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Tilahun M, Fiseha M, Alebachew M, Gedefie A, Ebrahim E, Tesfaye M, Belete MA, Seid A, Gebretsadik D, Alemayehu E, Demsiss W, Sharew B, Shibabaw A, Mekonnen H, Dessie T. Uro-pathogens: Multidrug resistance and associated factors of community-acquired UTI among HIV patients attending antiretroviral therapy in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. PLoS One 2024; 19:e0296480. [PMID: 38820330 PMCID: PMC11142584 DOI: 10.1371/journal.pone.0296480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/14/2023] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND Urinary tract infections are common bacterial and fungal infections in humans, occurring both in the community and in immunocompromised patients in healthcare settings. Urinary tract infections have a significant health impact on HIV-infected patients. Nowadays, drug-resistant pathogens are widespread poses a serious clinical risk, and causes urinary tract infection. The common agents of bacteria and fungi that cause urinary tract infection are Escherichia coli followed by Klebsiella pneumonia, Staphylococcus saprophyticus, Enterococcus faecalis, group B streptococcus, Proteus mirabilis, Pseudomonas aeruginosa, Staphylococcus aureus and Candida. albicans. This study aimed to investigate uro-pathogen, multidrug resistance pattern of bacteria, and associated factors of community-acquired urinary tract infection among HIV-positive patients attending antiretroviral therapy in Dessie comprehensive specialized hospital, Northeast Ethiopia from February 1, 2021, to March 30, 2021. METHODS An institutional-based cross-sectional study was conducted at Dessie Comprehensive Specialized Hospital. Socio-demographic and clinical data were collected by using structured questionnaires from HIV patients suspected of community-acquired urinary tract infections. About 10 ml of clean-catch midstream urine was collected and inoculated into Blood agar, MacConkey, and Cysteine lactose electrolyte deficient media. Yeasts were identified by using Gram stain, germ tube test, carbohydrate fermentation, assimilation tests, and chromogenic medium. Gram stain and biochemical tests were performed to identify isolates and an antimicrobial susceptibility pattern was performed on disc diffusion techniques. Data were entered and analyzed using SPSS version 25. Both bivariate and multivariable logistic regression analysis was performed and a P value of < 0.05 with an adjusted odds ratio with their 95% confidence interval (CI) was used as statistically significant associations. RESULTS From the total 346 study participants, 92 (26.6%) were culture positive 75 (81.52%) were bacterial and 17 (18.48%) were fungal pathogens. From a total of 75 bacteria isolates 51(68%) were Gram-negative bacteria and the most commonly isolated bacteria were E. coli 16 (21.33%) followed by K. pneumoniae 11(14.67%) and enterococcus species 10(10.87. Of the 17 fungal isolates of fungi, 8(47.1%) were represented by C. tropicalis. Of the isolated bacteria, 61(81.3%) were resistant to three and above classes of antibiotics (drug classes). About 13 (81.3%) of E. coli, 9(81.8%) of K. pneumoniae, 8(80%) of Enterococcus species, 7 (77.8%) of P. aeruginosa, and CoNs 7(87.5%) were the most frequently exhibited three and above classes of antibiotics (multi-drug resistance). Amikacin and gentamicin were effective against Gram-negative Uro-pathogens. Participants aged>44year, female, being daily labor, being farmer, unable to read and write, patients with CD4 count of ≤ 200 cells/mm3 and CD4 count of 201-350 cells/mm3, who had chronic diabetics, patients having a history of hospitalization and who had urgency of urinations were statistically significant association with significant urinary tract infections. CONCLUSION The burden of community-acquired urinary tract infections among HIV patients is alarmingly increased. Therefore, behavior change communications might be considered for promoting the health status of HIV patients. Moreover, CD4 level monitoring and therapeutics selection based on microbiological culture are quite advisable for the management of urinary tract infections of HIV patients.
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Affiliation(s)
- Mihret Tilahun
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mesfin Fiseha
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mihreteab Alebachew
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Alemu Gedefie
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Endris Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Melkam Tesfaye
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Melaku Ashagrie Belete
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Abdurahaman Seid
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Daniel Gebretsadik
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Ermiyas Alemayehu
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Wondmagegn Demsiss
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Bekele Sharew
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Agumas Shibabaw
- Department of Medical Laboratory Sciences, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | | | - Tewodros Dessie
- Amhara Public Health Institute Dessie Branch, Dessie, Ethiopia
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Kasanga M, Shempela DM, Daka V, Mwikisa MJ, Sikalima J, Chanda D, Mudenda S. Antimicrobial resistance profiles of Escherichia coli isolated from clinical and environmental samples: findings and implications. JAC Antimicrob Resist 2024; 6:dlae061. [PMID: 38680604 PMCID: PMC11055401 DOI: 10.1093/jacamr/dlae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/17/2024] [Indexed: 05/01/2024] Open
Abstract
Background The overuse and misuse of antimicrobials has worsened the problem of antimicrobial resistance (AMR) globally. This study investigated the AMR profiles of Escherichia coli isolated from clinical and environmental samples in Lusaka, Zambia. Methods This was a cross-sectional study conducted from February 2023 to June 2023 using 450 samples. VITEK® 2 Compact was used to identify E. coli and perform antimicrobial susceptibility testing. Data analysis was done using WHONET 2022 and SPSS version 25.0. Results Of the 450 samples, 66.7% (n = 300) were clinical samples, whereas 33.3% (n = 150) were environmental samples. Overall, 47.8% (n = 215) (37.8% clinical and 10% environmental) tested positive for E. coli. Of the 215 E. coli isolates, 66.5% were MDR and 42.8% were ESBL-producers. Most isolates were resistant to ampicillin (81.4%), sulfamethoxazole/trimethoprim (70.7%), ciprofloxacin (67.9%), levofloxacin (64.6%), ceftriaxone (62.3%) and cefuroxime (62%). Intriguingly, E. coli isolates were highly susceptible to amikacin (100%), imipenem (99.5%), nitrofurantoin (89.3%), ceftolozane/tazobactam (82%) and gentamicin (72.1%). Conclusions This study found a high resistance of E. coli to some antibiotics that are commonly used in humans. The isolation of MDR and ESBL-producing E. coli is a public health concern and requires urgent action. Therefore, there is a need to instigate and strengthen interventional strategies including antimicrobial stewardship programmes to combat AMR in Zambia.
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Affiliation(s)
- Maisa Kasanga
- Department of Epidemiology and Biostatistics, School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Doreen Mainza Shempela
- Laboratory Department, Churches Health Association of Zambia, CHAZ COMPLEX Meanwood Drive (off Great East Road), Plot No. 2882/B/5/10, P.O. Box 34511, JC9H+VFF, Lusaka, Zambia
| | - Victor Daka
- Public Health Department, Michael Chilufya Sata School of Medicine, Copperbelt University, Ndola, Zambia
| | - Mark J Mwikisa
- Department of Pathology and Microbiology, Lusaka Trust Hospital, Plot 2191, H8CC+52F, Nsumbu Rd, Woodlands, Lusaka, Zambia
| | - Jay Sikalima
- Laboratory Department, Churches Health Association of Zambia, CHAZ COMPLEX Meanwood Drive (off Great East Road), Plot No. 2882/B/5/10, P.O. Box 34511, JC9H+VFF, Lusaka, Zambia
| | - Duncan Chanda
- Adult Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Steward Mudenda
- Department of Pharmacy, School of Health Sciences, University of Zambia, Lusaka, Zambia
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Shtaiwi A, Khan SU, Khedraoui M, Alaraj M, Samadi A, Chtita S. A comprehensive computational study to explore promising natural bioactive compounds targeting glycosyltransferase MurG in Escherichia coli for potential drug development. Sci Rep 2024; 14:7098. [PMID: 38532068 DOI: 10.1038/s41598-024-57702-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 03/21/2024] [Indexed: 03/28/2024] Open
Abstract
Peptidoglycan is a carbohydrate with a cross-linked structure that protects the cytoplasmic membrane of bacterial cells from damage. The mechanism of peptidoglycan biosynthesis involves the main synthesizing enzyme glycosyltransferase MurG, which is known as a potential target for antibiotic therapy. Many MurG inhibitors have been recognized as MurG targets, but high toxicity and drug-resistant Escherichia coli strains remain the most important problems for further development. In addition, the discovery of selective MurG inhibitors has been limited to the synthesis of peptidoglycan-mimicking compounds. The present study employed drug discovery, such as virtual screening using molecular docking, drug likeness ADMET proprieties predictions, and molecular dynamics (MD) simulation, to identify potential natural products (NPs) for Escherichia coli. We conducted a screening of 30,926 NPs from the NPASS database. Subsequently, 20 of these compounds successfully passed the potency, pharmacokinetic, ADMET screening assays, and their validation was further confirmed through molecular docking. The best three hits and the standard were chosen for further MD simulations up to 400 ns and energy calculations to investigate the stability of the NPs-MurG complexes. The analyses of MD simulations and total binding energies suggested the higher stability of NPC272174. The potential compounds can be further explored in vivo and in vitro for promising novel antibacterial drug discovery.
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Affiliation(s)
- Amneh Shtaiwi
- Faculty of Pharmacy, Middle East University, Queen Alia Airport Street, Amman, P.O. Box No. 11610, Jordan.
| | - Shafi Ullah Khan
- Interdisciplinary Research Unit for Cancer Prevention and Treatment, Baclesse Cancer Centre, Université de Caen Normandie Inserm Anticipe UMR 1086, Normandie Univ, Research Building, F‑14000 François 3 Avenue Général Harris, BP 45026, 14076, Cedex 05 Caen, France
- Centre François Baclesse, Avenue Général Harris, 14076, Caen Cedex, France
| | - Meriem Khedraoui
- Laboratory of Analytical and Molecular Chemistry, Faculty of Sciences Ben M'Sik, Hassan II University of Casablanca, B. P 7955, Casablanca, Morocco
| | - Mohd Alaraj
- Faculty of Pharmacy, University of Jerash, Jerash, Jordan
| | - Abdelouahid Samadi
- Department of Chemistry, College of Science, UAEU, P.O. Box No. 15551, Al Ain, UAE.
| | - Samir Chtita
- Laboratory of Analytical and Molecular Chemistry, Faculty of Sciences Ben M'Sik, Hassan II University of Casablanca, B. P 7955, Casablanca, Morocco
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Iwodi C, Gberikon GM, Ogbonna IO, Agada EO. Multi-drug-resistant Escherichia coli in adult male patients with enlarged prostate attending general hospitals in Benue state. Braz J Microbiol 2024; 55:447-454. [PMID: 38308684 PMCID: PMC10920493 DOI: 10.1007/s42770-024-01260-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 01/15/2024] [Indexed: 02/05/2024] Open
Abstract
The aim of this study was to investigate multi-drug-resistant (MDR) Escherichia coli in urine of adult male patients with enlarged prostate. Three hundred and sixty-eight samples of urine and blood were collected. Escherichia coli was isolated, purified, and identified and prostate-specific antigen (PSA) was determined. Multi-drug resistance test and specific drug resistance genes were assessed. Prevalence of Escherichia coli was high (38.5%) in patients with PSA of 60-79 ng ml-1 and 60% were MDR. The isolates showed highest resistance to tetracycline (53.3.0%) and least to cephalosporins (5%). They had intL and gyrA genes, which are integron, and quinolone resistance genes and sul1 and sul2 which are sulphonamide resistance-associated genes. Levofloxacin, ertapenem, and Augmentin (100% susceptibilities) were considered choice drugs for treatment of Escherichia coli infection in patients with elevated PSA.
