Detection of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae Implicated in Urinary Tract Infection
Asian Journal of Research in Infectious Diseases,
Page 15-23
DOI:
10.9734/ajrid/2023/v12i1234
Abstract
Background and Objectives: Carbapenemase-producing bacteria are super bugs that make Urinary Tract Infections (UTIs) difficult to treat with drug of last resort such as carbapenem and other antibiotic thus limiting the treatment options. Carbapenemase production is increasing in clinical isolates of E. coli and K. pneumoniae, their potential to spread widely among patients necessitates molecular detection of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae implicated in Urinary Tract Infection.
Methodology: A total of twelve (12) non-repeated clinical isolate of Escherichia coli (E1, E2, E3, E4, E5, E6, E7) and Klebsiella pneumoniae (K8, K9, K10, K11, K12) were selected based on their in vitro phenotypic resistant to carbapenem antibiotics from patients diagnosed with urinary tract infection at Alex Ekwueme Federal University Teaching Hospital, Abakaliki (AE-FEUTHA) Ebonyi State Nigeria. Escherichia coli and Klebsiella pneumoniae were further confirmed using standard routine microbiological technique for isolation and identification of bacteria. Escherichia coli and Klebsiella pneumoniae strains were further screen for carbapenemase-producing gene by PCR specific primer.
Result: PCR analysis with specific primer for carbapenemase gene revealed the presence and predominant of blaKPC in Escherichia coli and Klebsiella pneumoniae 12(100 %) followed by blaNDM 11(91.7 %), blaIMP 7(58.3 %) and blaVIM 2(16.7) as the least carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae. blaKPC was predominant in Escherichia coli 7(58.3 %) followed by blaNDM 6(50.0 %) and blaIMP 5(41.7 %) while both blaOXA and blaVIM (16.7 %) were the least detected carbapenemase gene. Klebsiella pneumoniae harbor high proportion of blaNDM and blaKPC both recording 5(41.7 %) followed by blaOXA and blaIMP both recording 2(16.7 %) but blaVIM gene was not identified in Klebsiella pneumoniae.
Conclusion: The current findings highlight the occurrence of carbapenemase-producing gene in Escherichia coli and Klebsiella pneumoniae implicated in UTI. Since these genes are carried on the bacteria plasmid there is a tendency of cross-species dissemination over time. The detection of carbapenemase-producing gene call for prompt epidemiological surveillance and preventive strategies to limit the spread of these carbapenemase resistant genetic determinant and the need for antibiotic susceptibility testing of available antibiotic agent.
Keywords:
- Urinary tract infection
- carbapenemase-producing
- Escherichia coli
- Klebsiella pneumoniae
How to Cite
Nomeh, O. L., Federica, O. I., Joseph, O. V., Moneth, E. C., Ogba, R. C., Nkechi, O. A., Peter, I. U., Akpu, P. O., Edemekong, C. I., & Iroha, I. R. (2023). Detection of Carbapenemase-Producing Escherichia coli and Klebsiella pneumoniae Implicated in Urinary Tract Infection. Asian Journal of Research in Infectious Diseases, 12(1), 15-23. https://doi.org/10.9734/ajrid/2023/v12i1234
References
Nomeh OL, Chukwu EB, Ogba RC, Akpu PO, Peter IU, Nwuzo AC, Iroha IR. Prevalence and Antibiogram Profile of Carbapenem-resistant Escherichia coli and Klebsiella pneumoniae among Patients with Urinary Tract Infection in Abakaliki, Nigeria. Int J Pathogen Res. 2022; 11(3):14-28
World Health Organization (WHO). Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics; 2017.
Avilable:https://Www.Who.Int/Medicines/Publications/WHO-PPL-Short.
Nordmann P. Current situation on spread of metallo-b-lactamases in enterobacteriaceae [Abstract C1-1331]. In: Interscience Conference on Antimicrobial Agents and Chemotherapy. Boston: American Society for Microbiology; 2010.
Suwaiba M, Dadah AJ, Sanusi SB. Prevalence of Carbapenem resistant Escherichia coli and klebsiella pneumoniaein urine samples of patients attending selected general hospitals within Kaduna Metropolis. Sci. World J. 2020;15(4):23-67.
