Recent update on the mechanism and epidemiology of metallo-β-lactamases in nosocomial infections: A mini review

*Eze, I. F 0009-0007-7286-9273., Adeoye-Isijola, M. O 0000-0002-3186-5432., Adefisoye, M. A 0000-0002-4957-4609., and Olajuyigbe, O. O 0000-0002-7889-0416

Department of Microbiology, School of Science and Technology, Babcock University, Ogun State, Nigeria *Correspondence to: ezeifyfaith@gmail.com

Abstract:
Metallo-β-lactamases are different types of biological enzymes that breakdown a broad spectrum of beta-lactam antibiotics such as carbapenems. Antibiotic resistance exhibited by many Gram-negative bacteria is due to acquisition of genes encoding these enzymes, which underscores their importance in antibiotic resistance and has led to an increase in nosocomial infections caused by multi-drug-resistant pathogens. This review analyzes recent updates on the mechanism of antibiotic resistance and epidemiology of metallo-β- lactamases in nosocomial infections. Carbapenem antibiotics are regarded as effective and reserve antibiotics for the treatment of multidrug-resistant bacteria infections. Currently, there is paucity of inhibitors that prevent the activities of metallo beta-lactamase clinically. Carbapenem resistance in bacteria is a global health issue, associated with increased morbidity and mortality in the healthcare setting. There is a need for continuous research on metallo-β-lactamases inhibitors, rational use of carbapenems and appropriate infection control measures in order to curb the increase in infections. This mini-review is aimed to provide a broader scope on the current trends of antimicrobial resistance in metallo-β-lactamase-associated nosocomial infections. This will lead to a better understanding of the public health implication of the unabated spread of these infections, the need for judicious utilization of the limited therapeutic options, resulting to efficient antimicrobial stewardship. Continue reading “Recent update on the mechanism and epidemiology of metallo-β-lactamases in nosocomial infections: A mini review”

High prevalence of extended-spectrum β-lactamase (blaCTX-M-15) and New Delhi metallo-β-lactamase-1 (NDM-1) genes among high-level carbapenem resistance Klebsiella pneumonia: an alarm for our health system

S. Yaghoubi, Z Baseri, A. Rasti, M. Gharani, Y. Erfani

 

Abstract

Background: The extended-spectrum β-lactamase (ESBL) carbapenems-resistant Klebsiella isolates are considered one of the most significant challenging in the treatment of patients in hospitals. The aim of this study was to determine the prevalence of important carbapenem resistance genes ESBL subtypes and between K. pneumoniae from patients at hospital in Tehran, Iran.
Methods: Fifty-four isolates of K. pneumoniae were isolated from Shariatee Hospital in Tehran from February 2013 to July 2016. Antibiotic testing was done by using the standard disk diffusion method and E-test MIC. The confirmation of carbapenemase activity was performed using an MHT and a new method called the carbapenem inactivation method test (CIM). Finally, a polymerase chain reaction (PCR) and sequencing of related genes was performed.
Results: Our PCR data demonstrate that blaCTX-M group’s 40 (81.4%) genes were the most prevalent in our hospital followed by group genes blaCTX-M-3 (18.51%) and blaCTX-M-2 (20.38%). The distribution of the CTX-M group revealed that blaCTX-M-15 23 (42.6%) was the dominant subtype. The coexistence of multiple genes included blaTEM, CTX-M and blaSHV, and CTX-M The presence of blaNDM1, blaOXA-48, and blaKPC were identified in the carbapenem-resistant isolates, 22 (40.7%), 10 (18.5%), and 7 (12.9%) respectively.
Conclusion: Our research showed that a CIM test for the first time in Iran is possible and has a high facility for the fast identification of carbapenem-resistant Klebsiella (CRK). We are encountered with the emergence of CTX-M, OXA-48, KPC, and NDM1 harboring CRK strains in our hospitals. Therefore, the treatment of patients infected with these isolates will be an important future concern in our clinical settings.

Running Head: Resistance genes among carbapenem-resistant Klebsiella pneumonia

Keywords: New Delhi metallo-beta-lactamase-1, Klebsiella pneumoniae, Carbapenem, Extended-spectrum ß-lactamase

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High prevalence of extended-spectrum β-lactamase (blaCTX-M-15) and New Delhi metallo-β-lactamase-1 (NDM-1) genes among high-level carbapenem resistance Klebsiella