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Affiliation(s)
- Cornelius Iwodi
- Department of Microbiology, College of Biological Sciences, Joseph Sarwuan Tarka University, Makurdi, Nigeria
| | - Grace M Gberikon
- Department of Microbiology, College of Biological Sciences, Joseph Sarwuan Tarka University, Makurdi, Nigeria
| | - Innocent Okonkwo Ogbonna
- Department of Microbiology, College of Biological Sciences, Joseph Sarwuan Tarka University, Makurdi, Nigeria.
| | - Emmanuel O Agada
- Department of Microbiology, Joseph Sarwuan Tarka University, Makurdi, Nigeria
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Elsayed AGA, Badr DF, El Kheir NYA, Zaki MES, Mossad AEM, Mahmoud EMF. Prevalence of extended-spectrum beta-lactamase and molecular detection of blaTEM, blaSHV, and blaCTX-M genotypes among gram-negative Bacilli isolates from hospital acquired infections in pediatrics, one institutional study. Ital J Pediatr 2024; 50:31. [PMID: 38402215 PMCID: PMC10893665 DOI: 10.1186/s13052-024-01599-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/27/2024] [Indexed: 02/26/2024] Open
Abstract
BACKGROUND Gram-negative bacilli represents an important pathogen in hospital-acquired infections (HAIs) worldwide. The emergence of antibiotic resistance in these pathogens warrants attention for the proper management of infections. Extended-spectrum beta-lactamase (ESBL) resistance represents a major therapeutic problem in infections due to Gram-negative bacilli. The present study aimed to study the extended-spectrum beta-lactamase genes blaTEM, blaSHV, and blaCTX-M by multiplex polymerase reaction in isolated Gram-negative bacilli from HAIs in pediatric patients. METHODS The study included one hundred-five isolates of Gram-negative bacilli from pediatric patients with different types of HAIs. The isolates were subjected to full microbiological identification, antibiotics susceptibility by disc diffusion method, the phenotypic study of ESBL, and the genetic study of ESBL genes by multiplex PCR. RESULTS Fifty isolates of Gram-Negative bacilli showed ESBL activity by a phenotypic study by double disc diffusion method (50/105). All ESBL producers' isolates were positive by PCR for ESBL genes. The most frequent gene was blaTEM (64%), followed by blaSHV (30%) and CTX-M (22%). Mixed genes were found in 4 isolates (8%) for blaTEM and blaSHV, blaTEM and CTX-M. There was a significant association between PCR for ESBL genes and phenotypic ESBL detection (P = 0.001). There was significant detection of ESBL genes in E. coli (28%), followed by Enterobacter spp. (26%), Klebsiella spp. (24%), Serratia (14%), Pseudomonas spp. (6%) and Proteus (2%), P = 0.01. There Seventy percent of isolates positive for ESBL production had an insignificant association between MDR and PCR for ESBL genes (P = 0.23). CONCLUSION The present study highlights the prevalence of ESBL activity among clinical isolates of Gram-negative bacilli isolated from hospital-acquired infections in pediatric patients. The most common gene responsible for this activity was blaTEM gee followed by blaSHV and blaCTX-M. There was a high prevalence of multiple antibiotic resistance among isolates with ESBL activity. The finding of the present study denotes the importance of screening extended beta-lactamase among Gram-negative bacilli associated with HAIs in pediatric patients.
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Affiliation(s)
| | - Dina F Badr
- Medical Microbiology and Immunology, Mansoura Faculty of Medicine, Mansoura, Egypt
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Shah NM, Charani E, Ming D, Cheah FC, Johnson MR. Antimicrobial stewardship and targeted therapies in the changing landscape of maternal sepsis. JOURNAL OF INTENSIVE MEDICINE 2024; 4:46-61. [PMID: 38263965 PMCID: PMC10800776 DOI: 10.1016/j.jointm.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/04/2023] [Accepted: 07/30/2023] [Indexed: 01/25/2024]
Abstract
Pregnant and postnatal women are a high-risk population particularly prone to rapid progression to sepsis with significant morbidity and mortality worldwide. Moreover, severe maternal infections can have a serious detrimental impact on neonates with almost 1 million neonatal deaths annually attributed to maternal infection or sepsis. In this review we discuss the susceptibility of pregnant women and their specific physiological and immunological adaptations that contribute to their vulnerability to sepsis, the implications for the neonate, as well as the issues with antimicrobial stewardship and the challenges this poses when attempting to reach a balance between clinical care and urgent treatment. Finally, we review advancements in the development of pregnancy-specific diagnostic and therapeutic approaches and how these can be used to optimize the care of pregnant women and neonates.
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Affiliation(s)
- Nishel M Shah
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - Esmita Charani
- Health Protection Research Unit in Healthcare Associated Infection and Antimicrobial Resistance, Imperial College London, London, UK
- Division of Infectious Diseases and HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Damien Ming
- Department of Infectious Diseases, Imperial College London, Chelsea and Westminster Hospital, London, UK
| | - Fook-Choe Cheah
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Mark R Johnson
- Department of Metabolism, Digestion and Reproduction, Imperial College London, Chelsea and Westminster Hospital, London, UK
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Cantini F, Giannì P, Bobone S, Troiano C, van Ingen H, Massoud R, Perini N, Migliore L, Savarin P, Sanders C, Stella L, Sette M. Structural and Functional Characterization of the Newly Designed Antimicrobial Peptide Crabrolin21. MEMBRANES 2023; 13:365. [PMID: 36984752 PMCID: PMC10053045 DOI: 10.3390/membranes13030365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: antimicrobial resistance is becoming a dramatic problem for public health, and the design of new antimicrobial agents is an active research area. (2) Methods: based on our previous work, we designed an improved version of the crabrolin peptide and characterized its functional and structural properties with a wide range of techniques. (3) Results: the newly designed peptide, crabrolin21, is much more active than the previous ones and shows specific selectivity towards bacterial cells. (4) Conclusions: crabrolin21 shows interesting properties and deserves further studies.
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Affiliation(s)
- Francesca Cantini
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, 50019 Firenze, Italy
- Department of Chemistry, University of Florence, Sesto Fiorentino, 50019 Firenze, Italy
| | - Paola Giannì
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, 00133 Rome, Italy
- Fondazione G.I.M.EM.A.-Franco Mandelli Onlus, 00182 Rome, Italy
| | - Sara Bobone
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Cassandra Troiano
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Hugo van Ingen
- NMR Spectroscopy, Bijvoet Center for Biomolecular Research, Utrecht University, Padualaan 8, 3584 CH Utrecht, The Netherlands
| | - Renato Massoud
- Department of Experimental Medicine, University of Rome Tor Vergata, Viale della Ricerca Scientifica, 00133 Rome, Italy
| | - Nicoletta Perini
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Luciana Migliore
- Department of Biology, University of Rome Tor Vergata, 00133 Rome, Italy
- eCampus University, 22060 Novedrate, Italy
| | - Philippe Savarin
- Chemistry Structures Properties of Biomaterials and Therapeutic Agents Laboratory (CSPBAT), Nanomédecine Biomarqueurs Détection Team (NBD), Sorbonne Paris Nord University, The National Center for Scientific Research (CNRS), UMR 7244, 74 Rue Marcel Cachin, CEDEX, 93017 Bobigny, France
| | - Charles Sanders
- Department of Biochemistry, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Center for Structural Biology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Lorenzo Stella
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Marco Sette
- Department of Chemical Sciences and Technology, University of Rome Tor Vergata, 00133 Rome, Italy
- Chemistry Structures Properties of Biomaterials and Therapeutic Agents Laboratory (CSPBAT), Nanomédecine Biomarqueurs Détection Team (NBD), Sorbonne Paris Nord University, The National Center for Scientific Research (CNRS), UMR 7244, 74 Rue Marcel Cachin, CEDEX, 93017 Bobigny, France
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Cheung KT, Chan HY. Oral flora of domestic cats in Hong Kong: Identification of antibiotic-resistant strains. Vet Med Sci 2022; 9:25-36. [PMID: 36520663 PMCID: PMC9857102 DOI: 10.1002/vms3.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND As the clinical outcome of bite-associated infection is related to the oral commensals, evaluating their composition and antibiotic susceptibility pattern can provide more information for the antibiotic treatment of wound infections and increase the awareness of the multidrug-resistant bacteria in cat oral flora. AIMS This study was conducted to identify the various bacterial species in the oral cavity of cats. It aimed to identify the composition of cat oral flora and antibiotic resistant bacterial stains. MATERIALS AND METHODS Twenty-two cats were sampled for bacterial evaluation. Matrix-assisted laser desorption/ionization time of flight mass spectrometry was used to provide rapid and reliable detection and identification of the bacterial species. Antibiotic susceptibility tests were performed in the identified isolates to determine the antibiotic susceptibility pattern and to detect the multidrug-resistant bacteria in the cat oral cavities. RESULTS A total of 54 isolates were identified, Pasteurella was the genus most commonly isolated from the oral cavity of cats (19/54, 35.19%), followed by Neisseria spp. (8/54, 14.81%) and Staphylococcus spp. (7/54, 12.96%). Uncommon oral flora were isolated from the samples, including Pasteurella canis, Inquilinus limosus and the Enterobacteriaceae family of Escherichia coli, Klebsiella pneumoniae and Serratia marcescens. Fourteen different multidrug-resistant bacteria were detected, including Pasteurella species (4/14), Bacillus species (2/14), Neisseria species (3/14), Escherichia species (1/14) and Staphylococcus species (4/14). DISCUSSION AND CONCLUSIONS This study's findings will increase the understanding of the composition of cat oral flora in Hong Kong, which can provide more evidence-based information for the prophylactic treatment of patients with cat bite infections. Moreover, the study identified and detected the antibiotic resistance pattern and multidrug-resistant bacteria in the cat oral cavity, which can help cat owners increase their awareness of maintaining regular oral hygiene for their cats to prevent the spread of pathogens from cats to humans.
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Affiliation(s)
- Ka Tik Cheung
- School of Science and TechnologyHong Kong Metropolitan UniversityKowloonHong Kong,School of Medical and Health SciencesTung Wah CollegeKowloonHong Kong
| | - Hau Yan Chan
- School of Medical and Health SciencesTung Wah CollegeKowloonHong Kong
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Ajani T, Elikwu C, Anaedobe C, Onwuzo C, Tayo B, Okangba C, Makanjuola O. EVALUATION OF PHENOTYPIC AND MOLECULAR TECHNIQUE IN THE DETECTION OF EXTENDED SPECTRUM BETA-LACTAMASE (ESBL)-PRODUCING GRAM NEGATIVE BACILLI IN OGUN STATE, NIGERIA. Ann Ib Postgrad Med 2022; 20:160-168. [PMID: 37384347 PMCID: PMC10295097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023] Open
Abstract
Background Molecular diagnosis though faster and more sensitive than phenotypic techniques, is more expensive. Resource limited settings are thus limited to using more of phenotypic rather than molecular methods in the routine detection of Extended Spectrum beta lactamases (ESBL). Aim This study aimed to evaluate the performance of double disc synergy test (DSST) and Epsilometer (E) test with Polymerase Chain Reaction (PCR) and to detect the risk factors associated with ESBL producing organisms among in-patients at Babcock University Teaching Hospital, Ilishan-Remo, Nigeria. Methodology Hospital-based cross-sectional study in which bacterial isolates of 165 in-patients were collected fromMarch 2018 to September 2019. The isolates were evaluated for ESBL production by the use of DDST, Etest and PCR. The performance evaluation was done. Questionnaire was used to assess the risk factors associated with ESBL, IBM SPSS Version 23 was used to analyze the data. Results The participants' isolates yielded 50/165 (30.3%) that were ESBL positive by DDST, 47/165 (28.9%) by E-test and 48/165(29.1%) by PCR. Sensitivity and specificity of DSST was 100% and 98.3% while that of E-test was 98% and 100% respectively. Age, antibiotics intake without prescription, being on ventilator, urethral catheterization and nasogastric tubes were all significantly associated with presence of ESBL (p value <0.05). Conclusion Phenotypic tests remain reliable for the routine detection of ESBL in the absence of molecular methods. Rational use of instrumentation and antibiotics is advocated based on the risk factors detected from this study.
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Affiliation(s)
- T.A. Ajani
- Department of Medical Microbiology and Parasitology, University
College Hospital, Ibadan, Nigeria
| | - C.J. Elikwu
- Department of Medical Microbiology, Benjamin Carson (Snr) College
of Health and Medical Sciences, Babcock University, Ilisan Remo, Nigeria
| | - C.G. Anaedobe
- Department of Medical Microbiology and Parasitology, College of
Health Sciences, University of Abuja, Abuja, Nigeria
| | - C.N. Onwuzo
- Department of Medical Microbiology, Benjamin Carson (Snr) College
of Health and Medical Sciences, Babcock University, Ilisan Remo, Nigeria
| | - B. Tayo
- Department of Medical Microbiology, Benjamin Carson (Snr) College
of Health and Medical Sciences, Babcock University, Ilisan Remo, Nigeria
| | - C.C. Okangba
- Department of Medical Microbiology, Benjamin Carson (Snr) College
of Health and Medical Sciences, Babcock University, Ilisan Remo, Nigeria
| | - O.B. Makanjuola
- Department of Medical Microbiology and Parasitology, University
College Hospital, Ibadan, Nigeria
- Department of Medical Microbiology and Parasitology, University of
Ibadan, Ibadan, Nigeria
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The Potential of Antibiotics and Nanomaterial Combinations as Therapeutic Strategies in the Management of Multidrug-Resistant Infections: A Review. Int J Mol Sci 2022; 23:ijms232315038. [PMID: 36499363 PMCID: PMC9736695 DOI: 10.3390/ijms232315038] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 11/16/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022] Open
Abstract
Antibiotic resistance has become a major public health concern around the world. This is exacerbated by the non-discovery of novel drugs, the development of resistance mechanisms in most of the clinical isolates of bacteria, as well as recurring infections, hindering disease treatment efficacy. In vitro data has shown that antibiotic combinations can be effective when microorganisms are resistant to individual drugs. Recently, advances in the direction of combination therapy for the treatment of multidrug-resistant (MDR) bacterial infections have embraced antibiotic combinations and the use of nanoparticles conjugated with antibiotics. Nanoparticles (NPs) can penetrate the cellular membrane of disease-causing organisms and obstruct essential molecular pathways, showing unique antibacterial mechanisms. Combined with the optimal drugs, NPs have established synergy and may assist in regulating the general threat of emergent bacterial resistance. This review comprises a general overview of antibiotic combinations strategies for the treatment of microbial infections. The potential of antibiotic combinations with NPs as new entrants in the antimicrobial therapy domain is discussed.
