XML Print


1- College of Medicinal and industrial plants, University of Kirkuk, Kirkuk, Iraq , sarahahmed100@uokirkuk.edu.iq
2- Biology Department, Science College, Tikrit University, Tikrit, Iraq
3- College of Medicinal and industrial plants, University of Kirkuk, Kirkuk, Iraq
Abstract:   (447 Views)

Background: Carbapenems are broad-spectrum β-lactam antibiotics, often reserved as last-line treatment for infections caused by multidrug-resistant (MDR) Gram-negative bacteria. Carbapenemase producing organisms (CPOs) pose a serious public health threat, contributing to severe healthcare-associated infections and increased mortality rates. This study aimed to determine the prevalence of CPOs and their antibiotic resistance patterns in isolates from burn and wound infections.
Methods: A total of 250 clinical samples (140 wound swabs and 110 burn swabs) were collected from hospitalized patients in Kirkuk and Sulaimaniyah hospitals between January and July 2023. Specimens were cultured on MacConkey agar and cetrimide agar and incubated at 37°C for 18–24 hours. Bacterial identification and antimicrobial susceptibility testing were performed using the BD Phoenix™ M50 system, while carbapenemase production was confirmed using the BD RAPIDEC® CARBA NP assay.
Results: Among the isolates, 27 (38.02%) were confirmed as carbapenemase-producing and exhibited multidrug resistance. The distribution was as follows: Pseudomonas aeruginosa (44.44%, 12 isolates), Escherichia coli (33.33%, 9 isolates), Enterobacter cloacae (18.51%, 5 isolates), and Klebsiella pneumoniae (3.7%, 1 isolate). Notably, CP-P. aeruginosa and CP-K. pneumoniae showed the highest resistance, being resistant to 15 antibiotics across seven different classes.
Conclusion: This study reveals a high prevalence of MDR CPOs in burn and wound infections, likely due to antibiotic misuse or overuse. The findings highlight the urgent need for novel therapeutic strategies to combat carbapenem-resistant pathogens, which are associated with increased global morbidity and mortality.

Full-Text [PDF 462 kb]   (130 Downloads)    
Research Article: Original Paper | Subject: bacteriology
Received: 2024/04/22 | Accepted: 2024/04/23

