Emergence of NDM-1-producing escherichia coli in Iran

Abstract

Introduction: Carbapenems are a broad-spectrum class of beta-lactam antibiotics, which are used in treatment of multi-drug resistant infections. Unfortunately, global emerging and spreading of carbapenemase, especially New Delhi metallo β lactamase 1 (blaNDM-1), is a concern in the treatment of multi drug-resistant agents. Here, we report the appearance of blaNDM-1producing Escherichia coli (E. coli) in Iran for the first time. Case Presentation: In this study, 2 blaNDM-1producing E. coli strains were isolated from 2 burn wounds of patients in the Motahari hospital, Tehran. The isolates were resistant to carbapenems (imipenem, meropenem and ertapenem) and other common antibiotics except nitrofurantoin. Combined Disk Test showed that the isolates could not produce blaAmpC and blaKPC carbapenemase, whereas they can produce metallo-β-lactamases (MBL). However, genetic detection using Polymerase Chain Reaction amplification with specific primers for blaKPC, blaIMP, blaVIM-1, blaVIM-1 – blaVIM-37, and blaNDM-1genes showed that only the blaNDM-1gene is amplified from the resistant isolates. Further sequencing of PCR products confirmed the presence of the blaNDM-1gene in these isolates. Conclusions: The emerging of blaNDM-1producing E. coli is a new threat for to the health system in Iran, due to the spreading of the blaNDM-1gene among pathogenic bacteria, which resulted in the emergence of multi drug resistant photogenes. Therefore, early identification of these isolates is mandatory.