Sobel JD, Kaye D. Urinary tract infections. In: Mandell GL, Bennett JE, eds. Principles and Practice of Infectious Diseases, 8th Edition, Philadelphia, USA: Elsevier Saunders. 2014:886-913.
Nasir F, Khan MI, Kashif S, Uddin F, Naseer A, Masood S. Prevalence of ESBLs secreting and carbapenem-resistant E. coli from urinary tract infection. Rawal Med J. 2021;46:3-23.
Tenney J, Hudson N, Alnifaidy H, Li JTC, Fung KH. Risk factors for aquiring multidrug-resistant organisms in urinary tract infections: A systematic literature review. Saudi Pharm J. 2018;26:678–684.
Ngong IN, Fru Cho J, Yung MA, Akoachere JKT. Prevalence, antimicrobial susceptibility pattern and associated risk factors for urinary tract infections in pregnant women attending ANC in some integrated health centers in the Buea Health district. BMC Pregnancy Childbirth. 2021;21:673-674.
Al Yousef SA, Younis S, Farrag E, Moussa HS, Bayoumi FS, Ali AM. Clinical and laboratory profile of urinary tract infections associated with extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae. Annals of Clin and Laboratory Sci. 2016;46(4):393-400.
World Medical Association (WMA). Declaration of Helsinki. Ethical principles for Medical Research involving Human Subjects. Note of Clarification on paragraph 30 by the WMA General Assembly, Tokyo. 2004;9-10.
Peter IU, Emelda NC, Chukwu EB, Ngwu JN, Uzoeto HO, Moneth EC Stella AO, Edemekong CI, Uzoamaka EP, Nwuzo AC, Iroha IR. Molecular detection of bone sialoprotein-binding protein (bbp) genes among clinical isolates of methicillin resistant Staphylococcus aureus from hospitalized orthopedic wound patients. Asian J Orthopaedic Res. 2022;8(3):1-9.
Edemekong, CI, Iroha IR, Thompson, MD, Okolo, IO., Uzoeto HO, Ngwu JN, Mohammed ID, Chukwu EB, Nwuzo AC, Okike BM, Okolie SO, Peter IU. Phenotypic characterization and antibiogram of non-oral bacteria isolates from patients attending dental clinic at Federal College of Dental Technology and Therapy Medical Center Enugu. Int J Pathog Res. 2022;11(2):7-19.
Iroha IR, Orji JO, Onwa NC, Nwuzo AC, Okonkwo EC, Ibiam EO, Nwachi AC, Afuikwa FN, Agah VM, Ejikeugwu EPC, Agumah NB, Moses IB, Ugbo E, Ukpai EG, Nwakaeze E A, Oke B, Ogbu L and Nwunna E. Microbiology practical handbook. (Editor; Ogbu. O), 1st Edition. Charlieteximage Africa (CiAfrica Press). 2019:344.
Edemekong CI, Uzoeto HO, Mbong EO, Ikusika BA, Didiugwu, CM, Ngwu JN, NseAbasi PL, Ntekpe ME, Mohammed ID, John-Onwe BN, Alagba EE, Obodoechi IF, Joseph OV, Ogbonna IP, Ubom IJ, Peter IU. Molecular characterization and bioassay of soil Actinomycetes strains on multidrug resistant bacteria. IOSR J Biotechnol Biochem. 2022;(1):6-11.
Ogba RC, Nomeh OL, Edemekong CI, Nwuzo AC, Akpu, PO, Peter IU, Iroha IR. Molecular Characterization of Carbapenemase Encoding Genes in Pseudomonas aeruginosa from Tertiary Healthcare in South Eastern Nigeria. Asian J Bio Genet Mol Biol. 2022; 12(4): 161-168.
Wang B, Pan F, Wang C, Zhao W, Sun Y, Zhang T, Shi Y, Zhang H. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in a paediatric hospital in China. Int J Infect Dis. 2020;93:311–319.
Ferreira RL, da Silva BCM, Rezende GS, Nakamura-Silva R, Pitondo-Silva A, Campanini EB, Brito MCA, da Silva EML, Freire CCM, Cunha AF, Pranchevicius MC. High prevalence of multidrug-resistant Klebsiella pneumoniae harboring several virulence and beta-lactamase encoding genes in a Brazilian Intensive Care Unit. Front Microbiol. 2019;9:31-98.
Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD. Novel carbapenem-hydrolyzing β-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. J Antimicrob Agent Chemother. 2001;45:1151–1161.
Chen LF, Anderson DJ, Paterson DL. Overview of the epidemiology and the threat of Klebsiella pneumoniae carbapenemases (KPC) resistance. Infect Drug Resist. 2012; 5:133–41.
Mohammed Y, Zailani SB, Onipede AO. Characterization of KPC, NDM and VIM type carbapenem resistance enterobacteriaceae from North Eastern Nigeria. J Bio Med. 2015;3:100–7.
Wang Q, Wang X, Wang J, Ouyang P, Jin C, Wang R. Phenotypic and genotypic characterization of carbapenem-resistant enterobacteriaceae: Data from a longitudinal large-scale CRE study in China (2012–2016). Clin Infect Dis J. 2018;67(2):196–205.
Olalekana A, Onwugambab F, Iwalokunc B, Mellmann A, Beckerb K, Schaumburg F. High Proportion of Carbapenemase-producing Escherichia coli and Klebsiella pneumoniae among Extended-spectrum β-lactamase-producers in Nigerian Hospitals. J Glob Antimicrob Resist. 2020; 21:8–12.
Aminu A, Daneji IM, Yusuf MA, Jalo RI, Tsiga-Ahmed FI, Yahaya M. Carbapenem-resistant Enterobacteriaceae Infections among Patients Admitted to Intensive Care Units in Kano, Nigeria. Sahel Med J. 2021; 24:1-9.
Thapa A, Upreti MK, Bimali NK, Shrestha B, Sah AK, Nepal K, Dhungel B, Adhikari S, Adhikari N, Lekhak B, Rijal KR. Detection of NDM variants (blaNDM-1, blaNDM-2, blaNDM-3) from carbapenem-resistant Escherichia coli and Klebsiella pneumoniae: First report from Nepal. Infect and Drug Resist. 2022; 15 4419–4434.
Zhang Q, Lv L, Huang X, Huang Y, Zhuang Z, Lu J. Rapid increase in carbapenemase-producing enterobacteriaceae in retail meat driven by the spread of the carrying IncX3 plasmid in China from 2016 to 2018. J Antimicrob Agent Chemother. 2019;63(8):56-78.
Marques C, Belas A, Aboim C, Cavaco-Silva P, Trigueiro G, Gama LT. Evidence of sharing of Klebsiella pneumoniae strains between healthy companion animals and cohabiting humans. J Clin Microbiol Infect Dis. 2019;57(6):234-456.
Zhang F, Xie L, Wang X, Han L, Guo X, Ni Y. Further Spread of bla NDM-5 in Enterobacteriaceae via IncX3 plasmids in Shanghai, China. Front Microbiol. 2016; 7:424-425.
Zhang Y, Wang Q, Yin Y, Chen H, Jin L, Gu B. Epidemiology of carbapenem-resistant enterobacteriaceae infections: Report from the China CRE Network. J Antimicrob Agent Chemother. 2018;62(2):23-45.
Alhazmi W, Al-Jabri A, Al-Zahrani I. The molecular characterization of nosocomial carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM and blaOXA-48 in Jeddah. Microbiol Res. 2022;13:753–764.
Shibl A, Al-Agamy M, Memish Z, Senok A, Khader SA, Assiri A. The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis. 2013;17:1130–1133.
Shibl A, Senok A, Memish Z. Infectious diseases in the Arabian Peninsula and Egypt. J Clin Microbiol Infect Dis. 2012;18:1068–80.
Nordmann P, Naas T, Poirel L. Global Spread of Carbapenemase-producing enterobacteriaceae. Emerg Infect Dis. 2011;17:1791–8.
Alizadeh N, Rezaee MA, Kafil HS, Hasani A, Barhaghi MHS, Milani M, Sefidan FY, Memar MY, Lalehzadeh A, Ghotaslou R. Evaluation of resistance mechanisms in carbapenem-resistant enterobacteriaceae. Infect Drug Resist. 2020;13:1377–1385.
Potron A, Poirel L, Rondinaud E, Nordmann P. Intercontinental spread of OXA-48 β-lactamase-producing enterobacteriaceae over a 11-year period, 2001 to 2011. Euro Surveilliance. 2013;18:20549.
