scholarly journals Differential molecular approach and ESBL detection from Klebsiella pneumoniae and Escherichia coli isolated from the supraglottic region of patients undergoing mechanical ventilation in an intensive care unit

2018 ◽  
Vol 66 (4) ◽  
pp. 581-587
Author(s):  
Olga Lucía Tovar ◽  
Gloria Inés Estrada ◽  
María Cristina Florián ◽  
Alejandro Uribe ◽  
Carlos Andrés Marulanda ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Molecular Characterization ◽  
Coli Strain ◽  
E Coli ◽  
Infectious Origin ◽  
Inert Surfaces

Introduction: Given their ability for colonizing the supraglottic region, desiccation tolerance, resistance to β-lactam antibiotics, and adherence to both inert surfaces and epithelial cells, Klebsiella pneumoniae and Escherichia coli are potentially pathogenic microorganisms for patients undergoing mechanical ventilation in an intensive care unit (ICU).Objective: To perform a molecular characterization and detection of extended spectrum β-lactamases (ESBL) in K. pneumoniae and E. coli strains isolated from the supraglottic region of patients undergoing mechanical ventilation in an ICU.Materials and methods: A descriptive study was conducted in 18 isolates. Disk diffusion technique was used for detecting ESBL-producing bacteria. Molecular characterization was made by BOX-PCR technique, while ESBL production was confirmed by testing the isolates against cefotaxime and ceftazidime, alone and in combination with clavulanic acid.Results: a K. pneumoniae strain and another E. coli strain were confirmed as ESBL producers. A divergence greater than 50% was observed in most of the strains; besides non-infectious origin strains resistant to third generation cephalosporins were found.Conclusion: The polyclonality found in this study might indicate that most of the strains belong to each patient’s microbiota.

scholarly journals KARAKTERISTIK ANTIBIOGRAM ISOLAT Escherichia coli DAN Klebsiella pneumoniae DARI RUANG INTENSIVE CARE UNIT DAN NON-INTENSIVE CARE UNIT DI RSUP SANGLAH SELAMA TAHUN 2018-2020

2021 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
Ni Luh Ranthi Kurniawathi ◽  
Indramawan Setyojatmiko ◽  
Ni Nyoman Sri Budayanti
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Beta Lactamases ◽  
E Coli ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Resistesi antibiotik meningkat secara global dalam beberapa tahun ini, terutama kejadian Escherichia coli (E.coli) dan Klebsiella pneumoniae (K.pneumoniae) penghasil Extended Spektrum Beta Lactamases (ESBL). Tujuan dari penelitian ini adalah untuk memberikan gambaran prevalensi keberadaan dan antibiogram isolat E.coli dan K. pneumoniae penghasil ESBL di rumah sakit tersier di Bali. Penelitian retrospektif potong lintang ini dlikaukan pada Januari 2018- Desember 2020 di Rumah Sakit Umum Pusat Sanglah, Bali. Identifikasi bakteri dan uji sensitivitas antibiotik dilakukan dengan alat otomatis Vitek®2 Compact. Hasil penelitian menunjukkan dari 2972 isolat, 1067 (63,82%) isolat adalah E. coli penghasil ESBL dan 902 isolat (69,39%) adalah K. pneumoniae penghasil ESBL. Isolat penghasil ESBL ditemukan terbanyak pada non-ICU (89,39%). Bakteri E.coli penghasil ESBL menunjukkan sensitivitas > 80% terhadap Amikacin, Ertapenem, Meropenem, Nitrofurantoin, Piperacillin-tazobactam, dan Tigecycline. Sedangkan, K. pneumoniae penghasil ESBL menunjukkan sensitivitas > 80% terhadap Amikacin, Ertapenem, Meropenem, dan Tigecycline. Penelitian ini menyoroti tingginya prevalensi E.coli dan K.pneumoniae penghasil ESBL di rumah sakit rujukan tersier di Bali. Analisis yang seksama dari antibiogram kedua spesies penghasil ESBL tersebut akan membantu menyusun kebijakan penggunaan antibiotik dan pencegahan, pengendalian penyebaran bakteri penghasil ESBL.Kata Kunci: Escherichia coli; Klebsiella pneumoniae; Extended Spectrum Beta Lactamases; ICU dan Non-ICU

Risk of drug resistance and repeated infection with Klebsiella pneumoniae and Escherichia coli in intensive care unit cancer patients

2021 ◽  
Vol 24 ◽  
Author(s):  
Samah M. Refay ◽  
Eman H. Ahmed ◽  
Ahmed R. Abd ELzaher ◽  
Ahmed M. Morsy ◽  
Manal M. Yasser ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Drug Resistance ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Cancer Patients ◽  
Resistant Bacteria ◽  
E Coli ◽  
Repeated Infection ◽  
Repeated Infections

Background: Bacterial infection is a frequent complication in cancer and immunocompromised patients. The emergence of antibiotic resistance is a significant health problem and cancer patients are at risk of repeated infections with drug-resistant bacteria. Objective: This investigation aimed to identify predictors of repeat infections of Escherichia coli and Klebsiella pneumoniae and drug resistance in cancer patients admitted to the intensive care unit (ICU) in Upper Egypt. Methods: Blood, urine, sputum, pus, and mouth and nose swabs were collected form patients at the Pediatric Oncology and Medical Oncology ICUs during the period from February 2017 to May 2018. The samples were assessed by antibiotic susceptibility test and further evaluated by genetic testing for the temoniera (TEM) gene of β-lactamase. Samples positive for K. pneumoniae and E. coli were included and isolates positive for other microorganisms were excluded. Results: The study included 107 patients with malignant neoplasms and 136 samples. Repeated infection with K. pneumoniae and E. coli occurred in 31% and 22.45% of patients, respectively. Patients stayed for a longer period in the ICU were more likely to have repeated infections (OR 1.25, 95%CI 1.10-1.44, p=0.001) after control of other confounding factors. The type of malignant neoplasm whether it was hematologic or solid tumor (OR 7.46, 95% CI 2.56-21.7, p=0.0002) and a longer prior stay in the ICU (OR 1.14, 95% CI 1.02-1.28, p=0.025) remained the independent predictors for the drug resistance in the last infection. The TEM type of β-lactamase was encoded in 48.68% and 66.67% of K. pneumoniae and E. coli, respectively. Conclusion: Reinfection with K. pneumoniae and E. coli in patients with cancer can occur as the number of days in the hospital increases. Total prior days spent in the ICU by cancer patients were independently associated with both repeated infections and drug resistance. Samples from patients with hematologic neoplasms were associated with drug resistance.

