title: Molecular characterization of nitroimidazole resistance in metronidazole-resistant bacteroides species isolated from hospital patients in Kuwait.
abstract: OBJECTIVE
  The aim of this study was to screen for infections caused by metronidazole (MTZ)-resistant Bacteroides spp., and to characterize the genes that encode the MTZ resistance.
  
  
  METHODS
  A total of 7 MTZ-resistant Bacteroides spp. were isolated from 5 patients with MTZ-resistant infections. These organisms were investigated for carriage of genes that encode MTZ resistance. The presence of these genes was investigated by PCR and the PCR products were subjected to PCR-RFLP analysis.
  
  
  RESULTS
  The strains were MTZ-resistant with minimum inhibitory concentrations of > 32 microg/ml. The presence of nim genes was indicated by PCR in all 7 strains. PCR-RFLP analysis of the nim gene products demonstrated two of the five reported resistance genes, nimA-nimE. These two resistance genes were nimE in 5 of the 7 isolates and nimA in 2 strains.
  
  
  CONCLUSIONS
  MTZ-resistant Bacteroides spp. have been isolated from patients in Kuwait. Nim genes, specifically nimE and nimA, mediate the drug resistance in these isolates. The methods used in detecting these genes are rapid, accurate and relatively inexpensive and could be adopted easily to help in monitoring emergence of MTZ resistance determinants in Kuwait.
authors.affiliation: Department of Microbiology, Faculty of Medicine, Kuwait University/Mubarak Al-Kabeer Hospital, Jabriya, Kuwait.
authors.forename: Wafaa Y
authors.initials: WY
authors.lastname: Jamal
authors.forename: V O
authors.initials: VO
authors.lastname: Rotimi
authors.forename: J S
authors.initials: JS
authors.lastname: Brazier
authors.forename: Molly
authors.initials: M
authors.lastname: Johny
authors.forename: Wafaa M
authors.initials: WM
authors.lastname: Wetieh
authors.forename: B I
authors.initials: BI
authors.lastname: Duerden
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001439:Bacteroides / Q000187:drug effects / Q000235:genetics; D001442:Bacteroides Infections / Q000382:microbiology*; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D005260:Female; D020459:Genes, rRNA; D006801:Humans; D007730:Kuwait; D008297:Male; D008795:Metronidazole / Q000494:pharmacology*; D008875:Middle Aged; D009593:Nitroimidazoles / Q000494:pharmacology; D016133:Polymerase Chain Reaction / Q000379:methods; D012150:Polymorphism, Restriction Fragment Length; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents; D009593:Nitroimidazoles; D008795:Metronidazole