Poirel L, Carbonnelle E, Bernabeu S, Gutmann L, Rotimi V, Nordmann P. Importation of OXA-48-producing Klebsiella pneumoniae from Kuwait. J Antimicrob Agent Chemother. 2012;67:2051–2052.
Beyrouthy R, Robin F, Cougnoux A, Dalmasso G, Darfeuille-Michaud A, Mallat H. Chromosome-mediated OXA-48 carbapenemase in highly virulent Escherichia coli. J Antimicrob Agent Chemother. 2013;68:1558–1561.
Beyrouthy R, Robin F, Dabboussi F, Mallat H, Hamze M, Bonnet R. Carbapenemase and virulence factors of enterobacteriaceae in North Lebanon between 2008 and 2012: Evolution via Endemic Spread of OXA-48. J Antimicrob Agent Chemother. 2014;69:2699–2705.
de Toro M, Fernandez J, Garcia V, Mora A, Blanco J, De La Cruz F. Whole genome sequencing, molecular typing and in vivo virulence of OXA-48-producing Escherichiacoli isolates including ST131 H30-Rx, H22 and H41 subclones. J Scientific Report. 2017;7:12103-12109.
Hashemizadeh Z, Hosseinzadeh Z, Azimzadeh N, Motamedifar M. Dissemination pattern of multidrug resistant carbapenemase producing Klebsiella pneumoniae isolates using pulsed-field gel electrophoresis in Southwestern Iran. Infect Drug Resist. 2020;13:921–929.
Tian D, Pan F, Wang C, Sun Y, Zhang H. Resistance phenotype and clinical molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae among pediatric patients in Shanghai. Infect and Drug Resist. 2018;11:1935–43.
Saavedra SY, Bernal JF, Montilla-Escudero E, Arévalo SA, Andrés Prada D, Valencia MF, Moreno J, Hidalgo AM, García-Vega ÁS, Abrudan M, Argimón S, Kekre M, Underwood A, Aanensen DM, Duarte C, Donado-Godoy P, NIHR Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance. Complexity of genomic epidemiology of carbapenem-resistant Klebsiella pneumoniaeIsolates in Colombia Urges the reinforcement of whole genome sequencing-based surveillance programs. Clinical Infectious Diseases. 2021;73(4):290–9.
Murugan MS, Sinha DK, Vinodh Kumar OR, Yadav AK, Pruthvishree BS, Vadhana P, Nirupama KR, Bhardwaj M, Singh BR. Epidemiology of carbapenem resistant Escherichia coli and First Report of blaVIM carbapenemases gene in Calves from India. Epidemiol Infect. 2019;147:159, 1–5.
Lee K, Yong D, Choi YS, Yum JH, Kim J M, Woodford N, Livermore DM, Chong Y. Reduced imipenem susceptibility in Klebsiella pneumoniae clinical isolates with plasmid-mediated CMY-2 and DHA-1 beta-lactamases Co-mediated by Porin Loss. Int J Antimicrob Agents. 2007;29:201-206.
Ding H, Yang Y, Lu Q, Wang Y, Chen Y, Deng L, Wang A, Deng Q, Zhang H, Wang C. The prevalence of plasmid- mediated AmpC beta-lactamases among clinical isolates of Escherichia coli and Klebsiella pneumoniae from Five Children’s Hospitals in China. Euro J Clin Microbiol Nfect Dis. 2008;27:915-921.
Yamada Y, Ishii Y, Kouyama Y, Katho M, Odashiro R, Yamahata K, Tateda K, Yamaguchi K, Suwabe A. Characterization of Klebsiella pneumoniae producing SHV-12 and DHA-1 beta-lactamases accompanied by carbapenem resistance during hospitalization in a Chronic Care Ward in Japan. J Chemother. 2008;21: 445-447.
World Health Organization (WHO). Global priority list of antibiotic-resistant bacteria to guide research, discovery, and development of new antibiotics; 2017.
Avilable:https://Www.Who.Int/Medicines/Publications/WHO-PPL-Short.
Nordmann P. Current situation on spread of metallo-b-lactamases in enterobacteriaceae [Abstract C1-1331]. In: Interscience Conference on Antimicrobial Agents and Chemotherapy. Boston: American Society for Microbiology; 2010.
