EMERGENCE OF NDM-1 AMONG CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE IN IRAQI HOSPITALS

Carbapenems are the last drugs of choice apart from colistin against serious infections caused by Gram-negative bacteria. However, there are increasing number of reports indicating prevailing emergence of metallo-beta-lactamase (MBL)-producing clinical isolates worldwide and among them New Delhi MBL (NDM) is the most prevalent one. This study reports NDM-1 for the first time among Klebsiella pneumoniae from hospitalized patients in Baghdad, Iraq. Fifty-five clinical isolates of K. pneumoniae resistant to carbapenem were investigated from burned wounds, sputum, and blood samples. The susceptibility to different antibiotics was tested by VITEK-2 system. All strains were multidrug-resistant and they showed nine different antimicrobial-resistant patterns (A-I) and the most effective antibiotic on these strains was levofloxacin (85.45%). The phenotypic detection of carbapenemases by MAST-DISCS D70C revealed 29 (52.73%) strains were MBL-producing, out of 55 were carbapenem-resistant K. pneumoniae strains. The bla(NMD-1) and other MBL genes were detected by conventional PCR and the result showed 37 (67.27%) strains positive for bla(NMD-1) gene and only 5 (9.1%) strains harbored bla(IMP) gene, while all strains were negative for bla(VIM), bla(SIM), bla(GIM), and bla(SPM) genes. Our results showed the coexistence of both bla(NMD-1) and bla(IMP) genes in three strains of K. pneumoniae, while indicated widespread NDM-1 in Baghdad, Iraq. Hence, it is necessary to follow proper infection control practices and physicians should be aware of the patients with such risk factors.