Background: Molecular analysis of carbapenem-resistant genes in , an emerging pathogen, is less commonly reported from Nepal. In this study we determined the antibiotic susceptibility profile and genetic mechanism of carbapenem resistance in clinical isolates of
Methods: were isolated from various clinical specimens and identified based on Gram staining, biochemical tests, and PCR amplification of organism specific 16S rRNA and genes. The antibiotic susceptibility testing was performed using disc diffusion and E-test method. Multiplex PCR assays were used to detect the following β-lactamase genes: four class D carbapenem hydrolyzing oxacillinases (, , and ). Uniplex PCRs were used to detect three class B metallo-β-lactamases genes (, and ), class C cephalosporin resistance genes (), aminoglycoside resistance gene (), and IS of all isolates. Insertion sequence IS among NDM-1 positive strains was detected. Clonal relatedness of all isolates were analyzed using repetitive sequence-based PCR (rep-PCR).
Results: Of total 44 analyzed isolates, 97.7% ( = 43) were carbapenem-resistant (CR-AB) and 97.7% ( = 43) were multidrug resistant (MDR-AB). One isolate was detected to be extremely drug resistant (XDR-AB). All the isolates were fully susceptible to colistin (MICs < 2 μg/ml). The gene was detected in all isolates, while was detected in 6 isolates (13.6%). Insertion sequence, IS was detected in all of positive isolates. IS was detected in all positive strains. The and genes were detected in 90.1 and 40.1%, respectively. The rep-PCR of all isolates represented 7 different genotypes.
Conclusion: We found high prevalence of CR-AB and MDR-AB with gene in a tertiary care hospital in Nepal. Systemic network surveillance should be established for monitoring and controlling the spread of these resistant strains.
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| http://dx.doi.org/10.1186/s13756-017-0180-5 | DOI Listing |
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