scholarly journals Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species in Pediatric Patients Visiting International Friendship Children’s Hospital, Kathmandu, Nepal

2020 ◽  
Vol 13 ◽  
pp. 117863372090979 ◽  
Author(s):  
Karuna Kayastha ◽  
Binod Dhungel ◽  
Shovana Karki ◽  
Bipin Adhikari ◽  
Megha Raj Banjara ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pediatric Patients ◽  
Diffusion Method ◽  
Esbl Production ◽  
Klebsiella Species ◽  
Children's Hospital ◽  
Extended Spectrum ◽  
Routine Identification ◽  
Children’S Hospital ◽  
Esbl Producers

Introduction: Emergence and spread of antimicrobial resistance (AMR) is a global threat and significantly affects the treatment options for common infectious diseases. Inappropriate use of antibiotics, particularly third-generation cephalosporins, has contributed to the development of AMR. This study aims to determine the prevalence of extended-spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella species isolated from various clinical samples. Methods: This cross-sectional study was conducted at International Friendship Children’s Hospital, Kathmandu, Nepal, from August 2017 to January 2018. A total of 1443 samples that included urine, pus, wound swab, endotracheal tip, catheter tip, and blood were collected from pediatric patients below 15 years and processed by standard microbiological methods. Following sufficient incubation, isolates were identified by colony morphology, gram staining, and necessary biochemical tests. Identified bacterial isolates were then tested for antibiotic susceptibility test by modified Kirby-Bauer disk diffusion method and were subjected to ESBL screening by using 30 µg cefotaxime and ceftazidime. The ESBL production was confirmed by combination disk method. Results: From a total of 103 nonduplicated clinical isolates, E. coli (n = 79), Klebsiella pneumoniae (n = 18), and Klebsiella oxytoca (n = 6) were isolated from different clinical specimens. Of which, 64 (62.1%) exhibited multidrug resistance, and 29 (28.2%) were ESBL producers. All ESBL-producing isolates were resistant toward ampicillin, cefotaxime, ceftriaxone, and ceftazidime. Most ESBL producers were susceptible toward imipenem (89.7%; 26/29), nitrofurantoin (82.8%; 24/29), piperacillin/tazobactam (79.3%; 23/29), and amikacin (72.4%; 21/29). Conclusions: A high prevalence of multidrug-resistant ESBL organisms was found in this study among pediatric patients. Treatment based on their routine identification and susceptibility to specific antibiotics is critical to halt the spread of AMR and ESBL.

Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children's Hospital, Kathmandu, Nepal

2019 ◽  
Author(s):  
Karuna Kayastha ◽  
Binod Dhungel ◽  
Shovana Karki ◽  
Bipin Adhikari ◽  
Megha Raj Banjara ◽  
...  
Keyword(s):  
Clinical Samples ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Children's Hospital ◽  
Extended Spectrum ◽  
Children’S Hospital ◽  
Esbl Producers

Abstract Background Emergence of antibiotic resistance among pathogenic strains has spread due to production of β-lactamases, which can lead to failure of empirical therapy in clinical settings. Inappropriate use of antibiotics, particularly third generation cephalosporins has contributed to the development of antimicrobial resistance (AMR). This study aims to determine the prevalence of Extended Spectrum β-Lactamase (ESBL) production in E. coli and Klebsiella species isolated from various clinical samples. Methods This cross-sectional study was conducted at International Friendship Children's Hospital, Kathmandu, Nepal from August 2017 to January 2018. Various clinical samples that included urine, pus, Cerebro-Spinal Fluid (CSF), body fluids, wound swab, endotracheal tip, catheter tip and blood were processed for culture. Following sufficient incubation, isolates were identified by colony morphology, gram staining and necessary biochemical tests. Identified bacterial isolates were then tested for antibiotic susceptibility test by modified Kirby Bauer disc diffusion method, and were subjected to Extended Spectrum Beta Lactamase (ESBL) screening by using 30µg cefotaxime and ceftazidime. ESBL production was confirmed by combination disc method. Results From a total of 103 non-duplicated clinical isolates, E. coli (n=79), Klebsiella pneumoniae (n=18) and K. oxytoca (n=6) were isolated from different clinical specimens. Majority (62.1%; 64/103) exhibited Multi-Drug Resistance (MDR) and 28.2% (29/103) were ESBL producers. All of ESBL producing isolates were resistant towards ampicillin, cefotaxime, ceftriaxone, ceftazidime. Most ESBL producers were found to be susceptible towards imipenem (89.7%; 26/29), nitrofurantoin (82.8%; 24/29), piperacillin/tazobactam (79.3%; 23/29), and Amikacin (72.4%; 21/29). Conclusions High prevalence of multi-drug resistant ESBL organisms found in this study warrants restricting empirical treatment of the bacterial infection. Identification of ESBL producers in routine treatment of infectious diseases can reduce unnecessary and inappropriate antimicrobial use and can reduce the preventable morbidity and mortality.

