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. 2021 Apr 26;10(5):373.
doi: 10.3390/biology10050373.

Emergence of Colistin and Carbapenem Resistance in Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae Isolated from Chickens and Humans in Egypt

Walid Elmonir  1 , Norhan K Abd El-Aziz  2 , Yasmine H Tartor  2 , Samar M Moustafa  3 , Etab M Abo Remela  4   5 , Radwa Eissa  6 , Hosam A Saad  7 , Ahmed Abdel Tawab  8
Affiliations

Emergence of Colistin and Carbapenem Resistance in Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae Isolated from Chickens and Humans in Egypt

Walid Elmonir et al. Biology (Basel). .

Abstract

This study investigated the frequency of carbapenem and colistin resistance in ESBL-producing K. pneumoniae (ESBLK) isolates recovered from chickens and their environment, contact farm workers and hospitalized patients in Egypt. Further, the phenotypic and genotypic relationships between the community and hospital-acquired K. pneumoniae isolates in the same geographical area were investigated. From 272 total samples, 37 (13.6%) K. pneumoniae isolates were identified, of which 20 (54.1%) were hypervirulent. All isolates (100%) were multidrug-resistant (MDR) with multiple antibiotic resistance (MAR) indices ranging from 0.19 to 0.94. Colistin-resistant isolates (18.9%) displayed colistin MIC values >2 μg/mL, all harbored the mcr-1 gene. All isolates from patients (13/90, 14.4%), workers (5/22, 22.7%), chickens (9/100, 9%) and the environment (10/60, 16.7%) harbored a single or multiple β-lactamase genes, blaSHV, blaTEM, blaCTX-M1 and blaOXA-1, often in combination with carbapenemase genes (blaVIM, blaNDM-1 or blaIMP; 45.9%), the mcr-1 gene (18.9%) or both (13.5%). Enterobacterial repetitive intergenic consensus (ERIC)-PCR genotyping revealed 24 distinct ERIC types (ETs) with a discrimination index of 0.961. Six ETs showed clusters of identical isolates from chicken and human sources. The increased frequency and genetic relatedness of ESBLK and carbapenemase-producing K. pneumoniae (CPK) from chickens and humans pose a public health threat that urge more prudent use of antimicrobials in chicken farms to avoid the propagation and expansion of both ESBLK and CPK from the chicken sources to humans.

Keywords: ESBL; K. pneumoniae; carbapenems; chickens; colistin; environment; humans.

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Conflict of interest statement

The authors have no conflict of interest to declare.

Figures

Figure 1
Figure 1
Non-metric multidimensional scaling biplot showing the overall distribution of isolates from various hosts based on the frequency distribution of antimicrobial resistance genes. Each dot refers to one isolate and the arrows refer to the association of each gene with either dimension 1 or 2.
Figure 2
Figure 2
ERIC typing dendrogram of K. pneumoniae isolates from humans and chickens in the study area and their associated genetic and phenotypic antimicrobial resistance patterns. EB: ERIC branch; ET: ERIC type; black dot: positive for antibiotic resistance gene; black square: positive for antibiotic resistance phenotype; AMR: antimicrobial resistance; AMP: ampicillin; AMC: amoxicillin-clavulanic acid; CAZ: ceftazidime; FEB: cefepime; IPM: imipenem; NA: nalidixic acid; CIP: ciprofloxacin; AK: amikacin; CN: gentamicin; TE: tetracycline; C: chloramphenicol; ATM: aztreonam; AZM: azithromycin; SXT: trimethoprim-sulfamethoxazole; F: nitrofurantoin; CT: colistin.
See this image and copyright information in PMC

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