Molecular biology reports · 2025
Prevalence of New Delhi Metallo-β-lactamase (blaNDM) gene in a selected population of drug-resistant clinical isolates.
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Shafiq Muhammad, Ahmad Aftab, Latif Kunza, Saeed Muhammad, Ahmed Iftikhar, Hyder Muhammad Zeeshan
Аннотация
OBJECTIVES: Drug-resistant Enterobacterales carrying carbapenem-resistant genes cause severe infections in clinical settings worldwide. Among these, the New Dehli Metallo-β-lactamase (blaNDM) gene is significantly prevalent and associated with high morbidity. This study was designed to investigate the susceptibility profiling of Carbapenem-Resistant-Enterobacterales (CRE), prevalence of blaNDM and its variants, and associated risk factors.
METHODS: CRE isolates from a tertiary care hospital, in Islamabad, Pakistan, were identified and the susceptibility testing was performed using disc diffusion method. MICs were determined for imipenem, tigecycline, and colistin through E-strips and microbroth dilution method respectively. For molecular characterization and typing of the blaNDM gene, PCR products were sequenced, and the phylogenetic analysis was performed using MEGA ver 6.0 software.
RESULTS: Among 5,134 clinical samples, 42.13% (n = 2,163) yielded pathogens including 42.58% (n = 921) Enterobacterales. On further screening, 39.52% (n = 364) of Enterobacterales were identified as CRE. The blaNDM gene was detected in 75.27% (n = 274) in CRE isolates, comprising blaNDM-1 (44%), blaNDM-5 (53%), and blaNDM-7 (3%) variants. Tigecycline (86.7%) and colistin (100%) were most effective antimicrobial agents with MICs ranging from 0.064 to 8 and 0.125-1 µg/ml respectively. blaNDM-1-harboring bacteria exhibited high antimicrobial resistance compared to blaNDM-5 and blaNDM-7. Cefiderocol was 75.6% and ceftazidime/avibactam with aztreonam was 97.08% effective against blaNDM-harboring bacteria. The phylogenetic analysis indicated that blaNDM variants showed close genetic relationships and homology to the previously described sequences in GenBank databases having diverse connection with worldwide sequences.
CONCLUSION: The high prevalence of blaNDM in our study has of great concern for clinical practice and public health. Clinicians are left with few therapeutic options. However, ceftazidime/avibactam with aztreonam may show therapeutic success. Continuous surveillance is crucial to monitorgenetic variations of continuously evolving blaNDM gene, which is essential for effective clinical management.
METHODS: CRE isolates from a tertiary care hospital, in Islamabad, Pakistan, were identified and the susceptibility testing was performed using disc diffusion method. MICs were determined for imipenem, tigecycline, and colistin through E-strips and microbroth dilution method respectively. For molecular characterization and typing of the blaNDM gene, PCR products were sequenced, and the phylogenetic analysis was performed using MEGA ver 6.0 software.
RESULTS: Among 5,134 clinical samples, 42.13% (n = 2,163) yielded pathogens including 42.58% (n = 921) Enterobacterales. On further screening, 39.52% (n = 364) of Enterobacterales were identified as CRE. The blaNDM gene was detected in 75.27% (n = 274) in CRE isolates, comprising blaNDM-1 (44%), blaNDM-5 (53%), and blaNDM-7 (3%) variants. Tigecycline (86.7%) and colistin (100%) were most effective antimicrobial agents with MICs ranging from 0.064 to 8 and 0.125-1 µg/ml respectively. blaNDM-1-harboring bacteria exhibited high antimicrobial resistance compared to blaNDM-5 and blaNDM-7. Cefiderocol was 75.6% and ceftazidime/avibactam with aztreonam was 97.08% effective against blaNDM-harboring bacteria. The phylogenetic analysis indicated that blaNDM variants showed close genetic relationships and homology to the previously described sequences in GenBank databases having diverse connection with worldwide sequences.
CONCLUSION: The high prevalence of blaNDM in our study has of great concern for clinical practice and public health. Clinicians are left with few therapeutic options. However, ceftazidime/avibactam with aztreonam may show therapeutic success. Continuous surveillance is crucial to monitorgenetic variations of continuously evolving blaNDM gene, which is essential for effective clinical management.