Emergence of Fluoroquinolone resistance and carbapenemase plasmids in Enterobacter cloacae isolated from Egyptian Pediatric Hospital

Ghandour, Aliaa Mahmoud; Hadiya, Safy; Nasseif, Rania Gamal; Sabet, Marwa; Bakyr, Rania; Sror, Shaban

doi:10.21608/ejmm.2022.228621

Emergence of Fluoroquinolone resistance and carbapenemase plasmids in Enterobacter cloacae isolated from Egyptian Pediatric Hospital

Document Type : New and original researches in the field of Microbiology.

Authors

¹ Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

² Assiut International Center of Nanomedicine, Al-Rajhy Liver Hospital, Assiut University, Egypt

³ Women's Health Hospital, Assiut University, Assiut, Egypt

⁴ Department of Microbiology and Immunology, Faculty of Pharmacy, Sphinx University, New-Assiut, Egypt.

⁵ Department of Oncological Clinical Pathology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt.

⁶ Gastroenterology and Hepatology Unit, Pediatric Department, Faculty of Medicine, Assiut University, Assiut, Egypt.

10.21608/ejmm.2022.228621

Abstract

Background: Enterobacter cloacae cause opportunistic infections that are frequently associated with multidrug resistance (MDR). Co-carriage of plasmid mediated quinolone resistance (PMQR) genes and carbapenemases worsened the problem of resistance. Objectives: The current work aimed to detect the frequency of PMQR in E. cloacae as well as the co-carriage of carbapenemase resistance determinants in Egypt. Methodology: Fourteen E. cloacae isolates were collected from children suffered from gastroenteritis admitted at Pediatric Hospital at Assiut University. Identification and antimicrobial susceptibility were done by Vitek-2® system. Detection of PMQR and carbapenemases was done by PCR. Conjugation experiment was performed to test the transmissibility of the resistance determinants. Results: PMQR genes were detected in 3/14 (21.4%) of E. cloacae isolates. qnrB and qnrS were detected in 2/14 (14.3%) and 3/14 (21.4%) of the isolates, respectively. Two E. cloacae isolates co-harbored qnrB and qnrS. Neither qnrA, qnrD nor aac (6՛)-Ib was detected. Carbapenemase genes were detected in 7/14 (50%) E. cloacae isolates; 𝑏𝑙𝑎NDM-1, 𝑏𝑙𝑎OXA-48 and 𝑏𝑙𝑎VIM-2 were detected in 6/14(42.9%), 2/14 (14.3%) and 1/14(7.1%) of E. cloacae isolates respectively. Only one isolate (7.1%) co-harbored 𝑏𝑙𝑎NDM-1, 𝑏𝑙𝑎VIM-2 and 𝑏𝑙𝑎OXA-48 genes. Conclusion: PMQR and carbapenemases determinants are common among E. cloacae isolates in Egypt with the co-existence of multiple resistance determinants in the same isolate. All transmitted determinants suggest their presence on transmissible plasmids.

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