Different Phenotypic and Molecular Mechanisms Associated with Multidrug Resistance in Gram-negative Clinical Isolates from Egypt

Overview

Journal Infect Drug Resist

Publisher Dove Medical Press

Date 2017 Dec 22

PMID 29263684

Citations 9

Authors

Omneya M Helmy

Mona T Kashef

Affiliations

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Abstract

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%. isolates showed resistance to most of the tested antibiotics, including imipenem. The gene was detected in 69% of the MDR isolates. The MDR phenotype was detected in 65% of 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 ((6')--B, S) were detected in 57.6% and 83.33% of quinolone-resistant MDR and isolates, respectively. The β-lactamase-resistance gene was detected for the first time in one MDR isolate from an endotracheal tube specimen in Egypt, accompanied by , , , (6')--S, 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.

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