Exploring Multi-Drug Resistance Mechanisms in MBL-Producing Gram-Negative Bacteria Isolated from Hospitalized Patients: A Phenotypic Analysis
DOI:
https://doi.org/10.56294/mw2024523Keywords:
Multi-Drug Resistance (MDR), Metallo-Beta-Lactamase (MBL), Gram-Negative Bacteria, Polymerase Chain Reaction (PCR)Abstract
Multi-drug resistance (MDR) is a serious threat to the efficacy of therapeutic therapies for antimicrobial resistance (AMR), which is a worldwide health problem. Gram-negative bacteria that produce metallo-beta-lactamase (MBL) have become important sources of MDR, making it more difficult to treat infections in hospitalized patients. Objective: The Gram-negative bacteria (GNB) that produces MBL was isolated from hospitalized patients. Method: Fifty-five Acinetobacter baumannii isolates were analyzed in this Phenotypic Analysis. These isolates were taken from specimens of sputum that came from adult Intensive Care Unit (ICU) patients. Gram-negative panels, namely the "VITEK 2 AST–N233 and AST-XNO5 susceptibility cards," were used for the identification and testing of each isolate in compliance with the Clinical recommendations. Multi-Drug Resistance (MDR) isolates were identified using Polymerase Chain Reaction (PCR) and Minimal Inhibitory Concentrations (MIC) experiments. Result: A 100% resistance to cefepime, ciprofloxacin, aztreonem, piperacillin and ceftazidime was detected in all 55 isolates. The 90% of samples indicated resistance to levofloxacin, but 6% to colistin. A significant prevalence of resistance genes was found; 95% of samples tested positive for blaOXA-23 and percentages ranging from 3% to 12% were positive for blaOXA-24, blaOXA-51, blaOXA-143 and blaOXA-235. 21% expressed KPC, 85% carried Integron-1 and 25% carried NDM-1. The knowledge acquired aids in improving comprehension of the difficulties presented by MBL-producing bacteria, directing the creation of focused treatments and influencing infection control procedures in hospital environments.
References
Karaiskos I, Lagou S, Pontikis K, Rapti V, Poulakou G. The “old” and the “new” antibiotics for MDR gram-negative pathogens: for whom, when, and how. Frontiers in public health. 2019 Jun 11;7:151. https://doi.org/10.3389/fpubh.2019.00151
Vrancianu CO, Dobre EG, Gheorghe I, Barbu I, Cristian RE, Chifiriuc MC. Present and future perspectives on therapeutic options for carbapenemase-producing Enterobacterales infections. Microorganisms. 2021 Mar 31;9(4):730. https://doi.org/10.3390/microorganisms9040730
Omokhua-Uyi AG, Van Staden J. Extracts of Gomphrena celosioides Mart as potential treatment for urinary tract infections against antibiotic resistant β-lactamase producing uropathogens. South African Journal of Botany. 2020 Aug 1;132:502-10. https://doi.org/10.1016/j.sajb.2020.06.002
Kumar S, Anwer R, Azzi A. Virulence potential and treatment options of multidrug-resistant (MDR) Acinetobacter baumannii. Microorganisms. 2021 Oct 6;9(10):2104. https://doi.org/10.3390/microorganisms9102104
Said KB, Alsolami A, Khalifa AM, Khalil NA, Moursi S, Osman A, Fahad D, Rakha E, Rashidi M, Moussa S, Bashir AI. A multi-point surveillance for antimicrobial resistance profiles among clinical isolates of gram-negative bacteria recovered from Major Ha’il Hospitals, Saudi Arabia. Microorganisms. 2021 Sep 24;9(10):2024. https://doi.org/10.3390/microorganisms9102024
Saleh HH, El-Sayed AK. Traditional and Molecular Gene Detection (blaIMP-1 and blaIMP) of multi-drug resistant Acinetobacter baumannii. Catrina: The International Journal of Environmental Sciences. 2021 Dec 1;24(1):75-80. https://dx.doi.org/10.21608/cat.2022.244092
Sosibo SC, Somboro AM, Amoako DG, Osei Sekyere J, Bester LA, Ngila JC, Sun DD, Kumalo HM. Impact of Pyridyl Moieties on the Inhibitory Properties of Prominent Acyclic Metal Chelators Against Metallo-β-Lactamase-Producing Enterobacteriaceae: Investigating the Molecular Basis of Acyclic Metal Chelators' Activity. Microbial Drug Resistance. 2019 Apr 1;25(3):439-49. https://doi.org/10.1089/mdr.2018.0272
Dandachi I, Chaddad A, Hanna J, Matta J, Daoud Z. Understanding the epidemiology of multi-drug resistant gram-negative bacilli in the Middle East using a one health approach. Frontiers in microbiology. 2019 Aug 23;10:1941. https://doi.org/10.3389/fmicb.2019.01941
Banihashemi K, Amirmozafari N, Mehregan I, Bakhtiari R, Sobouti B. Antibacterial effect of carbon nanotube containing chemical compounds on drug-resistant isolates of Acinetobacter baumannii. Iranian Journal of Microbiology. 2021 Feb;13(1):112.