Suwaiba M, Dadah AJ, Sanusi SB. Prevalence of Carbapenem resistant Escherichia coli and klebsiella pneumoniaein urine samples of patients attending selected general hospitals within Kaduna Metropolis. Sci. World J. 2020;15(4):23-67.
Sobel JD, Kaye D. Urinary tract infections. In: Mandell GL, Bennett JE, eds. Principles and Practice of Infectious Diseases, 8th Edition, Philadelphia, USA: Elsevier Saunders. 2014:886-913.
Nasir F, Khan MI, Kashif S, Uddin F, Naseer A, Masood S. Prevalence of ESBLs secreting and carbapenem-resistant E. coli from urinary tract infection. Rawal Med J. 2021;46:3-23.
Tenney J, Hudson N, Alnifaidy H, Li JTC, Fung KH. Risk factors for aquiring multidrug-resistant organisms in urinary tract infections: A systematic literature review. Saudi Pharm J. 2018;26:678–684.
Ngong IN, Fru Cho J, Yung MA, Akoachere JKT. Prevalence, antimicrobial susceptibility pattern and associated risk factors for urinary tract infections in pregnant women attending ANC in some integrated health centers in the Buea Health district. BMC Pregnancy Childbirth. 2021;21:673-674.
Al Yousef SA, Younis S, Farrag E, Moussa HS, Bayoumi FS, Ali AM. Clinical and laboratory profile of urinary tract infections associated with extended spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae. Annals of Clin and Laboratory Sci. 2016;46(4):393-400.
World Medical Association (WMA). Declaration of Helsinki. Ethical principles for Medical Research involving Human Subjects. Note of Clarification on paragraph 30 by the WMA General Assembly, Tokyo. 2004;9-10.
Peter IU, Emelda NC, Chukwu EB, Ngwu JN, Uzoeto HO, Moneth EC Stella AO, Edemekong CI, Uzoamaka EP, Nwuzo AC, Iroha IR. Molecular detection of bone sialoprotein-binding protein (bbp) genes among clinical isolates of methicillin resistant Staphylococcus aureus from hospitalized orthopedic wound patients. Asian J Orthopaedic Res. 2022;8(3):1-9.
Edemekong, CI, Iroha IR, Thompson, MD, Okolo, IO., Uzoeto HO, Ngwu JN, Mohammed ID, Chukwu EB, Nwuzo AC, Okike BM, Okolie SO, Peter IU. Phenotypic characterization and antibiogram of non-oral bacteria isolates from patients attending dental clinic at Federal College of Dental Technology and Therapy Medical Center Enugu. Int J Pathog Res. 2022;11(2):7-19.
Iroha IR, Orji JO, Onwa NC, Nwuzo AC, Okonkwo EC, Ibiam EO, Nwachi AC, Afuikwa FN, Agah VM, Ejikeugwu EPC, Agumah NB, Moses IB, Ugbo E, Ukpai EG, Nwakaeze E A, Oke B, Ogbu L and Nwunna E. Microbiology practical handbook. (Editor; Ogbu. O), 1st Edition. Charlieteximage Africa (CiAfrica Press). 2019:344.
Edemekong CI, Uzoeto HO, Mbong EO, Ikusika BA, Didiugwu, CM, Ngwu JN, NseAbasi PL, Ntekpe ME, Mohammed ID, John-Onwe BN, Alagba EE, Obodoechi IF, Joseph OV, Ogbonna IP, Ubom IJ, Peter IU. Molecular characterization and bioassay of soil Actinomycetes strains on multidrug resistant bacteria. IOSR J Biotechnol Biochem. 2022;(1):6-11.
Ogba RC, Nomeh OL, Edemekong CI, Nwuzo AC, Akpu, PO, Peter IU, Iroha IR. Molecular Characterization of Carbapenemase Encoding Genes in Pseudomonas aeruginosa from Tertiary Healthcare in South Eastern Nigeria. Asian J Bio Genet Mol Biol. 2022; 12(4): 161-168.
Wang B, Pan F, Wang C, Zhao W, Sun Y, Zhang T, Shi Y, Zhang H. Molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae in a paediatric hospital in China. Int J Infect Dis. 2020;93:311–319.
