Anti-VIM monoclonal antibody, clone FQS4887 [DyLight® 594]

The increasing spread of carbapenem resistance is a serious global public health concern that negatively affects human and animal health. In this study we characterized the carbapenemase production in gram-negative bacteria isolated from different meat and meat products in Egypt. Phenotypic and genotypic susceptibility testing were investigated. TwoEnterobacter cloacaecomplex strains, isolated from kofta and beef burger, and onePseudomonas aeruginosaisolated from minced meat, were found to harbor VIM-1 and VIM-2, respectively. These isolates showed multidrug resistance phenotype. The phenotypic carbapenemase production was confirmed with Carba NP test in addition to modified Hodge test, modified carbapenem inactivation method, and ethylenediaminetetraacetic acid inhibition test. Thebla(VIM-1)gene in both non-clonally relatedE. cloacaecomplex strains was part of a class 1 integron that also carried other resistance gene cassettes such asaacA7,dfrA1,Delta aadA, andsmr. This integron was uncommonly disrupted by the insertion sequence ISPa21, located on a self-conjugative plasmid of either the A/C or HI2 incompatibility group with a size of >93 kb. Thebla(VIM-2)gene was identified within a class 1 integron, followed downstream by resistance genesaadBandbla(OXA-10). The transfer ofbla(VIM-2)gene fromP. aeruginosafailed, suggesting that this gene was located on the chromosome. Further studies are needed to screen the dissemination of carbapenemase-producing bacteria in both the environment and food chain.

Carbapenemase production is constantly increasing among differentEnterobacteralesspecies. We analyzed the microbiological characteristics and population structure of all carbapenemase-producingEnterobacterspp. (CP-Ent) isolates recovered at the Ramon y Cajal Hospital between 2005 and 2018. Overall, 178 CP-Ent isolates (60.7% colonization, 39.3% clinical) were recovered from 165 hospitalized patients (165/176, 93.7%; medical [102/165], surgical [34/165], and intensive care unit [29/165] areas), emergency unit (4/176, 2.3%), and ambulatory patients (7/176, 4.0%). In addition, three CP-Ent were found in environmental sources. Clinical samples were mainly urine (37.1%). The most frequent matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF)-identified species wereEnterobacter cloacae(n = 85) andEnterobacter asburiae(n = 49).hsp60 gene sequencing showed a higher species diversity than MALDI-TOF: 70Enterobacter hormaechei-clustersIII,VI,VIII; 69Enterobacter roggenkampii-IV; 15Enterobacter kobei-II; 9E. asburiae-I; 3Enterobacter ludwigii-V; and1 E. cloacaesubsp.dissolvens-XII.NineKlebsiella aerogeneswere also identified. Overall, a high clonal diversity (Simpson Diversity Index >0.90) was found among CP-Ent-clusters. Environmental isolates were clonally related to clinical ones. Amikacin and tigecycline showed the highest susceptibility (>93%). VIM-1 (n = 133/181, 73.5%) and OXA-48 (n = 34/181, 18.8%) carbapenemases were predominant, followed by KPC-2 (n = 9/181, 5.0%), KPC-3 (n = 2/181, 1.1%), VIM-2 (n = 1/181, 0.6%), and two coproducers (VIM-1+KPC-2 and VIM-1+KPC-3). Extended-spectrum beta-lactamase (ESBL) coproduction (14.4%) emerged in 2012, mainly associated withbla(SHV-12)(p < 0.001),E. roggenkampii(p < 0.001), and colonization (p = 0.03). VIM-1- and OXA-48-CP-Ent fecal carriers increased in our hospital, particularly between 2011 and 2018 (p < 0.001). Moreover, KPC and OXA-48 producers emerged in 2010 and 2012, respectively. They superimposed over VIM producers, which were persistently recovered since first detection in 2005. These results depict increased complexity over time of CP-Ent.