Prevalence of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolated From Clinical Samples in Illorin Metropolis, Kwara State Nigeria

2021 ◽  
Vol 6 (2) ◽  
pp. 1-7
Author(s):  
Eze EM
Keyword(s):  
Escherichia Coli ◽  
Health Care ◽  
Health Care Facilities ◽  
Diffusion Method ◽  
Klebsiella Pneumonia ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Significant Difference

Background: This study investigated the prevalence of extended spectrum beta-lactamase producing enterobacteriaceae in Illorin metropolis using standard methods. The prevalence of ESBLs is increasingly being reported worldwide, and it varies according to geographic location and is directly linked to the use and misuse of antibiotics extended spectrum lactamases (ESBLs) are a major challenge in hospitalized patients worldwide and cause epidemic outbreaks in health care facilities, spreading in the community leading to various infections. Objectives: Screen for the extended spectrum β-lactamase producing Enterobacteriaceae and also determine the prevalence of ESBL producing Enterobacteriaceae in relation to gender, age and sample source. Methods: One hundred and sixty eight samples collected from routine clinical specimen such as high vagina swabs, urine, urethra swabs and wound swabs and sputum from October to December 2018 were studied. Fifty two enterobacteriaceae were isolated using spread plate method on macConkey and Cystein lactose electrolyte deficient media. The organisms were Klebsiella pneumoniae, Escherichia coli, Salmonella sp, Shigella sp, and Proteus sp. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer standardized disc diffusion method. The antibiotics used were ceftazidine (30ug), cefuroxime (30ug), gentamicin (10ug), ciprofloxacin (5ug), ofloxacin 5ug, amoxicillin/clavulanate 30ug, nitrofurantoin 30ug and ampicillin 10ug. Ceftazidime showed a susceptibility percentage of 84.6%,, cefuroxime 61.5%, gentamicin 71.2% ciprofloxacin 46.2%, ofloxacin 51.9%, augmentin 61.5%, nitrofurantoin 71.2% and ampicillin, 44.2% with a significant difference (P< 0.05).Extended spectrum beta-lactamase ESBL, production by clinical and laboratory standards institute (CLSI) methods showed that 15(28.9%) of isolates belonging to the genera Escherichia, Klebsiella and Proteus expressed ESBL production. The order of ESBL production by the isolates were Escherichia coli 9 (17.3%), Klebsiella pneumonia 5(9.3%) and Proteus 1(1.9%). Thus, attention needs to be given by health care personnel’s to ESBL producing organisms in order to reduce the spread.

scholarly journals Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

2007 ◽  
Vol 51 (8) ◽  
pp. 2855-2860 ◽  
Author(s):  
Marie-Frédérique Lartigue ◽  
Catherine Zinsius ◽  
Aline Wenger ◽  
Jacques Bille ◽  
Laurent Poirel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Prevalence Rate ◽  
Pediatric Patients ◽  
University Hospital ◽  
Insertion Sequences ◽  
Extended Spectrum ◽  
Urinary Infections ◽  
Published Report ◽  
The University ◽  
Esbl Producers

ABSTRACT The epidemiology of clavulanic acid-inhibited extended-spectrum β-lactamases (ESBLs) was investigated among infection-associated enterobacterial isolates at the University Hospital in Lausanne, Switzerland, from January 2004 to June 2005. Out of 57 nonrepetitive ESBL producers (prevalence rate of 0.7%), 45 produced CTX-M-like ESBLs. CTX-M enzymes were mostly from clonally nonrelated Escherichia coli isolates, from urinary infections and community-acquired infections. Pediatric patients (20 out of 57) accounted for a large number of CTX-M producers. CTX-M-15 was the most frequent CTX-M-type enzyme. The plasmid-located bla CTX-M genes were associated with either ISEcp1 or ISCR1 insertion sequences. This study is the first published report of CTX-M-type β-lactamases in Switzerland.

