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Shahid M, Saeed NK, Ahmad N, Shadab M, Joji RM, Al-Mahmeed A, Bindayna KM, Tabbara KS, Ismaeel AY, Dar FK. Molecular Screening of Carbapenem-Resistant K. pneumoniae (CRKP) Clinical Isolates for Concomitant Occurrence of Beta-Lactam Genes (CTX-M, TEM, and SHV) in the Kingdom of Bahrain. J Clin Med 2023; 12:7522. [PMID: 38137591 PMCID: PMC10744081 DOI: 10.3390/jcm12247522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/05/2023] [Accepted: 11/14/2023] [Indexed: 12/24/2023] Open
Abstract
The emergence of extended-spectrum β-lactamase-producing Klebsiella pneumoniae, including CRKP infections, has resulted in significant morbidity and mortality worldwide. We aimed to explore the presence of bla genes (CTX-M, TEM, and SHV) in CRKP isolates. A total of 24 CRKP isolates were randomly selected from the Salmaniya Medical Complex Microbiology Laboratory. These isolates, which were positive for carbapenemases, were further explored for CTX-M, TEM, and SHV genes using PCR. All the CTX-M PCR amplicons were sent for sequencing. To determine genetic relatedness, molecular typing by ERIC-PCR was performed. The bla gene testing demonstrated that a significant proportion of these isolates harbored SHV, CTX-M, and TEM genes (100%, 91.6%, and 45.8%), respectively. Bioinformatic analyses confirmed CTX-M-15 in these isolates. ERIC-PCR analysis showed three clusters demonstrating genetic relatedness. The study findings reveal the concomitant carriage of the SHV and CTX-M-15 and a comparatively lower carriage of TEM genes in CRKP isolates. Our findings highlight the significance of routinely reporting the presence of antibiotic resistance genes along with regular antibiotic sensitivity reports, as this will aid clinicians in prescribing appropriate antibiotics.
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Affiliation(s)
- Mohammad Shahid
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Nermin Kamal Saeed
- Microbiology Section, Department of Pathology, Salmaniya Medical Complex, Manama 435, Bahrain;
| | - Nayeem Ahmad
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Mohd Shadab
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Ronni Mol Joji
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Ali Al-Mahmeed
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Khalid M. Bindayna
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Khaled Saeed Tabbara
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Abdulrahman Y. Ismaeel
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
| | - Fazal K. Dar
- Department of Microbiology, Immunology, and Infectious Diseases, College of Medicine & Medical Sciences, Arabian Gulf University, Manama 329, Bahrain; (N.A.); (M.S.); (R.M.J.); (A.A.-M.); (K.M.B.); (K.S.T.); (A.Y.I.); (F.K.D.)
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Dey TK, Lindahl JF, Lundkvist Å, Grace D, Deka RP, Shome R, Bandyopadhyay S, Goyal NK, Sharma G, Shome BR. Analyses of Extended-Spectrum-β-Lactamase, Metallo-β-Lactamase, and AmpC-β-Lactamase Producing Enterobacteriaceae from the Dairy Value Chain in India. Antibiotics (Basel) 2023; 12:1449. [PMID: 37760745 PMCID: PMC10650101 DOI: 10.3390/antibiotics12091449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 09/03/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Abstract
The consumption of milk contaminated with antibiotic-resistant bacteria poses a significant health threat to humans. This study aimed to investigate the prevalence of Enterobacteriaceae producing β-lactamases (ESBL, MBL, and AmpC) in cow and buffalo milk samples from two Indian states, Haryana and Assam. A total of 401 milk samples were collected from dairy farmers and vendors in the specified districts. Microbiological assays, antibiotic susceptibility testing, and PCR-based genotyping were employed to analyze 421 Gram-negative bacterial isolates. The overall prevalence of β-lactamase genes was 10% (confidence interval (CI) (7-13)), with higher rates in Haryana (13%, CI (9-19)) compared to Assam (7%, CI (4-11)). The identified β-lactamase genes in isolates were blaCMY, blaMOX, blaFOX, blaEBC, and blaDHA, associated with AmpC production. Additionally, blaCTX-M1, blaSHV, and blaTEM were detected as ESBL producers, while blaVIM, blaIMP, blaSPM, blaSIM, and blaGIM were identified as MBL producers. Notably, Shigella spp. were the dominant β-lactamase producers among identified Enterobacteriaceae. This study highlights the presence of various prevalent β-lactamase genes in milk isolates, indicating the potential risk of antimicrobial-resistant bacteria in dairy products. The presence of β-lactam resistance raises concern as this could restrict antibiotic options for treatment. The discordance between genotypic and phenotypic methods emphasizes the necessity for comprehensive approaches that integrate both techniques to accurately assess antibiotic resistance. Urgent collaborative action incorporating rational and regulated use of antibiotics across the dairy value chain is required to address the global challenge of β-lactam resistance.
