Resistance in Enterobacteriaceae: Results of a Multicenter Surveillance Study, 1995-2000

2003 ◽  
Vol 24 (8) ◽  
pp. 607-612 ◽  
Author(s):  
Ian Friedland ◽  
Lue Stinson ◽  
Margaretmary Ikaiddi ◽  
Sandra Harm ◽  
Gail L. Woods

AbstractObjectives:To assess changes over time in susceptibility of Enterobacteriaceae from patients in ICUs, compare susceptibility rates of isolates from patients in ICUs with those from inpatients outside ICUs, and explore phenotypic patterns of cross-resistance and co-resistance.Design:From 1995 to 2000, centers participating in the ICU Surveillance Study tested 100 to 200 consecutive nosocomial gram-negative bacilli by broth microdilution.Setting:Each year, 42 to 97 U.S. hospitals tested isolates.Results:In all years, imipenem was the most potent agent tested, followed by amikacin and ertapenem. Extended-spectrum beta-lactam and monobactam agents had good activity against Escherichia coli and Klebsiella species, but limited activity against Enterobacter species. Susceptibility to imipenem and amikacin did not fluctuate during the analysis period, whereas susceptibility to ceftazidime, ceftriaxone, and ciprofloxacin decreased 2% to 5%. The decline was most pronounced for susceptibility of Escherichia coli to ciprofloxacin: 98.7% of ICU isolates were susceptible in 1995 versus 93.2% in 2000. Susceptibility of ICU isolates was lower than that of non-ICU isolates, except for ciprofloxacin, for which the reverse was true. Cross-resistance was common among extended-spectrum cephalosporins and penicillins, but uncommon between imipenem and ertapenem. Only imipenem and ertapenem remained highly active against Enterobacteriaceae with a phenotype suggesting possible production of an extended-spectrum beta-lactamase and those with a phenotype suggesting possible Amp C hyperproduction.Conclusions:Imipenem was the most active agent against nosocomial Enterobacteriaceae. Susceptibility to ciprofloxacin decreased from 1995 to 2000, particularly in Escherichia coli, and, in contrast to other agents, was lower among non-ICU isolates.

Author(s):  
S. C. Tama ◽  
Y. B. Ngwai ◽  
G. R. I. Pennap ◽  
I. H. Nkene ◽  
R. H. Abimiku

Aims: This study investigates and reports the production of extended spectrum beta-lactamase in Escherichia coli isolates in poultry droppings sourced from selected poultry farms in Karu, Nigeria Study Design:  Cross sectional study Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between August 2019 and February 2020. Methodology: Escherichia coli was isolated from the samples using standard cultural and microbiological methods. Antibiotic susceptibility testing and minimum inhibitory concentrations were evaluated as described by the Clinical and Laboratory Standards Institute (CLSI). The detection of ESBL production in E. coli isolates was carried out using double disc synergy test.  In addition, molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method. Results: All (100%) samples collected had E. coli. Antibiotic resistances in the isolates in decreasing order were as follows: ampicillin (96.7%), streptomycin (94.4%), sulphamethoxazole /trimethoprim (87.8%), amoxicillin/ clavulanic acid (61.1%), gentamicin (52.2%), ciprofloxacin (40.0%), ceftazidime (35.6%), cefotaxime (31.1%), imipenems (22.2%), cefoxitin (13.3%). The commonest antibiotic resistant phenotype was AMP-SXT-S-CTX-CN (8.8%). Multiple antibiotic resistance (MAR) was observed in 92.2% (83/90) of the isolates with the common MAR indices being 0.5 (26.5%), 0.6 (19.2%), 0.4 (13.2%) and 0.9 (10.8%). Fifty nine of the eighty beta-lactam resistant isolates (73.7%) were confirmed ESBL producers. 55 of the 59 ESBL positive isolates (93.2%) carried bla genes as follows:   blaSHV (50/55, 90.9%), blaTEM (31/55, 56.3%) and blaCTX-M (46/55, 83.6%). Thirty six (65.5%) of the 55 isolates carried two bla genes (blaSHV and blaTEM, blaTEM and blaCTX-M, and blaCTX-M and blaSHV). Conclusion: The E. coli isolates showed lower resistances to cefoxitin, imipenem, cefotaxime, ceftazidime, and ciprofloxacin and most isolates were MAR, with resistance to 5 antibiotics being the most predominant. In addition, blaSHV gene was the most common ESBL gene detected in the confirmed ESBL-producing E. coli isolates.


