Molecular Detection Of Carbapenemases and ESBLs in Gram Negative Bacilli Isolated From Burn Wound Infections In Mosul City, Iraq
DOI:
https://doi.org/10.52783/jns.v14.2547Keywords:
carbapenemases, bacilli, Mosul cityAbstract
The presence of multidrug-resistant bacteria containing beta-lactamase enzymes (carbapenemase and Extended-Spectrum β-Lactamases ESBLs ) that cause burn wound infections is a serious threat to patient's health with the risk of their transmission to the blood stream and causing sepsis. This study seeks to identify antibiotic resistance patterns and ascertain the existence of β-lactamase enzymes (Carbapenemases and ESBLs) in Gram-negative bacilli isolated from burn wound infections. Following culture on MacConkey agar, 127 isolates were recovered from 150 samples, with Pseudomonas aeruginosa being the predominant bacterial species isolated (43.3%), succeeded by Escherichia coli (18.89%), while the isolation percentages of other species exhibited significant variability. Antimicrobial susceptibility testing results showed absolute resistance to Cefotaxime, Amoxicillin and Ceftazidime, and low resistance was against to Meropenem with rates of 58.2%. Furthermore the results showed that 0.79% of the isolates were Multiple Drug-Resistant (MDR) and 68.5% of them were Extensively Drug-Resistant (XDR), while Thirty-nine isolates (30.71%) were Pan Drug-Resistant (PDR). Phenotypic and molecular detection of carbapenemase and ESBL enzymes were performed for twenty-six antibiotic-resistant isolates, 96.2% of the isolates were ESBL producers and 80.8% were carbapenemase producers. Those results were confirmed at molecular level using 14 primers for carbapenemase genes and ESBLs (IMP, NDM, KPC, GES, NAM-C, OXA23, OXA48, OXA58, VIM, SPM, SIM, TEM, SHV, and CTX-M), results indicated the presence of carbapenemase genes OXA23, NDM, VIM with rates of 11.5% ,61.5%, 73%respectively,while OXA48 , KPC 42.3% for each. SHV, TEM and CTX-M ESBL genes detection rates were 69.2%, 84.6%, 88.4% respectively, the rest genes were not found.
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Abdel Hadi H, Dargham SR, Eltayeb F, Ali MO, Suliman J, Ahmed SA, Omrani AS, Ibrahim EB, Chen Y, Tsui CK, Skariah S. 2024. Epidemiology, Clinical, and Microbiological Characteristics of Multidrug-Resistant Gram-Negative Bacteremia in Qatar. Antibiotics. ;13(4):320.. https://doi.org/10.3390/antibiotics13040320
AL-Azzawi MH and AL-Kalifawi EJ. 2023. detection of bacteria causing burn infection isolated from several hospital of Baghdad. IHJPAS., 36(3). https://doi.org/10.30526/36.3.3090
Alharbi AS. 2022. Bacteriological profile of wound swab and their antibiogram pattern in a tertiary care hospital, Saudi Arabia. Saudi Med J ., 43 (12):1373-1382. https://smj.org.sa
Al-Hasso M Z . and Mohialdeen Z. Kh .2023. Phenotypic and molecular detection of CTX-M β-lactamases in Salmonella enterica local isolates from different origins in Mosul. Malays. J. Microbiol. Vol 19(2) 2023, pp. 156-165.
Ali MG, Abd Almoneim Z, Kareem SM. 2023. Evaluated gene expressions of Metallo beta lactamase genes GIM and, VIM, SPM in Pseudomonas aeruginosa clinical isolates. Molecular Biology Reports (Mol Biol Rep)., 50(12):10111-10120. https://doi.org/10.1007/s11033-023-08883-7
Al-Nabhani NA and Shami AM. 2023. Molecular Study of Carbapenem Resistance Genes in Proteus mirabilis Isolated from Clinical Samples in Baghdad Hospitals. Iraqi Journal of Biotechnology., 22(1): 154-162 .
Ambler RP. 1980. The Structure of β-Lactamases. Philos. Trans. R. Soc. Lond. B Biol. Sci., 289, 321–331.
Aslam B, Wang W, Arshad MI, Khurshid M, Muzammil S, Rasool MH, Nisar MA, Alvi RF, Aslam MA, Qamar MU, Salamat MK. 2018. Antibiotic resistance: a rundown of a global crisis. Infection and drug resistance. 1645-58. http://www.ncbi.nlm.nih.gov/pubmed/30349322
Aurilio C, Sansone P, Barbarisi M, Pota V, Giaccari LG, Coppolino F, Barbarisi A, Passavanti MB, Pace MC. 2022. Mechanisms of action of carbapenem resistance. Antibiotics. 11(3):421 https://doi.org/10.3390/antibiotics11030421.
