Metallo-β-lactamase mediated resistance and Class 1 integron in carbapenem-resistant Enterobacterales isolates from the clinical specimens of Nepal
4 affiliations
- 1Central Department of Microbiology, Tribhuvan University
- 2Department of Microbiology, Tribhuvan University
- 3Department of Pathology, Kathmandu Model Hospital
- 4Mycobacterial Research Laboratories, Anandaban Hospital, The Leprosy Mission Nepal
Abstract
Background Carbapenem-resistant Enterobacterales (CRE) pose an escalating public health threat due to their limited therapeutic options and their potential for rapid dissemination in healthcare settings. Mobile genetic elements (MGEs), such as integrons, facilitate the acquisition and dissemination of antimicrobial resistance genes, contributing to multidrug resistance. This study aimed to detect metallo-β-lactamase (MBL) encoding genes, bla NDM−1, bla VIM, and bla IMP, as well as class 1 integron gene (intI1) among clinical CRE isolates in a tertiary care hospital in Nepal. Methods A six-month observational cross-sectional study was conducted in a tertiary care hospital in Nepal. A total of 3,255 clinical specimens were processed to isolate Enterobacterales species and to assess their antibiotic susceptibility by Kirby-Bauer disc diffusion. Carbapenemase and MBL production were phenotypically confirmed by the modified carbapenem inactivation method (mCIM) in combination with the EDTA-modified carbapenem inactivation method (eCIM). MBL encoding genes bla NDM−1, bla VIM, and bla IMP and class 1 integron (intI1) were detected by polymerase chain reaction. Results Among 464 Enterobacterales isolates, 58.6% were multidrug-resistant, and 13.6% were carbapenem-resistant. Phenotypic detection confirmed MBL production in 84.1% of CRE isolates. The bla NDM−1 and bla VIM genes were detected in 57.1% and 31.7% CRE isolates, respectively, while bla IMP was not detected in any of the isolates. Notably, the class 1 integron gene was present in 98.4% of CRE isolates, indicating a high potential for horizontal gene transfer. Conclusions The high prevalence of MBL genes and class 1 integrons among CRE isolates highlights a substantial risk of carbapenem resistance spreading in healthcare settings in Nepal. These findings emphasize the urgent need for prompt detection, enhanced infection control and antimicrobial stewardship to curb the spread of highly resistant Enterobacterales.
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BibTeX
@article{shrestha2026metalloβlactamase,
title = {{Metallo-β-lactamase mediated resistance and Class 1 integron in carbapenem-resistant Enterobacterales isolates from the clinical specimens of Nepal}},
author = {Manisha Shrestha and Suchitra Thapa and Basudha Shrestha and Dev Raj Joshi and Yojana Pokhrel and Jivan Shakya and Reshma Tuladhar},
journal = {BMC Microbiology},
year = {2026},
month = jul,
doi = {10.1186/s12866-026-05439-0},
url = {https://doi.org/10.1186/s12866-026-05439-0},
note = {CC BY},
}
RIS
TY - JOUR
TI - Metallo-β-lactamase mediated resistance and Class 1 integron in carbapenem-resistant Enterobacterales isolates from the clinical specimens of Nepal
AU - Manisha Shrestha
AU - Suchitra Thapa
AU - Basudha Shrestha
AU - Dev Raj Joshi
AU - Yojana Pokhrel
AU - Jivan Shakya
AU - Reshma Tuladhar
PY - 2026
DA - 2026/07/01
JO - BMC Microbiology
DO - 10.1186/s12866-026-05439-0
UR - https://doi.org/10.1186/s12866-026-05439-0
AB - Background Carbapenem-resistant Enterobacterales (CRE) pose an escalating public health threat due to their limited therapeutic options and their potential for rapid dissemination in healthcare settings. Mobile genetic elements (MGEs), such as integrons, facilitate the acquisition and dissemination of antimicrobial resistance genes, contributing to multidrug resistance. This study aimed to detect metallo-β-lactamase (MBL) encoding genes, bla NDM−1, bla VIM, and bla IMP, as well as class 1 integron gene (intI1) among clinical CRE isolates in a tertiary care hospital in Nepal. Methods A six-month observational cross-sectional study was conducted in a tertiary care hospital in Nepal. A total of 3,255 clinical specimens were processed to isolate Enterobacterales species and to assess their antibiotic susceptibility by Kirby-Bauer disc diffusion. Carbapenemase and MBL production were phenotypically confirmed by the modified carbapenem inactivation method (mCIM) in combination with the EDTA-modified carbapenem inactivation method (eCIM). MBL encoding genes bla NDM−1, bla VIM, and bla IMP and class 1 integron (intI1) were detected by polymerase chain reaction. Results Among 464 Enterobacterales isolates, 58.6% were multidrug-resistant, and 13.6% were carbapenem-resistant. Phenotypic detection confirmed MBL production in 84.1% of CRE isolates. The bla NDM−1 and bla VIM genes were detected in 57.1% and 31.7% CRE isolates, respectively, while bla IMP was not detected in any of the isolates. Notably, the class 1 integron gene was present in 98.4% of CRE isolates, indicating a high potential for horizontal gene transfer. Conclusions The high prevalence of MBL genes and class 1 integrons among CRE isolates highlights a substantial risk of carbapenem resistance spreading in healthcare settings in Nepal. These findings emphasize the urgent need for prompt detection, enhanced infection control and antimicrobial stewardship to curb the spread of highly resistant Enterobacterales.
SN - 1471-2180
ER -