References
1. Dos Santos GS, Solidônio EG, Costa MC, Melo RO, de Souza IF, Silva G, et al. Study of the Enterobacteriaceae Group CESP (Citrobacter, Enterobacter, Serratia, Providencia, Morganella and Hafnia): A Review. The Battle Against Microbial Pathogens: Basic Science, Technological Advances and Educational Programs (A. Méndez-Vilas, Ed.) FORMATEX. 2015:794-805. [View at Publisher] [Google Scholar]
2. Patel G, Bonomo RA. Status report on carbapenemases: challenges and prospects. Expert Rev Anti Infect Ther. 2011;9(5):555-70. [View at Publisher] [DOI] [PMID] [Google Scholar]
3. Hasoon NA, Hamed SL. Molecular characterization of carbapenemase-producing Gram-negative bacteria isolated from clinical specimens in Baghdad. J Pure Appl Microbiol. 2019;13(2):1031-40. [View at Publisher] [DOI] [Google Scholar]
4. Tarashi S, Goudarzi H, Erfanimanesh S, Pormohammad A, Hashemi A. Phenotypic and molecular detection of metallo-beta-lactamase genes among imipenem resistant Pseudomonas aeruginosa and Acinetobacter baumannii strains isolated from patients with burn injuries. Arch Clin Infect Dis. 2016;11(4):e39036. [View at Publisher] [DOI] [Google Scholar]
5. Nordmann P. Carbapenemase-producing Enterobacteriaceae: overview of a major public health challenge. Med Mal Infect. 2014;44(2):51-6. [View at Publisher] [DOI] [PMID] [Google Scholar]
6. Iraz M, Düzgün AÖ, Sandallı C, Doymaz MZ, Akkoyunlu Y, Saral A, et al. Distribution of β-lactamase genes among carbapenem-resistant Klebsiella pneumoniae strains isolated from patients in Turkey. Ann Lab Med. 2015;35(6):595-601. [View at Publisher] [DOI] [PMID]
7. Bush K, Pannell M, Lock JL, Queenan AM, Jorgensen JH, Lee RM, et al. Detection systems for carbapenemase gene identification should include the SME serine carbapenemase. Int J Antimicrob Agents. 2013;41(1):1-4. [View at Publisher] [DOI] [PMID] [Google Scholar]
8. Thomson KS. Extended-spectrum-β-lactamase, AmpC, and carbapenemase issues. J Of Clin Microbiol. 2010;48(4):1019-25. [View at Publisher] [DOI] [PMID] [Google Scholar]
9. Mahrach Y, Mourabit N, Arakrak A, Bakkali M, Laglaoui A. Phenotypic and molecular study of carbapenemase-producing Enterobacteriaceae in a regional hospital in northern Morocco. J Clin Med Sci. 2019;3(1):113. [View at Publisher] [Google Scholar]
10. Hasan SA, Raoof WM, kamal Rachid S. A systematic review: The current status of carbapenem resistance in Iraq. World Bulletin of Public Health. 2022;13:88-94. [View at Publisher] [Google Scholar]
11. Hasan SA, Raoof WM, Ahmed KK. FIRST REPORT OF CO-HARBORING BLEOMYCIN RESISTANCE GENE (bleMBL) AND CARBAPENEMASE RESISTANCE GENE (blaNDM-1) KLEBSIELLA PNEUMONIAE IN IRAQ WITH COMPARISON STUDY AMONG THE SENSITIVITY TEST, THE BD PHOENIX CPO DETECT TEST, AND THE RAPIDEC® CARBA NP TEST. SJLSA. 2024;16(4):208-37. [View at Publisher] [DOI] [Google Scholar]
12. Suay-García B, Pérez-Gracia MT. Present and future of carbapenem-resistant Enterobacteriaceae infections. Advances in clinical immunology, medical microbiology, COVID-19, and big data. 2021:435-56. [View at Publisher] [DOI] [PMID] [Google Scholar]
13. Haji SH, Aka STH, Ali FA. Prevalence and characterisation of carbapenemase encoding genes in multidrug-resistant Gram-negative bacilli. PLoS One. 2021;16(11):e0259005. [View at Publisher] [DOI] [PMID] [Google Scholar]
14. Aurilio C, Sansone P, Barbarisi M, Pota V, Giaccari LG, Coppolino F, et al. Mechanisms of action of carbapenem resistance. Antibiotics. 2022;11(3):421. [View at Publisher] [DOI] [PMID] [Google Scholar]
15. Elshamy AA, Aboshanab KM. A review on bacterial resistance to carbapenems: epidemiology, detection and treatment options. Future science OA. 2020;6(3):FSO438. [View at Publisher] [DOI] [PMID] [Google Scholar]
16. Hasan SA, Abass KS. Prevalence of Gram Negative Bacteria Isolated from Patients with Burn Infection and their Antimicrobial Susceptibility Patterns in Kirkuk City, Iraq. Indian J Public Health Res Dev. 2019;10(8). [View at Publisher] [DOI] [Google Scholar]
17. Ahmed Hasan S, Raheem TF, Abdulla HM. Phenotypic, antibiotyping, and molecular detection of Klebsiella pneumoniae isolates from clinical specimens in Kirkuk, Iraq. Arch Razi Inst. 2021;76(4):1061-7. [View at Publisher] [DOI] [PMID] [Google Scholar]
18. Ahmed Hasan S, Mohammed Bakr M. Bacteriological and molecular detection of Klebsiella oxytoca and its resistance to antibiotics among clinical specimens from Kirkuk, Iraq. Arch Razi Inst. 2022;77(5):1521-5. [View at Publisher] [DOI] [PMID] [Google Scholar]
19. Workneh M, Yee R, Simner PJ. Phenotypic methods for detection of carbapenemase production in carbapenem-resistant organisms: what method should your laboratory choose?.Clin Microbiol Newsl. 2019;41(2):11-22. [View at Publisher] [DOI] [Google Scholar]
20. Hasan SA. Pseudomonas aeruginosa and the multifactorial antibiotic resistance. Eurasian Medical Research Periodical. 2022;11:85-94. [View at Publisher] [Google Scholar]
21. Fakhraddin Raheem T, Ahmed Hasan Ali S. Prevalence and multi-drug resistance patterns of uropathogenic E. coli isolated from women patients in Kirkuk City, Iraq. Iran J Microbio. 2022;16(6):609-14. [View at Publisher] [DOI] [Google Scholar]
22. Sadeghi MR, Ghotaslou R, Akhi MT, Asgharzadeh M, Hasani A. Molecular characterization of extended-spectrum β-lactamase, plasmid-mediated AmpC cephalosporinase and carbapenemase genes among Enterobacteriaceae isolates in five medical centres of East and West Azerbaijan, Iran. J Med Microbiol. 2016;65(11):1322-31. [View at Publisher] [DOI] [PMID] [Google Scholar]
23. Hasan SA, Raoof WM, Ahmed KK. Antibacterial activity of deer musk and Ziziphus spina-christi against carbapebem resis-tant gram negative bacteria isolated from patients with burns and wounds. Regulatory Mechanisms in Biosystems. 2024;15(2):267-78. [View at Publisher] [DOI] [Google Scholar]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2007 All Rights Reserved | Medical Laboratory Journal

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.