High Prevalence of Extended-spectrum Beta-lactamase-producing Enterobacteriaceae in Bacteremia After Transrectal Ultrasound-guided Prostate Biopsy: A Need for Changing Preventive Protocol

Background. Multidrug-resistant Enterobacteriaceae particularly extended-spectrum beta-lactamase producers have become a major public health threat. Despite efforts to limit their spread, rates of multidrug-resistance members of the Enterobacteriaceae continue to increase throughout the world causing increased morbidity and mortality and raised costs for medical care. Objective. The aim of this study was to determine the prevalence of multidrug resistance and extended-spectrum β-lactamase-producing Enterobacteriaceae. Methods. Four hundred forty Enterobacteriaceae isolates from outpatients referred to Arsho Advanced Medical Laboratory were identified and assessed for their antimicrobial resistance pattern by using the automated VITEK 2 compact system. Extended-spectrum β-lactamase production was determined by the VITEK 2 automated compact system using the extended-spectrum β-lactamase test panel as per the instruction of the manufacturer. Results. The overall resistance rates of Enterobacteriaceae against cephalosporins, aminoglycosides, and fluoroquinolones were high. Nitrofurantoin with a resistance rate of 14.3% and piperacillin/tazobactam combination with a resistance rate of 17.3% were better active against this group of Gram-negative bacteria. Out of 440 isolates of Enterobacteriaceae, 42.1% were multidrug-resistant of which 34.3% and 8.95% were extensively drug-resistant and pan-drug resistant, respectively. Among 185 multidrug-resistant Enterobacteriaceae, 63.9% of the isolates produced extended-spectrum β-lactamase of which 75.4%, 19.5%, 1.7%, 2.5%, and 0.8% were E. coli, K. pneumoniae, C. freundii, E. cloacae, and P. mirabilis, respectively. Conclusions. The present study demonstrated high prevalence rates of multidrug-resistant and extended-spectrum-beta-lactamase-producing Enterobacteriaceae. In order to combat these problems, infection control strategy and proper antibiotic policies should be formulated.

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High prevalence of extended-spectrum beta-lactamase-producing Gram-negative pathogens from patients attending Felege Hiwot Comprehensive Specialized Hospital, Bahir Dar, Amhara region

PLoS ONE ◽

10.1371/journal.pone.0215177 ◽

2019 ◽

Vol 14 (4) ◽

pp. e0215177 ◽

Cited By ~ 5

Author(s):

Feleke Moges ◽

Setegn Eshetie ◽

Wondwossen Abebe ◽

Feleke Mekonnen ◽

Mulat Dagnew ◽

...

Keyword(s):

Beta Lactamase ◽

Bahir Dar ◽

Amhara Region ◽

Gram Negative ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Specialized Hospital ◽

High Prevalence

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Impact of selective media for detecting fluoroquinolone-insusceptible/extended-spectrum beta-lactamase-producingEscherichia colibefore transrectal prostate biopsy

International Journal of Urology ◽

10.1111/iju.13447 ◽

2017 ◽

Vol 24 (12) ◽

pp. 842-847 ◽

Cited By ~ 4

Author(s):

Takuya Sadahira ◽

Koichiro Wada ◽

Motoo Araki ◽

Ayano Ishii ◽

Toyohiko Watanabe ◽

...

Keyword(s):

Prostate Biopsy ◽

Beta Lactamase ◽

Selective Media ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Transrectal Prostate Biopsy

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High Prevalence and Mechanism Associated With Extended Spectrum Beta-Lactamase-Positive Phenotype in Laribacter hongkongensis

Frontiers in Microbiology ◽

10.3389/fmicb.2021.618894 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jade L. L. Teng ◽

Ruibang Luo ◽

Bone S. F. Tang ◽

Jordan Y. H. Fong ◽

Li Wang ◽

...

Keyword(s):

Draft Genome ◽

Inhibition Zone ◽

Beta Lactamase ◽

Zone Size ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

High Prevalence ◽

Confirmatory Tests ◽

Laribacter Hongkongensis ◽

The Difference

In this study, we reported the prevalence and mechanism associated with the extended-spectrum beta-lactamase (ESBL)-positive phenotype in Laribacter hongkongensis isolated from patients and fish. Using the inhibition zone enhancement test, 20 (95.2%) of the 21 patient strains and 8 (57.1%) of the 14 fish strains were tested ESBL-positive. However, ESBL genes, including SHV, TEM, CTX-M, GES, and PER, were not detected in all of these 28 L. hongkongensis isolates. No ESBL gene could be detected in either the complete genome of L. hongkongensis HLHK9 or the draft genome of PW3643. PCR and DNA sequencing revealed that all the 35 L. hongkongensis isolates (showing both ESBL-positive and ESBL-negative phenotypes) were positive for the ampC gene. When the AmpC deletion mutant, HLHK9ΔampC, was subject to the zone enhancement test, the difference of zone size between ceftazidime/clavulanate and ceftazidime was less than 5 mm. When boronic acid was added to the antibiotic disks, none of the 28 “ESBL-positive” isolates showed a ≥ 5 mm enhancement of inhibition zone size diameter between ceftazidime/clavulanate and ceftazidime and between cefotaxime/clavulanate and cefotaxime. A high prevalence (80%) of ESBL-positive phenotype is present in L. hongkongensis. Overall, our results suggested that the ESBL-positive phenotype in L. hongkongensis results from the expression of the intrinsic AmpC beta-lactamase. Confirmatory tests should be performed before issuing laboratory reports for L. hongkongensis isolates that are tested ESBL-positive by disk diffusion clavulanate inhibition test.

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