NDM Production as a Dominant Feature in Carbapenem-Resistant Enterobacteriaceae Isolates from a Tertiary Care Hospital

• Published in: Antibiotics (Basel) 2021-12, Vol.11 (1), p.48
• Main Authors: Uddin, Fakhur, Imam, Syed Hadi, Khan, Saeed, Khan, Taseer Ahmed, Ahmed, Zulfiqar, Sohail, Muhammad, Elnaggar, Ashraf Y, Fallatah, Ahmed M, El-Bahy, Zeinhom M
• Format: Article
• Language: English
• Subjects: Antimicrobial agents; carbapenem-resistant Enterobacteriaceae; Carbapenemase; Carbapenems; Colistin; CRE bacteria; Drug resistance; E coli; Enterobacter cloacae; Enterobacteriaceae; Health care; Health care facilities; Infections; Klebsiella; Metallo-β-lactamase; metallo-β-lactamases; Metallography; Morbidity; NDM producers; Pathogens; Plasmids; Public health; Surveillance; β Lactamase
• ISSN: 2079-6382; 2079-6382
• DOI: 10.3390/antibiotics11010048

The worldwide spread and increasing prevalence of carbapenem-resistant Enterobacteriaceae (CRE) is of utmost concern and a problem for public health. This resistance is mainly conferred by carbapenemase production. Such strains are a potential source of outbreaks in healthcare settings and are associated with high rates of morbidity and mortality. In this study, we aimed to determine the dominance of NDM-producing Enterobacteriaceae at a teaching hospital in Karachi. A total of 238 Enterobacteriaceae isolates were collected from patients admitted to Jinnah Postgraduate Medical Centre (Unit 4) in Karachi, Pakistan, a tertiary care hospital. Phenotypic and genotypic methods were used for detection of metallo-β-lactamase. Out of 238 isolates, 52 (21.8%) were CRE and 50 isolates were carbapenemase producers, as determined by the CARBA NP test; two isolates were found negative for carbapenemase production by CARB NP and PCR. Four carbapenemase-producing isolates phenotypically appeared negative for metallo-β-lactamase (MBL). Of the 52 CRE isolates, 46 (88.46%) were positive. Most of the NDM producers were , followed by and . In all the NDM-positive isolates, the gene was found on plasmid. These isolates were found negative for the VIM and IPM MBLs. All the CRE and carbapenem-sensitive isolates were sensitive to colistin. It is concluded that the NDM is the main resistance mechanism against carbapenems and is dominant in this region.