Phenotypic and Genotypic Detection of Klebsiella Pneumoniae Carbapenemase and New Delhi Metallo-β-Lactamase of Enterobacteriaceae in Benha University Hospitals

Abstract

Background: The prevalence of carbapenem-resistant Enterobacteriacea is on the rise worldwide, posing a major public health threat as well as a serious concern for infection control management. The accurate identification and reporting of carbapenemase producing Enterobacteriacea (CPE) will aid infection control practitioners in preventing the spread of these multidrug- resistant isolates. Objectives: This study aimed to detect the prevalence of CPE in Benha university hospitals and to confirm the presence of k. Pneumoniae carbapenemase (KPC) and New Delhi Metallo-β- Lactamase (NDM) in Enterobacteriacea. Methodology: This study was conducted on 100 Enterobacteriacea strains collected from patients admitted to Benha University Hospitals. The isolated Enterobacteriacea strains were screened for CPE by chromID CARBA agar with species identification by using API 20 E test strips as a biochemical identification system. KPC and NDM carbapenemases detection was confirmed \phenotypically by Mast Disc ID carbapenemase detection set (MDI) and genotypically by multiplex PCR. Results: Out of 100 Enterobacteriacea isolates, 40 strains (40 %) are carbapenemase producers and 27strains of them (67.5 %) are carrying genes responsible for carbapenem resistant. Twenty six strains (65%) are carrying KPC gene and only one k. Pneumoniae strain (2.5%) is carrying NDM-1 gene for MβL production. MDI detected 60% of KPC and 25% of MβL producers with high sensitivity (92.6 %) in comparison to PCR. Intensive Care Unit patients harbored most of carbapenem-resistant isolates with the highest percentage of carbapenemases genes in k. Pneumoniae. Conclusion: Emergence of CPE pathogens in our setting create an important challenge for clinicians and hospital epidemiologists with the possibility of outbreak eruption by these difficult-to-treat pathogens, in the future.