Emergence of Colistin and Carbapenem Resistance in Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae Isolated from Chickens and Humans in Egypt

• Published in: Biology (Basel, Switzerland) Switzerland), 2021-04, Vol.10 (5), p.373
• Main Authors: Elmonir, Walid, Abd El-Aziz, Norhan K, Tartor, Yasmine H, Moustafa, Samar M, Abo Remela, Etab M, Eissa, Radwa, Saad, Hosam A, Tawab, Ahmed Abdel
• Format: Article
• Language: English
• Subjects: Acids; Animals; Antibiotic resistance; Antimicrobial agents; Carbapenemase; Carbapenems; chickens; Colistin; E coli; Enzymes; ESBL; Farms; Genes; Genotyping; Hospitalization; humans; Infections; K. pneumoniae; Klebsiella pneumoniae; Livestock; Minimum inhibitory concentration; Multidrug resistance; Poultry; Poultry farming; Public health; Software; Workers; β Lactamase
• ISSN: 2079-7737; 2079-7737
• DOI: 10.3390/biology10050373

This study investigated the frequency of carbapenem and colistin resistance in ESBL-producing (ESBLK) isolates recovered from chickens and their environment, contact farm workers and hospitalized patients in Egypt. Further, the phenotypic and genotypic relationships between the community and hospital-acquired isolates in the same geographical area were investigated. From 272 total samples, 37 (13.6%) isolates were identified, of which 20 (54.1%) were hypervirulent. All isolates (100%) were multidrug-resistant (MDR) with multiple antibiotic resistance (MAR) indices ranging from 0.19 to 0.94. Colistin-resistant isolates (18.9%) displayed colistin MIC values >2 μg/mL, all harbored the -1 gene. All isolates from patients (13/90, 14.4%), workers (5/22, 22.7%), chickens (9/100, 9%) and the environment (10/60, 16.7%) harbored a single or multiple β-lactamase genes, , , and , often in combination with carbapenemase genes ( , or ; 45.9%), the -1 gene (18.9%) or both (13.5%). Enterobacterial repetitive intergenic consensus (ERIC)-PCR genotyping revealed 24 distinct ERIC types (ETs) with a discrimination index of 0.961. Six ETs showed clusters of identical isolates from chicken and human sources. The increased frequency and genetic relatedness of ESBLK and carbapenemase-producing (CPK) from chickens and humans pose a public health threat that urge more prudent use of antimicrobials in chicken farms to avoid the propagation and expansion of both ESBLK and CPK from the chicken sources to humans.