Abhari SS, Azizi O, Modiri L, Aslani MM, Assmar M, Fereshteh S, Badmasti F. Two new rapid PCR-based methods for identification of Acinetobacter baumannii isolated from clinical samples. Molecular and cellular probes. 2021 Aug 1;58:101732. https://doi.org/10.1016/j.mcp.2021.101732
Dumaru R, Baral R, Shrestha LB. Study of biofilm formation and antibiotic resistance pattern of gram-negative Bacilli among the clinical isolates at BPKIHS, Dharan. BMC Research Notes. 2019 Dec;12:1-6. https://doi.org/10.1186/s13104-019-4084-8
Namaei MH, Yousefi M, Askari P, Roshanravan B, Hashemi A, Rezaei Y. High prevalence of multidrug-resistant non-fermentative Gram-negative bacilli harboring blaIMP-1 and blaVIM-1 metallo-beta-lactamase genes in Birjand, south-east Iran. Iranian journal of microbiology. 2021 Aug;13(4):470. https://doi.org/10.18502/ijm.v13i4.6971
De Jonge S, Boldingh Q, Solomkin J, Dellinger P, Egger M, Salanti G, Allegranzi B, Boermeester M. Conference on Prevention & Infection Control (ICPIC 2019). Antimicrobial Resistance and Infection Control. 2019;8(1):148.https://doi.org/10.1186/s13756-019-0567-6
Biswal M, Angrup A, Kanaujia R. Role of surveillance cultures in infection control. Indian journal of medical microbiology. 2020 Jul 1;38(3-4):277-83. https://doi.org/10.4103/ijmm.IJMM_20_129
Gupta S, Kumar M, Shergill SP, Tandel K. Evaluation of ceftriaxone-sulbactam-disodium edetate adjuvant combination against multi-drug resistant Gram-negative organisms. African Journal of Laboratory Medicine. 2020;9(1):1-6. https://doi.org/10.4102/ajlm.v9i1.991
Voulgaris GL, Voulgari ML, Falagas ME. Developments on antibiotics for multidrug resistant bacterial Gram-negative infections. Expert review of anti-infective therapy. 2019 Jun 3;17(6):387-401. https://doi.org/10.1080/14787210.2019.1610392
Hassuna NA, Darwish MK, Sayed M, Ibrahem RA. Molecular epidemiology and mechanisms of high-level resistance to meropenem and imipenem in Pseudomonas aeruginosa. Infection and Drug Resistance. 2020 Jan 30:285-93. https://doi.org/10.2147/IDR.S233808
Hao H, Liu Y, Cao J, Gao K, Lu Y, Wang W, Wang P, Lu S, Hu L, Tong Z, Li W. Genomic new insights into emergence and clinical therapy of multidrug-resistant Klebsiella pneumoniae in infected pancreatic necrosis. Frontiers in Microbiology. 2021 Jun 25;12:669230.
Zangane Matin F, Rezatofighi SE, Roayaei Ardakani M, Akhoond MR, Mahmoodi F. Virulence characterization and clonal analysis of uropathogenic Escherichia coli metallo-beta-lactamase-producing isolates. Annals of Clinical Microbiology and Antimicrobials. 2021 Dec;20:1-3. 0 https://doi.org/10.1186/s12941-021-00457-4
Haji SH, Aka ST, Ali FA. Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli. PLoS One. 2021 Nov 1;16(11):e0259005. https://doi.org/10.1371/journal.pone.0259005
Nikibakhsh M, Firoozeh F, Badmasti F, Kabir K, Zibaei M. Molecular study of metallo-β-lactamases and integrons in Acinetobacter baumannii isolates from burn patients. BMC Infectious Diseases. 2021 Dec;21:1-6. https://doi.org/10.1186/s12879-021-06513-w
Shilpakar A, Ansari M, Rai KR, Rai G, Rai SK. Prevalence of multidrug-resistant and extended-spectrum beta-lactamase producing Gram-negative isolates from clinical samples in a tertiary care hospital of Nepal. Tropical Medicine and Health. 2021 Dec;49:1-9. https://doi.org/10.1186/s41182-021-00313-3
Bassetti M, Peghin M, Vena A, Giacobbe DR. Treatment of infections due to MDR Gram-negative bacteria. Frontiers in medicine. 2019 Apr 16;6:74. https://doi.org/10.3389/fmed.2019.00074
Hemmati H, Hasannejad-Bibalan M, Khoshdoz S, Khoshdoz P, Yaghubi Kalurazi T, Sedigh Ebrahim-Saraie H, Nalban S. Two years study of prevalence and antibiotic resistance pattern of Gram-negative bacteria isolated from surgical site infections in the North of Iran. BMC research notes. 2020 Dec;13:1-6. https://doi.org/10.1186/s13104-020-05223-x
Gopichand P, Agarwal G, Natarajan M, Mandal J, Deepanjali S, Parameswaran S, Dorairajan LN. In vitro effect of fosfomycin on multi-drug resistant gram-negative bacteria causing urinary tract infections. Infection and drug resistance. 2019 Jul 9:2005-13. https://doi.org/10.2147/IDR.S207569
Hosu MC, Vasaikar SD, Okuthe GE, Apalata T. Detection of extended spectrum beta-lactamase genes in Pseudomonas aeruginosa isolated from patients in rural Eastern Cape Province, South Africa. Scientific reports. 2021 Mar 29;11(1):7110.
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