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Different phenotypic and molecular mechanisms associated with multidrug resistance in Gram-negative clinical isolates from Egypt
- Source :
- Infection and Drug Resistance
- Publication Year :
- 2017
- Publisher :
- Dove Medical Press, 2017.
-
Abstract
- Omneya M Helmy,Mona T Kashef Department of Microbiology and Immunology, Faculty of Pharmacy, Cairo University, Cairo, Egypt Objectives: We set out to investigate the prevalence, different mechanisms, and clonal relatedness of multidrug resistance (MDR) among third-generation cephalosporin-resistant Gram-negative clinical isolates from Egypt.Materials and methods: A total of 118 third-generation cephalosporin-resistant Gram-negative clinical isolates were included in this study. Their antimicrobial susceptibility pattern was determined using Kirby–Bauer disk diffusion method. Efflux pump-mediated resistance was tested by the efflux-pump inhibitor-based microplate assay using chlorpromazine. Detection of different aminoglycoside-, β-lactam-, and quinolone-resistance genes was done using polymerase chain reaction. The genetic diversity of MDR isolates was investigated using random amplification of polymorphic DNA.Results: Most of the tested isolates exhibited MDR phenotypes (84.75%). The occurrence of efflux pump-mediated resistance in the different MDR species tested was 40%–66%. Acinetobacter baumannii isolates showed resistance to most of the tested antibiotics, including imipenem. The blaOXA-23-like gene was detected in 69% of the MDR A. baumannii isolates. The MDR phenotype was detected in 65% of Pseudomonas aeruginosa isolates, of which only 23% exhibited efflux pump-mediated resistance. On the contrary, efflux-mediated resistance to piperacillin and gentamicin was recorded in 47.5% of piperacillin-resistant and 25% of gentamicin-resistant MDR Enterobacteriaceae. Moreover, the plasmid-mediated quinolone-resistance genes (aac(6’)-Ib-cr, qnrB, and qnrS) were detected in 57.6% and 83.33% of quinolone-resistant MDR Escherichia coli and Klebsiella pneumoniae isolates, respectively. The β-lactamase-resistance gene blaSHV-31 was detected for the first time in one MDR K. pneumoniae isolate from an endotracheal tube specimen in Egypt, accompanied by blaTEM-1, blaCTX-M-15, blaCTX-M-14, aac(6’)-Ib-cr, qnrS, and multidrug efflux-mediated resistance.Conclusion: MDR phenotypes are predominant among third-generation cephalosporin-resistant Gram-negative bacteria in Egypt and mediated by different mechanisms, with an increased role of efflux pumps in Enterobacteriaceae. Keywords: multidrug resistance, efflux pump, Egypt, Gram-negative bacilli, RAPD typing
- Subjects :
- 0301 basic medicine
Imipenem
Gram-negative bacilli
Klebsiella pneumoniae
030106 microbiology
medicine.disease_cause
RAPD typing
Microbiology
03 medical and health sciences
multidrug resistance
medicine
Pharmacology (medical)
Original Research
Pharmacology
biology
Pseudomonas aeruginosa
biology.organism_classification
Acinetobacter baumannii
Multiple drug resistance
Infectious Diseases
Infection and Drug Resistance
efflux pump
Gentamicin
Egypt
Efflux
medicine.drug
Piperacillin
Subjects
Details
- Language :
- English
- ISSN :
- 11786973
- Volume :
- 10
- Database :
- OpenAIRE
- Journal :
- Infection and Drug Resistance
- Accession number :
- edsair.doi.dedup.....ed4ddbc10b72af5867133da0a5a6f047