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Affiliation(s)
- Tushar Kumar Dey
- Department of Biosciences, International Livestock Research Institute, Nairobi 00100, Kenya
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, 75123 Uppsala, Sweden
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bengaluru 560064, India
| | - Johanna Frida Lindahl
- Department of Biosciences, International Livestock Research Institute, Nairobi 00100, Kenya
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, 75123 Uppsala, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, 75007 Uppsala, Sweden
| | - Åke Lundkvist
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, 75123 Uppsala, Sweden
| | - Delia Grace
- Department of Biosciences, International Livestock Research Institute, Nairobi 00100, Kenya
- Food and Markets Department, Natural Resources Institute, Chatham Maritime ME4 4TB, UK
| | - Ram Pratim Deka
- International Livestock Research Institute, Regional Office for South Asia, New Delhi 110012, India
| | - Rajeswari Shome
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bengaluru 560064, India
| | - Samiran Bandyopadhyay
- Eastern Regional Station, ICAR-Indian Veterinary Research Institute, Kolkata 700037, India
| | - Naresh Kumar Goyal
- Dairy Microbiology Division, National Dairy Research Institute, Karnal 132001, India
| | - Garima Sharma
- Department of Biosciences, International Livestock Research Institute, Nairobi 00100, Kenya
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, 75123 Uppsala, Sweden
| | - Bibek Ranjan Shome
- ICAR-National Institute of Veterinary Epidemiology and Disease Informatics, Bengaluru 560064, India
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Jung L, Kiwanuka J, Mbabazi L, Nakate V, Musaazi J, Nabajja H, Kajumbula H, Lübbert C, Mwaka E, Nsibirwa S, von Braun A. A case for routine microbial diagnostics: Results from antimicrobial susceptibility testing in post-traumatic wound infections at a Ugandan tertiary care hospital. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001880. [PMID: 37582103 PMCID: PMC10427013 DOI: 10.1371/journal.pgph.0001880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 07/25/2023] [Indexed: 08/17/2023]
Abstract
The global spread of antimicrobial resistance (AMR) poses an increasing challenge for clinicians in Uganda, where microbiological diagnostics are not routinely available or accessible. The aim of this study was to determine pathogen prevalence and antibiotic resistance patterns in patients with wound infections following trauma at a national referral hospital in Kampala, Uganda. In addition, the suitability of currently used empirical treatment options in this setting was evaluated. This prospective, observational study analysed antimicrobial prescriptions, culture results and antimicrobial sensitivity testing (AST) of wound swabs and blood samples from patients with clinical signs of wound infections on the trauma ward. A total of 124 patients (n = 99, 79.8% male) with a median age of 30 years (IQR 23-39) were enrolled between October 2021 and January 2022. Wound infections were classified as nosocomial in 69% of the cases. Pathogens were isolated from 122 wound swabs, yielding 238 bacterial isolates. The most prevalent pathogens were gram-negative bacteria including Escherichia coli (n = 48, 20.2%) and Acinetobacter spp. (n = 43, 18.1%). Empiric treatment consisted of ceftriaxone and gentamicin which was administered to 67.2% (n = 78) and 62.1% (n = 72) of patients, respectively. High rates of antimicrobial resistance could be demonstrated across gram-negative and gram-positive species towards the most common empiric antibiotics. Following the AST results, over 95% (n = 111) of patients required a change of treatment. Our findings demonstrate that current empiric treatment for wound infections is missing its target in hospitalized patients in Kampala. To address the growing problem of AMR in Uganda, there is a pressing need to enhance diagnostic capacity and implement structured antimicrobial stewardship programs.
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Affiliation(s)
- Laura Jung
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - James Kiwanuka
- Department of Orthopedics/Trauma, Mulago National Referral Hospital, Kampala, Uganda
| | - Leah Mbabazi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Vivian Nakate
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Joseph Musaazi
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Hawah Nabajja
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Henry Kajumbula
- Department of Medical Microbiology, Makerere University, Kampala, Uganda
| | - Christoph Lübbert
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Leipzig University Medical Center, Leipzig, Germany
| | - Erisa Mwaka
- Department of Orthopedics/Trauma, Mulago National Referral Hospital, Kampala, Uganda
| | - Sara Nsibirwa
- Infectious Diseases Institute, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Amrei von Braun
- Department of Medicine I, Division of Infectious Diseases and Tropical Medicine, Leipzig University Medical Center, Leipzig, Germany
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Žagar D, Zore A, Torkar KG. The occurrence of antibiotic-resistant bacteria on the clothes of nursery teachers in daycare centres. J Appl Microbiol 2022; 132:4517-4530. [PMID: 35267237 PMCID: PMC9314099 DOI: 10.1111/jam.15520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/28/2022] [Accepted: 03/05/2022] [Indexed: 11/28/2022]
Abstract
AIMS Childcare facilities act as microenvironments that facilitate and promote the selection, spread, and transmission of antibiotic-resistant microorganisms in the community. We focused on the study of antimicrobial resistance and genetic predispositions for β-lactamase production in bacterial isolates from nursery teachers' clothing. METHODS AND RESULTS Antimicrobial resistance of bacterial strains belonging to Enterobacteriaceae, Enterococcus, Staphylococcus spp., Pseudomonas spp. and Bacillus spp. isolated from 80 samples of nursery teachers' clothing was determined. The selected ESβL genes were found in 30 (44.1%) of 68 strains examined. The CTX-M type ESβL determinants were detected in 15.4%, 71.5%, and 42.5% of the Enterobacteriaceae, Pseudomonas, and Bacillus isolates, respectively. The OXA-type coding genes were detected only in strains of the genera Pseudomonas (57.1%) and Bacillus (48.6%). Thus, most B. cereus strains were sensitive to the recommended antibiotics used to treat infections caused by these bacteria. Methicillin resistance was phenotypically confirmed in 27 (14.6%) of 185 staphylococcal isolates. Four isolates (2.2%) were identified as MRSA. Vancomycin resistance was not observed in any of the staphylococcal and enterococci strains. CONCLUSIONS This study has shown that potential pathogens have been isolated from the clothing of nursery teachers, posing a risk of transmission to children. These clothes should be maintained and properly laundered to avoid cross-contamination and the spread of multidrug-resistant (MDR) bacteria in childcare centres. SIGNIFICANCE AND IMPACT OF THE STUDY This study provides insight into the route of transmission of MDR microorganisms through the clothing of nursery teachers, to which greater importance should be given in the future. Proper procedures for the cleaning and use of clothing in daycare centres should be clarified and standardised.