scholarly journals Extended spectrum β-lactamase producing uropathogenic Escherichia coli and the correlation of biofilm with antibiotics resistance in Nepal

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Raju Shrestha ◽  
Santosh Khanal ◽  
Pramod Poudel ◽  
Karan Khadayat ◽  
Sajani Ghaju ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Biofilm Formation ◽  
Strain Identification ◽  
Antibiotics Resistance ◽  
Host Immune System ◽  
Esbl Production ◽  
Positive Correlation ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

Abstract Background Urinary tract infection (UTI) is one of the frequently diagnosed infectious diseases which is caused mainly by Escherichia coli. E. coli confers resistance against the two major classes of antibiotics due to the production of extended spectrum β-lactamase enzymes (ESBL), biofilm, etc. Biofilm produced by uropathogenic E. coli (UPEC) protects from host immune system and prevent entry of antimicrobial compounds. The main objective of this cross-sectional study was to determine the correlation of biofilm production and antibiotic resistance as well as to characterize the pgaA and pgaC genes responsible for biofilm formation among uropathogenic ESBL producing E. coli. Methods A total of 1977 mid-stream urine samples were examined and cultured for bacterial strain identification. ESBL was detected by combined disc method following CLSI whereas biofilm formation was analyzed by semi-quantitative method. Furthermore, the pgaA and pgaC genes responsible for biofilm formation in UPEC were detected by multiplex PCR. All the statistical analyses were done via IBM SPSS Statistics 21 where Pearson’s correlation test were used to determine correlation (−1 ≥ r ≤ 1). Results E. coli was the predominant causative agent, which accounted 159 (59.3%) of the Gram-negative bacteria, where 81 (50.9%) E. coli strains were found to be ESBL producers. In addition, 86 (54.1%) E. coli strains were found to be biofilm producers. Both the pgaA and pgaC genes were detected in 45 (93.7%) the UPEC isolates, which were both biofilm and ESBL producers. Moreover, there was a positive correlation between biofilm and ESBL production. Conclusion The analyses presented weak positive correlation between biofilm and ESBL production in which biofilm producing UPEC harbors both pgaA and pgaC genes responsible for biofilm formation.

scholarly journals Variation in Resistance Traits, Phylogenetic Backgrounds, and Virulence Genotypes among Escherichia coli Clinical Isolates from Adjacent Hospital Campuses Serving Distinct Patient Populations

2015 ◽  
Vol 59 (9) ◽  
pp. 5331-5339 ◽  
Author(s):  
Sarah M. Drawz ◽  
Stephen Porter ◽  
Michael A. Kuskowski ◽  
Brian Johnston ◽  
Connie Clabots ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Virulence Gene ◽  
Clinical Isolates ◽  
Fluoroquinolone Resistance ◽  
Esbl Production ◽  
Content Type ◽  
E Coli ◽  
Children's Hospital ◽  
High Acuity ◽  
Children’S Hospital

ABSTRACTEscherichia colisequence type 13 (ST131), an emergent cause of multidrug-resistant extraintestinal infections, has important phylogenetic subsets, notably theH30 andH30Rx subclones, with distinctive resistance profiles and, possibly, clinical associations. To clarify the local prevalence of these ST131 subclones and their associations with antimicrobial resistance, ecological source, and virulence traits, we extensively characterized 233 consecutiveE. coliclinical isolates (July and August 2013) from the University of Minnesota Medical Center-Fairview Infectious Diseases and Diagnostic Laboratory, Minneapolis, MN, which serves three adjacent facilities (a children's hospital and low- and high-acuity adult facilities). ST131 accounted for 26% of the study isolates (more than any other clonal group), was distributed similarly by facility, and was closely associated with ciprofloxacin resistance and extended-spectrum β-lactamase (ESBL) production. TheH30 andH30Rx subclones accounted for most ST131 isolates and for the association of ST131 with fluoroquinolone resistance and ESBL production. Unlike ST131per se, these subclones were distributed differentially by hospital, being most prevalent at the high-acuity adult facility and were absent from the children's hospital. The virulence gene profiles of ST131 and its subclones were distinctive and more extensive than those of other fluoroquinolone-resistant or ESBL-producing isolates. Within ST131,blaCTX-M-15was confined toH30Rx isolates and otherblaCTX-Mvariants to non-RxH30 isolates. Pulsed-field gel electrophoresis documented a predominance of globally distributed pulsotypes and no local outbreak pattern. These findings help clarify the epidemiology, ecology, and bacterial correlates of theH30 andH30Rx ST131 subclones by documenting a high overall prevalence but significant segregation by facility, strong associations with fluoroquinolone resistance and specific ESBL variants, and distinctive virulence gene associations that may confer fitness advantages over other resistantE. coli.

