scholarly journals Colistin Resistance among Enterobacteriaceae Isolated from Clinical Samples in Gaza Strip

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Mohammad Qadi ◽  
Safaa Alhato ◽  
Rasha Khayyat ◽  
Abdelraouf A. Elmanama
Keyword(s):  
Bacterial Infections ◽  
Respiratory Infections ◽  
Gaza Strip ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Colistin Resistance ◽  
Disk Diffusion Method ◽  
Global Health Issue

Bacterial infections, especially drug-resistant infections, are a major global health issue. The emergence of multidrug-resistant (MDR) strains of Enterobacteriaceae and the lack of new antibiotics have worrisome prospects for all of humanity. Colistin is considered the last-line drug for MDR Gram-negative bacteria (GNB), and it is often used for treatment of respiratory infections caused by MDR-GNB. In recent years, there has been a marked increase in the incidence of colistin-resistant infections. The main objective of this study was to investigate the presence of colistin resistance among clinical GNB isolated from Gaza Strip hospitals. Clinical Enterobacteriaceae isolates (100) were obtained from microbiology laboratories of the hospitals of different geographical locations in Gaza Strip Governorate over a period of six months. Samples were cultured, and bacterial identification was performed by standard microbiological procedures. Enterobacteriaceae isolates were tested for their antimicrobial susceptibility by the disk diffusion method and the MIC method for colistin. Varying degrees of susceptibility were observed for the isolates against the tested antimicrobials even within members of the same antimicrobial class. Amikacin was the most effective drug (74%), followed by chloramphenicol (48%), fosfomycin, and gentamicin (45%). High resistance was recorded against trimethoprim (85%) and tetracycline (83%). Only 59% of the tested isolates were interpreted as susceptible, while 41% was classified as resistant. The highest resistance to colistin was found to be among the Proteus spp. (63.2%), followed by Serratia spp. (57.1%). The lowest resistance was observed among Klebsiella isolates (31.6%). Only 39.0% of meropenem-resistant Enterobacteriaceae was susceptible to colistin, while 45.8% of imipenem-resistant Enterobacteriaceae was susceptible to colistin. The overall resistance to colistin was high (41%) among tested clinical isolates. Furthermore, 89% was MDR. These limit and complicate treatment options for the infections caused by Enterobacteriaceae in Gaza Strip. This calls for immediate actions to control and monitor the use of antimicrobials in general and colistin in particular.

scholarly journals Antimicrobial Resistance Pattern of Extensively Drug Resistant Carbapenemase Producing Enterobacteriaceae

2019 ◽  
Vol 13 (2) ◽  
pp. 7-10
Author(s):  
Fatima Afroz ◽  
Shaheda Anwar ◽  
Mashrura Quraishi ◽  
GM Mohiuddin ◽  
SM Ali Ahmed ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Disk Diffusion Method ◽  
Cross Sectional ◽  
Extensively Drug Resistant ◽  
Broth Microdilution Method

Carbapenems, often agents of last resort for multidrug resistant bacterial infections are now threatened by widespread dissemination of carbapenem-resistant Enterobacteriaceae (CRE). Production of carbapenemases remain the most clinically important mechanism of carbapenem resistance in Enterobacteriaceae. The objective of this study was to determine the antibiogram pattern of carbapenemase producing Enterobacteriaceae. A cross sectional study was conducted at department of Microbiology and Immunology, BSMMU from September 2018 to August 2019. A total of 145 CRE isolates from different clinical samples were studied.Antimicrobial susceptibility was examinedby disk diffusion method and MIC of colistin by broth microdilution method. Resistant carbapenemase genes NDM and OXA-48 were identified by polymerase chain reaction. Out of 145 CRE isolates, 104 were NDM, 73 were OXA-48and 34 isolates were both NDM and OXA-48 co-producers. All the NDM and OXA-48 carbapenemase producing isolates were 100% resistant to meropenem, imipenem, ertapenem, ceftriaxone, ceftazidime, cefotaxime, cefuroxime, amoxicillin + clavulanic acid and piperacillin + tazobactam. Resistance rates of reserved antimicrobials to treat CRE isolates were also alarming. Thirty seven percent, 9.6% and 5.5 % of OXA-48 carbapenemase producers and 26.0%, 10.6% and 2.9% of NDM carbapenemase producers were resistant to colistin, polymyxin B and tigecycline respectively.Among the carbapenemase producing isolates, 16.6% (24) were multidrug resistant (MDR), 82.1% (119) were extensively drug resistant (XDR) and 1.3% (2) isolates were pan drug resistantwhich highlights the emerging therapeutic challenge for these superbugs. Bangladesh J Med Microbiol 2019; 13 (2): 7-10

scholarly journals Cockroaches as a Source of High Bacterial Pathogens with Multidrug Resistant Strains in Gondar Town, Ethiopia