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Oyaba Yinda LED, Onanga R, Mbehang Nguema PP, Akomo-Okoue EF, Nsi Akoue G, Longo Pendy NM, Otsaghe Ekore D, Lendamba RW, Mabika-Mabika A, Mbeang JCO, Poungou N, Ibrahim, Mavoungou JF, Godreuil S. Phylogenetic Groups, Pathotypes and Antimicrobial Resistance of Escherichia coli Isolated from Western Lowland Gorilla Faeces ( Gorilla gorilla gorilla) of Moukalaba-Doudou National Park (MDNP). Pathogens 2022; 11:1082. [PMID: 36297139 PMCID: PMC9607589 DOI: 10.3390/pathogens11101082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 07/28/2022] [Indexed: 11/23/2022] Open
Abstract
(1) Background: Terrestrial mammals in protected areas have been identified as a potential source of antimicrobial-resistant bacteria. Studies on antimicrobial resistance in gorillas have already been conducted. Thus, this study aimed to describe the phylogroups, pathotypes and prevalence of antimicrobial resistance of Escherichia coli isolated from western lowland gorilla's faeces living in MDNP. (2) Materials and Methods: Ninety-six faecal samples were collected from western lowland gorillas (Gorilla gorilla gorilla) during daily monitoring in the MDNP. Sixty-four E. coli isolates were obtained and screened for phylogenetic and pathotype group genes by polymerase chain reaction (PCR) after DNA extraction. In addition, antimicrobial susceptibility was determined by the disk diffusion method on Mueller Hinton agar. (3) Results: Sixty-four (64%) isolates of E. coli were obtained from samples. A high level of resistance to the beta-lactam family, a moderate rate for fluoroquinolone and a low rate for aminoglycoside was obtained. All E. coli isolates were positive in phylogroup PCR with a predominance of A (69% ± 11.36%), followed by B2 (20% ± 19.89%) and B1 (10% ± 8.90%) and low prevalence for D (1% ± 3.04%). In addition, twenty E. coli isolates (31%) were positive for pathotype PCR, such as EPEC (85% ± 10.82%) and EPEC/EHEC (15% ± 5.18%) that were obtained in this study. The majority of these MDR E. coli (DECs) belonged to phylogenetic group A, followed by MDR E. coli (DECs) belonging to group B2. (4) Conclusion: This study is the first description of MDR E. coli (DECs) assigned to phylogroup A in western lowland gorillas from the MDNP in Gabon. Thus, wild gorillas in MDNP could be considered as asymptomatic carriers of potential pathogenic MDR E. coli (DECs) that may present a potential risk to human health.
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Affiliation(s)
| | - Richard Onanga
- Laboratory of Bacteriology, Interdisciplinary Medical Research Center of Franceville, Franceville P.O. Box 769, Gabon
| | | | | | | | - Neil Michel Longo Pendy
- Laboratory of Vector Ecology, Interdisciplinary Medical Research Center of Franceville, Franceville P.O. Box 769, Gabon
| | - Desire Otsaghe Ekore
- Laboratory of Bacteriology, Interdisciplinary Medical Research Center of Franceville, Franceville P.O. Box 769, Gabon
| | - Roméo Wenceslas Lendamba
- Laboratory of Bacteriology, Interdisciplinary Medical Research Center of Franceville, Franceville P.O. Box 769, Gabon
| | - Arsène Mabika-Mabika
- Laboratory of Bacteriology, Interdisciplinary Medical Research Center of Franceville, Franceville P.O. Box 769, Gabon
| | | | - Natacha Poungou
- Microbiology Laboratory, Research Institute for Tropical Ecology, Libreville P.O. Box 13354, Gabon
| | - Ibrahim
- Laboratory of Biology, University of Science and Technology of Masuku, Franceville P.O. Box 913, Gabon
| | | | - Sylvain Godreuil
- Laboratoire de Bactériologie, CHU de Montpellier, UMR MIVEGEC (IRD, CNRS, Université de Montpellier), 34295 Montpellier, France
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Ejaz H. Molecular characterization and antibiogram of the carbapenemase gene variants in clinical strains of Pseudomonas aeruginosa. Mol Biol Rep 2022; 49:10531-10539. [PMID: 36129599 DOI: 10.1007/s11033-022-07930-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 08/30/2022] [Accepted: 09/06/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Carbapenemase-producing Pseudomonas aeruginosa (CPPA) is a substantial clinical concern because it jeopardizes therapeutic choices. This study characterizes the gene variants of CPPA and report its antibiogram. METHODS CPPA was isolated prospectively from diverse clinical sources in a tertiary care setting using a routine microbiological approach. Carbapenem-resistant P. aeruginosa strains were phenotypically identified using the modified carbapenem inactivation (mCIM) method. Minimum inhibitory concentration (MIC) breakpoints of several antibacterial drug groups were determined using broth microdilution methods and the MicroScan WalkAway plus system. Carbapenemase gene variants blaNDM, blaVIM, blaOXA,blaGES, and blaIMP were amplified using polymerase chain reaction (PCR), and the purified gene products were sequenced. RESULTS Seventy-one P. aeruginosa-infected cases were found, with 47 (66.2%) carrying CPPA; 46.8% of the latter were significantly associated with intensive care units (p = 0.03). CPPA was frequently detected in wound swabs (13; 27.7%), sputum (11; 23.4%), and blood (9; 19.1%). All strains were multidrug-resistant (MDR), and several were extensively drug-resistant. MIC50 and MIC90 breakpoints of all antibiotics, except colistin, were within the resistance range. MIC90 breakpoints of aztreonam, amikacin, cefepime, and piperacillin-tazobactam were > 512 µg/mL. The multiple antibiotic resistance index (MARI) was remarkably high, with a range of 0.38-0.92. The most commonly detected carbapenemase genes were blaVIM (74%), blaNDM-1 (19%), blaOXA-23 (14.9%), and blaGES (10.6%), while 12 of 47 strains co-harbored different combinations of carbapenemase gene variants. CONCLUSION A large proportion of CPPA strains carried the blaVIM gene variant, indicating intimidating health problems and emphasizing the need for extensive surveillance and antibiotic stewardship.
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Affiliation(s)
- Hasan Ejaz
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, 72388, Al Jouf, Saudi Arabia.
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13
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Charalambous A, Grivogiannis E, Dieronitou I, Michael C, Rahme L, Apidianakis Y. Proteobacteria and Firmicutes Secreted Factors Exert Distinct Effects on Pseudomonas aeruginosa Infection under Normoxia or Mild Hypoxia. Metabolites 2022; 12:449. [PMID: 35629953 PMCID: PMC9146490 DOI: 10.3390/metabo12050449] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/07/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
Microbiota may alter a pathogen's virulence potential at polymicrobial infection sites. Here, we developed a multi-modal Drosophila assay, amenable to the assessment of human bacterial interactions using fly survival or midgut regeneration as a readout, under normoxia or mild hypoxia. Deploying a matrix of 12 by 33 one-to-one Drosophila co-infections via feeding, we classified bacterial interactions as neutral, synergistic, or antagonistic, based on fly survival. Twenty six percent of these interactions were antagonistic, mainly occurring between Proteobacteria. Specifically, Pseudomonas aeruginosa infection was antagonized by various Klebsiella strains, Acinetobacter baumannii, and Escherichia coli. We validated these interactions in a second screen of 7 by 34 one-to-one Drosophila co-infections based on assessments of midgut regeneration, and in bacterial co-culture test tube assays, where antagonistic interactions depended on secreted factors produced upon high sugar availability. Moreover, Enterococci interacted synergistically with P. aeruginosa in flies and in test tubes, enhancing the virulence and pyocyanin production by P. aeruginosa. However, neither lactic acid bacteria nor their severely hypoxic culture supernatants provided a survival benefit upon P. aeruginosa infection of flies or mice, respectively. We propose that at normoxic or mildly hypoxic sites, Firmicutes may exacerbate, whereas Proteobacteria secreted factors may ameliorate, P. aeruginosa infections.
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Affiliation(s)
- Anna Charalambous
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus; (A.C.); (E.G.); (I.D.); (C.M.)
| | - Evangelos Grivogiannis
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus; (A.C.); (E.G.); (I.D.); (C.M.)
| | - Irene Dieronitou
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus; (A.C.); (E.G.); (I.D.); (C.M.)
| | - Christina Michael
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus; (A.C.); (E.G.); (I.D.); (C.M.)
| | - Laurence Rahme
- Department of Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02115, USA;
| | - Yiorgos Apidianakis
- Department of Biological Sciences, University of Cyprus, Nicosia 2109, Cyprus; (A.C.); (E.G.); (I.D.); (C.M.)
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Astaxanthin-Mediated Bacterial Lethality: Evidence from Oxidative Stress Contribution and Molecular Dynamics Simulation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:7159652. [PMID: 34925700 PMCID: PMC8677388 DOI: 10.1155/2021/7159652] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 01/26/2023]
Abstract
The involvement of cellular oxidative stress in antibacterial therapy has remained a topical issue over the years. In this study, the contribution of oxidative stress to astaxanthin-mediated bacterial lethality was evaluated in silico and in vitro. For the in vitro analysis, the minimum inhibitory concentration (MIC) of astaxanthin was lower than that of novobiocin against Staphylococcus aureus but generally higher than those of the reference antibiotics against other test organisms. The level of superoxide anion of the tested organisms increased significantly following treatment with astaxanthin when compared with DMSO-treated cells. This increase compared favorably with those observed with the reference antibiotics and was consistent with a decrease in the concentration of glutathione (GSH) and corresponding significant increase in ADP/ATP ratio. These observations are suggestive of probable involvement of oxidative stress in antibacterial capability of astaxanthin and in agreement with the results of the in silico evaluations, where the free energy scores of astaxanthins' complexes with topoisomerase IV ParC and ParE were higher than those of the reference antibiotics. These observations were consistent with the structural stability and compactness of the complexes as astaxanthin was observed to be more stable against topoisomerase IV ParC and ParE than DNA Gyrase A and B. Put together, findings from this study underscored the nature and mechanism of antibacterial action of astaxanthin that could suggest practical approaches in enhancing our current knowledge of antibacterial arsenal and aid in the novel development of alternative natural topo2A inhibitor.
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Hailemariam M, Alemayehu T, Tadesse B, Nigussie N, Agegnehu A, Habtemariam T, Ali M, Mitiku E, Azerefegne E. Major bacterial isolate and antibiotic resistance from routine clinical samples in Southern Ethiopia. Sci Rep 2021; 11:19710. [PMID: 34611232 PMCID: PMC8492677 DOI: 10.1038/s41598-021-99272-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 08/13/2021] [Indexed: 02/08/2023] Open
Abstract
Currently, antibiotic-resistant bacterial infections are a challenge for the health care system. Although physicians demand timely drug resistance data to guide empirical treatment, local data is rather scarce. Hence, this study performed a retrospective analysis of microbiological findings at the Hawassa public hospital. Secondary data were retrieved to assess the prevalence and level of drug resistance for the most common bacterial isolates from clinical samples processed at Hawassa University Comprehensive Specialized Hospital. Out of 1085 clinical samples processed in the microbiology laboratory, the prevalence of bacterial infection was 32.6%. Bacterial bloodstream infection was higher in children than in adults (OR, 4; 95% CI 1.8-14.6; p = 0.005). E. coli and K. pneumoniae were the commonest bacterial isolate both in children (36.8%, 26.3%) and in adults (33.3%, 26.7%) from the urine sample while, the leading bacteria identified from the CSF sample was P. aeruginosa, 37% in children and 43% in adult. In this study, all identified bacterial isolates were multi-drug resistant (MDR) ranging from 50 to 91%. The highest proportion of MDR was S. aureus 91.1 followed by K. pneumoniae 87.6%. Since the nationwide investigation of bacterial isolate, and drug resistance is rare in Ethiopia, a report from such type of local surveillance is highly useful to guide empirical therapy by providing awareness on the level resistance of isolates.