scholarly journals Occurrence and Antibiogram of Generic Extended-Spectrum Cephalosporin-Resistant and Extended-Spectrum β-Lactamase-Producing Enterobacteria In Horses

2018 ◽  
Vol 41 (2) ◽  
pp. 123-132
Author(s):  
Madubuike Umunna Anyanwu ◽  
Ifeoma Chinyere Ugwu ◽  
Collins Uchenna Onah
Keyword(s):  
Antibacterial Agents ◽  
Diffusion Method ◽  
Antibacterial Resistance ◽  
Esbl Production ◽  
Disc Diffusion Method ◽  
Extended Spectrum ◽  
Positive Growth ◽  
Amoxicillin Clavulanic Acid ◽  
Esbl Producers ◽  
Apparently Healthy

Abstract This study was conducted to isolate generic extended-spectrum cephalosporin (ESC)-resistant and extended-spectrum β-lactamase (ESBL)-producing enterobacteria from horses in Nigeria, and to determine the antibacterial resistance profile. Rectal swabs were collected from 155, systematic randomly selected, apparently-healthy horses. Isolation of ESC-resistant enterobacteria was done using Mac Conkey agar with ceftazidime. ESBL production was assessed by combination disc method. Resistance of the isolates was determined using disc diffusion method. Out of 155 samples, 5.2% gave positive growth. From these, 11 ESC-resistant enterobacteria comprising of 36.4% E. coli, 36.4% Salmonella spp. and 27.2% Proteus spp., were obtained. From 11 isolates, 45.5% consisting of all the 4 E. coli and 1 Proteus isolates, were ESBL-producers, these were recovered from 4 (2.6%) out of the 155 horses sampled. Resistance of the E. coli isolates was 25% to aztreonam (AZT), 75% to amoxicillin-clavulanic acid (AMC), gentamicin (GEN), perfloxacin (PEF), and sulphamethoxazoletrimethoprim (SXT-TRI), 50% to ofloxacin (OFL) and 100% to ampicillin (AMP), ceftazidime (CTZ), cefotaxime (CTX), chloramphenicol (CHL), streptomycin (STR), tetracycline (TET), sparfloxacin (SPA), ciprofloxacin (CIP), norfloxacin (NOR) and enrofloxacin (ENR). Resistance of the Salmonella isolates was 50% to PEF and 100% to CTZ, CTX, AMP, AZT, AMC, CHL, GEN, STR, TET, SPA, CIP, OFL, NOR and ENR. Resistance of the Proteus isolates was 25% to AMC, CHL, STR, TET, SPA and NOR, and 100% to CTZ, CTX, AZT and AMP. Resistance of the isolates to more than 3 classes of antibacterial agents tested was 75% for Proteus and 100% for E. coli and Salmonella, respectively. This study showed that horses in Nigeria are potential reservoirs and disseminators of ESC-resistant and ESBL-producing Enterobacteriaceae.

scholarly journals Phenotypic Detection of Extended-Spectrum ß-lactamase Produced by Escherichia coli Isolates from Health facilities in Otukpo, Benue State Nigeria

2021 ◽  
Vol 2 (2) ◽  
pp. 7-13
Author(s):  
PS Utulo ◽  
EU Umeh ◽  
GM Gberikon ◽  
PO Abba
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Agents ◽  
Health Facilities ◽  
Molecular Techniques ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Esbl Production ◽  
E Coli ◽  
Extended Spectrum ◽  
Microbiological Methods

