Phenotypic and genotypic characterization of carbapenem-resistant Gram-negative organisms, Beni-Suef, Egypt

Abstract

Background: Carbapenem-resistant Gram-negative organisms (CRGNO) are a growing threat. We aimed in our study to determine the genotype of carbapenemases at Beni-Suef University Hospital by using newly introduced lateral flow assays in comparison with molecular techniques and test the effectiveness of ceftazidime/avibactam against them. Methods: Screening for carbapenemase production was done by mSuperCARBA (CHROMagar™ company). Genotypic characterization was done using 3 different kits of lateral flow assays: the NG-Test CARBA5 assay (NG Biotech, Guipry, France), RESIST-3 O.K.N. (Coris BioConcept, Belgium) and Carbapenem-resistant K.N.I.V.O Detection K-Set (Beijing Gold Mountain river Tech Development Co, China), whereas genotypic characterization was done for blaVIM blaIMP, blaKPC, blaOXA-48, and blaNDM by PCR. Results: The high prevalence of CRGNO in Beni-Suef University Hospital (29%) was dominated by Klebsiella pneumonia (83.3%) harboring OXA-48 (92%). Lateral flow immunoassays showed high sensitivity and specificity for each type of carbapenemases in comparison with PCR. Conclusion: The coexistence of multiple carbapenemases genes in the same isolate increased resistance to new therapeutic options, e.g., CZA/AVI. Proper implementation of isolation measures in health care facilities can render the spread of CRGNO.