Antimicrobial Susceptibility of OXA-48, NDM-1 And VIM-4 Carbapenemase-producing Clinical Isolates of Enterobacteriaceae From Kuwait Government Hospitals
Emergence of infections due to multidrug-resistant Enterobacteriaceae presents a significant public health problem worldwide. Treatment alternatives for infections due to carbapenemase-producing Enterobacteriaceae are few and the resistant organisms have the potential for causing serious healthcare epidemics if not promptly detected and contained. The study was conducted to investigate types of carbapenemases-encoded genes and drug resistance among carbapenem-resistant Enterobacteriaceae isolates in 6 government hospitals in Kuwait.
Enterobacteriaceae isolates resistant to carbapenems were collected over a period of 3 years (2010-2013). Susceptibility testing to 13 commonly used antibiotics was carried out by E test according to the CLSI guidelines. PCR assay was performed for detection of genes encoding ESBLs (blaCTX-M, blaSHV and blaTEM) and carbapenemases (blaOXA-48, blaVIM, blaNDM, blaIMP, blaGIM and blaKPC).
Results: A total of 66 non-duplicated carbapenem-resistant isolates were collected over a period of 3 years. However, only 32/66 (48.5%) carried the carbapenemase resistance genes. Resistance genes analysis showed that 11 isolates carried blaOXA-48 gene, 11 carried blaVIM-4 gene and 10 carried blaNDM-1 gene. 9.1%, 72 and 80 % of blaOXA-48, blaVIM-4 and blaNDM-1-carrying Enterobacteriaceae, respectively were resistant to amikacin. 27.3, 18.2 and 40 % of blaOXA-48, blaVIM-4 and blaNDM-1 carrying isolates, respectively, were resistant to tigecycline and 9.1, 9.1, and 20%, respectively to colistin. Overall, almost 70% of the isolates were resistant to ciprofloxacin and cefepime.
Treatment of carbapenemase-producing Enterobacteriaeae in Kuwait is problematic as some of our isolates are resistant to tigecycline at an unacceptable level and resistance to colistin is emerging.
Acknowledgement: Kuwait University Research Grant No. MI 06/10 is fully acknowledged.
L. Poirel, None
V. Rotimi, None
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