2020 ◽  
Vol 44 (2) ◽  
Author(s):  
Freshinta Jellia Wibisono ◽  
Bambang Sumiarto ◽  
Tri Untari ◽  
Mustofa Helmi Effendi ◽  
Dian Ayu Permatasari ◽  
...  

This study aimed to determine the resistance profile and the nature of multidrug resistance in Extended Spectrum Beta Lactamase (ESBL)-producing Escherichia coli (E.coli) against several classes of antibiotics. Positive isolates of ESBL-producing E.coli were tested for antibiotic sensitivity using the VITEK® 2 compact method which then analyzed automatically. The results showed an antibiotic resistance profile against ESBL-producing E.coli showed the highest level of antibiotics in beta lactam, amoxicillin, ampicillin, cefazolin, cefotaxime, and ceftriaxone at 100%. Subsequent results found a relatively high level of resistance in the antibiotics aztreonam (86.36%), trimethoprim/sulfamethoxazole (77.27%), gentamicin (72.73%), and ciprofloxacin (68.18%). Antibiotics from carbapenem groups such as ertapenem and memenem, and antibiotics from the aminoglycosides (amicasin) and tigecycline groups of tetracycline still showed a high sensitivity level of 100%. The most common resistance patterns found in ESBL-producing E.coli isolates are AM/AMP/KZ/CTX/CRO/ATM/GM/CIP as much as 22.73%, and AM/AMP/KZ/CTX/CRO/ATM/GM/CIP/SXT patterns of 18.2%. The results of multi-class antibiotic resistance showed that 86.36% had multidrug resistance. The highest multidrug resistance pattern in ESBL-producing E.coli occurred with a BL/AG/Q/SP pattern of 50%. Other patterns of multidrug resistance in ESBL-producing E.coli that can be found in this study are, the BL/AG/Q/SP pattern is 18.20%, the BL/AG/Q/SP pattern is 13.64%, and the BL/AG/Q pattern is 4.55%. The high profile of resistance and the nature of multidrug resistance in ESBL-producing E.coli has the potential to spread these resistant genes, thus risking the use of antibiotics as a public health therapy and animal health, therefore further evaluation and control are needed.


2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Verna Biutifasari

<p>Antibiotika telah banyak digunakan sekarang ini. Pemakaian antibiotika yang berlebihan dan tidak sesuai dengan klinis dapat menyebabkan terjadinya resistensi terhadap antibiotika tersebut</p><p>Salah satu antibiotika yang dipakai adalah antibiotika golongan <em>beta-lactam</em> yang bekerja menghambat dinding sel. Pemakaian antibiotika <em>beta-lactam</em> yang tidak sesuai dapat menyebabkan terjadi resistensi terhadap antibiotika tersebut. Resistensi terhadap <em>beta-lactam</em> dapar terjadi di berbagai tingkatan. Salah satu resistensi dapat terjadi adalah  resistensi terhadap <em>extendedspectrum broad lactamase (ESBL)</em></p><p><em>Extended spectrum beta-lactamase</em> adalah enzim yang mempunyai kemampuan dalam menghidrolisis antibiotika golongan <em>penicillin, cephalosporin</em> generasi satu, dua, dan tiga serta golongan <em>monobactam </em>dan menyebabkan resistensi ke seluruh antibiotika tersebut.</p><p>ESBL banyak dihasilkan oleh <em>Enterobactericeae </em>(terutama <em>Escherichia coli</em>) dan <em>Klebsiella pneumoniae. </em><em>Enterobacteriacea</em><em>e</em> mempunyai 3 pola resistensi yang disebabkan b<em>road spectrum beta-lactamase,inhibitor </em>resistant beta-lactamase (derivat TEM) , <em>Cephalosporinase </em>yang berlebihan. ESBL dapat sulit terdeteksi karena ESBL mempunyai perbedaan tingkatan aktifitas terhadap bermacam-macam <em>cephalosporin</em></p><p>ESBL dapat dideteksi secara <em>clinical microbiology (phenotypic</em><em>)</em> dan <em>molecular detection (genotypic).</em></p><p><em> </em></p><p><strong>Keyword</strong><strong>s</strong><strong>:</strong> Antiobiotika, resistensi, ESBL</p>