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Affiliation(s)
- Mengistu Hailemariam
- grid.192268.60000 0000 8953 2273School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, P.O. Box 1560, Hawassa, Ethiopia
| | - Tsegaye Alemayehu
- grid.192268.60000 0000 8953 2273School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, P.O. Box 1560, Hawassa, Ethiopia
| | - Bereket Tadesse
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Netsanete Nigussie
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Asnakech Agegnehu
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Techilo Habtemariam
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Mulubrhan Ali
- grid.192268.60000 0000 8953 2273School of Medical Laboratory Science, Hawassa University College of Medicine and Health Sciences, P.O. Box 1560, Hawassa, Ethiopia
| | - Enkosilassie Mitiku
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
| | - Elshaday Azerefegne
- grid.192268.60000 0000 8953 2273Hawassa University Comprehensive and Specialized Hospital, Hawassa, Ethiopia
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Pierantoni L, Andreozzi L, Ambretti S, Dondi A, Biagi C, Baccelli F, Lanari M. Three-Year Trend in Escherichia coli Antimicrobial Resistance among Children's Urine Cultures in an Italian Metropolitan Area. CHILDREN-BASEL 2021; 8:children8070597. [PMID: 34356576 PMCID: PMC8303248 DOI: 10.3390/children8070597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/10/2021] [Accepted: 07/13/2021] [Indexed: 11/17/2022]
Abstract
Urinary tract infections (UTIs) are among the most common bacterial infections in children, and Escherichia coli is the main pathogen responsible. Several guidelines, including the recently updated Italian guidelines, recommend amoxicillin-clavulanic acid (AMC) as a first-line antibiotic therapy in children with febrile UTIs. Given the current increasing rates of antibiotic resistance worldwide, this study aimed to investigate the three-year trend in the resistance rate of E. coli isolated from pediatric urine cultures (UCs) in a metropolitan area of northern Italy. We conducted a retrospective review of E. coli-positive, non-repetitive UCs collected in children aged from 1 month to 14 years, regardless of a diagnosis of UTI, catheter colonization, urine contamination, or asymptomatic bacteriuria. During the study period, the rate of resistance to AMC significantly increased from 17.6% to 40.2% (p < 0.001). Ciprofloxacin doubled its resistance rate from 9.1% to 16.3% (p = 0.007). The prevalence of multidrug-resistant E. coli rose from 3.9% to 9.2% (p = 0.015). The rate of resistance to other considered antibiotics remained stable, as did the prevalence of extended spectrum beta-lactamases and extensively resistant E. coli among isolates. These findings call into question the use of AMC as a first-line therapy for pediatric UTIs in our population, despite the indications of recent Italian guidelines.
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Affiliation(s)
- Luca Pierantoni
- Division of Pediatric Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.D.); (C.B.); (M.L.)
| | - Laura Andreozzi
- Specialty School of Paediatrics—Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy;
- Correspondence:
| | - Simone Ambretti
- Unit of Clinical Microbiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Arianna Dondi
- Division of Pediatric Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.D.); (C.B.); (M.L.)
| | - Carlotta Biagi
- Division of Pediatric Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.D.); (C.B.); (M.L.)
| | - Francesco Baccelli
- Specialty School of Paediatrics—Alma Mater Studiorum, Università di Bologna, 40138 Bologna, Italy;
| | - Marcello Lanari
- Division of Pediatric Emergency, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (L.P.); (A.D.); (C.B.); (M.L.)
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Azab KSM, Abdel-Rahman MA, El-Sheikh HH, Azab E, Gobouri AA, Farag MMS. Distribution of Extended-Spectrum β-Lactamase (ESBL)-Encoding Genes among Multidrug-Resistant Gram-Negative Pathogens Collected from Three Different Countries. Antibiotics (Basel) 2021; 10:antibiotics10030247. [PMID: 33801418 PMCID: PMC7998439 DOI: 10.3390/antibiotics10030247] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/22/2021] [Accepted: 02/25/2021] [Indexed: 12/14/2022] Open
Abstract
The incidence of Extended-spectrum β-lactamase (ESBL)-encoding genes (blaCTX-M and blaTEM) among Gram-negative multidrug-resistant pathogens collected from three different countries was investigated. Two hundred and ninety-two clinical isolates were collected from Egypt (n = 90), Saudi Arabia (n = 162), and Sudan (n = 40). Based on the antimicrobial sensitivity against 20 antimicrobial agents from 11 antibiotic classes, the most resistant strains were selected and identified using the Vitek2 system and 16S rRNA gene sequence analysis. A total of 85.6% of the isolates were found to be resistant to more than three antibiotic classes. The ratios of the multidrug-resistant strains for Egypt, Saudi Arabia, and Sudan were 74.4%, 90.1%, and 97.5%, respectively. Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa showed inconstant resistance levels to the different classes of antibiotics. Escherichia coli and Klebsiella pneumoniae had the highest levels of resistance against macrolides followed by penicillins and cephalosporin, while Pseudomonas aeruginosa was most resistant to penicillins followed by classes that varied among different countries. The isolates were positive for the presence of the blaCTX-M and blaTEM genes. The blaCTX-M gene was the predominant gene in all isolates (100%), while blaTEM was detected in 66.7% of the selected isolates. This work highlights the detection of multidrug-resistant bacteria and resistant genes among different countries. We suggest that the medical authorities urgently implement antimicrobial surveillance plans and infection control policies for early detection and effective prevention of the rapid spread of these pathogens.
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Affiliation(s)
- Khaled S. M. Azab
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (K.S.M.A.); (H.H.E.-S.)
| | - Mohamed Ali Abdel-Rahman
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (K.S.M.A.); (H.H.E.-S.)
- Al-Azhar Center of Fermentation Biotechnology and Applied Microbiology, Al-Azhar University, Nasr City, Cairo 11884, Egypt
- Correspondence: or (M.A.A.-R.); or (M.M.S.F.)
| | - Hussien H. El-Sheikh
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (K.S.M.A.); (H.H.E.-S.)
| | - Ehab Azab
- Department of Biotechnology, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Adil A. Gobouri
- Department of Chemistry, College of Science, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia;
| | - Mohamed M. S. Farag
- Botany and Microbiology Department, Faculty of Science, Al-Azhar University, Nasr City, Cairo 11884, Egypt; (K.S.M.A.); (H.H.E.-S.)
- Correspondence: or (M.A.A.-R.); or (M.M.S.F.)
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18
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Dirar MH, Bilal NE, Ibrahim ME, Hamid ME. Prevalence of extended-spectrum β-lactamase (ESBL) and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Enterobacteriaceae isolates from patients in Khartoum, Sudan. Pan Afr Med J 2021; 37:213. [PMID: 33520052 PMCID: PMC7821812 DOI: 10.11604/pamj.2020.37.213.24988] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/22/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction the emergence of antibiotic resistance pathogens is an important health risk. Usually Gram negative bacteria acquire resistance to beta-lactam antibiotics by beta-lactamase production. The objectives of this study was to assess the prevalence of ESBL and to detect the frequency of blaTEM, blaSHV and blaCTX-M genotypes among ESBL producing Enterobacteriaceae isolates from patients in Khartoum, Sudan. Methods a total of 171 isolates of Enterobacteriaceae were recovered from hospitals in Khartoum, Sudan (2014 -2015) were used to detect ESBL production using disc diffusion method. blaTEM, blaSHV and blaCTX-M genes were investigated by PCR based methods using gene-specific primers. Results the high resistance among Enterobacteriaceae was noticed in ciprofloxacin (72%) and ofloxacin (73%). ESBL production was mainly in Escherichia Coli (38%) and Klebsiella pneumonia (34%). Prevalent genotypes were blaTEM (86%), blaCTX-M (78%) and blaSHV (28%). These were found mainly in Escherichia Coli (38%, 37%, 2%) and K. pneumonia (34%, 31%, 26.1%). The majority of ESBL producing isolates possess more than one ESBL genes. Conclusion the ESBL production in Enterobacteriaceae was high, with blaTEM and blaCTX-M genotypes more prevalent. Public health and laboratory standard of excellence is needed to reducing the spread of resistant pathogens.
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Affiliation(s)
- Maha Hassan Dirar
- College of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Naser Eldin Bilal
- College of Medical Laboratory Sciences, University of Khartoum, Khartoum, Sudan
| | - Mutasim Elhadi Ibrahim
- Department of Basic Medical Sciences, Microbiology Unit, College of Medicine, University of Bisha, Bisha, Kingdom of Saudi Arabia
| | - Mohamed Elamin Hamid
- Department of Clinical Microbiology and Parasitology, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia
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Overcoming bacterial resistance to antibiotics: the urgent need – a review. ANNALS OF ANIMAL SCIENCE 2021. [DOI: 10.2478/aoas-2020-0098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
The discovery of antibiotics is considered one of the most crucial breakthroughs in medicine and veterinary science in the 20th century. From the very beginning, this type of drug was used as a ‘miraculous cure’ for every type of infection. In addition to their therapeutic uses, antibiotics were also used for disease prevention and growth promotion in livestock. Though this application was banned in the European Union in 2006, antibiotics are still used in this way in countries all over the world. The unlimited and unregulated use of antibiotics has increased the speed of antibiotic resistance’s spread in different types of organisms. This phenomenon requires searching for new strategies to deal with hard-to-treat infections. The antimicrobial activity of some plant derivatives and animal products has been known since ancient times. At the beginning of this century, even more substances, such as antimicrobial peptides, were considered very promising candidates for becoming new alternatives to commonly used antimicrobials. However, many preclinical and clinical trials ended without positive results. A variety of strategies to fight microbes exist, but we are a long way from approving them as therapies. This review begins with the discovery of antibiotics, covers the modes of action of select antimicrobials, and ends with a literature review of the newest potential alternative approaches to overcoming the drug resistance phenomenon.
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Prevalence of Enterobacteriaceae spp. and its multidrug-resistant rates in clinical isolates: A two-center cross-sectional study. Mol Biol Rep 2021; 48:665-675. [PMID: 33389531 DOI: 10.1007/s11033-020-06114-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/19/2020] [Indexed: 10/22/2022]
Abstract
Enterobacteriaceae spp., owing to their high durability and antibiotic-resistant mechanisms, are described as an eminent part of health treatments in hospital-acquired infections. This study aimed to estimate the prevalence of clinical isolated Enterobacteriaceae spp., and their multidrug-resistant rate in the north of Iran. In this cross-sectional study, over two years (2017-2019), clinical isolates were collected and Enterobacteriaceae spp. were identified using the standard media culture and Analytical Profile Index (API 20E) kit from two centers in the north of Iran. Isolates were confirmed by targeting the rpoB gene. Moreover, the susceptibility patterns of isolates were assessed using disc diffusion methods according to the Clinical Laboratory Standard Institute (CLSI) guidelines. Out of 2645 clinical specimens, 297 (11.2%) were confirmed as Enterobacteriaceae spp. containing Eshershia. coli 93 (31%), Citrobacter freundii 65 (21.9%), Klebsiella pneumoniae 48 (16.2%), Enterobacter spp. 43 (14.5%), and Proteus spp. 23 (7.7%). As much as 8.7% of other spp. Ampicillin (81.1%) and cephalexin (80.9%) have been shown to have the greatest resistant, and nalidixic acid (65%) and amikacin (59.2%) were the most sensitive drugs. Multidrug-resistance (MDR) strains are more isolated in the Burn and Burn intensive care unit (BICU) than other wards. The MDR frequency in Bouali and Zareh hospitals were 65 (49.61%) and 130 (78.31%), respectively. Considering the high isolation rates of MDR Enterobacteriaceae spp., preventive measures need to be taken to remove the mentioned bacteria from hospital wards.
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Ramos-Martín F, Herrera-León C, Antonietti V, Sonnet P, Sarazin C, D’Amelio N. Antimicrobial Peptide K11 Selectively Recognizes Bacterial Biomimetic Membranes and Acts by Twisting Their Bilayers. Pharmaceuticals (Basel) 2020; 14:1. [PMID: 33374932 PMCID: PMC7821925 DOI: 10.3390/ph14010001] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/14/2020] [Accepted: 12/19/2020] [Indexed: 12/14/2022] Open
Abstract
K11 is a synthetic peptide originating from the introduction of a lysine residue in position 11 within the sequence of a rationally designed antibacterial scaffold. Despite its remarkable antibacterial properties towards many ESKAPE bacteria and its optimal therapeutic index (320), a detailed description of its mechanism of action is missing. As most antimicrobial peptides act by destabilizing the membranes of the target organisms, we investigated the interaction of K11 with biomimetic membranes of various phospholipid compositions by liquid and solid-state NMR. Our data show that K11 can selectively destabilize bacterial biomimetic membranes and torque the surface of their bilayers. The same is observed for membranes containing other negatively charged phospholipids which might suggest additional biological activities. Molecular dynamic simulations reveal that K11 can penetrate the membrane in four steps: after binding to phosphate groups by means of the lysine residue at the N-terminus (anchoring), three couples of lysine residues act subsequently to exert a torque in the membrane (twisting) which allows the insertion of aromatic side chains at both termini (insertion) eventually leading to the flip of the amphipathic helix inside the bilayer core (helix flip and internalization).
