title: High Carbapenem Resistance in Clinical Gram-Negative Pathogens Isolated in Egypt.
abstract: The emergence and spread of carbapenem-resistant gram-negative bacteria poses a serious threat to human health worldwide. Currently, little is known about the molecular mechanisms underlying carbapenem resistance and their prevalence among gram-negative bacteria in Egypt. In this study, we analyzed carbapenemase production in gram-negative bacteria isolated from hospitalized patients in Egypt in 2014. All isolates were subjected to phenotypic and genotypic susceptibility testing for carbapenem resistance. Our results indicated a high level of carbapenem-resistant gram-negative bacteria in Egypt, with 50.8% of the isolates harboring at least one carbapenem resistance gene. OXA-48-like and NDM-1 were the most prevalent carbapenemases, being detected in 49.2%, and 47.7% of carbapenemase-positive isolates, respectively, whereas Verona integron-encoded metallo-β-lactamase (VIM) was detected in only 26.2% of carbapenemase-positive isolates. This study reports for the first time carbapenemase-producing Serratia marcescens, Morganella morganii, and blaVIM-1-like-producing Pseudomonas aeruginosa in Egypt. It is also the first demonstration of the coexistence of different carbapenemases, being detected in 21.5% of carbapenemase-positive isolates. Effective antibiotic supervision, regional surveillance, and early detection of carbapenemase producers are imperative to prevent their future spread to epidemic levels.
authors.affiliation: 1 Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University , Higashi-Hiroshima, Japan .|2 Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University , Kafr El-Sheikh, Egypt .
authors.forename: Hazim O
authors.initials: HO
authors.lastname: Khalifa
authors.affiliation: 1 Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University , Higashi-Hiroshima, Japan .|3 Department of Microbiology and Immunology, Faculty of Pharmacy, Kafrelsheikh University , Kafr El-Sheikh, Egypt .
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Soliman
authors.affiliation: 1 Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University , Higashi-Hiroshima, Japan .|4 Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Kafrelsheikh University , Kafr El-Sheikh, Egypt .
authors.forename: Ashraf M
authors.initials: AM
authors.lastname: Ahmed
authors.affiliation: 1 Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University , Higashi-Hiroshima, Japan .
authors.forename: Toshi
authors.initials: T
authors.lastname: Shimamoto
authors.affiliation: 5 Project Research Center for Nosocomial Infectious Diseases, Hiroshima University , Hiroshima, Japan .|6 Department of Bacteriology, Hiroshima University , Hiroshima, Japan .
authors.forename: Toshinori
authors.initials: T
authors.lastname: Hara
authors.affiliation: 5 Project Research Center for Nosocomial Infectious Diseases, Hiroshima University , Hiroshima, Japan .|6 Department of Bacteriology, Hiroshima University , Hiroshima, Japan .
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: 5 Project Research Center for Nosocomial Infectious Diseases, Hiroshima University , Hiroshima, Japan .|7 Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University , Hiroshima, Japan .
authors.forename: Yuta
authors.initials: Y
authors.lastname: Kuroo
authors.affiliation: 5 Project Research Center for Nosocomial Infectious Diseases, Hiroshima University , Hiroshima, Japan .|6 Department of Bacteriology, Hiroshima University , Hiroshima, Japan .
authors.forename: Shizuo
authors.initials: S
authors.lastname: Kayama
authors.affiliation: 5 Project Research Center for Nosocomial Infectious Diseases, Hiroshima University , Hiroshima, Japan .|6 Department of Bacteriology, Hiroshima University , Hiroshima, Japan .
authors.forename: Motoyuki
authors.initials: M
authors.lastname: Sugai
authors.affiliation: 1 Laboratory of Food Microbiology and Hygiene, Graduate School of Biosphere Science, Hiroshima University , Higashi-Hiroshima, Japan .
authors.forename: Tadashi
authors.initials: T
authors.lastname: Shimamoto
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D015780:Carbapenems / Q000494:pharmacology; D004534:Egypt / Q000453:epidemiology; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D015870:Gene Expression; D006761:Hospitals; D006801:Humans; D032023:Integrons; D008826:Microbial Sensitivity Tests; D020613:Morganella morganii / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D010802:Phylogeny; D011552:Pseudomonas Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D011550:Pseudomonas aeruginosa / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D016868:Serratia Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D012706:Serratia marcescens / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; D001618:beta-Lactamases
keywords: Egypt; Escherichia coli; Klebsiella pneumoniae; Pseudomonas aeruginosa; Serratia marcescens; carbapenemases