Susceptibility of carbapenem-resistant Enterobacterales isolates to new antibiotics from a tertiary care hospital, Egypt: A matter of hope

Shahenda G Badran; Mai M Malek; Rehab M Ateya; Amira H Afifi; Mahmoud M Magdy; Eman S Elgharabawy

doi:10.3855/jidc.17349

Susceptibility of carbapenem-resistant Enterobacterales isolates to new antibiotics from a tertiary care hospital, Egypt: A matter of hope

Authors

Shahenda G Badran Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt https://orcid.org/0000-0003-3626-4318
Mai M Malek Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt https://orcid.org/0000-0003-0297-0601
Rehab M Ateya Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt https://orcid.org/0000-0002-9777-3493
Amira H Afifi Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt https://orcid.org/0000-0003-1681-9216
Mahmoud M Magdy Internal Medicine Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt https://orcid.org/0000-0001-6239-8489
Eman S Elgharabawy Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt https://orcid.org/0000-0003-2899-7175

DOI:

https://doi.org/10.3855/jidc.17349

Keywords:

Enterobacterales, carbapenem resistance, carbapenemases, novel antibiotics, multidrug resistance

Abstract

Introduction: Carbapenem-resistant Enterobacterales (CRE) are particularly worrisome pathogens because of their resistance to last-resort antibiotics, significant morbidity, and mortality. With limited treatment options, new therapeutic choices have become available for the management of CRE infections. Data regarding the efficacy of these novel agents are still limited particularly in a low-middle-income country like Egypt. This study aims to assess the prevalence of different carbapenemase genes among CRE isolates and the susceptibility of these isolates to novel antibiotics for improving antibiotic policy and infection control strategies in Egypt.

Methodology: In this cross-sectional study, 260 Enterobacterales were recovered from patients admitted to intensive care units between January and June 2021. Susceptibility testing was conducted using Kirby-Bauer method. Molecular detection of five carbapenemase genes, namely bla_KPC, bla_IMP, bla_VIM, bla_NDM, bla_OXA-48was done using polymerase chain reaction (PCR).

Results: Of the 260 Enterobacterales, 34.6% were found to be carbapenems resistant. All of the CRE isolates were multi-drug resistant exhibiting resistance to most antibiotics. All isolates harbored one or more carbapenemases genes. The most prevalent was bla_NDM (84.4%), followed by bla_OXA-48 (73.3%), bla_KPC (13.3%), bla_IMP (2.2%), while bla_VIM gene wasn’t detected. Among 62.2% of the CRE isolates, two or more carbapenemase genes co-existed. For the new antibiotics tested, 100% of CRE resisted ceftolozane/tazobactam, 86.7% resisted ceftazidime/avibactam, 51.1% were resistant to eravacyclin, and 42.2% were resistant to cefiderocol.

Conclusions: A high percentage of resistance to carbapenems among Enterobacterales isolates was revealed. bla_NDM was found to be the most predominant carbapenemase gene. A high rate of CRE resistance to novel agents signifies a major threat.

Author Biographies

Shahenda G Badran, Medical Microbiology and Immunology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

lecturer of Medical Microbiology and Immunology Department, Faculty of medicine, Zagazig University

Amira H Afifi, Clinical Pathology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Lecturer of Clinical pathology Department, Faculty of medicine, Zagazig University, Zagazig, Egypt.

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Published

2022-12-31

How to Cite

G Badran S, Malek MM, M Ateya R, Afifi AH, Magdy MM, Elgharabawy ES (2022) Susceptibility of carbapenem-resistant Enterobacterales isolates to new antibiotics from a tertiary care hospital, Egypt: A matter of hope. J Infect Dev Ctries 16:1852–1859. doi: 10.3855/jidc.17349

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Issue

Vol. 16 No. 12: December 2022

Section

Original Articles

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Copyright (c) 2022 Shahenda Gamal Badran , Mai M. Malek, Rehab M. Ateya, Amira Hamed Lecturer of Clinical pathology Department, Faculty of medicine, Zagazig University, Zagazig, Egypt. Mohamed Afifi, Mahmoud Mohamed Magdy , Eman Salah Elgharabawy

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