Phenotypic And Genotypic Characterization Of Carbapenem – Resistant Gram – Negative Bacteria Among Pediatrics With Positive Blood Cultures | ||||
| Egyptian Journal of Medical Microbiology | ||||
| Volume 33, Issue 3, July 2024, Page 165-171 PDF (344.52 K) | ||||
| Document Type: New and original researches in the field of Microbiology. | ||||
| DOI: 10.21608/ejmm.2024.298713.1271 | ||||
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| Authors | ||||
Nesreen M. Kamel   1; Azza A. Gaber1; Mohamed Sebak2; Aida M.S. Salem3; Ehab M. Fahmy4; Mai E. Ahmed1
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| 1Clinical Pathology Department, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt | ||||
| 2Department of Pharmaceutical Microbiology and Immunology, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt | ||||
| 3Department of Pediatrics, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt | ||||
| 4Department of Medical Microbiology and Immunology, Faculty of Medicine, Helwan University, Helwan, Egypt | ||||
| Abstract | ||||
| Background: Carbapenems are β-lactam antibiotics, which are regarded as one of the final options to treat severe infections resulting from multidrug-resistant organisms. Carbapenem resistance is mostly caused by carbapenemases, which are enzymes that break down this kind of β-lactam antibiotic. It can also occur through non-enzymatic processes such as efflux or changes in porin structure when AmpC or extended-spectrum β-lactamases (ESBL) are present. Carbapenemase-mediated resistance poses a far greater threat. Objectives: The aim of the study was to detect the underlying mechanisms of resistance of carbapenem resistant gram negative bacteria by phenotypic detection (lateral flow immunoassay) directly from positive blood cultures& genotypic detection (Conventional PCR). Methodology: This research was performed on clinical isolates of 25 positive blood cultures of carbapenem resistant Gram -ve bacteria from pediatric cases at Beni-Suef University Hospital. The isolates underwent identification & antimicrobial susceptibility testing by means of VITEK 2 compact system. We assessed a rapid lateral flow immunoassay (LFIA) directly on positive blood culture bottles for carbapenemase genes (OXA-48, KPC, NDM, VIM, and IMP) & compared outcomes with those obtained utilizing conventional polymerase chain reaction (PCR) techniques. Results: PCR test presented that OXA-48 was the most predominant genotype (96%), and the least prevalent was IMP (56%). We evaluated the results of the lateral flow immunoassay and found that the sensitivity of each type was in the range of 71.4%–100% and the specificity of each type was from 0%–90.9% in comparison with PCR as the gold standard. Conclusion: The lateral flow immunoassay is an effective & efficient phenotypic test for quickly identifying carbapenemase-generating isolates straight from blood culture bottles. It may also be utilized as a point-of-care test. | ||||
| Keywords | ||||
| Carbapenemases; lateral flow immunoassay; Conventional PCR; OXA-48 | ||||
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