Abo-Alella, D., Malek, M., Malek, M. (2021). Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study. Microbes and Infectious Diseases, 2(2), 295-307. doi: 10.21608/mid.2021.59593.1113
Doaa Abo-Alella; Mahmoud Mohamad Malek; Mai Mohamad Malek. "Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study". Microbes and Infectious Diseases, 2, 2, 2021, 295-307. doi: 10.21608/mid.2021.59593.1113
Abo-Alella, D., Malek, M., Malek, M. (2021). 'Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study', Microbes and Infectious Diseases, 2(2), pp. 295-307. doi: 10.21608/mid.2021.59593.1113
Abo-Alella, D., Malek, M., Malek, M. Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study. Microbes and Infectious Diseases, 2021; 2(2): 295-307. doi: 10.21608/mid.2021.59593.1113
Phenotypic and Genotypic Characterization of Metallo Beta Lactamases among Gram-Negative Uropathogens from a Tertiary Care Hospital in Egypt: A Cross Sectional Study
1Medical Microbiology & Immunology Department, Faculty of Medicine,Zagazig University, Zagazig, Egypt
2Urology Department, Faculty of Medicine, Zagazig university, Zagazig, Egypt.
3Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
Abstract
Background: Gram Negative bacilli (GNB) are the most common causes of urinary tract infections (UTIs). There is a worrying level of antimicrobial resistance emerging in UTIs pathogens. Metallo-β-lactamases (MBLs) are rapidly spreading β-lactamases with no available FDA approved inhibitor conferring resistance to most β-lactam antibiotics including carbapenems. We aimed to determine prevalence and antimicrobial resistance patterns of Gram-negative uropathogens in our tertiary care hospital, and to characterize MBLs production among them. Methods: A hundred and forty-three urine samples were collected from the Urology Department. Uropathogens were isolated on Cystiene Lactose Electrolyte Deficient agar and Mac-Conkey’s agar. GNB were identified by conventional methods. Antimicrobial susceptibility was evaluated by disc diffusion method. Carbapenems resistant Gram-negative bacilli (CRGNB) were tested for MBLs production both phenotypically and genotypically. Results: Eighty-five GNB (75.9%) were isolated from 112 positive cultures. Escherichia coli (49.4%) was the most prevalent isolate. Most of GNB showed high resistance patterns to various antimicrobials. Twenty-nine GNB isolates were resistant to at least one carbapenem (28.2% for imipenem, 30.6% for meropenem). Twenty-three isolates (79.3%) were phenotypically positive for MBL activity by combined disc test (CDT). Twenty-two isolates (75.9%) were positive for one or more of MBL genes (blaIMP, blaVIM and/or blaNDM). Conclusions: Our study emphasized on the alarming rates of resistance to most of the common antimicrobials particularly carbapenems among GNB uropathogens, which represent a public health threat. CRGNB isolates in our hospital are phenotypically and genotypically associated with MBLs production so an effective strategy to combat these strains is mandatory.