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Feleke Moges ◽  
Setegn Eshetie ◽  
Mengistu Endris ◽  
Kahsay Huruy ◽  
Dagnachew Muluye ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Bacterial Species ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Control Measures ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Gondar Town ◽  
Resistant Strains ◽  
And Control

Background. Cockroaches are source of bacterial infections and this study was aimed to assess bacterial isolates and their antimicrobial profiles from cockroaches in Gondar town, Ethiopia.Methods. A total of 60 cockroaches were collected from March 1 to May 30, 2014, in Gondar town. Bacterial species were isolated from external and internal parts of cockroaches. Disk diffusion method was used to determine antibiotic susceptibility patterns. Data were entered and analyzed by using SPSS version 20;Pvalues <0.005 were considered as statistically significant.Results. Of 181 identified bacteria species, 110 (60.8%) and 71 (39.2%) were identified from external and internal parts of cockroaches, respectively.Klebsiella pneumoniae32 (17.7%),Escherichia coli29 (16%), andCitrobacterspp. 27 (15%) were the predominant isolates. High resistance rate was observed to cotrimoxazole, 60 (33.1%), and least resistance rate was noted to ciprofloxacin, 2 (1.1%). Additionally, 116 (64.1%) of the isolates were MDR strains;Salmonellaspp. were the leading MDR isolates (100%) followed byEnterobacter(90.5%) andShigellaspp. (76.9%).Conclusion. Cockroaches are the potential source of bacteria pathogens with multidrug resistant strains and hence effective preventive and control measures are required to minimize cockroach related infections.

scholarly journals ESBL Producers in Gram Negative Isolates from Clinical Samples

2020 ◽  
Vol 14 (3) ◽  
pp. 2027-2032
Author(s):  
Mita D. Wadekar ◽  
J.V. Sathish ◽  
C. Pooja ◽  
S. Jayashree
Keyword(s):  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Beta Lactam Antibiotics ◽  
Esbl Producers

Resistance to beta lactam antibiotics is the most common cause for beta-lactamase production. Increasing number of extended spectrum beta-lactamase (ESBL) producers has reduced the treatment options which resulted in emergence of multidrug resistant strains, treatment failure and hence increased mortality. To detect phenotypically, ESBL producers in Gram negative isolates from different samples and to know their susceptibility pattern. A retrospective study of Gram negative isolates was conducted. Total of 521 isolates were isolated from various samples. They were processed and identified by standard procedures. The antibiotic susceptibility testing was performed by Kirby- Bauer disc diffusion method using CLSI guidelines. ESBL was detected by combination disk test. A total of 521 Gram negative isolates were isolated which included E. coli, Klebsiella pneumoniae, Citrobacter spp., Enterobacter spp., Proteus spp. and Acinetobacter spp. Pseudomonas aeruginosa. Of 521 isolates tested, ESBL was detected in 329 (63.1%) isolates. These isolates showed maximum susceptibility to piperacillin- tazobactam (86%) followed by imipenem (78.4%), amikacin (63.5%), cotrimoxazole (54.4%), ciprofloxacin (51%), amoxi-clav (44.9%), cefepime (44.1%), gentamicin (38.9%), cefoxitin (34.9%) and ampicillin (19.1%). ESBL producers which are resistant to beta lactam antibiotics have become a major problem. Detection of these beta-lactamase enzymes by simple disk method and its reporting will help clinicians in prescribing proper antibiotics.

scholarly journals Escherichia coli Overexpressing a Baeyer-Villiger Monooxygenase from Acinetobacter radioresistens Becomes Resistant to Imipenem

2015 ◽  
Vol 60 (1) ◽  
pp. 64-74 ◽  
Author(s):  
Daniela Minerdi ◽  
Ivan Zgrablic ◽  
Silvia Castrignanò ◽  
Gianluca Catucci ◽  
Claudio Medana ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Bacterial Infections ◽  
Bacterial Species ◽  
Carbapenem Resistance ◽  
Multidrug Resistant ◽  
Disk Diffusion ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Content Type ◽  
Acinetobacter Radioresistens

