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. 2018 Nov 8:11:2211-2217.
doi: 10.2147/IDR.S174869. eCollection 2018.

First reported nosocomial outbreak of Serratia marcescens harboring bla IMP-4 and bla VIM-2 in a neonatal intensive care unit in Cairo, Egypt

Doaa Mohammad Ghaith  1 , Mai Mahmoud Zafer  2 , Dalia Kadry Ismail  1 , Mohamed Hamed Al-Agamy  3   4 , Marie Fe F Bohol  5 , Ahmed Al-Qahtani  5 , Mohammed N Al-Ahdal  5 , Sherif M Elnagdy  6 , Islam Yousif Mostafa  7
Affiliations

First reported nosocomial outbreak of Serratia marcescens harboring bla IMP-4 and bla VIM-2 in a neonatal intensive care unit in Cairo, Egypt

Doaa Mohammad Ghaith et al. Infect Drug Resist. .

Abstract

Introduction: Serratia marcescens is a significant hospital-acquired pathogen, and many outbreaks of S. marcescens infection have been reported in neonates. We report a sudden breakout of S. marcescens harboring the bla IMP-4 and bla VIM-2 metallo-β-lactamase (MBL) genes that occurred from March to August 2015 in the neonatal intensive care unit of Cairo University Hospital, Cairo, Egypt.

Methods: During the study period, 40 nonduplicate clinical isolates of S. marcescens were collected from blood culture samples. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry was used to identify each isolate. Then, minimum inhibitory concentrations of different antibiotics were assessed by the Vitek 2 compact system. Screening of the MBL genes bla IMP, bla VIM, bla SIM-1, bla SPM-1, and bla GIM-1 as well as the carbapenemase genes KPC, NDM, OXA-48, SME-1, and SME-2 were evaluated. Pulsed field gel electrophoresis was preformed to detect the genetic relationship of the isolates.

Results: Analysis showed that 37.5% of the S. marcescens clinical isolates were resistant to meropenem (minimum inhibitory concentrations ≥ 2 µg/mL), and bla IMP-4 and bla VIM-2 were the most prevalent MBL genes (42.5% and 37.5%, respectively). None of the other investigated genes were observed. Pulsed field gel electrophoresis typing revealed two discrete clones; 33/40 (82.5%) were pulsotype A and 7/40 (17.5%) were pulsotype B.

Conclusion: Here, we report for the first time the detection of MBL-producing S. marcescens isolates, particularly IMP-4 and VIM-2 recovered from inpatients with bacteremias from the intensive care unit at Cairo University Hospital.

Keywords: MALDI-TOFF; MBL genes; PFGE; SME-1; SME-2; carbapenemases; outbreak.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Dendrogram of the pulsed field gel electrophoresis patterns showing the genetic relatedness of the 40 Serratia marcescens isolates. Abbreviation: IC-CDC, Centers for Disease Control and Prevention pulsotype.
See this image and copyright information in PMC

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