scholarly journals High Carriage Rate of Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species among Poultry Meat Vendors in Dar es Salaam: The Urgent Need for Intervention to Prevent the Spread of Multidrug-Resistant Pathogens

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Lutengano W. Mwanginde ◽  
Mtebe Majigo ◽  
Debora C. Kajeguka ◽  
Agricola Joachim

Background. Bacteria possessing extended-spectrum beta-lactamase (ESBL), especially E. coli and Klebsiella species, are problematic, particularly in hospitalized patients. Poultry meat vendors are at risk of carrying ESBL-producing bacteria when processing and handling meat products in an unhygienic environment. There is limited information on the carriage rate of ESBL-producing pathogens among poultry meat vendors that necessitated the conduction of the study. Method. A cross-sectional study was conducted among poultry meat vendors in Dar es Salaam, Tanzania. Participants provided rectal swabs in transport media upon instruction. The primary isolation of ESBL-producing bacteria was carried out using MacConkey agar supplemented with ceftazidime. Identification of isolates relied on conventional methods. Double-disk synergy was the method used to confirm ESBL-producing isolates. We performed descriptive statistics using Statistical Package for Social Sciences version 23. A p value < 0.05 was considered statistically significant. Results. A total of 300 participants were recruited from five districts, with a mean age of 27.2 ± 6.7 years. The majority was male (67.3%), and 74.7% worked as poultry meat vendors for more than one year. Out of 300 participants, 107 (35.7%) had confirmed ESBL-producing E. coli and Klebsiella spp. The majority of confirmed ESBL-producing isolates was E. coli (78.5%). Participants from Ubungo District had significantly higher carriage of ESBL-producing Escherichia coli and Klebsiella spp. (48.0%, 95% CI: 34.8–47.7) than Temeke District (21.4%, 95% CI: 13.4–32.4). Only 28.0% of participants had access to latrines at the workplace, and all working areas lacked access to running water. Conclusion. The study revealed a relatively high fecal carriage rate of ESBL-producing E. coli and Klebsiella spp. among poultry meat vendors. Poor working environments and hygienic practices are risks for spread of these multidrug-resitant pathogens.

Author(s):  
Bhawana Sapkota ◽  
Santosh K. Yadav ◽  
Gunaraj Dhungana ◽  
Shamshul Ansari ◽  
Shyam K. Mishra

Infections due to extended-spectrum β-lactamase- (ESBL-) producing Gram-negative bacteria have led to increased mortality, morbidity, and economic burden worldwide. These bacteria can colonize the healthy intestine of human beings and can disseminate in communities and hospital. This study aimed to investigate the prevalence of fecal carriage of ESBL-producing Escherichia coli and Klebsiella species among health science (HS) and non-health science (NHS) students. This descriptive cross-sectional study was conducted on 104 HS and 104 NHS students in which one stool sample from each student was collected and processed for bacterial culture and sensitivity testing according to standard bacteriological procedures. Each morphotype was identified and characterized phenotypically. The antimicrobial sensitivity profile of bacterial isolates was determined by the Kirby–Bauer disk diffusion technique. ESBL production was tested by combination disk method as recommended by the Clinical and Laboratory Standards Institute. Out of 208 stool samples, E. coli and Klebsiella spp. were recovered from 203 (86.8%) and 31 (13.2%) stool samples, respectively. Among those 234 isolates, 69 were positive for ESBL which included E. coli (n = 66, 95.7%) and Klebsiella spp. (n = 3, 4.3%). Fifty (42.4%) out of 118 isolates from HS students and 19 (16.4%) out of 116 from NHS students were colonized by ESBL-producers. Compared to non-ESBL producers, a higher number of ESBL-producing isolates were resistant to ciprofloxacin (14.5% vs. 1.8%, p < 0.001 ), cotrimoxazole (59.4% vs. 16.4%, p < 0.001 ), and amikacin (10.1% vs 4.2%, p < 0.001 ). All E. coli and Klebsiella species isolates were susceptible to meropenem. The prevalence of fecal carriage of ESBL-producing bacteria was higher in HS students; however, there was a considerable number of these strains colonizing NHS students as well. This “iceberg phenomenon” of asymptomatic carriage of ESBL-producing pathogens might act as a source of infection in both the community and hospitals. Therefore, surveillance of carriage of drug-resistant bacteria should be performed regularly.


