Molecular Survey of β-Lactamases Conferring Resistance to Newer β-Lactams in Enterobacteriaceae Isolates from Polish Hospitals

ABSTRACT The first national survey of resistance to newer β-lactams in nosocomial populations of Enterobacteriaceae in Poland was performed. The study covered all nonrepetitive enterobacterial isolates cultured from specimens from inpatients in 13 regional secondary-care hospitals from November 2003 to January 2004. Among 2,388 isolates, the predominant species was Escherichia coli (59.6%), followed by Proteus mirabilis (14.5%) and Klebsiella spp. (8.5%). The frequency of extended-spectrum β-lactamases (ESBLs) was very high, with ESBLs present in 11.1% of all isolates and 40.4% of Klebsiella pneumoniae isolates, the latter value greatly exceeding that for E. coli (2.5%). The contribution of outbreak isolates was significant, resulting, for example, in a particularly high rate of ESBL producers among Serratia marcescens isolates (70.8%). The pool of ESBL types was overwhelmingly dominated (81.7%) by CTX-M-like β-lactamases CTX-M-3 (80.6%) and CTX-M-15, with SHV types (17.5%; SHV-2, SHV-5, and SHV-12) and sporadic TEM-like enzymes (0.7%; TEM-19 and TEM-48) being the next most frequent. Acquired AmpC-type cephalosporinases were observed exclusively in P. mirabilis, in 20.5% of the isolates of this species (compared with the frequency of ESBL producers of 11.5% of P. mirabilis isolates). All these cephalosporinases (CMY-12, CMY-15, and a novel variant, CMY-38) originated from Citrobacter freundii. Four isolates of E. coli (two isolates), K. pneumoniae (one isolate), and P. mirabilis (one isolate) produced class A inhibitor-resistant β-lactamases (TEM-30, TEM-32, TEM-37, and SHV-49), being the first of such producers identified in Poland. The survey documented both specific and more global characteristics of the epidemiology of the β-lactamase-mediated resistance in enterobacteria from Polish hospitals and demonstrated that the ESBL frequency has reached an alarming level.

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Multiple-Antibiotic Resistance Mediated by Plasmids and Integrons in Uropathogenic Escherichia coli and Klebsiella pneumoniae

Bangladesh Journal of Microbiology ◽

10.3329/bjm.v24i1.1231 ◽

1970 ◽

Vol 24 (1) ◽

pp. 19-23 ◽

Cited By ~ 7

Author(s):

Taslima Taher Lina ◽

Sabita Rezwana Rahman ◽

Donald James Gomes

Keyword(s):

Escherichia Coli ◽

Drug Resistance ◽

Urinary Tract Infection ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Tract Infection ◽

Klebsiella Pneumoniae ◽

High Rate ◽

E Coli ◽

Class 1

Antibiotic resistance in urinary tract infection (UTI) is a growing public health problem in the world. In this study, a total of 182 uropathogens were isolated from patients with symptoms of urinary tract infection (UTI). Escherichia coli (88%) was the most prevalent isolate, while Klebsiella pneumoniae was recovered from 12% cases. The male/female ratio was 1:3. About 56% female and 51% male patients belonged to the age group >40 years. The antibiotic resistance rates of the isolates to fifteen different drugs were investigated. E. coli and K. pneumoniae showed variable pattern of susceptibility. The percentage of resistance to different drugs was higher in E. coli isolates compared to that of K. pneumoniae. Among the total number of isolates about 87% were resistant to at least three commonly used antibiotics. All the isolates were sensitive to imipenem. Analysis of the plasmid DNA had shown that the plasmid pattern was very diverse in both E. coli and K. pneumoniae. All the isolates contained multiple numbers of plasmid ranging from 1.0 to >140 MDa. Middleranged plasmids (30 to 80 MDa), the transferable resistance plasmids, were found to be present in 86% E. coli and 85% K. pneumoniae isolates. The strong association observed between plasmid profiles and drug resistance patterns suggest that plasmids other than the common plasmids may have epidemiological significance. The presence of class 1 and class 2 integrons were also investigated. A relatively high occurrence of class 1 integrons, that are associated with lateral transfer of antibacterial resistance genes, was observed in K. pneumoniae (88%) than in E. coli isolates (54%). Class 2 integrons were not found in any of the E. coli and K. pneumoniae isolates. These results show the high rate of drug resistance and the presence of high rate of transferable elements in these MDR isolates. Keywords: Uropathogens, Escherichia coli, Klebsiella pneumoniae, Multidrug-resistant (MDR) bacteria, Plasmid profiles, IntegronsDOI: http://dx.doi.org/10.3329/bjm.v24i1.1231 Bangladesh J Microbiol, Volume 24, Number 1, June 2007, pp 19-23

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Microbial and Parasitic Contamination of Fresh Raw Vegetable Samples and Detection of the BlaTEM and BlaCTX-M Genes from E. coli Isolates

Agriculture ◽

10.3390/agriculture10080341 ◽

2020 ◽

Vol 10 (8) ◽

pp. 341

Author(s):

Alina Ghimire ◽

Jitendra Upadhyaya ◽

Tulsi Nayaju ◽

Binod Lekhak ◽

Dhiraj Kumar Chaudhary ◽

...