ABSTRACTAntimicrobial resistance is a global issue currently resulting in the deaths of hundreds of thousands of people a year worldwide. Data present in the literature illustrate the emergence of many bacterial species that display resistance to known antibiotics;Acinetobacterspp. are a good example of this. We report here thatAcinetobacter radioresistenshas a Baeyer-Villiger monooxygenase (Ar-BVMO) with 100% amino acid sequence identity to the ethionamide monooxygenase of multidrug-resistant (MDR)Acinetobacter baumannii. Both enzymes are only distantly phylogenetically related to other canonical bacterial BVMO proteins. Ar-BVMO not only is capable of oxidizing two anticancer drugs metabolized by human FMO3, danusertib and tozasertib, but also can oxidize other synthetic drugs, such as imipenem. The latter is a member of the carbapenems, a clinically important antibiotic family used in the treatment of MDR bacterial infections. Susceptibility tests performed by the Kirby-Bauer disk diffusion method demonstrate that imipenem-sensitiveEscherichia coliBL21 cells overexpressing Ar-BVMO become resistant to this antibiotic. An agar disk diffusion assay proved that when imipenem reacts with Ar-BVMO, it loses its antibiotic property. Moreover, an NADPH consumption assay with the purified Ar-BVMO demonstrates that this antibiotic is indeed a substrate, and its product is identified by liquid chromatography-mass spectrometry to be a Baeyer-Villiger (BV) oxidation product of the carbonyl moiety of the β-lactam ring. This is the first report of an antibiotic-inactivating BVMO enzyme that, while mediating its usual BV oxidation, also operates by an unprecedented mechanism of carbapenem resistance.

scholarly journals Occurrence of carbapenem-resistant organisms in gastrointestinal postoperative infections: A therapeutic challenge

2021 ◽  
Vol 8 (4) ◽  
pp. 313-320
Author(s):  
Secunda Rupert ◽  
Pavithra Sankar ◽  
Karthick Govindaraj ◽  
Shanthi Sornamani David Raj ◽  
Jeswanth Sathyanesan ◽  
...  
Keyword(s):  
Early Detection ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Diagnostic Laboratory ◽  
Simple Method ◽  
Carbapenem Resistant ◽  
Operative Care ◽  
Multidrug Resistant Organisms

Dissemination of multidrug resistant organisms including Carbapenem-Resistant Organisms (CRO) in Hospitals is of global concern. Such nosocomial infections are more common during surgical procedures involving prolonged post-operative care and Hospital stay. Treatment options include administration of prophylactic antibiotics, which are broad-spectrum antibiotics. However, long-term administration of these antibiotics leads to an increase in the incidence of multidrug resistant organisms in Hospital sectors. To evaluate early detection of carbapenemase producing organisms from the clinical isolates of postoperative patients by carba NP test. The study was conducted at the diagnostic laboratory in clinical samples obtained from hospitalized patients. A total of 716 clinical samples were tested by employing basic microbiological and biochemical testing methods and the isolates were screened for antimicrobial susceptibility. Carbapenem-resistant isolates were then confirmed by E-test (imipenem, meropenem) and also via carba NP test.In a total of 716 samples, 257 tested positive for various microorganisms, of which 230 gram-negative bacilli were identified. Amongst them, 93 isolates were identified as resistant to carbapenem by disc diffusion method of which 50 isolates were tested for carbapenemase production. Within the 50 isolates, 47 isolates were resistant to E-test meropenem and 40 isolates were resistant to imipenem. Of note, 35 out of the 50 CROs were identified as carbapenemase producers. Our results show that Carba NP test is a simple method that can be employed routinely for early detection of carbapenemase mediated CROs thus reducing the spread of resistant strains in Hospitals.

Involvement of the AcrAB efflux pump in ciprofloxacin resistance in clinical Klebsiella pneumoniae isolates

2020 ◽  
Vol 20 ◽  
Author(s):  
Saeed Khoshnood ◽  
Mohsen Heidary ◽  
Ali Hashemi ◽  
Fatemeh Shahi ◽  
Morteza Saki ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bacterial Infections ◽  
Efflux Pump ◽  
Quinolone Resistance ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Disk Diffusion Method ◽  
Rapd Pcr ◽  
Ciprofloxacin Resistance