2012 ◽  
Vol 4 (2) ◽  
pp. 28-31 ◽  
Author(s):  
Nawshad Muhammad Wahidur Rahman ◽  
Afzalunnessa Binte Lutfor ◽  
Sanya Tahmina Jhora ◽  
Mahmuda Yasmin ◽  
Jalaluddin Ashraful Haq

A total of 200, non-duplicate ESBL producing strains (171 Escherichia coli and 29 Klebsiella spp.) from three tertiary care hospitals were detected using screening test & double disc synergy test. All isolates were screened for the detection of CTX-M type Extended spectrum Beta-lactamase (ESBL) using PCR. Among them 133 (66.5%) were positive for CTX-M type ESBLs which include 114 (66.66%) E.coli and 19 (65.51%) Klebsiella spp. This is the first report of identifying CTX-M gene in ESBL producing Escherichia coli and Klebsiella species of different hospitals.DOI: http://dx.doi.org/10.3329/bjmm.v4i2.10829 


2014 ◽  
Vol 77 (1) ◽  
pp. 112-112 ◽  
Author(s):  
H. ABGOTTSPON ◽  
R. STEPHAN ◽  
C. BAGUTTI ◽  
P. BRODMANN ◽  
H. HÄCHLER ◽  
...  

A worrisome phenomenon is the progressive global spread of Enterobacteriaceae in poultry and chicken meat expressing plasmid-mediated enzymes that inactivate β-lactam antibiotics, suggesting that the food chain might play a role in the epidemiology and the transmission of extended-spectrum cephalosporin-resistant Enterobacteriaceae to humans. The aim of the present study was to further characterize 24 extended-spectrum cephalosporin-resistant Enterobacteriaceae isolated from domestic and imported poultry meat by antibiotic susceptibility testing, identification of the blaESBL/blapAmpC genes, conjugation mating experiments and determination of plasmid incompatibility types, multilocus sequence typing, and analysis of the Escherichia coli phylogenetic groups. On account of their resistance patterns, 21 of the total 24 isolates were classified as multidrug resistant. Eleven isolates carried a blaCMY-2 gene, whereas 13 isolates harbored a blaCTX-M-1 gene. All isolates harbored plasmids that were assigned to 8 of the 18 described plasmid incompatibility groups, the most frequent of which were IncI1, IncFIB, IncB/O, and IncFrepB. The blaESBL/blapAmpC genes were harbored mainly by transferable IncI1 and IncB/O plasmids. Multilocus sequence typing as well as E. coli phylogenetic group typing revealed a high heterogenicity even among different isolates of the same sample.


Author(s):  
Oumar Ouchar Mahamat ◽  
Abdelsalam Tidjani ◽  
Manon Lounnas ◽  
Mallorie Hide ◽  
Julio Benavides ◽  
...  

Abstract Background Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) remains poorly documented in Africa. The objective of this study was to determine the prevalence of ESBL-PE fecal carriage in Chad. Methods In total, 200 fresh stool samples were collected from 100 healthy community volunteers and 100 hospitalized patients from January to March 2017. After screening using ESBL-selective agar plates and species identification by MALDI-TOF mass spectrometry, antibiotic susceptibility was tested using the disk diffusion method, and ESBL production confirmed with the double-disc synergy test. The different ESBL genes in potential ESBL-producing isolates were detected by PCR and double stranded DNA sequencing. Escherichia coli phylogenetic groups were determined using a PCR-based method. Results ESBL-PE fecal carriage prevalence was 44.5% (51% among hospitalized patients vs 38% among healthy volunteers; p < 0.05). ESBL-producing isolates were mostly Escherichia coli (64/89) and Klebsiella pneumoniae (16/89). PCR and sequencing showed that 98.8% (87/89) of ESBL-PE harbored blaCTX-M genes: blaCTX-M-15 in 94.25% (82/87) and blaCTX-M-14 in 5.75% (5/87). Phylogroup determination by quadruplex PCR indicated that ESBL-producing E. coli isolates belonged to group A (n = 17; 27%), C (n = 17; 27%), B2 (n = 9; 14%), B1 (n = 8; 13%), D (n = 8; 13%), E (n = 1; 1.6%), and F (n = 1; 1.6%). The ST131 clone was identified in 100% (9/9) of E. coli B2 strains. Conclusions The high fecal carriage rate of ESBL-PE associated with CTX-M-15 in hospital and community settings of Chad highlights the risk for resistance transmission between non-pathogenic and pathogenic bacteria.