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Affiliation(s)
- Dominika Žagar
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| | - Anamarija Zore
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
| | - Karmen Godič Torkar
- University of Ljubljana, Faculty of Health Sciences, Zdravstvena pot 5, SI-1000, Ljubljana, Slovenia
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Kar B, Sharma M, Peter A, Chetia P, Neog B, Borah A, Pati S, Bhattacharya D. Prevalence and molecular characterization of β-lactamase producers and fluoroquinolone resistant clinical isolates from North East India. J Infect Public Health 2021; 14:628-637. [PMID: 33848892 DOI: 10.1016/j.jiph.2021.02.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 01/26/2021] [Accepted: 02/14/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The rapid emergence and variations of antibiotic resistance among common gram negative bacteria cause a significant concern specially in India and all over the world because of high mortality and morbidity rates. METHODS In our study, we screened 189 bacterial isolates from Assam Medical College & Hospital, Dibrugarh for antibiotic resistance pattern and tried to identify the resistant genes causing responsible for β-lactam and fluoroquinolones resistance. RESULTS More than 80% and 45% strains were resistant to all the 3rd generation cephalosporins, fluoroquinolones respectively. Among the 3rd generation cephalosporin resistant strains, 38% and 24% isolates were only ESBL and MBL producers respectively and 11% were reported to have both ESBL and MBL genes. The ESBL positive isolates have shown the dominance of CTX-M3 gene. VIM-1 gene was mostly reported in MBL producers. Our study probably for the first time reporting SIM-1 and SPM-1 MBL gene from India. Mutations in QRDR is found to be the primary cause of fluoroquinolone resistance along with efflux pump and PMQR presence. CONCLUSION The study represents the first detailed study on antibiotic resistance from NE India this could help to take control measures for the emerging antibiotic resistance in hospital and community based infections in North East India.
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Affiliation(s)
- Bipasa Kar
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
| | - Mohan Sharma
- Department of Life Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India.
| | - Annalisha Peter
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
| | - Pankaj Chetia
- Department of Life Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India.
| | - Bijoy Neog
- Department of Life Sciences, Dibrugarh University, Dibrugarh 786004, Assam, India.
| | - Amrit Borah
- Department of Microbiology, Assam Medical College & Hospital, Dibrugarh 786002, Assam, India.
| | - Sanghamitra Pati
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
| | - Debdutta Bhattacharya
- Department of Bacteriology, ICMR-Regional Medical Research Centre (Dept. of Health Research, Ministry of Health & Family Welfare, Govt. of India), Chandrasekharpur, Bhubaneswar 751023, India.
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Eltai NO, Yassine HM, El-Obeid T, Al-Hadidi SH, Al Thani AA, Alali WQ. Prevalence of Antibiotic-Resistant Escherichia coli Isolates from Local and Imported Retail Chicken Carcasses. J Food Prot 2020; 83:2200-2208. [PMID: 32730573 DOI: 10.4315/jfp-20-113] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 07/30/2020] [Indexed: 12/17/2022]
Abstract
ABSTRACT The spread of antibiotic resistance among bacterial strains has been associated with consumption of food contaminated with both pathogenic and nonpathogenic bacteria. The objective of this study was to determine the prevalence of antibiotic resistant Escherichia coli isolates in local and imported retail raw chicken meat in Qatar. A total of 270 locally produced (chilled) and imported (chilled or frozen) whole chicken carcasses were obtained from three Hypermarket stores in Qatar. The 216 E. coli isolates recovered from the chicken samples were subjected to antibiotic susceptibility testing with the disk diffusion method. Extended-spectrum β-lactamase (ESBL) production was evaluated with the double disk synergy test. Isolates harboring colistin resistance were identified with a multiplex PCR assay and DNA sequencing. Nearly 89% (192) of the 216 isolates were resistant to at least one of the 18 antibiotics tested. Isolates from local and imported chicken carcasses had relatively higher resistance to sulfamethoxazole (62% of isolates), tetracycline (59.7%), ampicillin and trimethoprim (52.3% each), ciprofloxacin (47.7%), cephalothin (45.4%), and colistin (31.9%). Less resistance was found to amoxicillin-clavulanic acid (6%), ceftriaxone (5.1%), nitrofurantoin (4.2%), piperacillin-tazobactam (4.2%), cefepime (2.3%), meropenem (1.4%), ertapenem (0.9%), and amikacin (0.9%). Nine isolates (4.2%) were ESBL producers, and 137 (63.4%) were multidrug resistant. The percentages of multidrug-resistant, ESBL-producing, and colistin resistant isolates were significantly higher among isolates from local chilled than from imported chilled and frozen chicken samples. Our findings indicate the high prevalence of antibiotic-resistant E. coli in chicken meat sold at retail in Qatar. HIGHLIGHTS
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Affiliation(s)
| | | | - Tahra El-Obeid
- Department of Health Nutrition, College of Health Sciences, Qatar University, Doha, Qatar
| | | | | | - Walid Q Alali
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kuwait University, Safat, Kuwait
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Tumuhamye J, Sommerfelt H, Bwanga F, Ndeezi G, Mukunya D, Napyo A, Nankabirwa V, Tumwine JK. Neonatal sepsis at Mulago national referral hospital in Uganda: Etiology, antimicrobial resistance, associated factors and case fatality risk. PLoS One 2020; 15:e0237085. [PMID: 32776958 PMCID: PMC7416959 DOI: 10.1371/journal.pone.0237085] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 07/20/2020] [Indexed: 02/06/2023] Open
Abstract