Background: Increasing prevalence of multiple antibiotic resistance in Klebsiella pneumoniae strains confines the therapeutic options used to treat bacterial infections. Objective: We aimed in this study to investigate the role of AcrAB, qepA efflux pump, and AAC(6′)-Ib-cr enzyme in ciprofloxacin resistance and to detect the RAPD-PCR fingerprint of K. pneumoniae isolates. Methods: In total, 117 K. pneumoniae isolates were collected from hospitalized patients in three hospitals in Tehran, Iran from August 2013 to March 2014. Antimicrobial susceptibility tests were performed by the disk diffusion method. Molecular identification and expression level of encoding quinolone resistance genes, acrA, acrB, qepA, and aac(6')-Ib-cr, was per-formed by PCR and real-time PCR assays, respectively. All the K. pneumoniae isolates containing these genes was used simultaneously for RAPD-PCR typing. Results: Colistin and carbapenems were the most efficient antibiotics against the clinical isolates of K. pneumoniae. PCR assay demonstrated that among the 117 isolates, 110 (94%) and 102 (87%) were positive for acrA and acrB gene, and for qepA and aac(6′)-Ib-cr genes, 5 (4%) and 100 (85%) isolates were detected, respectively. Determination of AcrAB pump expression in 21% of strains demonstrated an increased expression, and the mean increase expression for acrB genes was 0.5-81. The results of RAPD-PCR reflected that in 95% CI, all isolates belong to a clone. Conclusion: A high prevalence of genes encoding quinolone resistance in K. pneumoniae was detected in clinical samples. Therefore, control of infection and prevention of drug-resistant bacteria spread need careful management of medication and identification of resistant isolates.

scholarly journals Coproduction of Extended Spectrum, AmpC and Metallo β- Lactamases in Pseudomonas aeruginosa Isolates from a Super Speciality Center

2021 ◽  
Vol 10 (10) ◽  
pp. 176-184
Author(s):  
Ashna Bhasin Poonam Loomba ◽  
Abha Sharma Bibhabati Mishra ◽  
Ashish Bajaj
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Diffusion Method ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Disk Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Pseudomonas aeruginosa (P. aeruginosa) is one of the leading causes of hospital as well as community acquired infections. They’re strenuous to treat as most of isolates exhibit various degrees of beta- lactamase mediated resistance to majority of the beta-lactam antibiotics. Single isolate can express multiple β- lactamase enzymes, further limiting the treatment options. Therefore, this study was outlined to research the coexistence of various beta-lactamase enzymes in clinical isolates of P. aeruginosa. The aim of the study was to detect the co-prevalence of Extended Spectrum Beta lactmases (ESBL), AmpC and Metallo β-Lactamases (MBL) in Pseudomonas aeruginosa isolates from a superspeciality center. Fifty clinical isolates of P. aeruginosa were tested for the presence of AmpC beta-lactamase, extended spectrum beta- lactamase (ESBL) and metallo beta-lactamase (MBL) enzyme. Discernment of AmpC beta-lactamase was performed by disk antagonism while ESBL detection was done by the combined disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines and MBL were detected by the Imipenem EDTA disk potentiation test. Eleven of 50 (22%) isolates were confirmed to be positive for AmpC and Extended spectrum beta lactamases. Co-production of AmpC along side ESBL and MBL was reported in 12 % isolates. The study shows the high prevalence of multidrug resistant P. aeruginosa producing beta-lactamase enzymes of diverse mechanisms. Consequently, formulation of a correct antibiotic policy and taking measures to restrict the indiscriminative use of cephalosporins and carbapenems should be taken to mitigate the emergence of this multiple beta-lactamase producing pathogens.

scholarly journals Prevalence of Multidrug-resistant and Carbapenemase-producing Klebsiella Pneumoniae and Pseudomonas Aeruginosa Isolates in Tertiary Care Hospital in Kathmandu, Nepal

2021 ◽  
Vol 23 (4) ◽  
pp. 290-296
Author(s):  
Rojina Darnal ◽  
Mehraj Ansari ◽  
Ganesh Rai ◽  
Kul Raj Rai ◽  
Shiba Kumar Rai
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Klebsiella Pneumoniae ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Care Hospital ◽  
Disk Diffusion Method

Carbapenemases are the enzymes that catalyze β–lactam groups of antibiotics. The carbapenemase producers are resistant to β–lactam antibiotics and are usually multidrug-resistant bacteria challenging widely used therapeutics and treatment options. Therefore, the detection of carbapenemase activity among clinical isolates is of great therapeutic importance. We aimed to study the MDR and carbapenemase-producing Klebsiella pneumoniae and Pseudomonas aeruginosa isolated from various clinical samples at a tertiary care hospital in Nepal. A total of 3,579 clinical samples were collected from the patients visiting the Department of Microbiology, B&B Hospital, Gwarko, Lalitpur. The samples were processed to isolate K. pneumoniae and P. aeruginosa and then subjected to antibiotic susceptibility testing (AST) by the Kirby-Bauer disk diffusion method. Phenotypic detection of carbapenemase activity was performed in the imipenem-resistant isolates by the modified Hodge test (MHT). Of the total samples, 1,067 (29.8%) samples showed significant growth positivity, out of which 190 (17.3%) isolates were K. pneumoniae and 121 (11.3%) were P. aeruginosa. Multidrug resistance was seen in 70.5% of the K. pneumoniae isolates and 65.3% of the P. aeruginosa isolates. Carbapenemase production was confirmed in 11.9%, and 12.2% of the imipenem-resistant K. pneumoniae and P. aeruginosa isolates, respectively, by the MHT. This study determined the higher prevalence of MDR among K. pneumoniae and P. aeruginosa; however, carbapenemase production was relatively low.