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Affiliation(s)
- Francisco Ramos-Martín
- Unité de Génie Enzymatique et Cellulaire UMR 7025 CNRS, Université de Picardie Jules Verne, 80039 Amiens, France; (C.H.-L.); (C.S.)
| | - Claudia Herrera-León
- Unité de Génie Enzymatique et Cellulaire UMR 7025 CNRS, Université de Picardie Jules Verne, 80039 Amiens, France; (C.H.-L.); (C.S.)
| | - Viviane Antonietti
- Agents Infectieux, Résistance et Chimiothérapie, AGIR UR 4294, Université de Picardie Jules Verne, UFR de Pharmacie, 80037 Amiens, France; (V.A.); (P.S.)
| | - Pascal Sonnet
- Agents Infectieux, Résistance et Chimiothérapie, AGIR UR 4294, Université de Picardie Jules Verne, UFR de Pharmacie, 80037 Amiens, France; (V.A.); (P.S.)
| | - Catherine Sarazin
- Unité de Génie Enzymatique et Cellulaire UMR 7025 CNRS, Université de Picardie Jules Verne, 80039 Amiens, France; (C.H.-L.); (C.S.)
| | - Nicola D’Amelio
- Unité de Génie Enzymatique et Cellulaire UMR 7025 CNRS, Université de Picardie Jules Verne, 80039 Amiens, France; (C.H.-L.); (C.S.)
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Molecular-Based Identification of Actinomycetes Species That Synthesize Antibacterial Silver Nanoparticles. Int J Microbiol 2020. [DOI: 10.1155/2020/8816111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Infectious diseases caused by antibiotic-resistant bacteria lead to a considerable increase in human morbidity and mortality globally. This requires to search potential actinomycete isolates from undiscovered habitats as a source of effective bioactive metabolites and to synthesis metabolite-mediated antibacterial silver nanoparticles (AgNPs). The main purpose of the present study was to identify actinomycetes isolated from Thika waste dump soils that produce bioactive metabolites to synthesize antibacterial AgNPs. The synthesis of metabolite-mediated AgNP was confirmed with visual detection and a UV-vis spectrophotometer, whereas the functional groups involved in AgNP synthesis were identified using a FTIR spectrophotometer. The antibacterial activity of the metabolite-mediated AgNPs was tested by a well diffusion assay. Identification of actinomycete isolates involved in the synthesis of antibacterial AgNPs was done based on 16S rRNA gene sequence analysis. The visual detection showed that dark salmon and pale golden color change was observed due to the formation of AgNPs by KDT32 and KGT32 metabolites, respectively. The synthesis was confirmed by a characteristic UV spectra peak at 415.5 nm for KDT32-AgNP and 416 nm for KGT32-AgNP. The FTIR spectra revealed that OH, C=C, and S-S functional groups were involved in the synthesis of KDT32-AgNP, whereas OH, C=C, and C-H were involved in the formation of KGT32-AgNP. The inhibition zone results revealed that KDT32-AgNP showed 22.0 ± 1.4 mm and 19.0 ± 1.4 mm against Escherichia coli and Salmonella typhi, whereas KGT32-AgNP showed 21.5 ± 0.7 mm and 17.0 ± 0.0 mm, respectively. KDT32 and KGT32 isolates were identified as genus Streptomyces and their 16S rRNA gene sequences were deposited in the GenBank database with MH301089 and MH301090 accession numbers, respectively. Due to the bactericidal activity of synthesized AgNPs, KDT32 and KGT32 isolates can be used in biomedical applications.
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Antibiotics Profile, Prevalence of Extended-Spectrum Beta-Lactamase (ESBL), and Multidrug-Resistant Enterobacteriaceae from Different Clinical Samples in Khartoum State, Sudan. Int J Microbiol 2020; 2020:8898430. [PMID: 33163078 PMCID: PMC7605932 DOI: 10.1155/2020/8898430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 05/23/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
One of the global requirements for controlling the occurrence of resistance to antimicrobial drugs is to understanding the resistivity profile of various clinical isolates. Therefore, this study aimed to deliver the indication of different resistant profiles of clinically isolated Enterobacteriaceae from different sources of samples from Khartoum state, Sudan, and to determine the prevalence rate of extended-spectrum beta-lactamase (ESBL), multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacteria. A total of 144 Gram-negative bacteria were collected from different sources (vaginal swab, urine, catheter tip, sputum, blood, tracheal aspirate, pus, stool, pleural fluid, and throat swab). Samples were subcultured and identified according to their cultural characteristics and biochemical tests. Antimicrobial susceptibility test was performed for twenty-four antibiotics from eleven categories against all isolated Enterobacteriaceae according to the recommendation of Clinical and Laboratory Standards Institute (CLSI). The result showed that out of 144 isolates, Escherichia coli and Klebsiella pneumoniae were predominant isolates with the percentage of 47.9 and 25%, respectively. The prevalence of ESBL was higher in K. pneumonia (38.9%) than E. coli (34.8%). All isolated E. coli were sensitive to nitrofurantoin and tigecycline. There was a high prevalence of MDR Enterobacteriaceae, and only one isolate was XDR, while PDR was zero for all isolated bacteria. Active antimicrobial-resistant (AMR) observation through constant data sharing and management of all stakeholders is crucial to recognize and control the AMR global burden. Also, effective antibiotic stewardship procedures would be applied to limit the unreasonable expenditure of antibiotics in Sudan.
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Kibwana UO, Majigo M, Kamori D, Manyahi J. High fecal carriage of extended Beta Lactamase producing Enterobacteriaceae among adult patients admitted in referral hospitals in Dar es Salaam, Tanzania. BMC Infect Dis 2020; 20:557. [PMID: 32736605 PMCID: PMC7393831 DOI: 10.1186/s12879-020-05272-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/20/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multi-drug resistance pathogens such as Extended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (ESBL-PE) are of great global health concern, since they are associated with increased morbidity and mortality. Even in the absence of infections caused by these pathogens, colonization is a great threat and can lead to cross transfer among hospitalized patients. To date data on carriage of these pathogens is still limited in Tanzania. Therefore, this study aimed to determine ESBL-PE fecal carriage rate and associated factors among hospitalized patients at Referral hospitals in Dar es Salaam. METHODS This was a cross sectional study conducted from May to July 2017 among patients admitted in three referral hospitals in Dar es Salaam, Tanzania. Rectal swabs were collected and screened for ESBL production using MacConkey agar supplemented with Ceftazidime 2 μg/ml. Phenotypic confirmation of ESBL-PE was done by double disk diffusion method. Statistical analysis was performed using Statistical Package for Social Sciences (SPPS) software version 20. RESULTS Of the 196 enrolled participants, 59.7% (117/196) were confirmed to carry ESBL-PE. Diarrheic patients (57/79) had statistically significant high prevalence of ESBL colonization compared to those without diarrhea (60/117) (p = 0.01). A total of 131 ESBL-PE were isolated from 117 patients, whereby, Escherichia coli accounted for 68.7%, Klebsiella pneumoniae 28.2% and Citrobacter species 0.8%. ESBL-PE carriage was significantly higher in patients with diarrhea compared to those without diarrhea (72% vs 53.1%, p = 0.01). Recent antibiotic use was independently associated with carriage of ESBL-PE (aOR 14.65, 95%CI 3.07-69.88, p = 0.01). CONCLUSIONS High prevalence of fecal carriage of ESBL-PE was observed in patients admitted in tertiary hospitals in Dar es Salaam, Tanzania. The use of antibiotics was associated with carriage of ESBL producers among the study population.
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Affiliation(s)
- Upendo O Kibwana
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences Dar es Salaam, P.O. Box 65001, Dar es Salaam, Tanzania.
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences Dar es Salaam, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Doreen Kamori
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences Dar es Salaam, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Joel Manyahi
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences Dar es Salaam, P.O. Box 65001, Dar es Salaam, Tanzania
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Molecular Characterization of Quinolone Resistant Urinary Isolates of Escherichia coli. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.2.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Nosheen S, Bukhari NI, Ejaz H, Abbas N. Antibiogram and recent incidence of multi-drug resistant carbapenemase producing Escherichia coli isolated from paediatric patients. Pak J Med Sci 2020; 36:246-250. [PMID: 32063968 PMCID: PMC6994894 DOI: 10.12669/pjms.36.2.928] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objective: To gauge the recent breadth of MDR E. coli along with antibiogram of carbapenemase producing (CP) E. coli among children from an institute which receives patients from all over Punjab. Methods: The bacterial strains of E. coli isolated from various specimens of patients were collected from April 2017 to August 2018 and processed using standard biochemical tests and API 20E system (bioMerieux). Phenotypic screening for CP E. coli was done by the modified Hodge test, whereas antibiotic susceptibility testing was done with Kirby-Bauer disc diffusion technique. Results: Total of 6,468 bacterial strains were isolated, out of which 1,552 (24%) were E. coli. Carbapenem resistance was observed in 245 (16%) strains, amongst which 113 (46%) were confirmed to be CP. E. coli isolated from males were higher as compared to females (p<0.05). Majority of the organisms were isolated from blood (37.2%) samples. The hospital discharged about 65% of patients, while 23% left against medical advice. Overall MDR amongst E. coli was 93.26%. Colistin sulphate (15.9%) and nitrofurantoin (16.8%) showed the most efficacy followed by amikacin (15%) and fosfomycin (10.6%). Conclusion: The isolation of high number of MDR E. coli amongst the paediatric patients is worrisome, which could serve as a potential source of horizontal genes transfer to other genera.
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Affiliation(s)
- Sumbal Nosheen
- Dr. Sumbal Nosheen, M.Phil. Punjab University College of Pharmacy (PUCP), University of the Punjab, Lahore, Pakistan
| | - Nadeem Irfan Bukhari
- Dr. Nadeem Irfan Bukhari, Ph.D. Punjab University College of Pharmacy (PUCP), University of the Punjab, Lahore, Pakistan
| | - Hasan Ejaz
- Dr. Hasan Ejaz, Ph.D. Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia
| | - Nasir Abbas
- Dr. Nasir Abbas, Ph.D. Punjab University College of Pharmacy (PUCP), University of the Punjab, Lahore, Pakistan
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Charani E, Cunnington AJ, Yousif AHA, Seed Ahmed M, Ahmed AEM, Babiker S, Badri S, Buytaert W, Crawford MA, Elbashir MI, Elhag K, Elsiddig KE, Hakim N, Johnson MR, Miras AD, Swar MO, Templeton MR, Taylor-Robinson SD. In transition: current health challenges and priorities in Sudan. BMJ Glob Health 2019; 4:e001723. [PMID: 31543996 PMCID: PMC6730568 DOI: 10.1136/bmjgh-2019-001723] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/21/2019] [Accepted: 07/23/2019] [Indexed: 11/17/2022] Open
Abstract
A recent symposium and workshop in Khartoum, the capital of the Republic of Sudan, brought together broad expertise from three universities to address the current burden of communicable and non-communicable diseases facing the Sudanese healthcare system. These meetings identified common challenges that impact the burden of diseases in the country, most notably gaps in data and infrastructure which are essential to inform and deliver effective interventions. Non-communicable diseases, including obesity, type 2 diabetes, renal disease and cancer are increasing dramatically, contributing to multimorbidity. At the same time, progress against communicable diseases has been slow, and the burden of chronic and endemic infections remains considerable, with parasitic diseases (such as malaria, leishmaniasis and schistosomiasis) causing substantial morbidity and mortality. Antimicrobial resistance has become a major threat throughout the healthcare system, with an emerging impact on maternal, neonatal and paediatric populations. Meanwhile, malnutrition, micronutrient deficiency and poor perinatal outcomes remain common and contribute to a lifelong burden of disease. These challenges echo the United Nations (UN) sustainable development goals and concentrating on them in a unified strategy will be necessary to address the national burden of disease. At a time when the country is going through societal and political transition, we draw focus on the country and the need for resolution of its healthcare needs.
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Affiliation(s)
- Esmita Charani
- Department of Medicine, Faculty of Medicine, Imperial College London, London, UK
| | | | | | | | - Ammar E M Ahmed
- Department of Medicine, University of Khartoum, Khartoum, Sudan
| | - Souad Babiker
- Department of Medicine, Ahfad University for Women, Omdurman, Sudan
| | - Shahinaz Badri
- Department of Pathology, School of Medicine, Ahfad University for Women, Omdurman, Sudan
| | | | | | | | - Kamal Elhag
- Department of Medicine, Ahfad University for Women, Omdurman, Sudan
| | | | - Nadey Hakim
- Department of Medicine, Imperial College London, London, UK
| | - Mark R Johnson
- Department of Medicine, Imperial College London, London, UK
| | | | - Mohamed O Swar
- Department of Medicine, Ahfad University for Women, Omdurman, Sudan
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Mulani MS, Kamble EE, Kumkar SN, Tawre MS, Pardesi KR. Emerging Strategies to Combat ESKAPE Pathogens in the Era of Antimicrobial Resistance: A Review. Front Microbiol 2019; 10:539. [PMID: 30988669 PMCID: PMC6452778 DOI: 10.3389/fmicb.2019.00539] [Citation(s) in RCA: 754] [Impact Index Per Article: 150.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 03/01/2019] [Indexed: 12/19/2022] Open
Abstract
The acronym ESKAPE includes six nosocomial pathogens that exhibit multidrug resistance and virulence: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. Persistent use of antibiotics has provoked the emergence of multidrug resistant (MDR) and extensively drug resistant (XDR) bacteria, which render even the most effective drugs ineffective. Extended spectrum β-lactamase (ESBL) and carbapenemase producing Gram negative bacteria have emerged as an important therapeutic challenge. Development of novel therapeutics to treat drug resistant infections, especially those caused by ESKAPE pathogens is the need of the hour. Alternative therapies such as use of antibiotics in combination or with adjuvants, bacteriophages, antimicrobial peptides, nanoparticles, and photodynamic light therapy are widely reported. Many reviews published till date describe these therapies with respect to the various agents used, their dosage details and mechanism of action against MDR pathogens but very few have focused specifically on ESKAPE. The objective of this review is to describe the alternative therapies reported to treat ESKAPE infections, their advantages and limitations, potential application in vivo, and status in clinical trials. The review further highlights the importance of a combinatorial approach, wherein two or more therapies are used in combination in order to overcome their individual limitations, additional studies on which are warranted, before translating them into clinical practice. These advances could possibly give an alternate solution or extend the lifetime of current antimicrobials.
