title: Molecular epidemiology of environmental and clinical carbapenemase-producing Gram-negative bacilli from hospitals in Guelma, Algeria: Multiple genetic lineages and first report of OXA-48 in Enterobacter cloacae.
abstract: This study was designed to investigate environmental colonisation in Algerian hospitals by carbapenem-resistant Gram-negative bacilli (GNB), including molecular characterisation of their resistance, and to perform a comparative molecular analysis between clinical and environmental strains. GNB isolated from hospitalised patients and the hospital environment were identified using microbiological methods and matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (MALDI-TOF/MS). Antibiotic susceptibility testing was performed by disk diffusion and Etest methods. Carbapenemase- and extended-spectrum β-lactamase (ESBL)-encoding genes were searched for using PCR and sequencing. Clonality of the environmental and clinical strains was assessed by multilocus sequencing typing (MLST). A total of 32 carbapenem-resistant GNB were isolated, including 16 (29%) of 56 multidrug-resistant (MDR) GNB from clinical specimens and 16 (48%) of 33 MDR-GNB from inanimate surfaces. Of the 32 carbapenem-resistant isolates, 14 produced a carbapenemase. The blaOXA-48gene was detected both in clinical and surface isolates of Klebsiella pneumoniae (n=3) and Enterobacter cloacae (n=2). Clinical and surface isolates of Acinetobacter baumannii were found to produce the carbapenemases NDM-1 (7 isolates) and OXA-23 (2 isolates). MLST revealed clonal diversity and a relationship between environmental and clinical strains with identical sequence types. Here we report the first description of an OXA-48-producing E. cloacae isolate in Algeria. We also highlight the important role of inanimate surfaces in the spread of carbapenem-resistant bacteria and the emergence of nosocomial infections.
authors: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France; Laboratoire de Biochimie et Microbiologie appliquée, Université de Annaba, Annaba, Algeria.
authors: Widad
authors: W
authors: Bouguenoun
authors: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France.
authors: Sofiane
authors: S
authors: Bakour
authors: Laboratoire de Microbiologie, CHU Dorban, Annaba, Algeria.
authors: Ahmed Aimen
authors: AA
authors: Bentorki
authors: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France.
authors: Charbel
authors: C
authors: Al Bayssari
authors: Laboratoire d'Amélioration Génétique des Plantes, Université de Annaba, Annaba, Algeria.
authors: Tarek
authors: T
authors: Merad
authors: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE), UM 63, CNRS 7278, IRD 198, INSERM 1095, IHU Méditerranée Infection, Faculté de Médecine et de Pharmacie, Aix-Marseille Université, Marseille, France. Electronic address: jean-marc.rolain@univ-amu.fr.
authors: Jean-Marc
authors: JM
authors: Rolain
mesh_terms: D000462:Algeria / Q000453:epidemiology; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins / Q000235:genetics*; D024901:Drug Resistance, Multiple, Bacterial; D016972:Enterobacter cloacae / Q000201:enzymology* / Q000235:genetics*; D006801:Humans; D017720:Molecular Epidemiology; D058885:Multilocus Sequence Typing; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D001618:beta-Lactamases; C063912:carbapenemase
keywords: Carbapenemase; Gram-negative bacilli; Hospital environment; Nosocomial infection