Detection of blaKPC gene among Carbapenem Resistant Enterobacteriacae Isolates from Ain Shams University Hospital, Egypt

Abstract

Background: Carbapenem resistance among Enterobacteriaceae , especially in Escherichia coli (E.coli) and Klebsiella pneumoniae (K. Pneumoniae) is considered a significant problem worldwide. Resistance to carbapenems in Enterobacteriaceae is mediated by different mechanisms. Production of class-A, Klebsiella pneumoniae carbapenemase (KPC) is the most common mechanisms. Objective: This work aims to measure the frequency of carbapenem resistance among enterobacteriacae isolates and detection of blaKPC gene among them. Methodology: Seventy (70) Enterobacteriaceae isolates were collected from Ain Shams University Hospital during a period of 3 months from February to May 2022.The bacterial isolates were identified by conventional methods. All Enterobacteriaceae isolates were screened for carbapenem resistance by disc diffusion method using meropenem disks. Twenty-five (25) CRE strains were tested for antimicrobial susceptibility testing by the KirbyBauer method. Then E test strips containing range of antibiotic concentrations (0.002-32 ug/ml) for meropenem was done for confirmation of CRE isolates. Twenty-five (25) CRE isolates were subjected to conventional PCR blaKPC gene detection. Results: Out of 70 Enterobacteriaceae isolates 36 strains were identified as K. pneumoniae, 25 were identified as E.coli and 9 were Proteus spp by conventional bacteriological methods. Twenty-five CRE isolates were detected by meropenem disk diffusion method (18 K. pneumoniae and 7 E.coli).. BlaKPC was detected in 3 out of CRE 22 isolates, (13.6%) by conventional PCR. Conclusion: CRE is increasing rapidly worldwide with emergence of BlaKPC gene carbapenem resistance.