Keyword(s):

Escherichia Coli ◽

High Rate ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Vegetable Samples ◽

Vegetable Sample ◽

Amoxicillin Clavulanate ◽

Polymerase Chain ◽

Esbl Producers

A total of 100 fresh-raw vegetable samples were collected from the Kathmandu, Lalitpur and Bhaktapur districts of Nepal to evaluate microbial and parasitic contamination, presence of Extended Spectrum Beta Lactamase (ESBL)-producing Escherichia coli and detect the blaTEM and blaCTX-M genes among the Escherichia coli isolates. This study revealed that the prevalence of Giardia cysts was highest (100%) and Hookworm and Entamoeba coli were lowest (1% each). Coliforms were isolated from every raw vegetable sample. A total of 178 bacterial isolates were isolated among which 57 isolates were identified as E. coli, out of which 33 were Multi-drug resistant (MDR) isolates. The high rate of resistance was found towards amoxicillin/clavulanate, tetracycline and cotrimoxazole. The 10 E. coli isolates tested positive in an ESBL screening, out of which 4 were confirmed as ESBL producers by a combined disc test. Out of these 4 confirmed ESBL E. coli, one was found to carry both the blaTEM gene and blaCTX-M genes by the Polymerase Chain Reaction (PCR) technique. One isolate has only the blaTEM gene, while other isolate harboured only blaCTX-M genes.

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Prevalence of Extended Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella species from Urinary Specimens of Children attending Friendship International Children’s Hospital

Nepal Journal of Biotechnology ◽

10.3126/njb.v5i1.18868 ◽

2017 ◽

Vol 5 (1) ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Ujjwal Rimal ◽

Shovana Thapa ◽

Roshani Maharjan

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Beta Lactamase ◽

Disc Diffusion ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Significant Bacteriuria ◽

Klebsiella Spp ◽

Esbl Producers

Extended-spectrum β-lactamase producing E. coli and K. pneumoniae is a serious threat to the patients. These organisms are major extended spectrum beta lactamase (ESBL) producers. The objective of this study was to determine the prevalence of Extended spectrum β- lactamase producing strains of Escherichia coli and Klebsiella spp isolates from the urine sample of children visiting International Friendship Children Hospital. During the seven months, between June 2016 to December 2016, 1018 mid-stream urine samples(MSU) were collected from patients suspected of having UTI. The samples were investigated by conventional semi-quantitative culture technique and identification of E. coli and Klebsiella spp. was done by microscopy and biochemical test. Antibiotic susceptibility test of isolates was performed by modified Kirby Bauer Disc diffusion test. ESBL screening test was done by using 3rd generation Cephalosporin and confirmation done by combination disc diffusion method. Out of total 1018 MSU samples investigated, 200(19.64%) isolates of E. coli and 28(2.7%) isolates of Klebsiella spp. making a total of 228(22.39%) were found to cause significant bacteriuria. 76(33.33%) isolates, from those causing significant bacteriuria, were Multi-drug resistant organisms. Out of 228 isolates, 54(23.68%) were ESBL producers, that includes 51(25.5%) Escherichia coli and 3(12.5%) Klebsiella pneumoniae. ESBL producers were more common in in-patient (36.17%) than out-patient (20.44%). Most of the ESBL producers were resistance to amoxicillin, followed by Cotrimoxazole and Ciprofloxacin respectively. They were highly sensitive to Imipenem, Tigecycline, Amikacin, Piperacillin-Tazobactam, and Nitrofurantoin. High prevalence of ESBL producing E. coli and Klebsiella pneumoniae was found among children. Regular and routine monitoring of ESBL producing isolates is essential.Nepal Journal of Biotechnology. Dec. 2017 Vol. 5, No. 1: 32-38

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In Vitro Efficacy of Flomoxef against Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Associated with Urinary Tract Infections in Malaysia

Antibiotics ◽

10.3390/antibiotics10020181 ◽

2021 ◽

Vol 10 (2) ◽

pp. 181

Author(s):