Background Sepsis is the third most common cause of death among neonates, with about 225,000 newborns dying every year globally. Data concerning the microbial etiology of neonatal sepsis and antimicrobial resistance profiles of its causative agents are necessary to inform targeted and effective treatment and prevention strategies. Objective To determine the proportion of newborns with symptoms and signs of sepsis who had a positive blood culture, its bacterial etiology, the antimicrobial resistance patterns as well as the factors associated with culture-positivity and case fatality at Mulago national referral hospital in Uganda. Methods We conducted a cross-sectional study among 359 neonates with symptoms and signs of sepsis who presented to the pediatric emergency care unit of Mulago national referral hospital from mid-January to end of December 2018. We performed blood culture and antimicrobial susceptibility testing, and conducted polymerase chain reaction to identify methicillin-resistant Staphylococcus aureus (MRSA) isolates. We used multivariable logistic regression to estimate the association between potential risk factors and culture-positive neonatal sepsis. Findings Of the 359 neonates recruited, 46 (12.8%; 95% CI 9.5%, 16.7%) had a positive blood culture. The predominant isolated bacteria were Staphylococcus aureus in 29 (63.0%), Escherichia coli in seven (15.2%), and Klebsiella pneumoniae in five (10.9%). Of the 46 pathogens, 73.9% were resistant to ampicillin, 23.9% to gentamicin and 8.7% to ceftriaxone. We isolated MRSA from the blood specimens of 19 (5.3%) of the 359 neonates, while 3 (0.8%) grew extended spectrum beta lactamase producers. The case fatality risk among neonates with neonatal sepsis was 9.5% (95% CI: 6.6%, 13.0%). Cesarean section delivery was strongly associated with culture-positive sepsis (adjusted odds ratio 3.45, 95% CI: 1.2, 10.1). Conclusion One in eight neonates with clinical signs of sepsis grew a likely causative bacterial pathogen. S. aureus was the main pathogen isolated and a third of these isolates were MRSA. A significant proportion of the isolated bacterial pathogens were resistant to the first and second line antibiotics used for the treatment of neonatal sepsis. There is need to revisit the current treatment guidelines for neonatal sepsis.
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Affiliation(s)
- Josephine Tumuhamye
- Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- * E-mail:
| | - Halvor Sommerfelt
- Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Freddie Bwanga
- Department of Medical Microbiology, Makerere University, Kampala, Uganda
| | - Grace Ndeezi
- Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
| | - David Mukunya
- Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Agnes Napyo
- Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Public Health, Busitema University, Mbale, Uganda
| | - Victoria Nankabirwa
- Centre for Intervention Science for Maternal and Child Health (CISMAC), Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Epidemiology and Biostatics School of Public Health, Makerere University, Kampala, Uganda
| | - James K. Tumwine
- Department of Pediatrics and Child Health, Makerere University, Kampala, Uganda
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Rhodes J, Jorakate P, Makprasert S, Sangwichian O, Kaewpan A, Akarachotpong T, Srisaengchai P, Thamthitiwat S, Khemla S, Yuenprakhon S, Paveenkittiporn W, Kerdsin A, Whistler T, Baggett HC, Gregory CJ. Population-based bloodstream infection surveillance in rural Thailand, 2007-2014. BMC Public Health 2019; 19:521. [PMID: 32326935 PMCID: PMC6696817 DOI: 10.1186/s12889-019-6775-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Background Bloodstream infection (BSI) surveillance is essential to characterize the public health threat of bacteremia. We summarize BSI epidemiology in rural Thailand over an eight year period. Methods Population-based surveillance captured clinically indicated blood cultures and associated antimicrobial susceptibility results performed in all 20 hospitals in Nakhon Phanom (NP) and Sa Kaeo (SK) provinces. BSIs were classified as community-onset (CO) when positive cultures were obtained ≤2 days after hospital admission and hospital-onset (HO) thereafter. Hospitalization denominator data were available for incidence estimates for 2009–2014. Results From 2007 to 2014 a total of 11,166 BSIs were identified from 134,441 blood cultures. Annual CO BSI incidence ranged between 89.2 and 123.5 cases per 100,000 persons in SK and NP until 2011. Afterwards, CO incidence remained stable in SK and increased in NP, reaching 155.7 in 2013. Increases in CO BSI incidence over time were limited to persons aged ≥50 years. Ten pathogens, in rank order, accounted for > 65% of CO BSIs in both provinces, all age-groups, and all years: Escherichia coli, Klebsiella pneumoniae, Burkholderia pseudomallei, Staphylococcus aureus, Salmonella non-typhi spp., Streptococcus pneumoniae, Acinetobacter spp., Streptococcus agalactiae, Streptococcus pyogenes, Pseudomonas aeruginosa. HO BSI incidence increased in NP from 0.58 cases per 1000 hospitalizations in 2009 to 0.91 in 2014, but were higher (ranging from 1.9 to 2.3) in SK throughout the study period. Extended-spectrum beta-lactamase production among E. coli isolates and multi-drug resistance among Acinetobacter spp. isolates was common (> 25% of isolates), especially among HO cases (> 50% of isolates), and became more common over time, while methicillin-resistance among S. aureus isolates (10%) showed no clear trend. Carbapenem-resistant Enterobacteriaceae were documented in 2011–2014. Conclusions Population-based surveillance documented CO BSI incidence estimates higher than previously reported from Thailand and the region, with temporal increases seen in older populations. The most commonly observed pathogens including resistance profiles were similar to leading pathogens and resistance profiles worldwide, thus; prevention strategies with demonstrated success elsewhere may prove effective in Thailand. Electronic supplementary material The online version of this article (10.1186/s12889-019-6775-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Julia Rhodes
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.
