Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria

Introduction: The spread of Carbapenemase-producing Enterobacterales (CPEs) has become a significant concern in Algeria, with limited data available on their presence in community settings. This research investigated the resistance mechanisms of carbapenem-resistant Enterobacterales (CREs) collecte...

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Main Authors: Amina Bougouizi, Zohra Chekroud, Hamza Rahab, Ali Boumegoura, Abdelaziz Touati
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2024-03-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/18263
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author Amina Bougouizi
Zohra Chekroud
Hamza Rahab
Ali Boumegoura
Abdelaziz Touati
author_facet Amina Bougouizi
Zohra Chekroud
Hamza Rahab
Ali Boumegoura
Abdelaziz Touati
author_sort Amina Bougouizi
collection DOAJ
description Introduction: The spread of Carbapenemase-producing Enterobacterales (CPEs) has become a significant concern in Algeria, with limited data available on their presence in community settings. This research investigated the resistance mechanisms of carbapenem-resistant Enterobacterales (CREs) collected from hospitals and the community in Skikda city, Algeria, between December 2020 and June 2022. Methodology: The study collected Enterobacterales strains resistant to ertapenem from inpatient and outpatient populations. An automated system was used for identification and antibiotic susceptibility testing. β-lactamase production was evaluated through phenotypic tests and confirmed by standard PCR. Lastly, the carbapenemase genes were sequenced using the Sanger method. Results: 17 CRE were isolated, with 9 from inpatients and 8 from outpatients. These isolates belonged to four species: Klebsiella pneumoniae (n = 8), Escherichia coli (n = 6), Enterobacter cloacae (n = 1), and Proteus mirabilis (n = 1). Of 15 CPEs, 11 were extended-spectrum β-lactamases (ESBLs) positive, 5 were plasmid-mediated cephalosporinase (AmpC) positive, and 1 harbored all three β-lactamases. All metallo-β-lactamase-producing strains carried the New Delhi metallo-beta-lactamase gene (blaNDM), including 5 NDM-1 and 7 NDM-5 variants. The presence of blaOXA-48 and blaOXA-244 was observed in one outpatient strain each. NDM was associated with Cefotaximase Munich (CTX-M) ESBL in 8 isolates, while Cephamycinase (CMY) was detected in 3 NDM-5-producing E. coli. Conclusions: This research highlights the rising prevalence of carbapenemases NDM-1 and NDM-5 among inpatients and outpatients and supports the notion that OXA-48 is becoming increasingly widespread beyond Algerian hospitals.
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spelling doaj-art-a36c2da471f4467285912e9b013a35c92025-08-20T03:52:39ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802024-03-01180310.3855/jidc.18263Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, AlgeriaAmina Bougouizi0Zohra Chekroud1Hamza Rahab2Ali Boumegoura3Abdelaziz Touati4Research Laboratory of Interactions, Biodiversity, Ecosystems and Biotechnology, Department of Nature and Life Sciences, Faculty of Sciences, University 20 August 1955 Skikda, Skikda 21000, AlgeriaLaboratoire de recherche des Interactions, Biodiversité, Ecosystèmes et Biotechnologie, faculté des Sciences de la Nature et de la Vie, AlgeriaBiotechnology Research Center - C.R.Bt Constantine, AlgeriaBiotechnology Research Center - C.R.Bt Constantine, AlgeriaLaboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia, Algeria Introduction: The spread of Carbapenemase-producing Enterobacterales (CPEs) has become a significant concern in Algeria, with limited data available on their presence in community settings. This research investigated the resistance mechanisms of carbapenem-resistant Enterobacterales (CREs) collected from hospitals and the community in Skikda city, Algeria, between December 2020 and June 2022. Methodology: The study collected Enterobacterales strains resistant to ertapenem from inpatient and outpatient populations. An automated system was used for identification and antibiotic susceptibility testing. β-lactamase production was evaluated through phenotypic tests and confirmed by standard PCR. Lastly, the carbapenemase genes were sequenced using the Sanger method. Results: 17 CRE were isolated, with 9 from inpatients and 8 from outpatients. These isolates belonged to four species: Klebsiella pneumoniae (n = 8), Escherichia coli (n = 6), Enterobacter cloacae (n = 1), and Proteus mirabilis (n = 1). Of 15 CPEs, 11 were extended-spectrum β-lactamases (ESBLs) positive, 5 were plasmid-mediated cephalosporinase (AmpC) positive, and 1 harbored all three β-lactamases. All metallo-β-lactamase-producing strains carried the New Delhi metallo-beta-lactamase gene (blaNDM), including 5 NDM-1 and 7 NDM-5 variants. The presence of blaOXA-48 and blaOXA-244 was observed in one outpatient strain each. NDM was associated with Cefotaximase Munich (CTX-M) ESBL in 8 isolates, while Cephamycinase (CMY) was detected in 3 NDM-5-producing E. coli. Conclusions: This research highlights the rising prevalence of carbapenemases NDM-1 and NDM-5 among inpatients and outpatients and supports the notion that OXA-48 is becoming increasingly widespread beyond Algerian hospitals. https://jidc.org/index.php/journal/article/view/18263Carbapenem-resistant Enterobacterales (cres)AlgeriainpatientsoutpatientsEnterobacterales
spellingShingle Amina Bougouizi
Zohra Chekroud
Hamza Rahab
Ali Boumegoura
Abdelaziz Touati
Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria
Journal of Infection in Developing Countries
Carbapenem-resistant Enterobacterales (cres)
Algeria
inpatients
outpatients
Enterobacterales
title Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria
title_full Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria
title_fullStr Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria
title_full_unstemmed Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria
title_short Prevalence and characterization of Carbapenem-Resistant Enterobacterales among inpatients and outpatients in Skikda, Algeria
title_sort prevalence and characterization of carbapenem resistant enterobacterales among inpatients and outpatients in skikda algeria
topic Carbapenem-resistant Enterobacterales (cres)
Algeria
inpatients
outpatients
Enterobacterales
url https://jidc.org/index.php/journal/article/view/18263
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