Emergence of Colistin and Carbapenem Resistance in Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae Isolated from Chickens and Humans in Egypt

Walid Elmonir; Norhan K Abd El-Aziz; Yasmine H Tartor; Samar M Moustafa; Etab M Abo Remela; Radwa Eissa; Hosam A Saad; Ahmed Abdel Tawab

doi:10.3390/biology10050373

Emergence of Colistin and Carbapenem Resistance in Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae Isolated from Chickens and Humans in Egypt

Biology (Basel). 2021 Apr 26;10(5):373. doi: 10.3390/biology10050373.

Authors

Walid Elmonir¹, Norhan K Abd El-Aziz², Yasmine H Tartor², Samar M Moustafa³, Etab M Abo Remela^{4

5}, Radwa Eissa⁶, Hosam A Saad⁷, Ahmed Abdel Tawab⁸

Affiliations

¹ Department of Hygiene and Preventive Medicine (Zoonoses), Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt.
² Department of Microbiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig 44511, Egypt.
³ Department of Zoonoses, Faculty of Veterinary Medicine, Benha University, Benha 13518, Egypt.
⁴ Department of Bacteriology, Mycology and Immunology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh 33516, Egypt.
⁵ Department of Biology, College of Science, Taibah University, Madina 42353, Saudi Arabia.
⁶ Department of Microbiology and Immunology, Faculty of Medicine, Tanta University, Tanta 31527, Egypt.
⁷ Department of Chemistry, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia.
⁸ Department of Microbiology, Faculty of Medicine, Al Azhar University, Cairo 11884, Egypt.

Abstract

This study investigated the frequency of carbapenem and colistin resistance in ESBL-producing K. pneumoniae (ESBLK) isolates recovered from chickens and their environment, contact farm workers and hospitalized patients in Egypt. Further, the phenotypic and genotypic relationships between the community and hospital-acquired K. pneumoniae isolates in the same geographical area were investigated. From 272 total samples, 37 (13.6%) K. pneumoniae isolates were identified, of which 20 (54.1%) were hypervirulent. All isolates (100%) were multidrug-resistant (MDR) with multiple antibiotic resistance (MAR) indices ranging from 0.19 to 0.94. Colistin-resistant isolates (18.9%) displayed colistin MIC values >2 μg/mL, all harbored the mcr-1 gene. All isolates from patients (13/90, 14.4%), workers (5/22, 22.7%), chickens (9/100, 9%) and the environment (10/60, 16.7%) harbored a single or multiple β-lactamase genes, bla_SHV, bla_TEM, bla_CTX-M1 and bla_OXA-1, often in combination with carbapenemase genes (bla_VIM, bla_NDM-1 or bla_IMP; 45.9%), the mcr-1 gene (18.9%) or both (13.5%). Enterobacterial repetitive intergenic consensus (ERIC)-PCR genotyping revealed 24 distinct ERIC types (ETs) with a discrimination index of 0.961. Six ETs showed clusters of identical isolates from chicken and human sources. The increased frequency and genetic relatedness of ESBLK and carbapenemase-producing K. pneumoniae (CPK) from chickens and humans pose a public health threat that urge more prudent use of antimicrobials in chicken farms to avoid the propagation and expansion of both ESBLK and CPK from the chicken sources to humans.

Keywords: ESBL; K. pneumoniae; carbapenems; chickens; colistin; environment; humans.