Beta-lactamase production by Escherichia coli and other bacteria is one of the most important mechanism of resistance to beta-lactam antibiotics such as Penicillins and Cephalosporins which are the most commonly used antibiotics in the treatment of bacterial infections in Hospitals. Resistance to antibiotics is emerging worldwide as a threat to human health resulting in limitations of therapeutic options. Susceptibility tests of microorganisms to antimicrobial agents do not reveal production of Extended-Spectrum ß-lactamase, hence the need to detect their presence by phenotypic or molecular techniques. This study is aimed at determining the prevalence of ESBL-production by Escherichia coli isolates from clinical samples collected from some selected health facilities in Otukpo, using phenotypic detection. Four hundred (400) specimens were collected from four different health facilities in Otukpo. Specimens collected included urine, blood, stool and wound swabs from 222 females and 178 males. Standard microbiological methods were employed for isolation, identification and characterization of Escherichia coli isolates from these specimens. Antibiotic susceptibility of the E. coli isolates was determined using Kirby-Bauer disc diffusion method while double disc synergy test (DDST) was used for ESBL production. Sixty-eight, (17%) of the 400 specimens tested for ESBL production were positive. Isolates from stool 22(22.7%) had the highest prevalence of ESBL-producing E. coli, followed by isolates from blood 4(21.4%). Urine isolates had the least prevalence 31(13.8%). Isolates from female subjects, 38(17.1%) had higher positivity rate than their male counterpart 30(16.9%). Otukpo General Hospital had the highest prevalence 20(20.0%) of ESBL followed by Otia Hospital 18(18.0%). Comprehensive health center, Otukpo had the least prevalence 14(14.0%). There is a high prevalence of ESBL production by Escherichia coli isolated from health facilities in Otukpo. Routine drug resistance surveillance therefore has become necessary to guide the appropriate and judicious antibiotic use.

scholarly journals Nosocomial blood-stream infections from extended-spectrum-beta-lactamase-producing Escherichia coli and Klebsiella pneumonia from GB Pant Hospital, New Delhi

2010 ◽  
Vol 4 (08) ◽  
pp. 517-520 ◽  
Author(s):  
Juhi Taneja ◽  
Bibhabati Mishra ◽  
Archana Thakur ◽  
Vinita Dogra ◽  
Poonam Loomba
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care ◽  
Test Method ◽  
Diffusion Method ◽  
Klebsiella Pneumonia ◽  
Care Hospital ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

Background: Nosocomial septicemia due to extended spectrum beta-(β)-lactamase (ESBL) producing Klebsiella pneumoniae and Escherichia coli are a therapeutic challenge due to resistance. Knowledge of disease burden and resistance patterns is required for proper and timely management. We report the prevalence and antimicrobial susceptibility of ESBL producing E. coli and K .pneumoniae from septicemia at a tertiary care hospital. Methodology: A total of 2,870 blood samples of suspected cases of septicemia were studied between January and December 2009. Antimicrobial susceptibility was determined by Kirby Bauer's disc diffusion method and MICs for imipenem, meropenem, and ertapenem were determined using the E-test. All isolates of E. coli and K. pneumoniae were tested for ESBL production by E-test method. Results: Forty-one (70.7%) K. pneumoniae isolates and ten (41.7%)  E. coli isolates were ESBL producers. Two (5%) of ESBL producing K. pneumoniae isolates, but no E. coli isolates, were resistant to carbapenems. In vitro, all ESBL producers were sensitive to tigecycline. Conclusion: Our data indicated that the prevalence of ESBL-producing E. coli and K. pneumonia strains isolated from blood cultures from hospitalized patients is high. ESBL-producing organisms were found to be more susceptible to meropenem than to imipenem and ertapenem. Tigecycline is active against all the ESBL or multidrug resistant (MDR) E. coli and Klebsiella spp. isolates.

THE CHARACTERISTICS OF CLINICLA AND PARACLINICAL IN ACUTE DIARRHEA CHILDREN PATIENT AT VIETNAM NATIONAL CHILDREN'S HOSPITAL

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Hoàng Ngọc Anh
Keyword(s):  
Escherichia Coli ◽  
Acute Diarrhea ◽  
Pediatric Patients ◽  
Cross Sectional ◽  
Fishy Odor ◽  
Children's Hospital ◽  
Children’S Hospital ◽  
Mild Fever

Objectives: To descriptive of clinical and subclinical characteristics of pediatric patients with acute diarrhea at Vietnam national children's hospital in 2019. Subjects: Children diagnosed with acute diarrhea at Vietnam national children's hospital from January 2019 to December 2019. Method: Cross-sectional description. Results and conclussion: 63.7% of children had vomiting, of which 59.2% vomited 5-10 times / day. 55.7% had a mild fever. 20.7% had dehydration. 76.7% of yellow feces and 77.3% of feces had no fishy odor. The majority of children had leukocytes, increased hematocrit. 55.1% of children had Escherichia coli in their stool.  

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