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


Author(s):  
S. N. Ushie ◽  
K. S. Oyedeji ◽  
G. I. Ogban ◽  
D. E. Ushie ◽  
F. O. Nwaokorie ◽  
...  

Irrational antibiotics use has added to the escalation of antibiotics resistance, especially among hospitalized patients on prolonged urethral catheterization, a significant risk factor for urinary tract infection and urosepsis. Extended-spectrum β-lactamases are transferable plasmid-mediated resistance mechanism orchestrated majorly by Enterobacteriaceae, which confer resistance to β- lactam antibiotics and other classes of antibiotics. This work was aimed at determining the molecular characteristics of uropathogenic Escherichia coli and Klebsiella spp involved in urinary tract infections among patients on prolonged urethral catheterization in two major tertiary hospitals in Lagos. One hundred and one samples were collected from participants in Lagos University Teaching Hospital and 68 Army Reference Hospital Yaba, between November 2015 and May 2016. The mean age of the participants was 49.04± 8.8years. Single, non -repeat aseptically aspirated urine specimens from the catheter ports were obtained from consenting participants and processed immediately. Bacterial species were isolated and characterized by conventional methods. Antibiotics susceptibility testing was done using a modified Kirby Bauer method. Further analysis was done by Polymerase Chain Reaction amplification aimed to detect bla SHV, bla TEM, and bla CTX-M resistance genes.  Isolates were considered significant if there were up to 104 CFU/ml in symptomatic participants and ≥105 CFU/ml in asymptomatic participants with analyzed. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 16.0 (Inc., Chicago 111). Forty (39.6 %) males and 61 (60.4 %) female participants’ catheter urines were sampled, with male to female ratio of 1:1.5. Fifty-nine (58.4%) out of 101 samples had significant growth, while 32 (54.2%) of these were lactose fermenters.  Of the 32 lactose fermenters, 26 were identified as E. coli and Klebsiella spp, while 23 (88.5%) of these 26 (identified as E. coli and Klebsiella spp) were ESBL producers carrying ESBL gene(s) and revealed various degrees of antibiotics resistance. We conclude by discussing the epidemiological importance of improving the infection control practices and antibiotics stewardship program as central dogma to controlling antibiotics resistance in hospitals.


2017 ◽  
Vol 80 (11) ◽  
pp. 1877-1881 ◽  
Author(s):  
Leila Ben Said ◽  
Mouna Hamdaoui ◽  
Ahlem Jouini ◽  
Abdellatif Boudabous ◽  
Karim Ben Slama ◽  
...  

ABSTRACT The purpose of this study was to determine the carriage rate of Escherichia coli isolates in seafood, to analyze the phenotype and genotype of antimicrobial resistance in the recovered isolates, and to characterize extended-spectrum β-lactamase (ESBL) E. coli producers. E. coli isolates were recovered from 24 (34.3%) of the 70 seafood samples analyzed, and one isolate per sample was further characterized. Antibiotic resistance was determined by the disk diffusion method in the 24 isolates, with the following results (number of resistant isolates): tetracycline (8), streptomycin (7), ampicillin (6), trimethoprim-sulfamethoxazole (4), chloramphenicol (4), ciprofloxacin (3), cefotaxime (2), and ceftazidime (2). Six isolates showed a multiresistant phenotype (including at least three families of antibiotics). Among tetracycline-resistant E. coli isolates, tet(A) was detected in five isolates and tet(B) in two isolates. The qnr(A) or aac(6′)-1b-cr genes were detected in two ciprofloxacin-resistant E. coli isolates, and the sul2 gene in two trimethoprim-sulfamethoxazole–resistant isolates. ESBL-containing E. coli isolates, carrying the blaCTX-M-1 gene, were detected in 2 of the 70 seafood samples, obtained from gilt-head bream aquaculture. The ESBL isolates were typed phylogenetically and by multilocus sequence typing, and they were ascribed to lineage ST48/A and to the new ST3497/B1; these isolates carried the fimA, aer, and papGIII virulence genes. One of the ESBL-producing E. coli isolates carried an unusual class 1 integron (with the array dfr32-ereA-aadA1). Seafood could be a source of multiresistant E. coli isolates for the aquatic environment, and these could enter the food chain.


