Emerge of NDM-1-Producing Multidrug-Resistant and Co-Harboring of Carbapenemase Genes in South of Iran.

Background: New Delhi metallobetalactamase1 (NDM-1) is one of the most important emerging antibiotic resistance. Co-harboring three or four carbapenemases is rare and only a few reports exist in the literature. We described the characteristics of the large epidemic outbreaks and reports co-producing with the other carbapenemase genes in isolates.

Methods: This present cross-sectional research was conducted on 369 isolates obtained from burn and general hospitals within years 2013 to 2016. Beta-lactamase classes A, B and D genes were identified by PCR method. Modified hodge test (MHT), double-disk potentiation tests (DDPT) and double disk synergy test (DDST) were performed for detection carbapenemase and metallo beta-lactamase (MBL) production of positive isolates.

Results: From 236 carbapenem-resistant (CRPA), 116 isolates have had MBL genes and twenty-nine isolates were found positive for . In CRPA isolates, , and were identified in 27.5%, 21.1% and 32.2% of isolates respectively, while co-producing , , , co-producing , , and co-producing , were determined in 11 (4.6%), 8 (3.4%) and 27 (11.4%) of isolates respectively.

Conclusion: The finding of this co-existence of multiple carbapenemase resistance genes is threating for public health. Dipicolinic acid is a superior MBL inhibitor in DDPT antique than EDTA in DDST method for the detection of MBL- producing .