Soo Tein Ngoi ◽

Cindy Shuan Ju Teh ◽

Chun Wie Chong ◽

Kartini Abdul Jabar ◽

Shiang Chiet Tan ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

In Vitro Susceptibility ◽

E Coli ◽

Extended Spectrum ◽

Tract Infections ◽

Esbl Producers

The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has greatly affected the clinical efficacy of β-lactam antibiotics in the management of urinary tract infections (UTIs). The limited treatment options have resulted in the increased use of carbapenem. However, flomoxef could be a potential carbapenem-sparing strategy for UTIs caused by ESBL-producers. Here, we compared the in vitro susceptibility of UTI-associated ESBL-producers to flomoxef and established β-lactam antibiotics. Fifty Escherichia coli and Klebsiella pneumoniae strains isolated from urine samples were subjected to broth microdilution assay, and the presence of ESBL genes was detected by polymerase chain reactions. High rates of resistance to amoxicillin-clavulanate (76–80%), ticarcillin-clavulanate (58–76%), and piperacillin-tazobactam (48–50%) were observed, indicated by high minimum inhibitory concentration (MIC) values (32 µg/mL to 128 µg/mL) for both species. The ESBL genes blaCTX-M and blaTEM were detected in both E. coli (58% and 54%, respectively) and K. pneumoniae (88% and 74%, respectively), whereas blaSHV was found only in K. pneumoniae (94%). Carbapenems remained as the most effective antibiotics against ESBL-producing E. coli and K. pneumoniae associated with UTIs, followed by flomoxef and cephamycins. In conclusion, flomoxef may be a potential alternative to carbapenem for UTIs caused by ESBL-producers in Malaysia.

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Risk factors for and mortality of extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652009000400006 ◽

2009 ◽

Vol 51 (4) ◽

pp. 211-216 ◽

Cited By ~ 16

Author(s):

Silvana Vargas Superti ◽

Gustavo Augusti ◽

Alexandre Prehn Zavascki

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Risk Factor ◽

Klebsiella Pneumoniae ◽

Bloodstream Infections ◽

Blood Cultures ◽

Esbl Production ◽

E Coli ◽

Extended Spectrum ◽

Esbl Producers

A case-control study, involving patients with positive blood cultures for Klebsiella pneumoniae (KP) or Escherichia coli (EC) EC and controls with positive blood cultures for non-ESBL-KP or EC, was performed to assess risk factors for extended-spectrum-β-lactamase (ESBL) production from nosocomial bloodstream infections (BSIs). Mortality among patients with BSIs was also assessed. The study included 145 patients (81, 59.5% with K. pneumoniae and 64, 44.1% with E. coli BSI); 51 (35.2%) isolates were ESBL producers and 94 (64.8%) nonproducers. Forty-five (55.6%) K. pneumoniae isolates were ESBL producers, while only six (9.4%) E. coli isolates produced the enzyme. Multivariate analysis showed that recent exposure to piperacillin-tazobactam (adjusted Odds Ratio [aOR] 6.2; 95%CI 1.1-34.7) was a risk factor for ESBL BSI. K. pneumoniae was significantly more likely to be an ESBL-producing isolate than E. coli (aOR 6.7; 95%CI 2.3-20.2). No cephalosporin class was independently associated with ESBLs BSI; however, in a secondary model considering all oxymino-cephalosporins as a single variable, a significant association was demonstrated (aOR 3.7; 95%CI 1.3-10.8). Overall 60-day mortality was significantly higher among ESBL-producing organisms. The finding that piperacillin-tazobactam use is a risk factor for ESBL-production in KP or EC BSIs requires attention, since this drug can be recommended to limit the use of third-generation cephalosporins.

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Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania

Scientific Reports ◽

10.1038/s41598-021-02186-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nuru Letara ◽

James Samwel Ngocho ◽

Nahid Karami ◽

Sia E. Msuya ◽

Balthazar Nyombi ◽

...

Keyword(s):

Escherichia Coli ◽

Health Care ◽

Klebsiella Pneumoniae ◽

Pediatric Patients ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Factors Associated ◽

