First Record of the Isolation of blaNDM-1-Producing Enterotoxigenic Enterobacter cloacae ssp. cloacae in Baghdad/Iraq.

BACKGROUND: Antibiotic resistance is a major problem threatening human beings. The genetic determinants that carry resistance genes can be transmitted in several ways in clinical and food environments. Hence, this research study aimed to investigate the presence of New Delhi metallo-beta-lactamase-1 (blaNDM-1) produced by enterotoxigenic Enterobacter cloacae in both clinical and food samples. METHODS AND RESULTS: Twenty-four isolates of Enterobacter spp. were isolated, seven isolates from food samples and 17 isolates from blood taken from neonates and children (1 day - 10 years old) resident in a children's hospital. Antibiotic susceptibility test to 14 antibiotics was performed for all isolates. Enterotoxigenicity of the clinical and foodborne isolates was detected phenotypically using Suckling mouse bioassay. Genomic deoxyribonucleic acid (DNA) was extracted from the isolated Enterobacter spp. that were detected resistant to imipenem. Polymerase chain reaction (PCR) was used to amplify blaNDM-1 gene followed by sequencing. The results of the bioassay revealed that 64.28% of E. cloacae ssp. cloacae isolates were enterotoxigenic. Two E. cloacae ssp. cloacae were imipenem resistant. CONCLUSIONS: This study showed that one isolate from a male child 1 < year was bla NDM-1 positive that was con-firmed by sequencing. This is the first report that revealed blaNDM-1 producing Enterobacter cloacae in Iraq.

The Correlation between Adhesion Genes and Biofilm Formation among Escherichia coli Clinical Isolates.

BACKGROUND: The adhesion genes are responsible for biofilm production which leads to chronic diseases like urinary tract infections (UTIs). Uropathogenic Escherichia coli (UPEC) is the most predominant pathogen involved in UTIs. This study aims to evaluate the relationship between adhesion genes and bacterial biofilm that form by UPEC. METHODS: Fifty clinical isolates of E. coli from patients infected with UTIs were identified and antimicrobial resistance was tested by MIC assay. A polymerase chain reaction (PCR), a quick and sensitive assay to identify the adhesions operon (Afa, papG, flu, and fimH), was developed using eight primers and used for amplification. E. coli K-12 strain and E. coli J96 were used as a negative and a positive control for detection of adhesion genes. RESULTS: The study reported 70% of isolates produce strong biofilm. Adhesion genes showed as follow Afa (64% n = 33), papG (42% n = 23), flu (94% n = 52), fimH (86% n = 45). CONCLUSIONS: The resistance to non-Beta lactam antibiotic was significantly correlated with the availability of genes that encode for adhesion. These genes were highly correlated to biofilm formation in E. coli clinical isolates.

Neonatal intensive care units: extended spectrum ß-lactamase genes and biofilm formation by Serratia marcescens.

BACKGROUND: The increasing cases of bloodstream infections among children at neonatal intensive care units (NICUs) led this work to investigate biofilm production, antibiotics and the presence of ESßL genes in Serratia marcescens (S. marcescens) strains isolated from blood. METHODS: Twenty S. marcescens strains were isolated and identified by the VITEK-2 system over 7 months from late 2022 to mid-2023 from Ibn Al-Balady Hospital in Baghdad. Kirby-Bauer test was used to measure antibiotic susceptibility. RESULTS: The results revealed that 95% of twenty S. marcescens isolates were non-susceptible to Ampicillin and Amoxicillin-clavulanic. Furthermore, S. marcescens isolates showed a high sensitivity rate 70% toward Imipenem. All S. marcescens strains 100% were produced biofilm. This work clarifies that, out of 20 S. marcescens strains, 80% were harbored ESßL genes. The coexistence of blaTEM, blaCTX and blaSHV genes was shown in 43.75% of strains, while 56.25% of S. marcescens strains harbored single ES[Formula: see text]L genes. The biofilm values increase with the accuracy of EsßL genes. Phylogenetic analyses based on the sequence of blaCTX-M and blaTEM were done with closely related genes in the GenBank using MEGA6 software. CONCLUSIONS: The distribution of blaTEM, blaCTX and blaSHV genes among local S. marcescens strains may be attributed to the indiscriminate use of antibiotics. The results confirmed the spread of ESßL genes in S. marcescens from blood infections among newborn infants.

Investigating the link between imipenem resistance and biofilm formation by Pseudomonas aeruginosa.

Pseudomonas aeruginosa, a ubiquitous environmental organism, is a difficult-to-treat opportunistic pathogen due to its broad-spectrum antibiotic resistance and its ability to form biofilms. In this study, we investigate the link between resistance to a clinically important antibiotic, imipenem, and biofilm formation. First, we observed that the laboratory strain P. aeruginosa PAO1 carrying a mutation in the oprD gene, which confers resistance to imipenem, showed a modest reduction in biofilm formation. We also observed an inverse relationship between imipenem resistance and biofilm formation for imipenem-resistant strains selected in vitro, as well as for clinical isolates. We identified two clinical isolates of P. aeruginosa from the sputum of cystic fibrosis patients that formed robust biofilms, but were sensitive to imipenem (MIC ≤ 2 µg/ml). To test the hypothesis that there is a general link between imipenem resistance and biofilm formation, we performed transposon mutagenesis of these two clinical strains to identify mutants defective in biofilm formation, and then tested these mutants for imipenem resistance. Analysis of the transposon mutants revealed a role for previously described biofilm factors in these clinical isolates of P. aeruginosa, including mutations in the pilY1, pilX, pilW, algC, and pslI genes, but none of the biofilm-deficient mutants became imipenem resistant (MIC ≥ 8 µg/ml), arguing against a general link between biofilm formation and resistance to imipenem. Thus, assessing biofilm formation capabilities of environmental isolates is unlikely to serve as a good predictor of imipenem resistance. We also discuss our findings in light of the limited literature addressing planktonic antibiotic resistance factors that impact biofilm formation.