title: Carbapenem-resistant Klebsiella pneumoniae isolates from Egypt containing blaNDM-1 on IncR plasmids and its association with rmtF.
abstract: OBJECTIVE
  The aim of this study was to characterize carbapenem-resistant Klebsiella pneumoniae (CRKP) isolates recovered from clinical specimens at a tertiary care hospital in Egypt over a period of 15 months.
  
  
  METHODS
  Eight CRKP isolates were included in this study. The minimum inhibitory concentrations of different antibiotics were determined by broth microdilution and Etest methods. Multilocus sequence typing was performed. Antibiotic resistance genes were assessed by PCR and DNA sequencing. Plasmid analysis was done by S1 nuclease digestion of whole genomic DNA followed by pulsed-field gel electrophoresis (S1-PFGE).
  
  
  RESULTS
  Eight carbapenem-resistant NDM-1-producing K. pneumoniae isolates of three different sequence types (ST) were identified (ST147, ST11, and ST17), in which blaNDM-1 was carried by either IncR or untypeable plasmids. Seven out of the eight isolates also contained the rmtF methylase gene.
  
  
  CONCLUSIONS
  This study describes the occurrence of IncR plasmids carrying blaNDM-1 and rmtF in Egypt, raising concerns regarding this type of replicon and its role in the transmission of these resistance determinants.
authors.affiliation: University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain; Microbiology Department, Theodor Bilharz Research Institute (TBRI), Cairo, Egypt. Electronic address: doaagamal@gmail.com.
authors.forename: Doaa
authors.initials: D
authors.lastname: Gamal
authors.affiliation: University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Fernández-Martínez
authors.affiliation: Microbiology Department, Theodor Bilharz Research Institute (TBRI), Cairo, Egypt.
authors.forename: Dalia
authors.initials: D
authors.lastname: Salem
authors.affiliation: Microbiology Department, Theodor Bilharz Research Institute (TBRI), Cairo, Egypt.
authors.forename: Inas
authors.initials: I
authors.lastname: El-Defrawy
authors.affiliation: University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
authors.forename: Laura Álvarez
authors.initials: LÁ
authors.lastname: Montes
authors.affiliation: University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain.
authors.forename: Alain A
authors.initials: AA
authors.lastname: Ocampo-Sosa
authors.affiliation: University Hospital Marqués de Valdecilla-IDIVAL, Santander, Spain; Molecular Biology Department, School of Medicine, University of Cantabria, Santander, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez-Martínez
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015780:Carbapenems / Q000494:pharmacology*; D004352:Drug Resistance, Microbial / Q000187:drug effects* / Q000235:genetics; D004534:Egypt / Q000453:epidemiology; D016521:Electrophoresis, Gel, Pulsed-Field; D004755:Enterobacteriaceae / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000187:drug effects* / Q000235:genetics; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D058885:Multilocus Sequence Typing; D010957:Plasmids; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000187:drug effects / Q000235:genetics / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases
keywords: Carbapenemases; Enterobacteriaceae; IncR plasmids; Methyl transferases; β-Lactamases