title: Prevalence and molecular characterization of Enterobacteriaceae producing NDM-1 carbapenemase at a military hospital in Pakistan and evaluation of two chromogenic media.
abstract: The aim of this study was to assess the frequency and genotypic diversity of carbapenemase-producing Enterobacteriaceae (CPE) in stool samples from patients attending a military hospital in Pakistan. Further aims included the identification of factors that might predispose to faecal carriage and evaluation of 2 chromogenic culture media: Brilliance CRE and chromID CARBA. Of 175 patients, 32 (18.3%) had faecal carriage of CPE and all produced NDM-1 carbapenemase. All of these 32 patients were detected using chromID CARBA compared with 20 patients (62.5%) detected using Brilliance CRE (P = 0.0015). Duration of hospitalization and treatment with co-amoxyclav were statistically associated with a higher likelihood of carriage of CPE (P ≤ 0.05). The majority of NDM-1-producing Enterobacteriaceae co-produced CTX-M-1 group extended spectrum β-lactamase, and one third produced armA-type methylase. NDM-1 carbapenemase was most commonly found amongst commensal types of Escherichia coli, especially phylogenetic group B1.
authors.affiliation: Department of Microbiology, Freeman Hospital, Newcastle Upon Tyne, UK.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Day
authors.forename: Shamshad
authors.initials: S
authors.lastname: Ali
authors.forename: Irfan Ali
authors.initials: IA
authors.lastname: Mirza
authors.forename: Hanna E
authors.initials: HE
authors.lastname: Sidjabat
authors.forename: Anna
authors.initials: A
authors.lastname: Silvey
authors.forename: Clare V
authors.initials: CV
authors.lastname: Lanyon
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Cummings
authors.forename: Shahid Ahmed
authors.initials: SA
authors.lastname: Abbasi
authors.forename: Muhammad W
authors.initials: MW
authors.lastname: Raza
authors.forename: David L
authors.initials: DL
authors.lastname: Paterson
authors.forename: John D
authors.initials: JD
authors.lastname: Perry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003470:Culture Media; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D005798:Genes, Bacterial; D006772:Hospitals, Military; D006801:Humans; D007902:Length of Stay; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010802:Phylogeny; D015995:Prevalence; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D003470:Culture Media; D001618:beta-Lactamases; C552864:beta-lactamase NDM-1