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Microb Drug Resist. 2017 Oct;23(7):895-900. doi: 10.1089/mdr.2016.0213. Epub 2017 Feb 22.

First Case of NDM-1-Producing Klebsiella pneumoniae in Annaba University Hospital, Algeria.

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1 Institut National de la Santé et de la Recherche Médicale, U1047, Université de Montpellier, UFR de Médecine , Nîmes, France .
2 Laboratoire d'Amélioration Génétique des Plantes, Equipe Microorganismes et Environnement, Université Badji Mokhtar , Annaba, Algérie.
3 Laboratoire de Microbiologie, CHU Ibn Rochd , Annaba, Algérie.
4 Service de Microbiologie, CHU Carémeau , Nîmes, France .
5 Centre de Réanimation et de Traitement des Brûlés, Hôpital Ibn-Sina, CHU Annaba , Annaba, Algérie.
6 Service des Maladies Infectieuses et Tropicales, CHU Carémeau , Nîmes, France .



The aim of this study was to characterize two carbapenem-resistant Klebsiella pneumoniae isolates recovered from urine samples in a patient hospitalized at Annaba University hospital (Algeria) in 2014.


Two K. pneumoniae isolates were studied because they proved resistant to almost all antibiotics tested with a high level resistance to ertapenem (minimum inhibitory concentration = 32 mg/L). The results of modified Hodge test and combined disk test (ROSCO Diagnostica, Taastrup, Denmark) were positive. The two isolates harbored the blaNDM-1 gene and one was also positive for blaCTX-M-15. Screening of aminoglycoside-modifying enzymes and plasmid-mediated quinolone resistance contents detected aac(6')-Ib-cr, aac(3')-II, qnrB2, and oqxAB in both isolates. Multilocus sequence typing demonstrated that the two isolates belonged to sequence type 147. However, repetitive sequence-based PCR and pulsed-field gel electrophoresis showed that they were not clonally related. The blaNDM-1 gene and all other resistant genes were contained on an IncR plasmid of c.a. 85 kb.


This study comprises the first identification of NDM-1-producing K. pneumoniae in Algeria. We thus confirm the concerning worldwide dissemination of this carbapenemase that involves the emergence of the IncR plasmid and the success of the ST147 clonal complex harboring it.


Algeria; IncR; Klebsiella pneumoniae; MLST; NDM-1; ST147; carbapenemase

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