| | - Possawat Jorakate
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Sirirat Makprasert
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Ornuma Sangwichian
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Anek Kaewpan
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Thantapat Akarachotpong
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Prasong Srisaengchai
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | - Somsak Thamthitiwat
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand
| | | | | | - Wantana Paveenkittiporn
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand
| | - Anusak Kerdsin
- Department of Medical Sciences, National Institute of Health, Ministry of Public Health, Nonthaburi, Thailand.,Faculty of Public Health, Kasetsart University Chalermphrakiat, Sakon Nakhon Province, Thailand
| | - Toni Whistler
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.,Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA, USA
| | - Henry C Baggett
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.,Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA, USA
| | - Christopher J Gregory
- Global Disease Detection Center, Thailand Ministry of Public Health (MOPH) - United States Centers for Disease Control and Prevention (CDC) Collaboration, Nonthaburi, Thailand.,Division of Global Health Protection, Center for Global Health, CDC, Atlanta, GA, USA
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9
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GHAZVINI H, TAHERI K, EDALATI E, SEDIGHI M, MIRKALANTARI S. Virulence factors and antimicrobial resistance in uropathogenic Escherichiacoli strains isolated from cystitis and pyelonephritis. Turk J Med Sci 2019; 49:361-367. [PMID: 30761847 PMCID: PMC7350878 DOI: 10.3906/sag-1805-100] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background/aim The aim of this study was to investigate the prevalence of virulence genes as well as patterns of antibiotic resistance in cystitis and pyelonephritis uropathogenic Escherichia coli (UPEC) isolates. Materials and methods Two hundred UPEC isolates were collected from hospitalized patients with pyelonephritis (n = 50) and cystitis (n = 150) in Shafa Hospital in Iran. Antimicrobial susceptibility and ESBL production were determined with confirmatory tests. Polymerase chain reaction assay was performed to determine the prevalence of virulence genes in UPEC strains. Results Of a total 200 UPEC isolates, the highest and lowest resistance rates to antibiotics were for cephalexin (74%) and nitrofurantoin (9%), respectively. Of these isolates, 72 (36%) and 128 (64%) strains were ESBL-positive and ESBL-negative, respectively. The frequency of fimH, papC, and hly was 64%, 38%, and 12%, respectively. The most commonly identified virulence gene in ESBL-positive and ESBL-negative strains was fimH 46 (23%) and 86 (43%), respectively. The hlyA gene was more prevalent among patients with pyelonephritis than cystitis. Conclusion The frequency of virulence genes was not significantly different between pyelonephritis and cystitis UPEC strains in the studied patients, but the prevalence rates of hlyA and papC genes were higher among UPEC strains isolated from inpatients compared to outpatients; hence, they could be considered as useful targets for prophylactic interventions.
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Affiliation(s)
| | - Keyvan TAHERI
- Department of Biology, Damghan Branch, Islamic Azad University, DamghanIran
| | - Elahe EDALATI
- Department of Microbiology, Kerman Branch, Islamic Azad University, KermanIran
| | - Mansour SEDIGHI
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, TehranIran
- Azarbaijan-Gharbi Regional Blood Transfusion Center, UrmiaIran
| | - Shiva MIRKALANTARI
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, TehranIran
- Institute of Immunology and Infectious Disease, Iran University of Medical Sciences, TehranIran
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10
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Eltai NO, Yassine HM, Al Thani AA, Abu Madi MA, Ismail A, Ibrahim E, Alali WQ. Prevalence of antibiotic resistant Escherichia coli isolates from fecal samples of food handlers in Qatar. Antimicrob Resist Infect Control 2018; 7:78. [PMID: 29983931 PMCID: PMC6019201 DOI: 10.1186/s13756-018-0369-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 06/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background It is well documented that food handlers harbor and shed enteric foodborne pathogens causing foodborne disease outbreaks. However, little known on enteric antibiotic resistant (AR) bacteria carriage in food handlers. The objective of this study was to establish a baseline prevalence of fecal AR E. coli among food handlers in Qatar. Methods Fecal samples were collected from 456 migrant food handlers of different nationalities arriving in Qatar on a work permit between January 2015 and December 2016. These samples (25 g each) were collected based on the availability and examination schedule at the Medical Commission facility from those consented to participate. Isolated E. coli bacteria were tested for antibiotic susceptibility against nine antibiotics using the E-test method and Double Disc Synergy Test (DDST) for extended-spectrum beta-lactamase (ESBL) production. Results From the 78 E. coli positive samples (17.1%, n = 456), 60% of the isolates were resistant to at least one antibiotic, whereas, 27% were multi-drug resistant (MDR). Seven isolates (9%, n = 78) were ESBL producers of which five were MDR. Individual AR E. coli frequencies to the nine antibiotics were not significantly (P > 0.05) different by nationality. Conclusions Based on our findings, we revealed that individual resistant E. coli and MDR resistant E. coli were common in fecal samples of food handlers in Qatar. This may indicate that food handlers can potentially contaminate foods with AR E. coli, a possible public health concern.
