Phenotypic and Genotypic Features of Klebsiella pneumoniae Harboring Carbapenemases in Egypt: OXA-48-Like Carbapenemases as an Investigated Model

Suzan Mohammed Ragheb; Mahmoud Mohamed Tawfick; Amani Ali El-Kholy; Abeer Khairy Abdulall

doi:10.3390/antibiotics9120852

Phenotypic and Genotypic Features of Klebsiella pneumoniae Harboring Carbapenemases in Egypt: OXA-48-Like Carbapenemases as an Investigated Model

Antibiotics (Basel). 2020 Nov 28;9(12):852. doi: 10.3390/antibiotics9120852.

Authors

Suzan Mohammed Ragheb¹, Mahmoud Mohamed Tawfick^{2

3}, Amani Ali El-Kholy⁴, Abeer Khairy Abdulall⁵

Affiliations

¹ Department of Microbiology and Immunology, Faculty of Pharmacy, Modern University for Technology and Information (MTI), Cairo 11571, Egypt.
² Department of Microbiology and Immunology, Faculty of Pharmacy (Boys), Al-Azhar University, Cairo 11884, Egypt.
³ Department of Microbiology, Faculty of Pharmacy, Heliopolis University, Cairo 11785, Egypt.
⁴ Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt.
⁵ Department of Microbiology and Immunology, Faculty of Pharmacy (Girls), Al-Azhar University, Cairo 11884, Egypt.

Abstract

This study aimed at the characterization of carbapenem-resistant Klebsiella pneumoniae isolates focusing on typing of the bla_OXA-48-like genes. Additionally, the correlation between the resistance pattern and biofilm formation capacity of the carbapenem-resistant K. pneumoniae isolates was studied. The collected isolates were assessed for their antimicrobial resistance and carbapenemases production by a modified Hodge test and inhibitor-based tests. The carbapenemases encoding genes (bla_KPC, bla_NDM, bla_VIM, bla_IMP, and bla_OXA-48-like) were detected by PCR. Isolates harboring bla_OXA-48-like genes were genotyped by Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction (ERIC-PCR) and plasmid profile analysis. The discriminatory power of the three typing methods (antibiogram, ERIC-PCR, and plasmid profile analysis) was compared by calculation of Simpson's Diversity Index (SDI). The transferability of bla_OXA-48 gene was tested by chemical transformation. The biofilm formation capacity and the prevalence of the genes encoding the fimbrial adhesins (fimH-1 and mrkD) were investigated. The isolates showed remarkable resistance to β-lactams and non-β-lactams antimicrobials. The coexistence of the investigated carbapenemases encoding genes was prevalent except for only 15 isolates. The plasmid profile analysis had the highest discriminatory power (SDI = 0.98) in comparison with ERIC-PCR (SDI = 0.89) and antibiogram (SDI = 0.78). The transferability of bla_OXA-48 gene was unsuccessful. All isolates were biofilm formers with the absence of a significant correlation between the biofilm formation capacity and resistance profile. The genes fimH-1 and mrkD were prevalent among the isolates. The prevalence of carbapenemases encoding genes, especially bla_OXA-48-like genes in Egyptian healthcare settings, is worrisome and necessitates further strict dissemination control measures.

Keywords: ERIC-PCR; Klebsiella pneumoniae; biofilm formation; blaOXA-48; carbapenemases; plasmid profile analysis.