Molecular epidemiology of environmental and clinical ă carbapenemase-producing Gram-negative bacilli from hospitals in Guelma, ă Algeria: Multiple genetic lineages and first report of OXA-48 in ă Enterobacter cloacae

International audienceThis study was designed to investigate environmental colonisation in ă Algerian hospitals by carbapenem-resistant Gram-negative bacilli (GNB), ă including molecular characterisation of their resistance, and to perform ă a comparative molecular analysis between clinical and environmental ă strains. GNB isolated from hospitalised patients and the hospital ă environment were identified using microbiological methods and ă matrix-assisted laser desorption/ionisation time-of-flight mass ă spectrometry (MALDI-TOF/MS). Antibiotic susceptibility testing was ă performed by disk diffusion and Etest methods. Carbapenemase- and ă extended-spectrum beta-lactamase (ESBL)-encoding genes were searched for ă using PCR and sequencing. Clonality of the environmental and clinical ă strains was assessed by multilocus sequencing typing (MLST). A total of ă 32 carbapenem-resistant GNB were isolated, including 16 (29%) of 56 ă multidrug-resistant (MDR) GNB from clinical specimens and 16 (48%) of ă 33 MDR-GNB from inanimate surfaces. Of the 32 carbapenem-resistant ă isolates, 14 produced a carbapenemase. The bla(OXA-48) gene was detected ă both in clinical and surface isolates of Klebsiella pneumoniae (n =3) ă and Enterobacter cloacae (n = 2). Clinical and surface isolates of ă Acinetobacter baumannii were found to produce the carbapenemases NDM-1 ă (7 isolates) and OXA-23 (2 isolates). MLST revealed clonal diversity and ă a relationship between environmental and clinical strains with identical ă sequence types. Here we report the first description of an ă OXA-48-producing E. cloacae isolate in Algeria. We also highlight the ă important role of inanimate surfaces in the spread of ă carbapenem-resistant bacteria and the emergence of nosocomial ă infections. (C) 2016 International Society for Chemotherapy of Infection ă and Cancer. Published by Elsevier Ltd. All rights reserved