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Affiliation(s)
- Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha, Qatar
| | - Hadi M. Yassine
- Biomedical Research Center, Qatar University, Doha, Qatar
- College of Health Sciences, Qatar University, Doha, Qatar
| | - Asmaa A. Al Thani
- Biomedical Research Center, Qatar University, Doha, Qatar
- College of Health Sciences, Qatar University, Doha, Qatar
| | | | - Ahmed Ismail
- Laboratory Services, Medical Commission, Ministry of Public Health, Doha, Qatar
| | - Emad Ibrahim
- Department of Lab Medicine and Pathology, Hamad Medical Hospital, Doha, Qatar
| | - Walid Q. Alali
- College of Public Health, Hamad Bin Khalifa University, Doha, Qatar
- Present Address: Department of Veterinary Medicine, College of Food and Agriculture, United Arab Emirates University, Alain, United Arab Emirates
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11
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Eltai NO, Abdfarag EA, Al-Romaihi H, Wehedy E, Mahmoud MH, Alawad OK, Al-Hajri MM, Al Thani AA, Yassine HM. Antibiotic Resistance Profile of Commensal Escherichia coli Isolated from Broiler Chickens in Qatar. J Food Prot 2018; 81:302-307. [PMID: 29369690 DOI: 10.4315/0362-028x.jfp-17-191] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Antibiotic resistance (AR) is a growing public health concern worldwide, and it is a top health challenge in the 21st century. AR among Enterobacteriaceae is rapidly increasing, especially in third-generation cephalosporins and carbapenems. Further, strains carrying mobilized colistin resistance ( mcr) genes 1 and 2 have been isolated from humans, food-producing animals, and the environment. The uncontrolled use of antibiotics in food-producing animals is a major factor in the generation and spread of AR. No studies have been done to evaluate AR in the veterinary sector of Qatar. This study aimed at establishing primary baseline data for the prevalence of AR among food-producing animals in Qatar. Fecal samples (172) were obtained from two broiler farms and one live bird market in Qatar, and 90 commensal Escherichia coli bacteria were isolated and subjected to susceptibility testing against 16 clinically relevant antibiotics by using the E-test method. The results found that 81 (90%) of 90 isolates were resistant to at least one antibiotic, 14 (15.5%) of 90 isolates were colistin resistant, 2 (2.2%) of 90 isolates were extended-spectrum β-lactamase producers, and 2 (2.2%) of 90 isolates were multidrug resistant to four antibiotic classes. Extended-spectrum β-lactamase-producing E. coli and colistin-resistant isolates were confirmed by using double-disc susceptibility testing and PCR, respectively. Such a high prevalence of antibiotic-resistant E. coli could be the result of a long application of antibiotic treatment, and it is an indicator of the antibiotic load in food-producing animals in Qatar. Pathogens carrying AR can be easily transmitted to humans through consumption of undercooked food or noncompliance with hygiene practices, mandating prompt development and implementation of a stewardship program to control and monitor the use of antibiotics in the community and agriculture.
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Affiliation(s)
| | - Elmoubasher A Abdfarag
- 2 Public Health Department, Ministry of Public Health, P.O. Box 42, Al Rumaila, Onaiza Street No. 222, Doha, Qatar; and
| | - Hamad Al-Romaihi
- 2 Public Health Department, Ministry of Public Health, P.O. Box 42, Al Rumaila, Onaiza Street No. 222, Doha, Qatar; and
| | | | - Mahmoud H Mahmoud
- 3 Department of Animal Resources, Ministry of Municipality and Environment, P.O. Box 22332, Doha, Qatar
| | - Osama K Alawad
- 3 Department of Animal Resources, Ministry of Municipality and Environment, P.O. Box 22332, Doha, Qatar
| | - Mohammed M Al-Hajri
- 2 Public Health Department, Ministry of Public Health, P.O. Box 42, Al Rumaila, Onaiza Street No. 222, Doha, Qatar; and
| | - Asmaa A Al Thani
- 1 Biomedical Research Center and.,4 College of Health Sciences, Qatar University, Doha, Qatar (ORCID: http://orcid.org/0000-0001-7592-2788 [H.M.Y.])
| | - Hadi M Yassine
- 1 Biomedical Research Center and.,4 College of Health Sciences, Qatar University, Doha, Qatar (ORCID: http://orcid.org/0000-0001-7592-2788 [H.M.Y.])
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12
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Extended-spectrum β-lactamase-producing Enterobacteriaceae colonisation in long-term care facilities: a systematic review and meta-analysis. Int J Antimicrob Agents 2017; 50:649-656. [PMID: 28782707 DOI: 10.1016/j.ijantimicag.2017.08.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 07/08/2017] [Accepted: 08/01/2017] [Indexed: 11/23/2022]
Abstract
The objectives of this study were to estimate the colonisation rate by extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) among residents of long-term care facilities (LTCFs) and to identify pertinent risk factors. A systematic search of PubMed and EMBASE databases for studies published up to May 2016 that provided raw data for gastrointestinal colonisation by ESBL-PE among LTCF residents was performed. Twenty-three studies reporting data on 9775 screened subjects met the inclusion criteria. The pooled prevalence of ESBL-PE among LTCF residents was 18% [95% confidence interval (CI) 12-24%]. Risk factors for colonisation included recent antibiotic use (within 6 months) [odds ratio (OR) = 2.06, 95% CI 1.78-2.38], previous hospitalisation (within 2.5 years) (OR = 1.50, 95% CI 1.04-2.15), history of invasive procedures (within 2 years) (OR = 2.79, 95% CI 1.66-4.70), previous ESBL-PE colonisation or infection (OR = 6.77, 95% CI 1.33-34.62), history of urinary tract infection (OR = 2.66, 95% CI 1.76-4.01) and urinary catheter use (OR = 2.55, 95% CI 1.29-5.04). In conclusion, almost one in five LTCF residents is colonised with ESBL-PE, and colonised residents are more likely to have a history of recent antibiotic use or healthcare facility utilisation. Strict adherence to antimicrobial stewardship in LTCFs is needed to address these high resistance rates.