Ferreira RL, da Silva BCM, Rezende GS, Nakamura-Silva R, Pitondo-Silva A, Campanini EB, Brito MCA, da Silva EML, Freire CCM, Cunha AF, Pranchevicius MC. High prevalence of multidrug-resistant Klebsiella pneumoniae harboring several virulence and beta-lactamase encoding genes in a Brazilian Intensive Care Unit. Front Microbiol. 2019;9:31-98.
Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD. Novel carbapenem-hydrolyzing β-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. J Antimicrob Agent Chemother. 2001;45:1151–1161.
Chen LF, Anderson DJ, Paterson DL. Overview of the epidemiology and the threat of Klebsiella pneumoniae carbapenemases (KPC) resistance. Infect Drug Resist. 2012; 5:133–41.
Mohammed Y, Zailani SB, Onipede AO. Characterization of KPC, NDM and VIM type carbapenem resistance enterobacteriaceae from North Eastern Nigeria. J Bio Med. 2015;3:100–7.
Wang Q, Wang X, Wang J, Ouyang P, Jin C, Wang R. Phenotypic and genotypic characterization of carbapenem-resistant enterobacteriaceae: Data from a longitudinal large-scale CRE study in China (2012–2016). Clin Infect Dis J. 2018;67(2):196–205.
Olalekana A, Onwugambab F, Iwalokunc B, Mellmann A, Beckerb K, Schaumburg F. High Proportion of Carbapenemase-producing Escherichia coli and Klebsiella pneumoniae among Extended-spectrum β-lactamase-producers in Nigerian Hospitals. J Glob Antimicrob Resist. 2020; 21:8–12.
Aminu A, Daneji IM, Yusuf MA, Jalo RI, Tsiga-Ahmed FI, Yahaya M. Carbapenem-resistant Enterobacteriaceae Infections among Patients Admitted to Intensive Care Units in Kano, Nigeria. Sahel Med J. 2021; 24:1-9.
Thapa A, Upreti MK, Bimali NK, Shrestha B, Sah AK, Nepal K, Dhungel B, Adhikari S, Adhikari N, Lekhak B, Rijal KR. Detection of NDM variants (blaNDM-1, blaNDM-2, blaNDM-3) from carbapenem-resistant Escherichia coli and Klebsiella pneumoniae: First report from Nepal. Infect and Drug Resist. 2022; 15 4419–4434.
Zhang Q, Lv L, Huang X, Huang Y, Zhuang Z, Lu J. Rapid increase in carbapenemase-producing enterobacteriaceae in retail meat driven by the spread of the carrying IncX3 plasmid in China from 2016 to 2018. J Antimicrob Agent Chemother. 2019;63(8):56-78.
Marques C, Belas A, Aboim C, Cavaco-Silva P, Trigueiro G, Gama LT. Evidence of sharing of Klebsiella pneumoniae strains between healthy companion animals and cohabiting humans. J Clin Microbiol Infect Dis. 2019;57(6):234-456.
Zhang F, Xie L, Wang X, Han L, Guo X, Ni Y. Further Spread of bla NDM-5 in Enterobacteriaceae via IncX3 plasmids in Shanghai, China. Front Microbiol. 2016; 7:424-425.
Zhang Y, Wang Q, Yin Y, Chen H, Jin L, Gu B. Epidemiology of carbapenem-resistant enterobacteriaceae infections: Report from the China CRE Network. J Antimicrob Agent Chemother. 2018;62(2):23-45.
Alhazmi W, Al-Jabri A, Al-Zahrani I. The molecular characterization of nosocomial carbapenem-resistant Klebsiella pneumoniae co-harboring blaNDM and blaOXA-48 in Jeddah. Microbiol Res. 2022;13:753–764.
Shibl A, Al-Agamy M, Memish Z, Senok A, Khader SA, Assiri A. The emergence of OXA-48- and NDM-1-positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. Int J Infect Dis. 2013;17:1130–1133.
Shibl A, Senok A, Memish Z. Infectious diseases in the Arabian Peninsula and Egypt. J Clin Microbiol Infect Dis. 2012;18:1068–80.
Nordmann P, Naas T, Poirel L. Global Spread of Carbapenemase-producing enterobacteriaceae. Emerg Infect Dis. 2011;17:1791–8.
