Rabbit Anti-Human VIM Monoclonal Antibody, clone CQ7121

The spread of carbapenem-resistant Enterobacteriaceae (CRE) has been enabled by the lack of control measures directed at carriers of multidrug-resistant organisms in healthcare settings. Screening patients for asymptomatic colonization on the one hand, and implementation of contact precautions on the other hand, reduces patient-to-patient transmission. Screening plates represents a relatively low-cost method for isolating CRE from rectal swabs; however, molecular assays have become widely available. This study compared the performance of four commercial molecular platforms in detecting clinically significant carbapenemase genes versus routine screening for CRE. A total of 1015 non-duplicated rectal swabs were cultured on a chromogenic carbapenem-resistant selective medium. All growing Enterobacteriaceae strains were tested for carbapenemase-related genes. The same specimens were processed using the following molecular assays: Allplex (TM) Entero-DR, Amplidiag((R)) CarbaR + MCR, AusDiagnostics MT CRE EU, and EasyScreen (TM) ESBL/CPO. The prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae detected by swab culture was 2.2%, while organisms producing oxacillinase (OXA)-48 and metallo-beta-lactamases were infrequent. The cost of CRE-related infection control precautions, which must be kept in place while waiting for screening results, are significant, so the molecular tests could become cost-competitive, especially when the turnaround time is decreased dramatically. Molecular assays represent a powerful diagnostic tool as they allow the rapid detection of the most clinically relevant carbapenemases.

Introduction Even though the increasing incidence of VIM-producing E. coli and K. pneumoniae has been reported worldwide, studies are still lacking in Palestine. The aim of this study was to screen carbapenem-resistant E. coli and K. pneumoniae bacteria in the Gaza Strip, Palestine and further to characterize carbapenemase-producing isolates. Methods A total of 69 E. coli and 27 K pneumoniae isolates were obtained from three Gaza hospitals and recovered from urine, wound swabs, blood and ear discharge. The screening for metallo-beta-lactamases (MBLs) was performed by using the imipenem-EDTA disc synergy test. The detection of beta-lactamases genes, detection of non-beta-lactam genes and the characterization of integrons were performed by PCR and sequencing. The clonal relationship among the isolates was determined by pulsed-field gel electrophoresis (PFGE). Results Our study showed that 4 E. coli (5.8%) and 5 K. pneumoniae (18.5%) were positive by the imipenem-EDTA disc synergy test. Bla(VIM-4) was detected in six isolates and bla(VIM-28) was identified in three isolates. The beta-lactamases genes in the VIM-producing K. pneumonthe isolates were bla(CTX-M-15) is (n=3), bla(CTX-M-14) (n=1), bla(SHV-1) (n=3), bla(SHV-12) (n = 1), bla(TEM-1) (n=1) and bla(OXA-1) (n=1). Aac(6')-Ib-cr gene was confirmed in four E. coli and in two K. pneumoniae isolates. QnrS1 was identified in two K. pneumonthe isolates. The class 1 integron was identified with the different gene cassette; dfrA17-aadAS, dfrA5, dh-A12-orf-aadA2 and dfrA17-aadA5 were identified. Conclusions Our study indicated for the first time the emergence of multidrug-resistant VIM-containing K. pneumonthe and E. coli isolates of clinical origin in Gaza Strip hospitals.