Genomic insights into antibiotic resistance genes in Gram-negative associated with obstetric complications in hospitalized pregnant women in Cairo | ||||
| Microbes and Infectious Diseases | ||||
| Articles in Press, Accepted Manuscript, Available Online from 14 May 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mid.2025.358966.2528 | ||||
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| Authors | ||||
Hamido m hefny1; Abdelfattah Ahmed Abdulmajeed2; Mona el sayed Kafrawy3; Tarek Abdelmonem Ismail 2; MOHAMMED SALAH  1
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| 1Department of Microbiology and Immunology Department, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt | ||||
| 2Egyptian Drug Authority (EDA), Egypt | ||||
| 3Department of Obstetrics and Gynecology, Faculty of Medicine (Girls), Al-Azhar University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: Microbial infections during pregnancy pose serious risks to both maternal and neonatal health, contributing to high rates of infant mortality. A major global health concern is the increasing prevalence of antibiotic resistance, which complicates treatment strategies. This study aims to investigate the prevalence of Gram-negative bacterial infections among pregnant women in Cairo, Egypt, to identify the antibiotic resistance profiles and elucidate the molecular mechanisms. Methods: the study involved 200 pregnant women aged 20 to 35 years who were facing obstetric problems. The clinics are equipped with advanced diagnostic instruments and in obstetrics and gynecology. All participants were recruited during standard clinic visits and received comprehensive clinical assessments prior to enrollment in the trial. The sample size estimate was predicated on the statistical principles. Isolates were identified using cultural, morphological, and biochemical methods. Antimicrobial susceptibility testing was conducted using the Kirby-Bauer disc diffusion method. Phenotypic analysis included screening for ESBL production tests, AmpC detection, and MBL identification. Molecular methods by PCR amplification, and sequencing of purified products. Results: 187/359 isolates identified as Gram-negative bacteria (52.1%). The most prevalent pathogens were E. coli (52.4%) P value 0.0812. These bacteria exhibited resistance to various antibiotics, with E. coli and K. pneumoniae showing high resistance to beta-lactams (P = 0.889). Phenotypic analysis revealed ESBL production in 21.9% of isolates and AmpC in 19 isolates. Molecular detection using PCR identified ESBL genes (blaTEM, blaSHV, blaOXA-1, blaCTX) and AmpC genes (FOX, DHA, AmpC) in several isolates. Additionally, MBL genes (IMP, VIM, NDM-1, NDM-2) were detected in P. aeruginosa isolates. Conclusion: pregnant women with obstetric complications are at significant risk of multidrug-resistant infections due to the high prevalence of genes associated with ESBLs, AmpC, MBLs, and quinolone resistance. The widespread presence of blaTEM and blaSHV genes underscores the role of horizontal gene transfer in resistance spread. | ||||
| Keywords | ||||
| Genomic insights; antibiotic resistance genes; Gram-negative; obstetric complications; hospitalized pregnant women | ||||
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