Research Article Carbapenemase Genes among Multidrug Resistant Gram Negative Clinical Isolates from a Tertiary Hospital in Mwanza, Tanzania Martha F. Mushi, 1,2 Stephen E. Mshana, 1 Can Imirzalioglu, 3,4 and Freddie Bwanga 2,5 1 Department of Microbiology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania 2 Department of Medical Microbiology, School of Biomedical Sciences, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda 3 Institute of Medical Microbiology, Justus-Liebig University, Schubertstraße 81, 35392 Giessen, Germany 4 German Centre for Infection Research (DZIF), Partner Site Giessen-Marburg-Langen, Campus, Giessen, Germany 5 MBN Clinical Laboratories, Plot 28 Nakasero Road, Kampala, Uganda Correspondence should be addressed to Martha F. Mushi; marthamushi@yahoo.com Received 5 November 2013; Revised 30 December 2013; Accepted 16 January 2014; Published 24 February 2014 Academic Editor: Branka Bedenic Copyright © 2014 Martha F. Mushi et al. his is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. he burden of antimicrobial resistance (AMR) is rapidly growing across antibiotic classes, with increased detection of isolates resistant to carbapenems. Data on the prevalence of carbapenem resistance in developing countries is limited; therefore, in this study, we determined the prevalence of carbapenemase genes among multidrug resistant gram negative bacteria (MDR-GNB) isolated from clinical specimens in a tertiary hospital in Mwanza, Tanzania. A total of 227 MDR-GNB isolates were analyzed for carbapenem resistance genes. For each isolate, ive diferent PCR assays were performed, allowing for the detection of the major carbapenemase genes, including those encoding the VIM-, IMP-, and NDM-type metallo-beta-lactamases, the class A KPC-type carbapenemases, and the class D OXA-48 enzyme. Of 227 isolates, 80 (35%) were positive for one or more carbapenemase gene. IMP-types were the most predominant gene followed by VIM, in 49 (21.59%) and 28 (12%) isolates, respectively. Carbapenemase genes were most detected in K. pneumoniae 24 (11%), followed by P. aeruginosa 23 (10%), and E. coli with 19 isolates (8%). We have demonstrated for the irst time a high prevalence of MDR-GNB clinical isolates having carbapenem resistance genes in Tanzania. We recommend routine testing for carbapenem resistance among the MDR-GNB particularly in systemic infections. 1. Introduction Carbapenem antibiotics have been used as the last resort sal- vage treatment for infections caused by multidrug resistance- gram negative bacteria (MDR-GNB) [1], that is, gram nega- tive bacteria resistant to at least three of the following antimi- crobials: ampicillin, augmentin, cetazidime, ciproloxacin, gentamicin, and/or trimethoprim-sulfamethoxazole (SXT) [2]. hus, resistance to carbapenems becomes a real threat to the survival of patients with infections caused by MDR-GNB, and the overall mortality in such infections has been reported to be up to 50% [3, 4]. Resistance to carbapenems among the MDR-GNB is mostly due to the production of carbapenemases, which are -lactamases with capacity to hydrolyze not only the carbapenems themselves but also all the other beta lactam agents [5]. Some of these carbapenemases include veron inte- gron metallo-beta-lactamases, imipenemase, Klebsiella pneu- moniae carbapenemases, oxacillinase-48, and New Delhi metallo-beta-lactamase 1 which are encoded by what is termed carbapenem resistance determining genes (CRDG):  VIM ,  IMP ,  KPC ,  OXA-48 , and  NDM , respectively [6]. Recently, increasing resistance to carbapenems in health care associated infections has been reported worldwide [1, 7]. Studies in New York City found 39% of patients with fecal colonization of KPC producing K. pneumoniae [3]. In Africa, data on the prevalence and distribution of carbapenem Hindawi Publishing Corporation BioMed Research International Volume 2014, Article ID 303104, 6 pages http://dx.doi.org/10.1155/2014/303104