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Affiliation(s)
- Mansura S Mulani
- Department of Microbiology, Savitribai Phule Pune University, Pune, India
| | - Ekta E Kamble
- Department of Microbiology, Savitribai Phule Pune University, Pune, India
| | - Shital N Kumkar
- Department of Microbiology, Savitribai Phule Pune University, Pune, India
| | - Madhumita S Tawre
- Department of Microbiology, Savitribai Phule Pune University, Pune, India
| | - Karishma R Pardesi
- Department of Microbiology, Savitribai Phule Pune University, Pune, India
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Characterisation of Extended-Spectrum β-Lactamases among Multidrug Resistant Enterobacteriaceae from Sudan. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2019. [DOI: 10.22207/jpam.13.1.06] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Teklu DS, Negeri AA, Legese MH, Bedada TL, Woldemariam HK, Tullu KD. Extended-spectrum beta-lactamase production and multi-drug resistance among Enterobacteriaceae isolated in Addis Ababa, Ethiopia. Antimicrob Resist Infect Control 2019; 8:39. [PMID: 30815254 PMCID: PMC6377715 DOI: 10.1186/s13756-019-0488-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 02/03/2019] [Indexed: 11/25/2022] Open
Abstract
Background The global emergence and spread of extended-spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae have been threatening the ability to treat an infection. Hence, this study aimed to determine the prevalence of ESBL-producing and multi-drug resistance (MDR) Enterobacteriaceae (ESBLs-E) from different clinical specimens in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted from January 1 to May 30, 2017. A total of 426 Enterobacteriaceae isolates were identified from clinical specimens. The isolates were collected from four laboratories. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method on Muller Hinton agar (MHA). All Enterobacteriaceae were screened for ESBLs production using cefotaxime and ceftazidime as per CLSI guideline. Each ESBL screening positive Enterobacteriaceae were confirmed by a combination disk test (CDT). Data were entered and analyzed by using SPSS version-20. Result The most frequent Enterobacteriaceae were E. coli 228 (53.5%) and K. pneumoniae 103 (24.1%). The magnitude of ESBLs-E was 57.7% (246/426). The highest frequencies of ESBLs-E were observed in blood specimesns (84.4%) and the highest ESBLs production was observed in K. pneumoniae (85.4%). The highest resistance level was seen to sulfamethoxazole-trimethoprim (77.0%), amoxicillin with clavulanic acid (71.6%), cefotaxime (62.2%), cefepime (60.3%) and ceftazidime (60.8%). The overall magnitude of multi-drug resistance (MDR) level was 68.3%. Of ESBLs-E, 96.3% of them were MDR (P < 0.001). Conclusion There was a high prevalence of ESBLs-E and MDR isolate in Addis Ababa. Most of ESBLs-E was isolated primarily in blood and urine. The highest ESBLs production was observed among K. pneumoniae. Hence, strong infection control strategies must be implemented in hospital settings of the country.
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Affiliation(s)
- Dejenie Shiferaw Teklu
- 1Department of Clinical Bacteriology and Mycology National Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebe Aseffa Negeri
- 3Department of Clinical Bacteriology and Mycology National Reference Laboratory, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Melese Hailu Legese
- 2Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfaye Legesse Bedada
- 4Department of Public Health Microbiology, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Hiwot Ketema Woldemariam
- 5Department of Virology, Ethiopian Public Health Institute, P. O. Box, 1242 Addis Ababa, Ethiopia
| | - Kassu Desta Tullu
- 2Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Uropathogens and their antimicrobial resistance patterns: Relationship with urinary tract infections. Int J Health Sci (Qassim) 2019; 13:48-55. [PMID: 30983946 PMCID: PMC6436442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This study was performed to determine the prevalence of uropathogens causing urinary tract infections (UTIs) and to determine their pattern of antimicrobial resistance. METHODS This study was conducted on 273 urine samples collected from outpatient departments (OPDs) of Qassim University affiliated hospitals. Fully automated VITEK 2 compact system was used in the identification and antimicrobial susceptibility testing of causative microorganisms. RESULTS Of 273 urine samples, only 89 (32.6%) were found to show significant growth for UTI, and overall, drug resistance was found in 92% (n = 82/89) of samples, with most (80%) being resistant to at least two drugs. Antibiotic resistance was commonly observed in ampicillin (88.3%), piperacillin (72.7%), clindamycin (66.7%), amoxicillin/clavulanic acid (66.2%), and trimethoprim/sulfamethoxazole (50%). The commonly isolated microorganisms were Escherichia coli 24 (27%), Klebsiella pneumoniae 11 (12.4%), Proteus mirabilis 4 (4.5%), Pseudomonas aeruginosa 4 (4.5%), Enterobacter cloacae 5 (5.6%), Enterococcus faecalis 5 (5.6%), and Staphylococcus saprophyticus 3 (3.4%). CONCLUSIONS This research work has shown that patients with UTI in Qassim are at high risk of antibiotic resistance. The work also showed that multidrug-resistant bacteria can lead to momentous therapeutic problems in OPD patients.
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Abia ALK, Ubomba-Jaswa E, Schmidt C, Dippenaar MA. Where Did They Come from-Multi-Drug Resistant Pathogenic Escherichia coli in a Cemetery Environment? Antibiotics (Basel) 2018; 7:antibiotics7030073. [PMID: 30110918 PMCID: PMC6164573 DOI: 10.3390/antibiotics7030073] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/01/2018] [Accepted: 08/10/2018] [Indexed: 12/17/2022] Open
Abstract
Human burial in cemeteries facilitates the decomposition of corpses without posing a public health danger. However, the role of cemeteries as potential environmental reservoirs of drug-resistant pathogens has not been studied. Thus, we investigated cemeteries as potential environmental reservoirs of multi-drug resistant (MDR) pathogenic Escherichia coli. E. coli isolates were obtained from water samples (collected from surface water bodies and boreholes in three cemeteries) after isolation using the Colilert® 18 system. Pathogenic potentials of the isolates were investigated using real-time polymerase chain reactions targeting seven virulence genes (VGs) pertaining to six E. coli pathotypes. The resistance of isolates to eight antibiotics was tested using the Kirby–Bauer disc diffusion method. The mean E. coli concentrations varied from <1 most probable number (MPN)/100 mL to 2419.6 MPN/100 mL with 48% of 100 isolates being positive for at least one of the VGs tested. Furthermore, 87% of the isolates were resistant to at least one of the antibiotics tested, while 72% of the isolates displayed multi-drug resistance. Half of the MDR isolates harboured a VG. These results suggest that cemeteries are potential reservoirs of MDR pathogenic E. coli, originating from surrounding informal settlements, which could contaminate groundwater if the cemeteries are in areas with shallow aquifers.
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Affiliation(s)
- Akebe Luther King Abia
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Private Bag X54001, Durban 4000, South Africa.
| | - Eunice Ubomba-Jaswa
- Water Research Commission, Private Bag X03 Gezina, Pretoria 0031, South Africa.
- Department of Biotechnology, University of Johannesburg, Doornfontein, Johannesburg 2094, South Africa.
| | - Chantelle Schmidt
- Engineering Geology and Hydrology, Department of Geology, University of Pretoria, Pretoria 0084, South Africa.
| | - Matthys Alois Dippenaar
- Engineering Geology and Hydrology, Department of Geology, University of Pretoria, Pretoria 0084, South Africa.
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Ramírez-Castillo FY, Moreno-Flores AC, Avelar-González FJ, Márquez-Díaz F, Harel J, Guerrero-Barrera AL. An evaluation of multidrug-resistant Escherichia coli isolates in urinary tract infections from Aguascalientes, Mexico: cross-sectional study. Ann Clin Microbiol Antimicrob 2018; 17:34. [PMID: 30041652 PMCID: PMC6057003 DOI: 10.1186/s12941-018-0286-5] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 07/14/2018] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Uropathogenic Escherichia coli (UPEC) are one of the main bacteria causing urinary tract infections (UTIs). The rates of UPEC with high resistance towards antibiotics and multidrug-resistant bacteria have increased dramatically in recent years and could difficult the treatment. METHODS The aim of the study was to determine multidrug-resistant bacteria, antibiotic resistance profile, virulence traits, and genetic background of 110 E. coli isolated from community (79 isolates) and hospital-acquired (31 isolates) urinary tract infections. The plasmid-mediated quinolone resistance genes presence was also investigated. A subset of 18 isolates with a quinolone-resistance phenotype was examined for common virulence genes encoded in diarrheagenic and extra-intestinal pathogenic E. coli by a specific E. coli microarray. RESULTS Female children were the group most affected by UTIs, which were mainly community-acquired. Resistance to trimethoprim-sulfamethoxazole, ampicillin, and ampicillin-sulbactam was most prevalent. A frequent occurrence of resistance toward ciprofloxacin (47.3%), levofloxacin (43.6%) and cephalosporins (27.6%) was observed. In addition, 63% of the strains were multidrug-resistant (MDR). Almost all the fluoroquinolone (FQ)-resistant strains showed MDR-phenotype. Isolates from male patients were associated to FQ-resistant and MDR-phenotype. Moreover, hospital-acquired infections were correlated to third generation cephalosporin and nitrofurantoin resistance and the presence of kpsMTII gene. Overall, fimH (71.8%) and fyuA (68.2%), had the highest prevalence as virulence genes among isolates. However, the profile of virulence genes displayed a great diversity, which included the presence of genes related to diarrheagenic E. coli. Out of 110 isolates, 25 isolates (22.7%) were positive to qnrA, 23 (20.9%) to qnrB, 7 (6.4%) to qnrS1, 7 (6.4%) to aac(6')lb-cr, 5 (4.5%) to qnrD, and 1 (0.9%) to qnrC genes. A total of 12.7% of the isolates harbored blaCTX-M genes, with blaCTX-M-15 being the most prevalent. CONCLUSIONS Urinary tract infection due to E. coli may be difficult to treat empirically due to high resistance to commonly used antibiotics. Continuous surveillance of multidrug resistant organisms and patterns of drug resistance are needed in order to prevent treatment failure and reduce selective pressure. These findings may help choosing more suitable treatments of UTI patients in this region of Mexico.
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Affiliation(s)
- Flor Y. Ramírez-Castillo
- Laboratorio de Biología Celular y Tisular, Departamento de Morfología, Universidad Autónoma de Aguascalientes, Av. Universidad 940, Col. Cd. Universitaria, 20131 Aguascalientes, Mexico
| | - Adriana C. Moreno-Flores
- Laboratorio de Biología Celular y Tisular, Departamento de Morfología, Universidad Autónoma de Aguascalientes, Av. Universidad 940, Col. Cd. Universitaria, 20131 Aguascalientes, Mexico
| | - Francisco J. Avelar-González
- Laboratorio de Ciencias Ambientales, Departamento de Fisiología y Farmacología, Universidad Autónoma de Aguascalientes, Av. Universidad 940, Col. Cd. Universitaria, 20131 Aguascalientes, Mexico
| | - Francisco Márquez-Díaz
- Departamento de Infectología, Centenario Hospital Miguel Hidalgo, Galeana Sur 495, Obraje, 20000 Aguascalientes, Mexico
| | - Josée Harel
- Département de pathologie et microbiologie, Centre de Recherche en Infectologíe Porcine et Aviaire, Faculté de Médecine Vétérinaire, Université de Montréal, 3200, rue Sicott, Saint-Hyacinthe, Montreal, QC J2S 2M2 Canada
| | - Alma L. Guerrero-Barrera
- Laboratorio de Biología Celular y Tisular, Departamento de Morfología, Universidad Autónoma de Aguascalientes, Av. Universidad 940, Col. Cd. Universitaria, 20131 Aguascalientes, Mexico
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Ayele AA, Gebresillassie BM, Erku DA, Gebreyohannes EA, Demssie DG, Mersha AG, Tegegn HG. Prospective evaluation of Ceftriaxone use in medical and emergency wards of Gondar university referral hospital, Ethiopia. Pharmacol Res Perspect 2018; 6:e00383. [PMID: 29417764 PMCID: PMC5817827 DOI: 10.1002/prp2.383] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2017] [Accepted: 10/27/2017] [Indexed: 11/29/2022] Open
Abstract
Ceftriaxone is among the most commonly utilized antibiotics owing to its high potency, wide spectrum of activity, and low risk of toxicity. It is used to treat different types of bacterial infections including pneumonia, bone infections, abdominal infections, Skin and soft tissue infections, urinary tract infections. However, evidence around the globe shows the misuse of Ceftriaxone. This study aimed at evaluating the appropriateness of ceftriaxone use in medical and emergency wards of Gondar university referral hospital (GURH), Northwest Ethiopia. A prospective, cross-sectional study design was employed to evaluate the use of ceftriaxone. The medical records of patients who received ceftriaxone were reviewed prospectively between January 1 and March 30, 2017. Appropriateness of ceftriaxone use was evaluated as per the protocol developed from current treatment guidelines. A total of 390 patients' medical records were reviewed. The utilization rate of ceftriaxone was found to be high with a point prevalence of 59%. Ceftriaxone was empirically used in 79.5% of cases. The most common indications of Ceftriaxone were respiratory tract infections (29.3%), central nervous system infections (24.1%), and prophylactic indications (16.4%). The mean duration of ceftriaxone therapy in our study was 11.47 days, with a range of 1-52 days. More than two-thirds (80.2%) of ceftriaxone use were found to be inappropriate and majority of unjustified ceftriaxone use emanated from inappropriate frequency of administration (78.3%), absence of culture and sensitivity test (68.7%), and duration of therapy (47%). Empiric treatment with ceftriaxone and the presence of coadministered drugs was significantly associated with its inappropriate use. The present study revealed a very high rate of inappropriate use of ceftriaxone which may potentially lead to emergence of drug-resistant microorganisms and ultimately exposes the patient to treatment failure and increased cost of therapy.
