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Emergence of heteroresistance to carbapenems in Gram-negative clinical isolates from two Egyptian hospitals.
Al-Shebiny, Alaa G; Shawky, Riham M; Emara, Mohamed.
Afiliação
  • Al-Shebiny AG; Faculty of Pharmacy, Department of Microbiology and Immunology, Helwan University, P. O. Box: 11795, Ain-Helwan, Cairo, 01060564729, Egypt.
  • Shawky RM; Faculty of Pharmacy, Department of Microbiology and Immunology, Helwan University, P. O. Box: 11795, Ain-Helwan, Cairo, 01060564729, Egypt.
  • Emara M; Faculty of Pharmacy, Department of Microbiology and Immunology, Helwan University, P. O. Box: 11795, Ain-Helwan, Cairo, 01060564729, Egypt. mohamed_emara@pharm.helwan.edu.eg.
BMC Microbiol ; 24(1): 278, 2024 Jul 26.
Article em En | MEDLINE | ID: mdl-39060973
ABSTRACT

BACKGROUND:

Antimicrobial resistance is a global concern, linking bacterial genotype and phenotype. However, variability in antibiotic susceptibility within bacterial populations can lead to misclassification. Heteroresistance exemplifies this, where isolates have subpopulations less susceptible than the main population. This study explores heteroresistance in Gram-negative bacteria, distinguishing between carbapenem-sensitive isolates and stable heteroresistant isolates (SHIs).

METHODS:

A total of 151 Gram-negative clinical isolates including Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii and Proteus mirabilis from various sources were included. Heteroresistant isolates and their stability were detected by disc-diffusion technique while genotypic analysis was carried out by PCR and efflux activity was assessed by ethidium bromide (EtBr)-agar cartwheel method.

RESULTS:

A total of 51 heteroresistant subpopulations were detected, producing 16 SHIs upon stability-detection. Amplified resistance genes and EtBr-agar cartwheel method showed a significant difference between resistant subpopulations and their corresponding-sensitive main populations.

CONCLUSION:

Genotypic analysis confirmed that genetic mutation can lead to resistance development although the main populations were sensitive, thereby leading to treatment failure. This is a neglected issue which should be highly considered for better treatment outcomes.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Testes de Sensibilidade Microbiana / Carbapenêmicos / Infecções por Bactérias Gram-Negativas / Genótipo / Bactérias Gram-Negativas / Antibacterianos Limite: Humans País/Região como assunto: Africa Idioma: En Revista: BMC Microbiol Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Testes de Sensibilidade Microbiana / Carbapenêmicos / Infecções por Bactérias Gram-Negativas / Genótipo / Bactérias Gram-Negativas / Antibacterianos Limite: Humans País/Região como assunto: Africa Idioma: En Revista: BMC Microbiol Ano de publicação: 2024 Tipo de documento: Article