Carriage of ndm & imp carbapenem resistance genes among e. coli & k. pneumoniae isolates from Mbarara.

Abstract

The first reports of carbapenem resistance in Enterobacteriaceae isolates occurred in the early 1990s. Researchers published the first report of an isolate that produced Klebsiella pneumoniae carbapenemase in 2001. Antimicrobial resistance has become one of the greatest threats to public health, with rising resistance to carbapenems being a particular concern due to the lack of effective and safe alternative treatment options. The emerging spread of carbapenemase-producing Enterobacteriaceae strains, in particular, Klebsiella pneumoniae and Escherichia coli, has become a significant threat to hospitalized patients. Carbapenemase genes are frequently located on plasmids that can be exchanged among clonal strains, increasing the antibiotic resistance rate. Colistin and tigecycline have been used as first-line agents for the treatment of infections caused by these pathogens; however, there are uncertainties regarding their efficacy even when used in combination with other agents. More recently, several new agents with activity against certain carbapenem-resistant pathogens have been approved for clinical use or are reaching late-stage clinical development. They include ceftazidime-avibactam, ceftolozane-tazobactam, meropenem-vaborbactam, imipenem-cilastatin-relebactam, plazomicin, eravacycline, and cefiderocol. In addition, fosfomycin has been redeveloped in a new intravenous formulation. This study aimed to determine the prevalence of NDM and IMP carbapenem resistance genes among E.coli and K.pneumoniae isolates from Mbarara. An investigation of the antibiotic resistance and genetic features of circulating carbapenemase-producing E.coli and K.pneumoniae was carried out. Phenotypic tests and molecular typing were performed on 32 carbapenemase-producing strains of K. pneumoniae and E. coli isolates. Carbapenem-resistance was confirmed by PCR detection of resistance genes. All strains were first cultured and incubated at 37◦C overnight. Genomic DNA was extracted using the CTAB extraction method from the cultured isolates and a conventional PCR was done for the detection of resistant Genes. More than 50% of the strains were found to be multidrug-resistant, and the bla KPC gene was detected in all the isolates except an E. coli strain. According to this study, 5 isolates (16.7%) in total were producers of either NDM or IMP genes. However, none of the isolates were producers of both genes This study highlights the importance of screening patients upon their admission to limit the spread of carbapenem-resistant Enterobacteriaceae in hospitals.