Baron EJ, Peter son L, fingold SM. 1994. Diagnostic Microbiology. 9th ed., Mosbg. Year Book, inc., st. Louis, U.S.A.
Bharadwaj A, Rastogi A, Pandey S, Gupta S and Sohal JS. 2022. Multidrug-Resistant Bacteria: Their Mechanism of Action and Prophylaxis. Biomed Res Int , 5419874. https://doi.org/10.1155/2022/5419874
Bush K and Jacoby GA. 2010. Updated Functional Classification of β-Lactamases. Antimicrob. Agents Chemother., 54, 969–976.
Castanheira M, Simner PJ, Bradford PA. 2024. Extended-spectrum b-lactamases: an update on their characteristics, epidemiology and detection. JAC Antimicrob Resist, https://doi.org/10.1093/jacamr/dlab092
Cayci YT, Biyik I and Birinci A. 2022. VIM, NDM, IMP, GES, SPM, GIM, SIM Metallobetalactamases in Carbapenem-Resistant Pseudomonas aeruginosa Isolates from a Turkish University Hospital.J Arch Mil Med. , 10(1):e118712. https://doi.org/10.5812/jamm-118712
Church D, Elsayed S, Reid O, Winston B, Lindsay R. 2006. Burn wound infections, Clin. Microbiol. Rev. 19 (2): 403–434.
Clinical and Laboratory Standards Institute (CLSI). 2022. Performance Standards for Antimicrobial Susceptibility Testing. 32nd ed. CLSI supplement M100 (ISBN 978-1-68440-134-5 (Print); ISBN 978-1-68440-135-2 (Electronic)). Clinical and Laboratory Standards Institute, USA,
Clinical and Laboratory Standards Institute CLSI, 2012. Performance Standards for Antimicrobial Susceptibility Testing, Twenty Second Informational Supplement update. CLSI Document M100-S22, Clinical and Laboratory Standards Institute, Wayne, PA, USA.
Codjoe FS and Donkor ES. 2018. Carbapenem Resistance: A Review. Med. Sci., 6(1). https://doi.org/10.3390/medsci6010001.
Deshpande A, Gans J, Graves SW, Green L, Taylor L, Kim HB, Kunde YA, Leonard PM, Li PE, Mark J, Song J, Vuyisich M and Scott White P. 2010. A rapid multiplex assay for nucleic acid-based diagnostics. Journal of Microbiological Methods. 80(2):155-163. https://doi.org/10.1016/j.mimet.2009.12.001
El Aila NA, Al Laham NA and Ayesh B M. 2023. Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip. BMC Infectious Diseases, 23:99. https://doi.org/10.1186/s12879-023-08017-1
Elguindy NF, Mostafa F, Abd elsalam A and Elsheshtawy N. 2021. Efficiency of chromogenic medium (HiChrome universal medium) for identification of organisms causing burn wound infection and their pattern of antimicrobial susceptibility at Ain Shams University Hospitals. Microbes Infect Dis., 2(3): 567-574.
Ellington MJ, Kistler J and Livermore DM. 2007. Woodford N Multiplex PCR for rapid detection of genes encoding acquired metallo-β-lactamases. J Antimicrob Chemother. 59(2):321-2. https://doi.org/10.1093/jac/dkl481.Epub 2006 Dec 21.
ElTaweel M, Said HS and Barwa R. 2024. Emergence of extensive drug resistance and high prevalence of multidrug resistance among clinical Proteus mirabilis isolates in Egypt. Ann Clin Microbiol Antimicrob., 46. https://doi.org/10.1186/s12941-024-00705-3
Forbes BA, Sahm DF and weissfed AS. 2007. Bailey and Scott,s Diagnostic Microbiology.12thed., Mosby Inc anaffiliate of Elsevier Inc.
Franklin C, Liolios L and Peleg AY. 2006. Phenotypic detection of carbapenem-susceptible metallo-β-lactamase-producing gram-negative bacilli in the clinical laboratory. Journal of clinical microbiology, 44(9):3139-44. https://doi.org/10.1128/JCM.00879-06
Garcia MM. 2013. Carbapenemases: A real threat. APUA Newsl., 31, 4–6.
Gatya Al-Mayahie SM, Al-Guranie DRT, Hussein AA and Bachai ZA. 2022. Prevalence of common carbapenemase genes and multidrug resistance among uropathogenic Escherichia coli phylogroup B2 isolates from outpatients in Wasit Province/ Iraq. PLoS ONE .,17(1): e0262984. https://doi.org/10.1371/journal.pone.0262984
Ghafil JA and flieh MT. 2021. Isolation and Identification of Bacterial Burn Wound Infection in Iraqi Patient. Indian Journal of Forensic Medicine & Toxicology. 15( 4):1351-1357.