Author(s):  
Shawnm Ahmed Aziz

Antibiotic resistance has become a major world health challenge and has limited the ability of physician's treatment. Staphylococcus aureus the most notorious pathogens causes morbidity and mortality especially in burn patients. However, Staphylococcus aureus rapidly acquired resistance to multiple antibiotics. Vancomycin, a glycopeptide antibiotic remains a drug of choice for treatment of severe Methicillin Resistance S. aureus infections. This study aimed to detect the emergence of beta-lactam and glycopeptide resistance genes. 50 clinical specimens of S. aureus collected from burn patients in burn and plastic surgery units in Sulaimani-Iraq city. All specimens were confirmed to be positive for S. aureus. All the isolates were assessed for their susceptibility to different antibiotics depending on NCCL standards, followed by Extended Spectrum Beta Lactamase detection by double disk diffusion synergy test. The production of β- lactamases was evaluated in the isolated strains by several routine methods and polymerase chain reaction. Among the isolates 94% were Methicillin resistance and 34.28% were Extended Spectrum Beta Lactamase producer. PCR based molecular technique was done for the bla genes related to β- lactamase enzymes by the specific primers, as well as genes which related to reduced sensitivity to Vancomycin were detected. The results indicated that all isolated showed the PBP1, PBP2, PBP3, PBP4, trfA and trfB, graSR, vraS except the vraR gene and the prolonged therapy of Methicillin resistance infection with teicoplanin have been associated with progress of resistance and the rise of tecoplanin resistance may be a prologue to evolving Vancomycin resistance. In conclusion, beta-lactam over taking can rise Vancomycin- Intermediate S. aureus strains leading to appearance of Vancomycin resistance although the treatment of Vancomycin resistant infections is challenging.


Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 406
Author(s):  
Zuhura I. Kimera ◽  
Fauster X. Mgaya ◽  
Gerald Misinzo ◽  
Stephen E. Mshana ◽  
Nyambura Moremi ◽  
...  

We determined the phenotypic profile of multidrug-resistant (MDR) Escherichia coli isolated from 698 samples (390 and 308 from poultry and domestic pigs, respectively). In total, 562 Enterobacteria were isolated. About 80.5% of the isolates were E. coli. Occurrence of E. coli was significantly higher among domestic pigs (73.1%) than in poultry (60.5%) (p = 0.000). In both poultry and domestic pigs, E. coli isolates were highly resistant to tetracycline (63.5%), nalidixic acid (53.7%), ampicillin (52.3%), and trimethoprim/sulfamethoxazole (50.9%). About 51.6%, 65.3%, and 53.7% of E. coli were MDR, extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), and quinolone-resistant, respectively. A total of 68% of the extended-spectrum beta lactamase (ESBL) producers were also resistant to quinolones. For all tested antibiotics, resistance was significantly higher in ESBL-producing and quinolone-resistant isolates than the non-ESBL producers and non-quinolone-resistant E. coli. Eight isolates were resistant to eight classes of antimicrobials. We compared phenotypic with genotypic results of 20 MDR E. coli isolates, ESBL producers, and quinolone-resistant strains and found 80% harbored blaCTX-M, 15% aac(6)-lb-cr, 10% qnrB, and 5% qepA. None harbored TEM, SHV, qnrA, qnrS, qnrC, or qnrD. The observed pattern and level of resistance render this portfolio of antibiotics ineffective for their intended use.


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