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13
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Legese MH, Weldearegay GM, Asrat D. Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae among Ethiopian children. Infect Drug Resist 2017; 10:27-34. [PMID: 28182124 PMCID: PMC5279835 DOI: 10.2147/idr.s127177] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Infections by extended-spectrum beta-lactamase- (ESBL) and carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in children nowadays. Hence, the aim of this study was to determine the prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae among children suspected of septicemia and urinary tract infections (UTIs). METHODS A cross-sectional study was conducted from January to March 2014. A total of 322 study participants suspected of septicemia and UTIs were recruited. All blood and urine samples were cultured on blood and MacConkey agar. All positive cultures were characterized by colony morphology, Gram stain, and standard biochemical tests. Antimicrobial susceptibility test was performed on Muller-Hinton agar using disk diffusion. ESBL was detected using combination disk and double-disk synergy methods, and the results were compared. Carbapenemase was detected by modified Hodge method using meropenem. Data were analyzed using SPSS version 20. RESULTS The overall prevalence of ESBL- and carbapenemase-producing Enterobacteriaceae was 78.57% (n=22/28) and 12.12%, respectively. Among the Enterobacteriaceae tested, Klebsiella pneumoniae (84.2%, n=16/19), Escherichia coli (100%, n=5/5), and Klebsiella oxytoca (100%, n=1/1) were positive for ESBL. Double-disk synergy method showed 90.9% sensitivity, 66.7% specificity, 95.2% positive predictive value, and 50% negative predictive value. Carbapenemase-producing Enterobacteriaceae were K. pneumoniae (9.09%, n=3/33) and Morganella morganii (3.03%, n=1/33). CONCLUSION Screening Enterobacteriaceae for ESBL production is essential for better antibiotics selection and preventing its further emergence and spread. In resource-limited settings, double-disk synergy method can be implemented for screening and confirming ESBL production. Moreover, occurrence of CRE in countries where no carbapenems are sold is worrying microbiologists as well as clinicians. Hence, identifying factors that induce carbapenemase production in the absence of carbapenems prescription is essential for control of CRE dissemination within the community.
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Affiliation(s)
- Melese Hailu Legese
- Department of Clinical Laboratory Sciences, School of Allied Health Sciences
| | | | - Daniel Asrat
- Department of Microbiology, Immunology and Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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14
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Sid Ahmed MA, Bansal D, Acharya A, Elmi AA, Hamid JM, Sid Ahmed AM, Chandra P, Ibrahim E, Sultan AA, Doiphode S, Bilal NE, Deshmukh A. Antimicrobial susceptibility and molecular epidemiology of extended-spectrum beta-lactamase-producing Enterobacteriaceae from intensive care units at Hamad Medical Corporation, Qatar. Antimicrob Resist Infect Control 2016; 5:4. [PMID: 26865975 PMCID: PMC4748476 DOI: 10.1186/s13756-016-0103-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 02/03/2016] [Indexed: 11/12/2022] Open
Abstract
Background The emergence of extended-spectrum beta-lactamase (ESBL)-producing isolates has important clinical and therapeutic implications. High prevalence of ESBL-producing Enterobacteriaceae has been reported in the literature for clinical samples from a variety of infection sites. The present study was undertaken to evaluate the prevalence of ESBL-producing Enterobacteriaceae, and to perform molecular characterization and antimicrobial susceptibility testing of clinical isolates from patients admitted to the intensive care units at Hamad Medical Corporation, Doha, Qatar, from November 2012 to October 2013. Methods A total of 629 Enterobacteriaceae isolates were included in the study. Identification and susceptibility testing was performed using Phoenix (Becton Dickinson) and the ESBL producers were confirmed by double-disk potentiation as recommended by the Clinical and Laboratory Standards Institute. Molecular analysis of the ESBL producers was performed by polymerase chain reaction. Results In total, 109 isolates (17.3 %) were confirmed as ESBL producers and all were sensitive to meropenem in routine susceptibility assays. Most of the ESBL producers (99.1 %) were resistant to amoxicillin/clavulanic acid and ceftriaxone and 93.6 % were resistant to cefepime. Among the ESBL-producing genes, blaCTX-M (66.1 %) was the most prevalent, followed by blaSHV (53.2 %) and blaTEM (40.4 %). Conclusions These findings show the high prevalence of ESBL-producing Enterobacteriaceae within the intensive care units at Hamad Medical Corporation, Qatar, and emphasize the need for judicious use of antibiotics and the implementation of strict infection control measures.
