scholarly journals Incidence and Antimicrobial Susceptibility of Escherichia coli and Klebsiella pneumoniae with Extended-Spectrum β-Lactamases in Community- and Hospital-Associated Intra-Abdominal Infections in Europe: Results of the 2008 Study for Monitoring Antimicrobial Resistance Trends (SMART)

2010 ◽  
Vol 54 (7) ◽  
pp. 3043-3046 ◽  
Author(s):  
Stephen P. Hawser ◽  
Samuel K. Bouchillon ◽  
Daryl J. Hoban ◽  
Robert E. Badal ◽  
Rafael Cantón ◽  
...  

ABSTRACT From 2002 to 2008, there was a significant increase in extended-spectrum beta-lactamase (ESBL)-positive Escherichia coli isolates in European intra-abdominal infections, from 4.3% in 2002 to 11.8% in 2008 (P < 0.001), but not for ESBL-positive Klebsiella pneumoniae isolates (16.4% to 17.9% [P > 0.05]). Hospital-associated isolates were more common than community-associated isolates, at 14.0% versus 6.5%, respectively, for E. coli (P < 0.001) and 20.9% versus 5.3%, respectively, for K. pneumoniae (P < 0.01). Carbapenems were consistently the most active drugs tested.

2021 ◽  
Vol 6 (2) ◽  
pp. 105
Author(s):  
Regina Ama Banu ◽  
Jorge Matheu Alvarez ◽  
Anthony J. Reid ◽  
Wendemagegn Enbiale ◽  
Appiah-Korang Labi ◽  
...  

Infections by Extended-Spectrum Beta-Lactamase producing Escherichia coli (ESBL-Ec) are on the increase in Ghana, but the level of environmental contamination with this organism, which may contribute to growing Antimicrobial Resistance (AMR), is unknown. Using the WHO OneHealth Tricycle Protocol, we investigated the contamination of E. coli (Ec) and ESBL-Ec in two rivers in Ghana (Odaw in Accra and Okurudu in Kasoa) that receive effluents from human and animal wastewater hotspots over a 12-month period. Concentrations of Ec, ESBL-Ec and percent ESBL-Ec/Ec were determined per 100 mL sample. Of 96 samples, 94 (98%) were positive for ESBL-Ec. concentrations per 100 mL (MCs100) of ESBL-Ec and %ESBL-Ec from both rivers were 4.2 × 104 (IQR, 3.1 × 103–2.3 × 105) and 2.79 (IQR, 0.96–6.03), respectively. MCs100 were significantly lower in upstream waters: 1.8 × 104 (IQR, 9.0 × 103–3.9 × 104) as compared to downstream waters: 1.9 × 106 (IQR, 3.7 × 105–5.4 × 106). Both human and animal wastewater effluents contributed to the increased contamination downstream. This study revealed high levels of ESBL-Ec in rivers flowing through two cities in Ghana. There is a need to manage the sources of contamination as they may contribute to the acquisition and spread of ESBL-Ec in humans and animals, thereby contributing to AMR.


2017 ◽  
Vol 5 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Ujjwal Rimal ◽  
Shovana Thapa ◽  
Roshani Maharjan

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


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Sahar Besharati Zadeh ◽  
Pegah Shakib ◽  
Mohammad Reza Zolfaghari ◽  
Ahmad Farajzadeh Sheikh

