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372055

Phenotypic versus molecular assays for detecting carbapenemase-producing <i>Enterobacterales</i> from urinary tract infections

Article

Last updated: 25 Dec 2024

Subjects

-

Tags

Antimicrobial resistance

Abstract

Background:  Carbapenem-resistant Enterobacterales (CRE) have been identified as a public health problem. Treatment options for CRE are limited as they are mostly resistant to βeta-lactams, aminoglycosides, and fluoroquinolones as well as carbapenems. The present study aims to evaluate the performance of three phenotypic methods compared to a molecular-based technique for carbapenemase detection in Enterobacterales and determining their applicability in clinical and epidemiological settings. Methods: A total of 1,158 Enterobacterales were isolated from the urine samples in the microbiology laboratory of Alexandria main university hospital during the period from April 2020 to April 2021. Fifty randomly selected (39 Klebsiella and 11 E. coli) Enterobacterales were screened for carbapenem resistance by disc diffusion method. They were subjected to 3 phenotypic tests which are: Carba NP method, Modified carbapenem inactivation method (m CIM) and EDTA- modified carbapenem inactivation method (e CIM). Detection of 5 carbapenemase genes (blaKPC, blaIMP, blaVIM, blaOXA-48 and blaNDM-1) was performed using real time PCR. Results: CRE represented 33% of Enterobacterales isolates. Twenty-six cases (52%) were males and 94% of the cases were above 40 years old. Carba NP test was positive in 43/50 (86%) of the selected isolates, m CIM was positive in 35/50 (70%) and e CIM was positive in 30/50 (60%). The most common carbapenemase gene detected was blaNDM-1 (94%), followed by blaOXA-48 gene (72%) and blaVIM gene (24%). The blaKPC gene and blaIMP gene were not detected. Coexistence of the blaOXA-48 and the blaNDM-1 genes was detected in 48% isolates, while the blaNDM-1, the blaOXA-48 and the blaVIM genes were found in 22% isolates. The sensitivity of Carba NP, m CIM and e CIM was 87.5%, 72.9%, and 85.7% respectively. Conclusion: The study highlights the necessity of early detection of CRE. Carba NP test assists in the rapid identification of carbapenemase production. However, the genotypic test remains the gold standard for detection of CRE.

DOI

10.21608/mid.2024.301393.2044

Keywords

carbapenem, β-lactamase, Carbapenemase, Antibiotic resistance, Enterobacterales

Authors

First Name

Amina

Last Name

Nour El Deen

MiddleName

Mahmoud

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, University of Alexandria, Egypt

Email

aminamnd@gmail.com

City

Alexandria

Orcid

-

First Name

Yasmin

Last Name

Naga

MiddleName

Salah

Affiliation

Internal Medicine Nephrology Department , Faculty of Medicine, University of Alexandria, Egypt

Email

yasminenaga@gmail.com

City

Alexandria

Orcid

-

First Name

Ahmed

Last Name

El Menshawy

MiddleName

Moustafa

Affiliation

Critical care medicine Department, Faculty of Medicine, University of Alexandria, Egypt

Email

ahmedmenshawy@hotmail.com

City

Alexandria

Orcid

-

First Name

Mai

Last Name

Mahar

MiddleName

khaled

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, University of Alexandria, Egypt

Email

maima7ar@gmail.com

City

Alexandria

Orcid

-

First Name

Yara

Last Name

Roshdy

MiddleName

Safwat

Affiliation

Medical Microbiology and Immunology Department, Faculty of Medicine, University of Alexandria, Egypt

Email

yara.safwat@alexmed.edu.eg

City

Alexandria

Orcid

0000-0003-0941-0834

Volume

5

Article Issue

4

Related Issue

51278

Issue Date

2024-11-01

Receive Date

2024-07-03

Publish Date

2024-11-01

Page Start

1,506

Page End

1,518

Print ISSN

2682-4132

Online ISSN

2682-4140

Link

https://mid.journals.ekb.eg/article_372055.html

Detail API

https://mid.journals.ekb.eg/service?article_code=372055

Order

26

Type

Original Article

Type Code

1,157

Publication Type

Journal

Publication Title

Microbes and Infectious Diseases

Publication Link

https://mid.journals.ekb.eg/

MainTitle

Phenotypic versus molecular assays for detecting carbapenemase-producing <i>Enterobacterales</i> from urinary tract infections

Details

Type

Article

Created At

25 Dec 2024