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Affiliation(s)
- Mazen A Sid Ahmed
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
| | - Devendra Bansal
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Anushree Acharya
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Asha A Elmi
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Jemal M Hamid
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
| | - Abuelhassan M Sid Ahmed
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
| | - Prem Chandra
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
| | - Emad Ibrahim
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
| | - Ali A Sultan
- Department of Microbiology and Immunology, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Sanjay Doiphode
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
| | - Naser Eldin Bilal
- College of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Anand Deshmukh
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Microbiology Section, Hamad Medical Corporation, Doha, Qatar
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15
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Nandagopal B, Sankar S, Sagadevan K, Arumugam H, Jesudason MV, Aswathaman K, Nair A. Frequency of extended spectrum β-lactamase producing urinary isolates of Gram-negative bacilli among patients seen in a multispecialty hospital in Vellore district, India. Indian J Med Microbiol 2015; 33:282-5. [DOI: 10.4103/0255-0857.153563] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Figueiredo R, Henriques A, Sereno R, Mendonça N, da Silva GJ. Antimicrobial Resistance and Extended-Spectrum β-Lactamases of Salmonella enterica Serotypes Isolated from Livestock and Processed Food in Portugal: An Update. Foodborne Pathog Dis 2015; 12:110-7. [DOI: 10.1089/fpd.2014.1836] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- Rui Figueiredo
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | | | | | - Nuno Mendonça
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
| | - Gabriela Jorge da Silva
- Faculty of Pharmacy and Center for Neuroscience and Cell Biology, University of Coimbra, Coimbra, Portugal
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17
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Krishnamurthy V, G S V, Kumar M S, H V P, R P, E R N. Phenotypic and Genotypic Methods for Detection of Extended Spectrum β Lactamase Producing Escherichia coli and Klebsiella pneumoniae Isolated from Ventilator Associated Pneumonia. J Clin Diagn Res 2013; 7:1975-8. [PMID: 24179913 DOI: 10.7860/jcdr/2013/6544.3376] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Accepted: 07/24/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Ventilator Associated Pneumonia (VAP) is one of the common nosocomial infections associated with high morbidity due to multidrug resistant pathogens. Rapid spread of resistance to broad spectrum beta-lactams in pathogenic strains causes antibiotics ineffectiveness and increased severity of illness. The CTX-M is the most dominant Extended Spectrum β Lactamase (ESBL) among Enterobacteriaceae in many regions of the world. The aim of the study was to identify the occurrence of ESBL and detect the genes responsible for ESBL production by conventional Polymerase Chain Reaction (PCR) method. METHODS This prospective study included patients, clinically diagnosed as VAP. Endotracheal aspirates (EA) were collected and cultured by quantitative method. The bacterial isolates were identified as per standard methods. Isolates resistant to 3(rd) generation cephalosporins were screened for ESBL production by disk approximation method and combination disc diffusion method. Isolates confirmed as ESBL producers were subjected to genotyping by conventional PCR. STATISTICAL ANALYSIS Statistical analysis was done by using MS Excel sheet. Descriptive statistics like percentage was done in the study. RESULTS Among the isolates from 428 patients who developed VAP, 144 isolates belonged to the Enterobacteriaceae family (Klebsiella pneumoniae 87 and Escherichia coli 57). A total of 66 isolates (28 Klebsiella pneumoniae and 38 Escherichia coli) were confirmed as ESBL producer by disc approximation method and 63 isolates by double disc combination method. In the present study by conventional PCR bla CTX-M was the common gene in 48.5% strains followed by 22.22% bla SHV and 14.81% bla TEM. CONCLUSION The genotypic methods using specific PCR amplification of resistance genes seems to have 100% specificity and sensitivity in detection of ESBL when compared to phenotypic methods which lacks the constant sensitivity.
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Affiliation(s)
- Veena Krishnamurthy
- Assistant Professor, Department of Microbiology, Sri Siddhartha Medical College , Agalakote, Tumkur-572107, Karnataka, India
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18
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Aruna K, Mobashshera T. Prevalence of extended spectrum beta-lactamase production among uropathogens in south Mumbai and its antibiogram pattern. EXCLI JOURNAL 2012; 11:363-72. [PMID: 27418912 PMCID: PMC4942789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Accepted: 07/02/2012] [Indexed: 11/24/2022]
Abstract
β-lactams are the most widely used group of antimicrobials. However, increasing resistance to these valuable drugs in uropathogens, mediated principally by β-lactamases, has become a major concern. The present study was undertaken to determine the prevalence of Extended Spectrum β-Lactamase (ESBL) producers in clinical isolates of urine specimens, collected from various healthcare centres across south Mumbai. A total of 195 gram negative urine isolates were identified as Pseudomonas aeruginosa (13), Proteus mirabilis (21), Klebsiella pneumoniae (29), Escherichia coli (96), Enterobacter aerogenes (1), Enterobacter cloacae (1), Enterococcus fecalis (1), Morganella morganii (1), Citrobacter diversus (16), Citrobacter amalonaticus (5) and Proteus vulgaris (11). Antimicrobial Susceptibility Testing (AST) by Kirby-Bauer method showed 43.07 % (84/195) of the isolates were resistant to more than 70 % of the antibiotics used. Confirmatory screening using a combination of Double Disk Synergy Test (DDST), Phenotypic Confirmatory Disc Diffusion Test (PCDDT) and E-test revealed the overall prevalence of ESBL producers to be 34.71 % (68/195). The study showed 72.05 % of the ESBL producers to be resistant to fluoroquinolones, highlighting its extensive use in the region of south Mumbai. All ESBL producers were found to be sensitive to Imipenem whereas 82.36 % showed susceptibility to Amikacin making these 2 antibiotics the most effective choice of drug against ESBLs. In order to ensure rational treatment of highly resistant pathogens, the occurrence of ESBL and its primary studies may serve as a base for further research and findings.
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Affiliation(s)
- K. Aruna
- Department of Microbiology, Wilson College, Mumbai- 400 007, India
| | - T. Mobashshera
- Department of Microbiology, Wilson College, Mumbai- 400 007, India
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