title: Emergence of Imipenem-Resistant Pseudomonas aeruginosa Clinical Isolates from Egypt Coharboring VIM and IMP Carbapenemases.
abstract: Pseudomonas aeruginosa is an important human pathogen and the leading cause of nosocomial infections. P. aeruginosa is characterized by massive intrinsic resistance to a multiple classes of antibiotics with carbapenems being the most potent inhibitor of P. aeruginosa and considered the first choice for its treatment. Therefore, it is crucial to investigate novel mechanisms of resistance of P. aeruginosa to carbapenems for achieving successful therapy. A total of 114 P. aeruginosa isolates from two university hospitals in Egypt were recruited in this study. Antimicrobial susceptibility testing revealed that 50 isolates (43.8%) exhibited multidrug-resistant (MDR) phenotype, of them 14 isolates (12.2%) were imipenem (IPM)-resistant. Of these 14 isolates, 13 isolates (11.4%) exhibited the metallo-β-lactamase (MBL) phenotype. MBLs encoding genes, VIM and IMP, were identified by PCR. PCR results revealed that four isolates harbored the VIM gene alone, one isolate harbored IMP gene alone, and four isolates harbored both genes. The correct size of PCR products of VIM and IMP genes (390 and 188 bp, respectively) were sequenced to confirm results of PCR and to look for any possible polymorphism among MBL genes of tested isolates. Data analysis of these sequences showed 100% identity of nucleotide sequences of MBL genes among tested Egyptian patients. To our knowledge, this is the first report of IMP carbapenemase-encoding gene in Africa and the first detection of the emergence of P. aeruginosa coproducing VIM and IMP genes in Egypt.
authors.affiliation: 1 Department of Microbiology and Immunology, Faculty of Pharmacy, Kafrelsheikh University , Kafrelsheikh, Egypt .
authors.forename: Ramadan Ahmed
authors.initials: RA
authors.lastname: El-Domany
authors.affiliation: 2 Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University , Cairo, Egypt .
authors.forename: Mohamed
authors.initials: M
authors.lastname: Emara
authors.affiliation: 3 Department of Anatomy and Embryology, Faculty of Veterinary Medicine, Kafrelsheikh University , Kafrelsheikh, Egypt .
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: El-Magd
authors.affiliation: 2 Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University , Cairo, Egypt .
authors.forename: Walaa H
authors.initials: WH
authors.lastname: Moustafa
authors.affiliation: 1 Department of Microbiology and Immunology, Faculty of Pharmacy, Kafrelsheikh University , Kafrelsheikh, Egypt .
authors.forename: Nesma M
authors.initials: NM
authors.lastname: Abdeltwab
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004534:Egypt; D006801:Humans; D015378:Imipenem / Q000494:pharmacology*; D007291:Inosine Monophosphate / Q000235:genetics*; D008826:Microbial Sensitivity Tests / Q000379:methods; D011552:Pseudomonas Infections / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D007291:Inosine Monophosphate; D015378:Imipenem; D001618:beta-Lactamases; C063912:carbapenemase
keywords: IMP; MDR; PCR; Pseudomonas aeruginosa; VIM; carbapenems; imipenem; metallo-β-lactamases; sequencing