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Affiliation(s)
- Asnakew Achaw Ayele
- Department of Clinical PharmacySchool of PharmacyCollege of Medicine and Health SciencesUniversity of GondarGondarEthiopia
| | - Begashaw Melaku Gebresillassie
- Department of Clinical PharmacySchool of PharmacyCollege of Medicine and Health SciencesUniversity of GondarGondarEthiopia
| | - Daniel Asfaw Erku
- Department of Clinical PharmacySchool of PharmacyCollege of Medicine and Health SciencesUniversity of GondarGondarEthiopia
| | - Eyob Alemayehu Gebreyohannes
- Department of Clinical PharmacySchool of PharmacyCollege of Medicine and Health SciencesUniversity of GondarGondarEthiopia
| | | | - Amanual Getnet Mersha
- School of MedicineCollege of Medicine and Health SciencesUniversity of GondarGondarEthiopia
| | - Henok Getachew Tegegn
- Department of Clinical PharmacySchool of PharmacyCollege of Medicine and Health SciencesUniversity of GondarGondarEthiopia
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Maleki N, Tahanasab Z, Mobasherizadeh S, Rezaei A, Faghri J. Prevalence of CTX-M and TEM β-lactamases in Klebsiella pneumoniae Isolates from Patients with Urinary Tract Infection, Al-Zahra Hospital, Isfahan, Iran. Adv Biomed Res 2018; 7:10. [PMID: 29456981 PMCID: PMC5812061 DOI: 10.4103/abr.abr_17_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Extended-spectrum β-lactamase (ESBL)-producing is a significant resistant mechanism to β-lactams in Enterobacteriaceae, especially in Klebsiella pneumoniae. The main objectives of this study were to genetically characterize urinary clinical isolates of K. pneumoniae through the investigating of blaTEM, blaCTX-M and using molecular typing by Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) method. We also determined the frequency of antibiotic resistance of K. pneumoniae strains to characterize the β-lactamases included. Materials and Methods: A cross-sectional study was carried out to evaluate 98 strains of K. pneumoniae isolated from urine culture of outpatients referred to Al-Zahra Hospital, Isfahan, Iran. Antibiotic susceptibility testing was performed using Kirby–Bauer's method. Screening of ESBLs was carried out using double-disk screening test. PCR technique was performed to detect TEM and CTX-M genes. The total DNA of each strain was tested by ERIC-PCR. Results: In 98 K. pneumoniae studied clinical isolates, 25.5% were ESBL producing and 44.9% multidrug-resistant (MDR). From 25 ESBL isolates, 23 (92%) cases showed MDR phenotype. In ESBL producing isolates, 23 (92%) were blaCTX-M and 19 (76%) blaTEM positive. The antimicrobial drug susceptibilities of ESBL isolates indicated high resistant rates for cefotaxime and ceftazidime. All 25 ESBL producing isolates were resistant to cefotaxime. Complex patterns of fingerprints isolates showed that 36% of the isolates were belonged to the cluster no 5. Conclusion: This study revealed high antimicrobial resistance rates among ESBL isolates which can lead to various health difficulties. Epidemiological data collection from patients is recommended to develop the strategies to manage antibiotic resistance.
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Affiliation(s)
- Nafiseh Maleki
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Tahanasab
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sina Mobasherizadeh
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aliakbar Rezaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jamshid Faghri
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Evaluation of ceftriaxone utilization in medical and emergency wards of Tikur Anbessa specialized hospital: a prospective cross-sectional study. BMC Pharmacol Toxicol 2016; 17:7. [PMID: 26891697 PMCID: PMC4759859 DOI: 10.1186/s40360-016-0057-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/17/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ceftriaxone is one of the most commonly used antibiotics due to its high antibacterial potency, wide spectrum of activity and low potential for toxicity. However, the global trend shows misuse of this drug. The aim of this study was to evaluate prospectively the appropriateness of ceftriaxone use in medical and emergency wards of Tikur Anbessa Specialized Hospital. METHODS A prospective cross-sectional study was conducted by reviewing medication records of patients receiving ceftriaxone during hospitalization at Tikur Anbessa Specialized Hospital between February 1 and June 30, 2014. Drug use evaluation was conducted to determine whether ceftriaxone was being used appropriately based on six criteria namely indication for use, dose, frequency of administration, duration of treatment, drug-drug interaction, culture and sensitivity test. The evaluation was made as per the protocol developed from current treatment guidelines. RESULTS The total of 314 records of patients receiving ceftriaxone was reviewed. The prescribing rate of ceftriaxone was found to be very high (58 % point prevalence). Ceftriaxone use was empiric in 274 (87.3 %) cases. The most common indication for ceftriaxone use was pneumonia; observed in 110 (35.0 %) cases. The most common daily dosage, frequency of administration and duration of treatment with ceftriaxone were 2 g (88.9 %), twice-daily (98.4 %) and 8-14 days (46.2 %), respectively. Inappropriate use of ceftriaxone was observed in most of cases (87.9 %), the greatest proportion of which was attributed to inappropriate frequency of administration (80.3 %), followed by absence of culture and sensitivity test (53.2 %). CONCLUSION This study revealed that the inappropriate use of ceftriaxone was very high in the medical and emergency wards of Tikur Anbessa Specialized Hospital. This may lead to emergence of resistant pathogens which in turn lead to treatment failure and increased cost of therapy. Therefore, adherence to current evidence-based guidelines is recommended.
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Moini AS, Soltani B, Taghavi Ardakani A, Moravveji A, Erami M, Haji Rezaei M, Namazi M. Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolated From Patients in Kashan, Iran. Jundishapur J Microbiol 2015; 8:e27517. [PMID: 26587220 PMCID: PMC4644348 DOI: 10.5812/jjm.27517] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 06/03/2015] [Accepted: 07/11/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Escherichia coli and Klebsiella pneumoniae are common human pathogens that cause a wide spectrum of infections. Antimicrobial resistance is a basic obstacle in the management of these infections which has different patterns in various regions. OBJECTIVES In this study, the antibiotic resistance patterns and risk factors for multidrug-resistant (MDR) E. coli and K. pneumoniae were determined. PATIENTS AND METHODS In this cross-sectional study, a total of 250 isolates (134 E. coli and 116 K. pneumoniae) were collected and antimicrobial resistances to ampicillin, amoxicillin-clavulanic acid, amikacin, gentamycin, ceftriaxone, ceftazidime, ciprofloxacin and imipenem were evaluated by disc diffusion method and confirmed by E-test. Moreover, risk factors for MDR E. coli and K. pneumoniae were also detected. RESULTS The mean ages of the culture-positive cases of E. coli and K. pneumoniae were 33.39 ± 24.42 and 36.54 ± 24.66 years, respectively (P = 0.31); 137 (54.8%) cases were male and 113 (45.2%) were female (P = 0.53). Nineteen (14.2%) isolates of E. coli and 12 (10.3%) isolates of K. pneumoniae were sensitive to all the evaluated antibiotics. The prevalence of MDR E. coli and MDR K. pneumoniae was 50% and 46.6%, respectively (P = 0.59). The highest resistance for both strains was to ampicillin and no imipenem resistance was seen. The risk factors for MDR E. coli were admission history during the recent three months (P = 0.043) and antibiotic use in the previous month (P = 0.03); for MDR K. pneumoniae, they were admission in the pediatric ward (P = 0.016), surgical ward (P = 0.019), or gynecology ward (P = 0.12), admission duration of > seven days, and antibiotic use during the past month (P = 0.04). CONCLUSIONS The prevalence of multidrug resistance was high compared with developed countries, and history of admission, antibiotic use, admission duration and admission wards were the risk factors for multidrug resistance.
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Affiliation(s)
- Atieh Sadat Moini
- Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Babak Soltani
- Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran
- Corresponding author: Babak Soltani, Department of Pediatrics, Kashan University of Medical Sciences, Kashan, IR Iran. Tel: +98-3155575840, Fax: +98-3155548900, E-mail:
| | | | - Alireza Moravveji
- Department of Community Medicine, Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mahzad Erami
- Department of Microbiology, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mostafa Haji Rezaei
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
| | - Mansoor Namazi
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, IR Iran
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Srinivasan B, Tonddast-Navaei S, Skolnick J. Ligand binding studies, preliminary structure-activity relationship and detailed mechanistic characterization of 1-phenyl-6,6-dimethyl-1,3,5-triazine-2,4-diamine derivatives as inhibitors of Escherichia coli dihydrofolate reductase. Eur J Med Chem 2015; 103:600-14. [PMID: 26414808 DOI: 10.1016/j.ejmech.2015.08.021] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/29/2015] [Accepted: 08/09/2015] [Indexed: 01/16/2023]
Abstract
Gram-negative bacteria are implicated in the causation of life-threatening hospital-acquired infections. They acquire rapid resistance to multiple drugs and available antibiotics. Hence, there is the need to discover new antibacterial agents with novel scaffolds. For the first time, this study explores the 1,3,5-triazine-2,4-diamine and 1,2,4-triazine-2,4-diamine group of compounds as potential inhibitors of Escherichia coli DHFR, a pivotal enzyme in the thymidine and purine synthesis pathway. Using differential scanning fluorimetry, DSF, fifteen compounds with various substitutions on either the 3rd or 4th positions on the benzene group of 6,6-dimethyl-1-(benzene)-1,3,5-triazine-2,4-diamine were shown to bind to the enzyme with varying affinities. Then, the dose dependence of inhibition by these compounds was determined. Preliminary quantitative structure-activity relationship analysis and docking studies implicate the alkyl linker group and the sulfonyl fluoride group in increasing the potency of inhibition. 4-[4-[3-(4,6-diamino-2,2-dimethyl-1,3,5-triazin-1-yl)phenyl]butyl]benzenesulfonyl fluoride (NSC120927), the best hit from the study and a molecule with no reported inhibition of E. coli DHFR, potently inhibits the enzyme with a Ki value of 42.50 ± 5.34 nM, followed by 4-[6-[4-(4,6-diamino-2,2-dimethyl-1,3,5-triazin-1-yl)phenyl]hexyl]benzenesulfonyl fluoride (NSC132279), with a Ki value of 100.9 ± 12.7 nM. Detailed kinetic characterization of the inhibition brought about by five small-molecule hits shows that these inhibitors bind to the dihydrofolate binding site with preferential binding to the NADPH-bound binary form of the enzyme. Furthermore, in search of novel diaminotriazine scaffolds, it is shown that lamotrigine, a 1,2,4-triazine-3,5-diamine and a sodium-ion channel blocker class of antiepileptic drug, also inhibits E. coli DHFR. This is the first comprehensive study on the binding and inhibition brought about by diaminotriazines of a gram-negative prokaryotic enzyme and provides valuable insights into the SAR as an aid to the discovery of novel antibiotics.
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Affiliation(s)
- Bharath Srinivasan
- Center for the Study of Systems Biology, School of Biology, Georgia Institute of Technology, 950, Atlantic Drive, Atlanta, GA 30332, United States.
| | - Sam Tonddast-Navaei
- Center for the Study of Systems Biology, School of Biology, Georgia Institute of Technology, 950, Atlantic Drive, Atlanta, GA 30332, United States.
| | - Jeffrey Skolnick
- Center for the Study of Systems Biology, School of Biology, Georgia Institute of Technology, 950, Atlantic Drive, Atlanta, GA 30332, United States.
