Emergence of NDM in Association with OXA-48 Carbapenemase in Raoultella Terrigena from a Moroccan University Hospital in Casablanca, Morocco
DOI:
https://doi.org/10.55677/IJCSMR/V3I6-01/2023Keywords:
Raoultella terrigena, morocco, carbapenemases, ndm, oxa-48Abstract
Objective: The purpose of this study was to investigate the emergence of Raoultella terrigena, a rarely found opportunistic pathogen, co-producing NDM and OXA-48 carbapenemases in isolates recovered from various clinical specimens in our institution.
Methods: From April 2020 to November 2021, we focused on strains of Enterobacteriaceae with reduced sensitivity to ertapenem giving rise to suspicion of the production of carbapenemases according to the CASFM-EUCAST criteria. These strains were isolated from samples for diagnostic purposes and identified in the microbiology laboratory of our institution. Only non-duplicate clinical and surveillance isolates obtained from patients were included.
Results: Out of 159 Enterobacteriaceae suspected, 53 strains of Raoultella terrigena producing carbapenemases were isolated. Among these isolates, 64%(n=34) were NDM producers, 4% (n=2) were OXA-48 producers and 32% (n=17) had both the NDM and OXA-48. The co-existence of NDM and OXA-48 carbapenemases was found more often in Raoultella terrigena than Klebsiella pneumoniae. Among the seventeen isolates of Raoultella terrigena, all were multidrug-resistant.
Conclusion: This study reported for the first time the emergence of NDM and OXA-48 carbapenemases co-existence in Raoultella terrigena isolates in our country which is starting to limit treatment options.
References
Lekhniuk N, Fesenko U, Pidhirnyi Y, Sękowska A, Korniychuk O, Konechnyi Y. Raoultella terrigena: Current state of knowledge, after two recently identified clinical cases in Eastern Europe. Clin Case Rep. 31 mars 2021;9(5):e04089.
Hansen GT. Continuous Evolution: Perspective on the Epidemiology of Carbapenemase Resistance Among Enterobacterales and Other Gram-Negative Bacteria. Infect Dis Ther. mars 2021;10(1):75‑92.
Apport de l’algorithme d’EUCAST dans le criblage des carbapénèmase: Expérience du laboratoire de microbiologie au CHU Ibn Rochd Casablanca - ProQuest [Internet]. [cité 13 nov 2022]. Disponible sur: https://www.proquest.com/openview/765d0f3aaeacc4f934ce9e61d2f2df4e/1?pq-origsite=gscholar&cbl=2031961
El Kettani A, Maaloum F, Nzoyikorera N, Khalis M, Katfy K, Belabbes H, et al. Evaluation of the Performances of the Rapid Test RESIST-5 O.O.K.N.V Used for the Detection of Carbapenemases-Producing Enterobacterales. Antibiotics. août 2021;10(8):953.
Drancourt M, Bollet C, Carta A, Rousselier P. Phylogenetic analyses of Klebsiella species delineate Klebsiella and Raoultella gen. nov., with description of Raoultella ornithinolytica comb. nov., Raoultella terrigena comb. nov. and Raoultella planticola comb. nov. Int J Syst Evol Microbiol. mai 2001;51(Pt 3):925‑32.
Mal PB, Sarfaraz S, Herekar F, Ambreen R. Clinical manifestation and outcomes of multi-drug resistant (MDR) Raoultella terrigena infection - A case series at Indus Health Network, Karachi, Pakistan. IDCases. 2019;18:e00628.
Yu X, Zheng B, Zhang J, Xu H, Xiao T, Zhou Y, et al. Comprehensive Genome Analysis of Carbapenem-Resistant Strains of Raoultella Species, an Emerging Multidrug-Resistant Bacterium in Hospitals. Antimicrob Agents Chemother. 21 nov 2019;63(12):e01367-19.
Ponce-Alonso M, Rodríguez-Rojas L, Del Campo R, Cantón R, Morosini MI. Comparison of different methods for identification of species of the genus Raoultella: report of 11 cases of Raoultella causing bacteraemia and literature review. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. mars 2016;22(3):252‑7.
Greissl C, Saleh A, Hamprecht A. Rapid detection of OXA-48-like, KPC, NDM, and VIM carbapenemases in Enterobacterales by a new multiplex immunochromatographic test. Eur J Clin Microbiol Infect Dis Off Publ Eur Soc Clin Microbiol. févr 2019;38(2):331‑5.
Nordmann P, Dortet L, Poirel L. Carbapenem resistance in Enterobacteriaceae: here is the storm! Trends Mol Med. mai 2012;18(5):263‑72.
Barguigua A, Zerouali K, Katfy K, El Otmani F, Timinouni M, Elmdaghri N. Occurrence of OXA-48 and NDM-1 carbapenemase-producing Klebsiella pneumoniae in a Moroccan university hospital in Casablanca, Morocco. Infect Genet Evol J Mol Epidemiol Evol Genet Infect Dis. avr 2015;31:142‑8.
Ambler RP. The structure of beta-lactamases. Philos Trans R Soc Lond B Biol Sci. 16 mai 1980;289(1036):321‑31.
Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-beta-lactamase gene, bla(NDM-1), and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. déc 2009;53(12):5046‑54.
Solgi H, Nematzadeh S, Giske CG, Badmasti F, Westerlund F, Lin YL, et al. Molecular Epidemiology of OXA-48 and NDM-1 Producing Enterobacterales Species at a University Hospital in Tehran, Iran, Between 2015 and 2016. Front Microbiol [Internet]. 2020 [cité 19 oct 2022];11. Disponible sur: https://www.frontiersin.org/articles/10.3389/fmicb.2020.00936
Ben Nasr A, Decré D, Compain F, Genel N, Barguellil F, Arlet G. Emergence of NDM-1 in Association with OXA-48 in Klebsiella pneumoniae from Tunisia. Antimicrob Agents Chemother. août 2013;57(8):4089‑90.
El-Domany RA, El-Banna T, Sonbol F, Abu-Sayedahmed SH. Co-existence of NDM-1 and OXA-48 genes in Carbapenem Resistant Klebsiella pneumoniae clinical isolates in Kafrelsheikh, Egypt. Afr Health Sci. 2 août 2021;21(2):489‑96.
Gondal AJ, Saleem S, Jahan S, Choudhry N, Yasmin N. Novel Carbapenem-Resistant Klebsiella pneumoniae ST147 Coharboring bla NDM-1, bla OXA-48 and Extended-Spectrum β-Lactamases from Pakistan. Infect Drug Resist. 2020;13:2105‑15.
Remya P, Shanthi M, Sekar U. Prevalence and clonal relatedness of NDM and OXA-48-producing Klebsiella pneumoniae in a tertiary care hospital in South India. J Lab Physicians. 2019;11(4):312‑6.
Seiffert SN, Marschall J, Perreten V, Carattoli A, Furrer H, Endimiani A. Emergence of Klebsiella pneumoniae co-producing NDM-1, OXA-48, CTX-M-15, CMY-16, QnrA and ArmA in Switzerland. Int J Antimicrob Agents. 1 sept 2014;44(3):260‑2.
Lorenzin G, Gona F, Battaglia S, Spitaleri A, Saluzzo F, Trovato A, et al. Detection of NDM-1/5 and OXA-48 co-producing extensively drug-resistant hypervirulent Klebsiella pneumoniae in Northern Italy. J Glob Antimicrob Resist. 1 mars 2022;28:146‑50.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 International Journal of Clinical Science and Medical Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