Background: A major problem in the treatment of the infectious diseases healthcare centers is extended-spectrum beta-lactamase (ESBL)-producing bacteria. Objectives: The aim of present study was to identify the antibiotic sensitivity pattern and prevalence of the blaCTX, blaTEM, and blaSHV genes in Escherichia coli and Klebsiella pneumoniae strains. Methods: In this study, E. coli and K. pneumoniae specimens were collected in Shushtar hospitals, Khuzestan (southwest Iran), from March to October 2015. Sensitivity antibiotic pattern performed by disc diffusion method. Double disc synergy test (DDST) done for identifying ESBLs isolates and PCR for blaTEM, blaSHV, and blaCTX-M genes. Results: One hundred E. coli and 30 K. pneumoniae isolates were collected from different specimens. The highest rates of antibiotic resistance related to cefotaxime and aztreonam in E. coli and K. pneumoniae. ESBL-harboring K. pneumoniae and E. coli were 13.5 and 28%, respectively. Overall, bla TEM was the most prevalent ESBL gene. Conclusions: In this study, the rate of antibiotic resistance was high, and due to the carrying of coding genes on mobile genetic elements and the ability of these elements to carry genes that create resistance to other antibiotic families, identification and isolation of these isolates are essential to find effective antibiotics and eliminate the infection.


1970 ◽  
Vol 4 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Iraj Alipourfard ◽  
Nilufar Yeasmin Nili

Extended spectrum beta-lactmase (ESBL) producing organisms create a major problem for clinical therapeutics. The frequency of ESBL producing strains among clinical isolates has been steadily increasing over the past few years resulting in limitation of the therapeutic options. These resistant bacteria are emerging world wide as a threat to human health in both the community and hospital settings. -lactamase production by several organisms is the most important mechanism of resistance to beta-lactam antibiotics, such as penicillins and cephalosporins. This study was done to determine the susceptibility of different antimicrobials to ESBL producing Escherichia coli and Klebsiella pneumoniae isolated from wound swabs, blood, urine, fluid, tracheal aspirates and sputum in Shahid Bahonar Hospital of Tehran from July, 2007 to June, 2008. A total of 115 ESBLproducing isolates were obtained from outdoor and indoor patients. Out of 115 isolates, 60% were E. coli and 40% were K. pneumoniae. All ESBL-producing isolates were confirmed using the Clinical and Laboratory Standards Institute (CLSI)-approved double-disk diffusion method. 29.6% of these isolates were collected from medical wards and 24.3% were collected from outdoor. Urine (70.4%) was the main source of ESBL-producing isolates from all patients, followed by blood (16.5%). All isolates were susceptible to both imipenem and meropenem. Of all isolates, 93.9% were susceptible to amikacin. The cephalosporins (1-4 generations) were almost 100% resistant. For Nitrofurantoin, 57.4% were sensitive. High rate resistance (74.8%) was observed to all quinolones tested. Aztreonam, Ampicillin, Co-amoxyclav and Ampicillin/Sulbactam were 100% resistant. This study shows that the frequency of ESBL producing strains of E. coli and K. pneumoniae is high in both hospital and community levels and it has a significant implication for patients’ management. Advance drug resistance surveillance and molecular characteristics of ESBL isolates is necessary to guide the appropriate and judicious antibiotic use. Key words: Extended spectrum beta-lactamase (ESBL), Drug sensitivity, Escherichia coli, Klebseilla pneumoniae DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8467 BJMM 2011; 4(1): 32-36  


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nuru Letara ◽  
James Samwel Ngocho ◽  
Nahid Karami ◽  
Sia E. Msuya ◽  
Balthazar Nyombi ◽  
...  

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.