Extended Spectrum ◽

Very High

AbstractExtended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (EPE) is increasing worldwide, though less documented in low-income settings. Here we determined the prevalence of EPE infection and carriage, and patient factors associated with EPE-carriage among pediatric patients in three health care levels in Tanzania. Between January and April 2016, 350 febrile children (median age 21 months) seeking care at a university or a regional referral hospital, or a health centre in Moshi municipality, Tanzania, were included. Socio-demographic characteristics were collected using a questionnaire. Rectal swabs and blood cultures were collected from all children (n = 350) and urinary samples from 259 children at admission. ESBL-phenotype and antimicrobial susceptibility were determined for Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) isolates. Only one EPE case (E. coli) in blood and four in urine (one E. coli and three K. pneumoniae) were found, whereas (n = 90, 26%) of the children were colonized in feces (ESBL-E. coli; n = 76, ESBL-K. pneumoniae, n = 14). High resistance rates were seen in fecal ESBL-E. coli (n = 76) against trimethoprim-sulfamethoxazole (n = 69, 91%), gentamicin (n = 51, 67%), ciprofloxacin (n = 39, 51%) and chloramphenicol (n = 27, 35%) whereas most isolates were sensitive to amikacin (n = 71, 93%). Similar rates were seen for fecal ESBL-K. pneumoniae. Resistance to first line antibiotics were also very high in fecal E. coli not producing ESBL. No sociodemographic factor was associated with EPE-carriage. Children colonized with EPE were younger than 12 months (n = 43, 48%) and often treated with antibiotics (n = 40, 44%) in the previous two months. After adjustment for age children admitted to the intensive care unit had higher odds of EPE fecal carriage compared with those in the general wards (OR = 3.9, 95%CI = 1.4–10.4). Despite comparatively high rates of fecal EPE-carriage and previous antibiotic treatment, clinical EPE cases were rare in the febrile children. The very high resistant rates for the EPE and the non-ESBL producing E. coli to commonly used antibiotics are worrying and demand implementation of antibiotic stewardship programs in all levels of health care in Tanzania.

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Metallo-β-lactamase and AmpC genes in Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa isolates from abattoir and poultry origin in Nigeria

BMC Microbiology ◽

10.1186/s12866-021-02179-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chika Ejikeugwu ◽

Okoro Nworie ◽

Morteza Saki ◽

Hussein O. M. Al-Dahmoshi ◽

Noor S. K. Al-Khafaji ◽

...

Keyword(s):

Escherichia Coli ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Resistance Genes ◽

High Rate ◽

E Coli ◽

Regular Control ◽

Poultry Birds ◽

Synergy Test ◽

Undue Advantage

Abstract Background Gram-negative bacteria (GNB) including Escherichia coli, Pseudomonas aeruginosa, and Klebsiella pneumoniae represent the most relevant reservoir of resistance genes such as metallo-β-lactamase (MBL) and AmpC genes that give them the undue advantage to resist antimicrobial onslaught. This study aimed to investigate the occurrence of MBL (blaIMP-1, blaIMP-2, blaVIM-1, blaVIM-2) and AmpC (blaFOX, blaDHA, blaCMY, blaACC) resistance genes in aforementioned GNB collected from abattoir and poultry sources in Nigeria. Results In total, 370 isolates were collected from abattoir tables (n = 130), anal region of cows (n = 120), and the cloacae of poultry birds (n = 120). The test isolates showed high rate of resistance to cephalosporins and carbapenems. The MBLs were phenotypically detected in 22 E. coli, 22 P. aeruginosa, and 18 K. pneumoniae isolates using combined disc test (CDT). However, only 11 E. coli, 24 P. aeruginosa, and 18 Klebsiella pneumoniae isolates were phenotypically confirmed to be AmpC producers using cefoxitin-cloxacillin double disk synergy test (CC-DDST). MBL encoding genes (particularly the blaIMP-1 genes and blaIMP-2 genes) were detected by polymerase chain reaction (PCR) in 12 (54.6%) E. coli, 15 (83.3%) K. pneumoniae, and 16 (72.7%) P. aeruginosa isolates. AmpC genes (particularly the blaCMY genes and blaFOX genes) were found in a total of 5 (29.4%) E. coli isolates, 5 (27.8%) isolates of K. pneumoniae, and 10 (41.7%) isolates of P. aeruginosa. Conclusions Our study showed the circulation of MBL and AmpC genes in GNB from abattoir and poultry origin in Nigeria. Adoption of regular control policies is necessary to reduce the spread of these species as soon as possible, especially in poultry and slaughterhouses.

