PREVALENCE OF ANTIMICROBIAL RESISTANCE AND MOLECULAR CHARACTERIZATION OF CARBAPENEMASE ENCODING GENE IN ESCHERICHIA COLI ISOLATES IN HOSPITAL OF HUE UNIVERSITY OF MEDICINE AND PHARMACY

Abstract

Background: Currently, the existence of Extended-spectrum beta-lactamases (ESBL) and carbapenemase genes as well as genetic diversity has led to the rapid spread of resistance between E. coli species and the emergence of bacteria with pan-resistance. Objectives: To investigate the prevalence of antimicrobial resistance, prevalence of ESBL-producing E. coli, and carbapenemase-coding gene in E. coli isolates at Hospital of Hue University of Medicine and Pharmacy. Materials and method: The susceptibility to 13 antimicrobials of 246 E. coli isolates was detemined by the Kirby-Bauer method. ESBL-producing potential E. coli isolates were confirmed phenotypic by the Double Disc Synergy Test (DDST) and Combination Disc Test (CDT). Using multiplex PCR to detect genes encoding carbapenemase belonging to class B (Metallo β-lactamase), class D (oxacillinase), and blaKPC gene. Sequencing of carbapenemase genes were used to identify carbapenemase variants. Results: 91.46% of E. coli strains were identified as multidrug-resistant; most of them resistant to penicillins, fluoroquinolone, sulfonamide; high frequency of resistance to 3rd generation cephalosporin, chloramphenicol, gentamycin. The high isolation rate of ESBL-producing E. coli (50%) was detected. The resistance to carbapenems was largely mediated by the expression of acquired carbapenemases: blaKPC-2, blaNDM-4, and blaOXA-48. This study first reported blaNDM-4-harboring E. coli isolates in Vietnam. Conclusion: The high prevalence of multidrug-resistant and ESBL-producing E. coli, as well as the coexistence of ESBLs and carbapenemase genes, could seriously limit options for clinical treatment.