scholarly journals Evolved resistance to colistin and its loss due to genetic reversion in Pseudomonas aeruginosa

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Ji-Young Lee ◽  
Young Kyoung Park ◽  
Eun Seon Chung ◽  
In Young Na ◽  
Kwan Soo Ko
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Bacterial Infections ◽  
Lipid A ◽  
Treatment Options ◽  
Genomic Analysis ◽  
Multidrug Resistant ◽  
Genetic Alterations ◽  
Comparative Genomic ◽  
Colistin Resistance

Abstract The increased reliance on colistin for treating multidrug-resistant Gram-negative bacterial infections has resulted in the emergence of colistin-resistant Pseudomonas aeruginosa. We attempted to identify genetic contributors to colistin resistance in vitro evolved isogenic colistin-resistant and -susceptible strains of two P. aeruginosa lineages (P5 and P155). Their evolutionary paths to acquisition and loss of colistin resistance were also tracked. Comparative genomic analysis revealed 13 and five colistin resistance determinants in the P5 and P155 lineages, respectively. Lipid A in colistin-resistant mutants was modified through the addition of 4-amino-L-arabinose; this modification was absent in colistin-susceptible revertant strains. Many amino acid substitutions that emerged during the acquisition of colistin resistance were reversed in colistin-susceptible revertants. We demonstrated that evolved colistin resistance in P. aeruginosa was mediated by a complicated regulatory network that likely emerges through diverse genetic alterations. Colistin-resistant P. aeruginosa became susceptible to the colistin upon its withdrawal because of genetic reversion. The mechanisms through which P. aeruginosa acquires and loses colistin resistance have implications on the treatment options that can be applied against P. aeruginosa infections, with respect to improving bactericidal efficacy and preventing further resistance to antibiotics.

scholarly journals Susceptibility to Nisin, Bactofencin, Pediocin and Reuterin of Multidrug Resistant Staphylococcus aureus, Streptococcus dysgalactiae and Streptococcus uberis Causing Bovine Mastitis

Antibiotics ◽  
2021 ◽  
Vol 10 (11) ◽  
pp. 1418
Author(s):  
Samantha Bennett ◽  
Laila Ben Said ◽  
Pierre Lacasse ◽  
François Malouin ◽  
Ismail Fliss
Keyword(s):  
Bacterial Infections ◽  
Bovine Mastitis ◽  
Multidrug Resistant ◽  
Inhibitory Effect ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Streptococcus Dysgalactiae ◽  
Disk Diffusion Method ◽  
Intramammary Infections ◽  
Streptococcus Uberis

Antibiotics are the most effective strategy to prevent and treat intramammary infections. However, their misuse has led to the dissemination of multidrug resistant bacteria (MDR) for both animals and humans. Efforts to develop new alternative strategies to control bacterial infections related to MDR are continuously on the rise. The objective of this study was to evaluate the antimicrobial activity of different bacteriocins and reuterin against MDR Staphylococcus and Streptococcus clinical isolates involved in bovine mastitis. A bacterial collection including S. aureus (n = 19), S. dysgalactiae (n = 17) and S. uberis (n = 19) was assembled for this study. Antibiotic resistance profiles were determined by the disk diffusion method. In addition, sensitivity to bacteriocins and reuterin was evaluated by determining minimum inhibitory concentrations (MIC). A total of 21 strains (37.5%) were MDR. MICs ranged from ≤1.0 μg/mL to ≥100 μg/mL for nisin and 2.0 to ≥250 μg/mL for bactofencin. Reuterin was active against all tested bacteria, and MICs vary between 70 and 560 μg/mL. Interestingly, 20 MDR strains were inhibited by bactofencin at a concentration of ≤250 μg/mL, while 14 were inhibited by nisin at an MIC of ≤100 μg/mL. Pediocin did not show an inhibitory effect.

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