2015 ◽  
Vol 14 (9) ◽  
pp. 1597-1604
Author(s):  
S Riaz ◽  
MF Bashir

Purpose: To investigate the distribution of plasmid-encoded extended spectrum beta-lacatamases (ESBLs) in Lahore, Pakistan using different phenotypic and molecular methods.Methods: Escherichia coli and Klebsiella spp were obtained over a period of nineteen months (June 2007 to December 2008). Both were tested by the double disk synergy test, combined disk test and  Epsiometer-test (E-test) to evaluate their ability to detect ESBLs. The genotypes of ESBLs were analyzed by monoplex polymerase chain reaction (PCR), multiplex PCR, DNA sequencing and isoelectric focusing.Results: 662 E. coli and 153 Klebsiella spp were analyzed. Among these isolates, 39.3 % E. coli and 26.1 % Klebsiella spp were positive for extended spectrum beta-lactamases (ESBLs).71.9 % E. coli and 79.6 % Klebsiella spp showed minimum inhibitory concentration (MIC) in the range > 32/0.064 = 500 μl/mL for cetatzidime/cetatzidime + clavulanic acid, while 66.5 % E. coli and 69.1 % Klebsiella spp revealed MIC in the range of > 16/0.016 = 1000 μl/mL for cefotaxime/cefotaxime + clavulanic acid. Antibiotic susceptibility testing revealed that imipemem, meropenem and tazocine were the most effective in the management of such infections. The most frequent genotype of ESBL was OXA (19.2 %) for E. coli and SHV (92.5 %) for Klebsiella spp. The highest genotypic combination found was the combination of TEM/OXA (44.2 %) for E. coli.Conclusion: The resistance of E. coli and Klebsiella spp-producing ESBLs in Pakistan is a serious issue, and TEM, OXA and SHV type ESBL were the most common genotypes. Some isolates produced two or three genotypes at a time. Multiplex PCR of ESBL may help in early detection as well as phenotypic antibiotic therapy of these infections.Keywords: Beta-lactamases, Escherichia coli, Klebsiella spp, Antibiotic susceptibility,  Plasmidencoded, Structural genes, Imipemem, Meropenem, Tazocine


2012 ◽  
Vol 4 (1) ◽  
pp. 22-25 ◽  
Author(s):  
MB Islam ◽  
ST Jhora ◽  
MA Yusuf ◽  
AFMA Sattar ◽  
S Shahidullah ◽  
...  

Background: Infections due to extended spectrum ?-lactamases (ESBL) producing Escherichia coli and Klebsiella pneumoniae have become an important clinical problem. These organisms are important regarding the infection control by the physicians. Objective: The present study was undertaken to determine the prevalence of ESBLs along with their antimicrobial sensitivity pattern in Escherichia coli and Klebsiella pneumoniae. Methodology: This cross sectional study was conducted in the Department of Microbiology at Sir Salimullah Medical College, Dhaka. Urine samples were collected from patients who were clinically suspected to have UTI. After incubation, plates were checked for presence of suspected pathogens. Organisms were identified to species level by conventional methods. All isolated E. coli and K. pneumoniae were included in the study. The susceptibility to antibiotics was determined by Kirby Bauer method on Muller Hinton agar. Isolates were screened for ESBL production by using disk diffusion of cefotaxime, ceftazidime, ceftriaxone and cefpodoxime placed on inoculated plates containing Muller Hinton agar according to the CLSI recommendations. Phenotypic confirmatory test for ESBL producers was done by combined disc diffusion for all the isolates that were screened positive for the ESBL production following CLSI guidelines. Combined disk diffusion method was also done in this study. Result: A total of 220 non repeated urine samples were cultured of which 132(60%) cases had shown the bacterial growth. Among the 132 samples Escherichia coli had found in 103(78.0%) cases and Klebsiella spp. was found in 14(10.6%) cases. Out of 103 E coli 23(22.3%) cases was found as ESBL strain. On the other hand within 14 Klebsiella species, the ESBL strain was found in 5(35.7%) cases. Both E coli and Klebsiella species were 100% sensitive to imipenem. However, cephamycin was sensitive in 93.7% and 100% in E coli and Klebsiella species respectively. Conclusion: Results indicate that routine ESBL detection should be made imperative and empirical use of third generation cephalosporins must be discouraged. DOI: http://dx.doi.org/10.3329/jssmc.v4i1.11999 J Shaheed Suhrawardy Med Coll, 2012;4(1):22-25


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