Halat DH and Moubareck CA. 2020). The Current Burden of Carbapenemases: Review of Significant Properties and Dissemination among Gram-Negative Bacteria. Antibiotics, 9, 186. https://doi.org/10.3390/antibiotics9040186
Hamad ST, Ghaim KK and Al-lawi AA. 2022. Prevalence of Carbapenemase Genes in Klebsiella pneumoniae Isolates from Patients with Urinary Tract Infections in Baghdad Hospitals. Iraqi Journal of Biotechnology, 21(1): 102-114.
Hong SS, Kim K, Huh JY, Jung B, Kang MS and Hong SG. 2012. Multiplex PCR for rapid detection of genes encoding class A carbapenemases. Annals of laboratory medicine. 1;32(5):359-61. https://doi.org/10.3343/alm.2012.32.5.359
Hussaini IM, Suleiman AB, Olonitola OS and Oyi RA. 2023. Phenotypic and molecular detection of carbapenemase producing Escherichia coli and Klebsiella pneumoniae. Microbes Infect Dis, 4(1): 151-159.
Jafari-Sales A, Al-Khafaji NSK, Al-Dahmoshi HOM, Deylamdeh ZS, Akrami S, Shariat A, Judi HK, Nasiri R, Baghi HB, Saki M. 2023. Occurrence of some common carbapenemase genes in carbapenem-resistant Klebsiella pneumoniae isolates collected from clinical samples in Tabriz, northwestern Iran. BMC Research Notes., 16:311. https://doi.org/10.1186/s13104-023-06558-x
Jin W, Xu C, Dong N, Chen K, Zhang D, Ning J, Li Y, Zhang G, Ke J, Hou A, Chen L, Chen S and Chan K. 2023. Identification of isothiazolones analogues as potent bactericidal agents against antibiotic resistant CRE and MRSA strains. BMC Chem., 17(1):183. https://doi.org/10.1186/s13065-023-01100-3
Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas M E, Giske CG, Harbarth S, Hindler J F, Kahlmeter G, Olsson-Liljequist B, Paterson DL, Rice L B, Stelling J, Struelens MJ, Vatopoulos A, Weber JT and Monnet DL. 2012. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect., 18: 268–281. https://doi.org/10.1111/j.1469-0691.2011.03570.x
Mahmood NH and Al-Brefkani A. 2022. Molecular Characterisation of Carbapenemase-Producing Acinetobacter baumannii isolates from Hospitalised Patients in Iraq. Journal of Life and Bio Sciences Research., 3(02): 27 - 32. https://doi.org/10.38094/jlbsr30261
Mooney DP and Gamelli RL. 1989. Sepsis following thermal injury. Comp Ther. . 15:22 29
Ogunsola FT, Oduyebo O and Iregbu KC. 1998. A review of nosocomial infections at LUTH: problems and strategies for improvement. J Nigerian infection Control Association. 1: 14-20.
Poirel L, Potron S, Nordmann P. 2012. OXA-48-like carbapenemases: the phantom menace.J Antimicrob Chemother. 67: 1597–1606. https://doi.org/10.1093/jac/dks121
Poirel L and Nordmann P. 2006. Genetic structures at the origin of acquisition and expression of the carbapenem-hydrolyzing oxacillinase gene blaOXA-58 in Acinetobacter baumannii. Antimicrob Agents Chemother; 50:1442–8. https://doi.org/10.1128/AAC.50.4.1442-1448.2006
Prescot JP, Harley LM and Klein DA. 2002. Microbiology 4thed., McGraw-Hill companies, Inc., U.S.A.
Primeau CA, Bharat A, Janecko N, Carson CA, Mulvey M, Reid-Smith R, McEwen S, McWhirter JE and Parmley EJ. 2023. Integrated surveillance of extended-spectrum beta-lactamase (ESBL)-producing Salmonella and Escherichia coli from humans and animal species raised for human consumption in Canada from 2012 to 2017. Epidemiology & Infection.151:e14.2024
Pruitt BA, McManus AT, Kim SH and Goodwin CW. 1998. Burn wound infections: current status. World J Surg. 22: 135-145.
Raffelsberger N, Buczek DJ, Svendsen K, Småbrekke L, Pöntinen AK, Löhr IH, Andreassen LL, Simonsen GS and Norwegian E. 2023. coli ESBL Study Group, Sundsfjord A, Gravningen K. Community carriage of ESBL-producing Escherichia coli and Klebsiella pneumoniae: a cross-sectional study of risk factors and comparative genomics of carriage and clinical isolates. Msphere.
(4):e00025-23.