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Prevalence and Antibiogram of Microbial Agents Causing Nosocomial Urinary Tract Infection in Surgical Ward of Dhaka Medical College Hospital

Journal of Enam Medical College ◽

10.3329/jemc.v6i2.27761 ◽

2016 ◽

Vol 6 (2) ◽

pp. 75-79

Author(s):

Tashmin Afroz Binte Islam ◽

SM Shamsuzzaman ◽

Naznin Nehar ◽

Jannatul Fardows

Keyword(s):

Escherichia Coli ◽

Pseudomonas Aeruginosa ◽

Klebsiella Pneumoniae ◽

Nosocomial Infections ◽

Medical College Hospital ◽

High Rate ◽

Structural Constraints ◽

College Hospital ◽

Medical College ◽

Esbl Producers

Background: Nosocomial infections pose substantial risk to patients receiving care in hospitals. In Bangladesh, this problem is aggravated by inadequate infection control due to poor hygiene, resource and structural constraints and lack of awareness regarding nosocomial infections.Objective: We carried out this study to determine the prevalence of different microorganisms from urine in surgery ward and antimicrobial susceptibility pattern against various antibiotics.Materials and Methods: This cross sectional study was carried out in Department of Microbiology, Dhaka Medical College, Dhaka over a period of 12 months from July 2011 to June 2012. A total of 52 urine specimens were collected from catheterized patients admitted in general surgery ward of Dhaka Medical College Hospital (DMCH) and incubated in blood agar, MacConkey agar media and the isolates were identified by different biochemical tests oxidase test and reaction in MIU (motility indole urease) and Simmons citrate and TSI (triple sugar iron) media. ESBL producers were detected by double-disk synergy test (DDST).Results: Bacteria were isolated from 35 specimens and Escherichia coli was the commonest isolate (23, 65.71%) followed by Pseudomonas aeruginosa 6 (17.14%), Klebsiella pneumoniae 3 (8.57%), Acinetobacter baumannii 2 (5.72%) and Proteus vulgaris 1 (2.86%) respectively. Among the isolates, 10 (28.57%) ESBL producers were detected and the highest ESBL production was observed in Escherichia coli (8, 22.85%) followed by Klebsiella pneumoniae 1 (2.86%) and Pseudomonas aeruginosa 1 (2.86%). The isolates were resistant to most of the commonly used antimicrobial agents.Conclusion: The emergence of multi-drug resistant (MDR) bacteria poses a difficult task for physicians who have limited therapeutic options. However, the high rate of nosocomial infections and multi-resistant pathogens necessitate urgent comprehensive interventions of infection control.J Enam Med Col 2016; 6(2): 75-79

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Activity of NXL104 in Combination with β-Lactams against Genetically Characterized Escherichia coli and Klebsiella pneumoniae Isolates Producing Class A Extended-Spectrum β-Lactamases and Class C β-Lactamases

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01722-10 ◽

2011 ◽

Vol 55 (5) ◽

pp. 2434-2437 ◽

Cited By ~ 65

Author(s):

P. R. S. Lagacé-Wiens ◽

F. Tailor ◽

P. Simner ◽

M. DeCorby ◽

J. A. Karlowsky ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

The Novel ◽

Content Type ◽

E Coli ◽

Class A ◽

Extended Spectrum ◽

Class C ◽

Lactamase Inhibitor

ABSTRACTThe novel non-β-lactam β-lactamase inhibitor NXL104, in combination with cefepime, ceftazidime, ceftriaxone, amdinocillin, and meropenem, was tested against 190 extended-spectrum β-lactamase (ESBL)-producingEscherichia coliandKlebsiella pneumoniaeisolates, 94 AmpC-hyperproducingE. coliisolates, and 8 AmpC/ESBL-coexpressingE. coliisolates. NXL104 restored 100% susceptibility to the partner cephalosporins for all isolates tested. Amdinocillin and meropenem MICs were modestly improved (2 to 32 times lower) by NXL104. These results suggest that NXL104 may be useful in combination with β-lactams for the treatment of infections caused by ESBL- and AmpC-producingEnterobacteriaceae.

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Genetic Features ofblaNDM-1-Positive Enterobacteriaceae

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00585-11 ◽

2011 ◽

Vol 55 (11) ◽

pp. 5403-5407 ◽

Cited By ~ 242

Author(s):

Laurent Poirel ◽

Laurent Dortet ◽

Sandrine Bernabeu ◽

Patrice Nordmann

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Clonal Diversity ◽

Citrobacter Freundii ◽

Content Type ◽

E Coli ◽

Resistance Determinants ◽

16S Rna ◽

Genetic Features ◽

Providencia Stuartii

ABSTRACTGenetic features associated with theblaNDM-1gene were investigated in 6Escherichia coli, 7Klebsiella pneumoniae, 1Citrobacter freundii, 1Proteus mirabilis, and 1Providencia stuartiiisolate of worldwide origin. Clonal diversity was observed for bothE. coliandK. pneumoniae. TheblaNDM-1gene was carried by different plasmid types (IncA/C, IncF, IncL/M, or untypeable) and was likely chromosome borne in two isolates. TheblaNDM-1plasmids coharbored a variety of resistance determinants, including β-lactamase genes, quinolone resistance genes, and 16S RNA methylase genes.

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