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

Aims: This study investigated the antimicrobial resistance profile and extended spectrum beta-lactamase resistance genes of Escherichia coli isolated from droppings of from selected poultry farms in Nasarawa, Nigeria. Study Design: Investigative Place and Duration of Study: Department of Microbiology, Nasarawa State University, Keffi, between November 2019 and February 2020. Methodology: A total of 90 samples from poultry droppings were collected from selected farms. 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 extended-spectrum beta-lactamase (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: The prevalence of E. coli was 100%. Antibiotic resistances of E. coli were recorded as follows: streptomycin (S: 94.4%), sulphamethoxazole / trimethoprim (SXT: 90.0%), ampicillin (AMP: 88.9%), gentamicin (CN: 68.9%), amoxicillin/clavulanic acid (AMC: 55.6%), ciprofloxacin (CIP: 41.1%), cefoxitin (FOX: 35.6%), ceftazidime (CAZ: 34.4%), cefotaxime (CTX: 22.2%), and imipenems (IPM: 17.8%). The most common antibiotic resistant resistance phenotype was AMP-CTX-CAZ-CIP-CN (11.1%). Multiple antibiotic resistance (MAR) was observed in 97.7% (88/90) of the isolates, with the common MAR index being 0.5 (33.3%). Twenty five of the thirty beta-lactam resistant isolates (83.3%) were confirmed ESBL producers. The 25 ESBL positive isolates carried bla genes as follows: blaTEM (11/25, 44.0%) and blaCTX-M (18/25, 72.0%). blaSHV was not found in any isolate. Conclusion: E. coli isolated from the droppings of selected poultry farms in Nasarawa were less resistant to imipenem, cefotaxime, ceftazidime and cefoxitin in the study location. This implies that the antibiotics are useful in the treatment of infection caused by E. coli. Also, ESBL-positive E. coli isolates harbored ESBL genes, with blaCTX-M as the most common.


2021 ◽  
Vol 12 ◽  
Author(s):  
Gopalan Krishnan Sivaraman ◽  
Vineeth Rajan ◽  
Ardhra Vijayan ◽  
Ravikrishnan Elangovan ◽  
Alison Prendiville ◽  
...  

This study was undertaken to evaluate the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae in selected shrimp aquaculture farms (n = 37) in Kerala, South India and to characterize the isolates using molecular tools. Overall, a low prevalence of ESBL-producers was found in the farms, most likely due to the reduced antibiotic usage in the shrimp farming sector. Out of the 261 samples (77 shrimp and 92 each of water and sediment), 14 (5.4%) tested positive for ESBL-E. coli or ESBL-K. pneumoniae. A total of 32 ESBL-E. coli and 15 ESBL- K. pneumoniae were recovered from these samples. All ESBL isolates were cefotaxime-resistant with minimal inhibitory concentration (MIC) ≥32 μg/ml. Of all isolates, 9 (28.1%) E. coli and 13 (86.7%) K. pneumoniae showed simultaneous resistance to tetracycline, ciprofloxacin, and trimethoprim-sulfamethoxazole. PCR analysis identified CTX-M group 1 (blaCTX–M–15) as the predominant ESBL genotype in both E. coli (23, 71.9%) and K. pneumoniae (15, 100%). Other beta-lactamase genes detected were as follows: blaTEM and blaSHV (11 K. pneumoniae), blaCTX–M group 9 (9 E. coli), and blaCMY–2 (2 E. coli). Further screening for AMR genes identified tetA and tetB (13, 40.6%), sul1 (11, 34.4%), sul2 (9, 28.1%), catA and cmlA (11, 34.4%), qepA and aac(6′)-Ib-cr (9, 28.1%) and strAB and aadA1 (2, 6.3%) in E. coli, and qnrB (13, 86.7%), qnrS (3, 20%), oqxB (13, 86.7%), tetA (13, 86.7%), and sul2 (13, 86.7%) in K. pneumoniae isolates. Phylogenetic groups identified among E. coli isolates included B1 (4, 12.5%), B2 (6, 18.8%), C (10, 31.3%), D (3, 9.4%), and E (9, 28.1%). PCR-based replicon typing (PBRT) showed the predominance of IncFIA and IncFIB plasmids in E. coli; however, in K. pneumoniae, the major replicon type detected was IncHI1. Invariably, all isolates of K. pneumoniae harbored virulence-associated genes viz., iutA, entB, and mrkD. Epidemiological typing by pulsed-field gel electrophoresis (PFGE) revealed that E. coli isolates recovered from different farms were genetically unrelated, whereas isolates of K. pneumoniae showed considerable genetic relatedness. In conclusion, our findings provide evidence that shrimp aquaculture environments can act as reservoirs of multi-drug resistant E. coli and K. pneumoniae.


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