Rahim HR. 2021. Isolation and Identification of Some Bacteria Contemn in Burn Wounds in Misan, Iraq. Arch Razi Inst. 76(6):1665–1670. https://doi.org/10.22092/ari.2021.356367.1833
Ranjbar R, Zayeri S and Mirzaie A. 2020 Development of multiplex PCR for rapid detection of metallo-β-lactamase genes in clinical isolates of Acinetobacter baumannii. Iran J Microbiol, 12:107–12. https://doi.org/10.18502/ijm.v12i2.2615
Saadulla SOK and Muhammed SM. 2023. detection of biofilm-related genes and antibiotic resistance in acinetobacter baumannii isolated from clinical specimens. Biodiversitas. 24(3): 1809-1816 https://doi.org/10.13057/biodiv/d240356
Saaed AA and Sulaiman AI. 2025. Identification of blaOxa23 Gene in Acinetobacter baumannii Isolated From Clinical and Hospitals Environment in Mosul City-Iraq. Egypt. J. Vet. Sci., 56 (7):1457 -1465. DOI: https://doi.org/10.21608/EJVS.2024.282669.2003
Sawa T, Kooguchi K and Moriyama K. 2020. Molecular diversity of extended-spectrum β-lactamases and carbapenemases, and antimicrobial resistance. Journal of Intensive Care ., 8: 13.
Scavuzzi AML, Beltr˜ao EMB, Firmo EF, Oliveira ´EM, Beserra FG, Lopes ACS. 2019. Emergence of blaVIM-2, blaNDM-1, blaIMP-7 and blaGES-1 in blaKPC-2-harbouring Pseudomonas aeruginosa isolates in Brazil. J Glob Antimicrob Resist. 19:181–2. https://doi.org/10.1016/j.jgar.2019.09.009
Sobouti B, Mirshekar M, Fallah S, Tabaei A, Mehrabadi JF, Darbandi A. 2020. Pan drug-resistant Acinetobacter baumannii causing nosocomial infections among burnt children. Med J Islam Repub Iran, 34:24. https://doi.org/10.34171/mjiri.34.24
Tchakal-Mesbahi A, Abdouni MA and Metref M. 2021. prevalence of multidrug-resistant bacteria isolated from burn wounds in Algeria. Annals of Burns and Fire Disasters. . XXXIV ( 2)
Temesgen M, Kumalo A, Teklu T, Alemu G and Odoko D. 2023. Bacterial Profile and Their Antimicrobial Susceptibility Pattern ofIsolates Recovered from Intensive Care Unit Environments at Wachemo University Nigist Ellen Mohammed Memorial Comprehensive Specialized Hospital, Southern Ethiopia. Canadian Journal of Infectious Diseases and Medical Microbiology, Article ID 1216553, 13 pages. https://doi.org/10.1155/2023/1216553
Thapa P, Bhandari D, Shrestha D, Parajuli H, Chaudhary P, Amatya J, Amatya RA 2017. hospital based surveillance of metallo-beta-lactamase producing gram negative bacteria in Nepal by imipenem-EDTA disk method. BMC research notes. 10:1-6. https://doi.org10.1186/s13104-017-2640-7
Tharia AM, Mohammeda KAS, Abu-Mejdadb NMJ. 2024. Antimicrobial susceptibility of bacterial clinical specimens isolated from Al-Sader Teaching Hospital in Basra-Iraq. AsPac J. Mol. Biol. Biotechnol., 32 (1) : 76-84.
van Hout D, Verschuuren TD, Bruijning-Verhagen PC, Bosch T, Schürch AC, Willems RJ, Bonten MJ and Kluytmans JA. 2020. Extended-spectrum beta-lactamase (ESBL)-producing and non-ESBL-producing Escherichia coli isolates causing bacteremia in the Netherlands (2014–2016) differ in clonal distribution, antimicrobial resistance gene and virulence gene content. PloS one. 15(1):e0227604.
Yavari SA, Farajzadeh F, Diba K and Kazemzadeh J. 2024. Frequency and Antibiotic Resistance Patterns of Isolated Bacteria from Burn Wounds Infections in Imam Khomeini Medical Center in Urmia. Journal of Research in Applied and Basic Medical Sciences(RABMS)., 10(1):13-22
Yazdansetad S, Alkhudhairy MK, Najafpour R, Farajtabrizi E, Al-Mosawi RM, Saki M, Jafarzadeh E, Izadpour F and Ameri A. 2019 Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran. Heliyon. 5(9). https://doi.org/10.1016/j.heliyon.2019.e02349
Younis RM and Faisal RM. 2024. Plasposon mutagenesis in Pseudomonas aeruginosa isolates illustrates the role of ABC transporter in intrinsic resistance to antibiotics. Journal of Applied and Natural Science, 16(3): 1256-1264.
Zarabadi-Pour M, Peymani A, Habibollah-Pourzereshki N, Sarookhani MR, Karami AA, and Javadi A. 2021. Detection of among Acinetobacter Baumannii Isolated from Hospitals of Qazvin, Iran. Ethiop J Health Sci., 31(2):229-236. https://doi.org/10.4314/ejhs.v31i2.4.
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