Alizadeh N, Rezaee MA, Kafil HS, Hasani A, Barhaghi MHS, Milani M, Sefidan FY, Memar MY, Lalehzadeh A, Ghotaslou R. Evaluation of resistance mechanisms in carbapenem-resistant enterobacteriaceae. Infect Drug Resist. 2020;13:1377–1385.
Potron A, Poirel L, Rondinaud E, Nordmann P. Intercontinental spread of OXA-48 β-lactamase-producing enterobacteriaceae over a 11-year period, 2001 to 2011. Euro Surveilliance. 2013;18:20549.
Poirel L, Carbonnelle E, Bernabeu S, Gutmann L, Rotimi V, Nordmann P. Importation of OXA-48-producing Klebsiella pneumoniae from Kuwait. J Antimicrob Agent Chemother. 2012;67:2051–2052.
Beyrouthy R, Robin F, Cougnoux A, Dalmasso G, Darfeuille-Michaud A, Mallat H. Chromosome-mediated OXA-48 carbapenemase in highly virulent Escherichia coli. J Antimicrob Agent Chemother. 2013;68:1558–1561.
Beyrouthy R, Robin F, Dabboussi F, Mallat H, Hamze M, Bonnet R. Carbapenemase and virulence factors of enterobacteriaceae in North Lebanon between 2008 and 2012: Evolution via Endemic Spread of OXA-48. J Antimicrob Agent Chemother. 2014;69:2699–2705.
de Toro M, Fernandez J, Garcia V, Mora A, Blanco J, De La Cruz F. Whole genome sequencing, molecular typing and in vivo virulence of OXA-48-producing Escherichiacoli isolates including ST131 H30-Rx, H22 and H41 subclones. J Scientific Report. 2017;7:12103-12109.
Hashemizadeh Z, Hosseinzadeh Z, Azimzadeh N, Motamedifar M. Dissemination pattern of multidrug resistant carbapenemase producing Klebsiella pneumoniae isolates using pulsed-field gel electrophoresis in Southwestern Iran. Infect Drug Resist. 2020;13:921–929.
Tian D, Pan F, Wang C, Sun Y, Zhang H. Resistance phenotype and clinical molecular epidemiology of carbapenem-resistant Klebsiella pneumoniae among pediatric patients in Shanghai. Infect and Drug Resist. 2018;11:1935–43.
Saavedra SY, Bernal JF, Montilla-Escudero E, Arévalo SA, Andrés Prada D, Valencia MF, Moreno J, Hidalgo AM, García-Vega ÁS, Abrudan M, Argimón S, Kekre M, Underwood A, Aanensen DM, Duarte C, Donado-Godoy P, NIHR Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance. Complexity of genomic epidemiology of carbapenem-resistant Klebsiella pneumoniaeIsolates in Colombia Urges the reinforcement of whole genome sequencing-based surveillance programs. Clinical Infectious Diseases. 2021;73(4):290–9.
Murugan MS, Sinha DK, Vinodh Kumar OR, Yadav AK, Pruthvishree BS, Vadhana P, Nirupama KR, Bhardwaj M, Singh BR. Epidemiology of carbapenem resistant Escherichia coli and First Report of blaVIM carbapenemases gene in Calves from India. Epidemiol Infect. 2019;147:159, 1–5.
Lee K, Yong D, Choi YS, Yum JH, Kim J M, Woodford N, Livermore DM, Chong Y. Reduced imipenem susceptibility in Klebsiella pneumoniae clinical isolates with plasmid-mediated CMY-2 and DHA-1 beta-lactamases Co-mediated by Porin Loss. Int J Antimicrob Agents. 2007;29:201-206.
Ding H, Yang Y, Lu Q, Wang Y, Chen Y, Deng L, Wang A, Deng Q, Zhang H, Wang C. The prevalence of plasmid- mediated AmpC beta-lactamases among clinical isolates of Escherichia coli and Klebsiella pneumoniae from Five Children’s Hospitals in China. Euro J Clin Microbiol Nfect Dis. 2008;27:915-921.
Yamada Y, Ishii Y, Kouyama Y, Katho M, Odashiro R, Yamahata K, Tateda K, Yamaguchi K, Suwabe A. Characterization of Klebsiella pneumoniae producing SHV-12 and DHA-1 beta-lactamases accompanied by carbapenem resistance during hospitalization in a Chronic Care Ward in Japan. J Chemother. 2008;21: 445-447.
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