الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
The emergence of carbapenemase- producing Klebsiella pneumoniae represents a great problem in many Egyptian hospitals. This study was conducted over a period of 14 months from April 2018 to May 2019 on 188 Klebsiella spp. obtained from 188 patients admitted to Assiut Hospitals. One hundred and twenty-six K. pneumoniae isolates from patients admitted to Assiut Hospitals were identified by API20E kit. K. pneumoniae isolates were mostly recovered from chest ward (31.7%), and pediatrics ICU (15.8%). Carbapenemase-producing K. pneumoniae (CPKP) were detected by modified carbapenem inactivation method (mCIM) (61.1%), EDTA-modified carbapenem inactivation method (eCIM) and E-test. Based on the polymerase chain reaction, all isolates were negative for blaVIM and blaIMP, fifteen of these isolates were positive for both blaKPC and blaNDM, two isolates were positive for blaKPC only and twenty-eight isolates for blaNDM only. Only 71.1% of CPKP transferred their plasmids to their corresponding transconjugants (E. coli J53). Resistance pattern of the clinical isolates and their transconjugate were similar except for 12 isolates which showed difference with their transconjugates in the resistance profile of 4 antibiotics. Molecular typing of plasmid based on replicon typing showed that Inc FIIK and FII plasmids predominated in both isolates and their transconjugants carrying blaKPC and ̸ or blaNDM. Conjugative Inc FII plasmids play important role in the spread of CPKP and their recognition is essential to limit their spread.
Localizing the source of carbapenemase-producing K. pneumoniae is considering an important step to prevent their spread in this community. Thirty-three carbapenemase-producing K. pneumoniae isolates were typed by Enterobacterial Repetitive Intergenic Consensus (ERIC). ERIC gel profile showed that several identical isolates were found especially in chest ward and between different medical wards of these hospitals suggested clonal transmission of carbapenemase-producing K. pneumoniae. Also, there are differences in the number and size of ERIC-PCR profiles indicated the genetic diversity among carbapenemase-producing K. pneumoniae isolates.