Detection of diverse carbapenem and multidrug resistance genes and high-risk strain types among carbapenem non-susceptible clinical isolates of target gram-negative bacteria in Kenya

• DOI: 10.1371/journal.pone.0246937
• Publication Date: 2021-02-22T18:28:50Z
• Authors: Lillian Musila; Cecilia Kyany’a; Rosslyn Maybank; Jason Stam; Valerie Oundo; Willie Sang
• Keywords: Tigecycline; Acinetobacter baumannii; Enterobacter cloacae; Carbapenem

Carbapenem-resistant gram-negative bacteria are an increasingly significant clinical threat globally. This risk may be underestimated in Kenya as only four carbapenemase genes three bacterial species have been described. The study aimed to understand the antibiotic resistance profiles, genes, sequence types, and distribution of carbapenem-resistant from patients six hospitals across five Kenyan counties by culture, susceptibility testing, whole-genome analysis. Forty-eight, non-duplicate, carbapenem non-susceptible, isolates were identified (predominantly Nairobi Kisii): twenty-seven Acinetobacter baumannii , fourteen Pseudomonas aeruginosa Escherichia coli two Enterobacter cloacae Klebsiella pneumoniae . All non-susceptible β-lactam drugs with variable tigecycline (66%), minocycline (52.9%), tetracycline (29.4%), levofloxacin (22.9%). Thirteen P resistant all antibiotics tested. Eleven identified: bla NDM-1, OXA-23, -58, -66, -69, -91 A ( STs 1, 2, 164 a novel ST1475), NDM-1 E (STs 25,182), VIM-1and -6 OXA-50 316, 357, 654, and1203), OXA-181, K 147 219), NDM-5 (ST164). Five had carbapenemases, either OXA-23 (4) or OXA-58 (1). AmpC detected (bla ADC-25 ), DHA-1 ACT-6, 16 CMY ). Significant multiple-drug pan-aminoglycoside resistance16srRNA methyltransferase arm A, rmt B, C, F genes. is first report OXA-420, -181, VIM-6, isolates. High-risk (ST1475, ST2), ST182, ST147, (ST357, 654), ST167, ST648 which present considerable therapeutic danger. recommends urgent use regulation containment high-risk bacteria.