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Alem N, Frikh M, Srifi A, Maleb A, Chadli M, Sekhsokh Y, Louzi L, Ibrahimi A, Lemnouer A, Elouennass M. Evaluation of antimicrobial susceptibility of Escherichia coli strains isolated in Rabat University Hospital (Morocco). BMC Res Notes 2015; 8:392. [PMID: 26319229 PMCID: PMC4553218 DOI: 10.1186/s13104-015-1380-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 08/24/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Escherichia coli (E. coli) is the most commonly isolated bacteria in human pathology. In Morocco the data concerning the nature and the rates of antibiotic resistance of E. coli in both hospitals and city environment remains relatively poor and needs further investigations. METHODS During a 16 months period, E. coli isolates were collected from different culture specimens received in the Bacteriology Department of the Military teaching Hospital Mohammed-V-Rabat for routine diagnostic purposes. E. coli isolates were identified and their antimicrobial susceptibility pattern was determined. RESULTS A total of 1369 E. coli isolates comprising 33% (1369/4110) of culture-positive samples were consecutively collected. Isolates of E. coli were, in 40.5% (554/1369) of cases from hospitalized patients and in 59.5% (815/1369) of cases from outpatients. Urine isolates represented 82% (1123/1369) of the cases. High rates of resistance were found for amoxicillin (42.5%), cefalotin (30.4%), norfoloxacin (29.9%) and sulfamethoxazole (37.7%). The detection rate of ESBL was 6.1% (85/1369). In hospitalized patients 11.9% of the isolates of E. coli (66/554) had an ESBL phenotype while in outpatients cases only 2.3% of isolates of E. coli (19/815) had this phenotype. CONCLUSIONS Our findings suggest that more judicious use of antibiotics is needed especially in probabilistic treatment. The emergence of ESBL in the Moroccan cities is an indicator of the severity of this problem that is not limited to health care facilities.
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Affiliation(s)
- Nabil Alem
- Hôpital Militaire d'Instruction Mohammed V, Rabat, Morocco. .,Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco. .,, villa 96 la corniche hay el fath, Rabat, Morocco.
| | - Mohammed Frikh
- Hôpital Militaire d'Instruction Mohammed V, Rabat, Morocco. .,Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Abdellatif Srifi
- Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Adil Maleb
- Faculté de Médecine de Pharmacie d'Oujda Université Mohammed I, Oujda, Morocco.
| | - Mariama Chadli
- Hôpital Militaire d'Instruction Mohammed V, Rabat, Morocco. .,Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Yassine Sekhsokh
- Hôpital Militaire d'Instruction Mohammed V, Rabat, Morocco. .,Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Lhoucin Louzi
- Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Azzedine Ibrahimi
- Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Abdelhay Lemnouer
- Hôpital Militaire d'Instruction Mohammed V, Rabat, Morocco. .,Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
| | - Mostafa Elouennass
- Hôpital Militaire d'Instruction Mohammed V, Rabat, Morocco. .,Faculté de Médicine et de Pharmacie de Rabat Université Mohammed V Souissi, Rabat, Morocco.
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Ansari S, Nepal HP, Gautam R, Shrestha S, Neopane P, Gurung G, Chapagain ML. Community acquired multi-drug resistant clinical isolates of Escherichia coli in a tertiary care center of Nepal. Antimicrob Resist Infect Control 2015; 4:15. [PMID: 25937923 PMCID: PMC4416386 DOI: 10.1186/s13756-015-0059-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Accepted: 04/16/2015] [Indexed: 11/24/2022] Open
Abstract
Background Multi-drug resistance (MDR) in Gram-negative organisms is an alarming problem in the world. MDR and extensively-drug resistance (XDR) is in increasing trend due to the production of different types of beta (β)-lactamases. Thus the aim of this study was to document the incidence of MDR and XDR in clinical isolates of Escherichia coli and also to find out the enzymatic mechanisms of β-lactam antibiotics resistance. Methods Two hundred clinical isolates of Escherichia coli (E. coli) identified by standard laboratory methods were studied. Antibiotic susceptibility profile was performed for all the isolates and the suspected isolates were phenotypically tested for the production of extended spectrum β-lactamase (ESBL), metallo β-lactamase (MBL) and AmpC β-lactamase (AmpC) by recommended methods. Results Around three-fourth (78%) of the total isolates were multi-drug resistant. ESBL, MBL and AmpC production was found in 24%, 15% and 9% of isolates respectively. Amikacin, chloramphenicol and colistin were found to be the most effective antibiotics. Conclusions High percentage of MDR was observed. β-lactamase mediated resistance was also high. Thus, regular surveillance of drug resistance due to β-lactamases production and infection control policy are of utmost importance to minimize the spread of resistant strains.
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Affiliation(s)
- Shamshul Ansari
- Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
| | - Hari Prasad Nepal
- Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
| | - Rajendra Gautam
- Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
| | - Sony Shrestha
- Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
| | - Puja Neopane
- Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
| | - Ganga Gurung
- College of Nursing, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
| | - Moti Lal Chapagain
- Department of Microbiology, Chitwan Medical College Teaching Hospital, Bharatpur, Chitwan Nepal
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Bhatt P, Tandel K, Shete V, Rathi KR. Burden of extensively drug-resistant and pandrug-resistant Gram-negative bacteria at a tertiary-care centre. New Microbes New Infect 2015; 8:166-70. [PMID: 27257498 PMCID: PMC4877402 DOI: 10.1016/j.nmni.2015.01.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/11/2015] [Accepted: 01/23/2015] [Indexed: 11/24/2022] Open
Abstract
The emergence of resistance to multiple antimicrobial agents in Gram-negative bacteria is a significant threat to public health, as it restricts the armamentarium of the clinician against these infections. The aim of this study was to determine the burden of extensively drug-resistant (XDR) and pandrug-resistant (PDR) Gram-negative bacteria at a tertiary-care centre. Antimicrobial susceptibility testing of 1240 clinical isolates of Gram-negative bacteria obtained from various clinical samples during the study period was carried out by the Kirby-Bauer disc diffusion method. Minimum inhibitory concentration of all antibiotics including tigecycline and colistin was determined by Vitek-2 automated susceptibility testing system. Out of 1240 isolates of Gram-negative bacteria, 112 isolates (9%) were resistant to all the antibiotics tested by Kirby-Bauer disc diffusion method. This finding was corroborated by Vitek-2. In addition, Vitek-2 found that 67 isolates were resistant to all antibiotics except tigecycline and colistin. A total of 30 isolates were susceptible to only colistin, and four isolates were susceptible to only tigecycline. It was also found that six isolates (excluding five isolates of Proteus spp.) were resistant to both colistin and tigecycline. Thus, 101 (8.1%) out of 1240 isolates were XDR and 11 isolates (0.9%) were PDR. The findings of this study reveal increased burden of XDR and PDR Gram-negative bacteria in our centre. It also highlights the widespread dissemination of these bacteria in the community. This situation warrants the regular surveillance of antimicrobial resistance of Gram-negative bacteria and implementation of an efficient infection control program.
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Ntirenganya C, Manzi O, Muvunyi CM, Ogbuagu O. High prevalence of antimicrobial resistance among common bacterial isolates in a tertiary healthcare facility in Rwanda. Am J Trop Med Hyg 2015; 92:865-70. [PMID: 25646259 DOI: 10.4269/ajtmh.14-0607] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Accepted: 12/17/2014] [Indexed: 11/07/2022] Open
Abstract
Antimicrobial resistance (AMR) is a serious public health threat in both developed and developing countries. Many developing countries, including Rwanda, lack adequate surveillance systems, and therefore, the prevalence of AMR is not well-known. We conducted a prospective observational study to assess the prevalence of AMR among common bacterial isolates from clinical specimens obtained from patients on the medical wards of Kigali University Teaching Hospital (KUTH). We evaluated the antibiotic sensitivity patterns of bacterial pathogens cultured from urine, blood, sputum, and wound swab specimens obtained over a 6-month period (July 1 to December 30, 2013). There were 154 positive cultures from specimens obtained from 141 unique patients over the study period. Urine, blood, wound swab, and sputum cultures comprised 55.2%, 25.3%, 16.2%, and 3.3% of the total specimens evaluated; 31.4% and 58.7% of Escherichia coli and Klebsiella isolates, respectively, were resistant to at least one of the third generation cephalosporins. Eight percent of E. coli isolates were resistant to imipenem; 82% and 6% of Staphylococcus aureus strains were oxacillin- and vancomycin-resistant respectively. Antimicrobial resistance rates are high in Rwanda and pose a serious therapeutic challenge to the management of common infections.
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Affiliation(s)
- Cyprien Ntirenganya
- Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut
| | - Olivier Manzi
- Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut
| | - Claude Mambo Muvunyi
- Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut
| | - Onyema Ogbuagu
- Department of Medicine, Kigali University Teaching Hospital, Kigali, Rwanda; Department of Clinical Biology, School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Butare, Rwanda; Section of Infectious Diseases, Yale University School of Medicine, New Haven, Connecticut
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Ibrahim ME, Bilal NE, Hamid ME. Comparison of phenotypic characteristics and antimicrobial resistance patterns of clinical Escherichia coli collected from two unrelated geographical areas. Glob J Health Sci 2014; 6:126-35. [PMID: 25363111 PMCID: PMC4825506 DOI: 10.5539/gjhs.v6n6p126] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 05/24/2014] [Accepted: 05/19/2014] [Indexed: 11/12/2022] Open
Abstract
Background: Antimicrobial resistance among pathogenic Escherichia coli is an increasing problem especially in developing countries. Aims: To compare between resistance patterns of E. coli collected from two unrelated geographical areas. Methods: A descriptive comparative study was conducted between May 2010 and August 2011. E. coli (n= 402) collected from hospitals in Khartoum state, Sudan and in Aseer region, Saudi Arabia were studied. Identification and antimicrobial susceptibility testing of isolates were performed following standard methods. Multi-drug resistance (MDR) was defined as non-susceptibility to ≥ three antimicrobials. Results: Of the 402 E. coli isolates studied, MDR patterns were significantly higher among isolates from Sudan than Saudi Arabia [92.2% (214/232) vs. 70.6% (120/170)] (p = 0.000). The resistance rates of E. coli isolates were recorded as follows (Sudan and Saudi Arabia): High to moderate resistance to amoxicillin (97.7% and 94.2%), trimethoprim-sulfamethoxazole (88.3% and 82.5%), tetracycline (77.1% and 74.2%), amoxicillin- clavulanic acid (51.4% and 70%), ceftriaxone (64% and 52.4%) and ciprofloxacin (58.4% and 40%). Low resistance was to ceftazidime (35% and 20%), gentamicin (35% and 17.5%) and nitrofurantoin (22.4% and 11.7%). Resistance to amikacin was uncommon (1.9% and 5%). Significant differences (p < 0.05) in resistance rates of isolates between both countries in term to patient’s gender and age. The most frequent MDR phenotypes among isolates were to 7(15.9%) in Khartoum state and to 3(20.8%) in Aseer region. Conclusions: Variation and emerging of antimicrobial resistance among pathogenic E. coli isolates was observed in both regions. Continuous monitoring of resistance profiles, locally and international surveillance programs are required.
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Scherbaum M, Kösters K, Mürbeth RE, Ngoa UA, Kremsner PG, Lell B, Alabi A. Incidence, pathogens and resistance patterns of nosocomial infections at a rural hospital in Gabon. BMC Infect Dis 2014; 14:124. [PMID: 24592922 PMCID: PMC3943987 DOI: 10.1186/1471-2334-14-124] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 02/19/2014] [Indexed: 12/28/2022] Open
Abstract
Background Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Africa, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints, deficient surveillance data and lack of awareness regarding nosocomial infections. We carried out this study to determine the incidence and spectrum of nosocomial infections, pathogens and antibiotic resistance patterns in a tertiary regional hospital in Lambaréné, Gabon. Methods This prospective case study was carried out over a period of six months at the Albert Schweitzer Hospital, Lambaréné, Gabon. All patients admitted to the departments of surgery, gynecology/obstetrics and internal medicine were screened daily for signs and symptoms of hospital-acquired infections. Results A total of 2925 patients were screened out of which 46 nosocomial infections (1.6%) were diagnosed. These comprised 20 (44%) surgical-site infections, 12 (26%) urinary-tract infections, 9 (20%) bacteraemias and 5 (11%) other infections. High rates of nosocomial infections were found after hysterectomies (12%) and Caesarean sections (6%). Most frequent pathogens were Staphylococcus aureus and Escherichia coli. Eight (40%) of 20 identified E. coli and Klebsiella spp. strains were ESBL-producing organisms. Conclusion The cumulative incidence of nosocomial infections in this study was low; however, the high rates of surgical site infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.
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Affiliation(s)
| | | | | | | | | | - Bertrand Lell
- Centre de Recherches Medicales de Lambarene, Albert Schweitzer Hospital, PB 118 Lambaréné, Gabon.
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