceptibility pattern. Modified Hodge test was used to detect carbapenemase production. Genes associated with CPE were detected by standard polymerase chain reaction amplification with a series of established primers, followed by DNA sequencing. RESULTS: Out of 259 Enterobacteriaceae isolates, four Klebsiella pneumoniae isolates (1.5%) were found to be phenotypically carbapenem‑resistant. NDM‑1 carbapenemase was detected in three of the four isolates. Two of them were recovered from blood and the third strain was isolated from a urine sample. The three isolates were found to be resistant to all β‑lactams antibiotics and the majority of other nonβ‑lactam antibiotics. Meanwhile, all the isolates were susceptible to polymyxin B. They also carried other β‑lactamase genes along with the blaNDM gene. Nucleotide sequence of the blaNDM‑1 gene showed no base variation with other NDM‑1 sequences from the NCBI nucleotide database. CONCLUSION: The presence of NDM‑producing K. pneumoniae in the HTAA is alarming and of serious concern due to the high‑level resistance of this gene and the risk of an outbreak occurrence. Further studies to detect the genetic relatedness and clonality of these resistance organisms are highly recommended. JSS University Sri Shivrathreeshwara Nagar, 2018-03 Article PeerReviewed application/pdf en http://irep.iium.edu.my/63741/1/Saleh%20Mahdi%20IntJHealthAlliedSci7117-1817684_050256.pdf Yahya Mohsen, Saleh Mahdi and Hamzah, Hairul Aini and Mustafa Mahmoud, Mohammed Imad Al-Deen (2018) Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia. International ournal of Health & Allied Sciences, 7 (1). pp. 17-22. ISSN 2278-4292 E-ISSN 2278-344X. http://www.ijhas.in/showBackIssue.asp?issn=2278-344X;year=2018;volume=7;issue=1;month=January-March 10.4103/ijhas.IJHAS_96_17
repository_type	Digital Repository
institution_category	Local University
institution	International Islamic University Malaysia
building	IIUM Repository
collection	Online Access
language	English
topic	QR Microbiology
spellingShingle	QR Microbiology Yahya Mohsen, Saleh Mahdi Hamzah, Hairul Aini Mustafa Mahmoud, Mohammed Imad Al-Deen Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia
description	Introduction: Infections due to carbapenemase‑producing Enterobacteriaceae have been increasingly reported worldwide and are causing significant health concerns. In this study, we investigated the occurrence of New Delhi Metallo‑beta‑lactamase (NDM) carbapenemase‑producing Enterobacteriaceae (CPE) in Enterobacteriaceae isolates from Hospital Tengku Ampuan Afzan (HTAA) and verified the presence of associated carbapenemases genes. MATERIALS AND METHODS: Standard antimicrobial susceptibility testing was performed to analyze the isolates’ susceptibility pattern. Modified Hodge test was used to detect carbapenemase production. Genes associated with CPE were detected by standard polymerase chain reaction amplification with a series of established primers, followed by DNA sequencing. RESULTS: Out of 259 Enterobacteriaceae isolates, four Klebsiella pneumoniae isolates (1.5%) were found to be phenotypically carbapenem‑resistant. NDM‑1 carbapenemase was detected in three of the four isolates. Two of them were recovered from blood and the third strain was isolated from a urine sample. The three isolates were found to be resistant to all β‑lactams antibiotics and the majority of other nonβ‑lactam antibiotics. Meanwhile, all the isolates were susceptible to polymyxin B. They also carried other β‑lactamase genes along with the blaNDM gene. Nucleotide sequence of the blaNDM‑1 gene showed no base variation with other NDM‑1 sequences from the NCBI nucleotide database. CONCLUSION: The presence of NDM‑producing K. pneumoniae in the HTAA is alarming and of serious concern due to the high‑level resistance of this gene and the risk of an outbreak occurrence. Further studies to detect the genetic relatedness and clonality of these resistance organisms are highly recommended.
format	Article
author	Yahya Mohsen, Saleh Mahdi Hamzah, Hairul Aini Mustafa Mahmoud, Mohammed Imad Al-Deen
author_facet	Yahya Mohsen, Saleh Mahdi Hamzah, Hairul Aini Mustafa Mahmoud, Mohammed Imad Al-Deen
author_sort	Yahya Mohsen, Saleh Mahdi
title	Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia
title_short	Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia
title_full	Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia
title_fullStr	Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia
title_full_unstemmed	Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia
title_sort	phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the east coast malaysia
publisher	JSS University Sri Shivrathreeshwara Nagar,
publishDate	2018
url	http://irep.iium.edu.my/63741/ http://irep.iium.edu.my/63741/ http://irep.iium.edu.my/63741/ http://irep.iium.edu.my/63741/1/Saleh%20Mahdi%20IntJHealthAlliedSci7117-1817684_050256.pdf
first_indexed	2023-09-18T21:30:23Z
last_indexed	2023-09-18T21:30:23Z
_version_	1777412471209852928

Phenotypic and molecular study of carbapenem‑resistant enterobacteriaceae in a referral hospital in the East coast Malaysia

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