scholarly journals Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ifeyinwa N. Nwafia ◽  
Martin E. Ohanu ◽  
Samuel O. Ebede ◽  
Uchenna C. Ozumba
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Associated Risk Factors

Abstract Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli. Conclusion There is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

scholarly journals Emergence of Serratia marcescens, Klebsiella pneumoniae, and Escherichia coli Isolates Possessing the Plasmid-Mediated Carbapenem-Hydrolyzing β-Lactamase KPC-2 in Intensive Care Units of a Chinese Hospital

2008 ◽  
Vol 52 (6) ◽  
pp. 2014-2018 ◽  
Author(s):  
Jia Chang Cai ◽  
Hong Wei Zhou ◽  
Rong Zhang ◽  
Gong-Xiang Chen
Keyword(s):  
Escherichia Coli ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Serratia Marcescens ◽  
Intensive Care Units ◽  
Gel Electrophoresis ◽  
Outer Membrane Proteins ◽  
Carbapenem Resistance ◽  
E Coli ◽  
Insertional Inactivation

ABSTRACT Twenty-one Serratia marcescens, ten Klebsiella pneumoniae, and one Escherichia coli isolate with carbapenem resistance or reduced carbapenem susceptibility were recovered from intensive care units (ICUs) in our hospital. Enterobacterial repetitive intergenic consensus-PCR and pulsed-field gel electrophoresis demonstrated that all the S. marcescens isolates belonged to a clonal strain and the 10 K. pneumoniae isolates were indistinguishable or closely related to each other. The MICs of imipenem, meropenem, and ertapenem for all isolates were 2 to 8 μg/ml, except for K. pneumoniae K10 (MICs of 128, 256, and >256 μg/ml). Isoelectric focusing, PCRs, and DNA sequencing indicated that all S. marcescens isolates produced KPC-2 and a β-lactamase with a pI of 6.5. All K. pneumoniae isolates produced TEM-1, KPC-2, CTX-M-14, and a β-lactamase with a pI of 7.3. The E. coli E1 isolate produced KPC-2, CTX-M-15, and a β-lactamase with a pI of 7.3. Conjugation studies with E. coli (EC600) resulted in the transfer of reduced carbapenem susceptibility compared to that of the original isolates, and only the bla KPC-2 gene was detected in E. coli transconjugants. Plasmid restriction analysis showed identical restriction patterns among all E. coli transconjugants. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and ompK35/36 gene sequence analysis of outer membrane proteins revealed that K. pneumoniae K10 failed to express OmpK36, because of insertional inactivation by an insertion sequence ISEcp1. All these results indicate that KPC-2-producing S. marcescens, K. pneumoniae, and E. coli isolates emerged in ICUs in our hospital. KPC-2 combined with porin deficiency results in high-level carbapenem resistance in K. pneumoniae. The same bla KPC-2-encoding plasmid was spread among the three different genera.

scholarly journals Comparative Genomics of an IncA/C Multidrug Resistance Plasmid from Escherichia coli and Klebsiella Isolates from Intensive Care Unit Patients and the Utility of Whole-Genome Sequencing in Health Care Settings

2014 ◽  
Vol 58 (8) ◽  
pp. 4814-4825 ◽  
Author(s):  
Tracy H. Hazen ◽  
LiCheng Zhao ◽  
Mallory A. Boutin ◽  
Angela Stancil ◽  
Gwen Robinson ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Comparative Genomics ◽  
Resistance Genes ◽  
Whole Genome ◽  
Content Type ◽  
Health Care Settings ◽  
E Coli

ABSTRACTThe IncA/C plasmids have been implicated for their role in the dissemination of β-lactamases, including gene variants that confer resistance to expanded-spectrum cephalosporins, which are often the treatment of last resort against multidrug-resistant, hospital-associated pathogens. AblaFOX-5gene was detected in 14Escherichia coliand 16Klebsiellaisolates that were cultured from perianal swabs of patients admitted to an intensive care unit (ICU) of the University of Maryland Medical Center (UMMC) in Baltimore, MD, over a span of 3 years. Four of the FOX-encoding isolates were obtained from subsequent samples of patients that were initially negative for an AmpC β-lactamase upon admission to the ICU, suggesting that the AmpC β-lactamase-encoding plasmid was acquired while the patient was in the ICU. The genomes of fiveE. coliisolates and sixKlebsiellaisolates containingblaFOX-5were selected for sequencing based on their plasmid profiles. An ∼167-kb IncA/C plasmid encoding the FOX-5 β-lactamase, a CARB-2 β-lactamase, additional antimicrobial resistance genes, and heavy metal resistance genes was identified. Another FOX-5-encoding IncA/C plasmid that was nearly identical except for a variable region associated with the resistance genes was also identified. To our knowledge, these plasmids represent the first FOX-5-encoding plasmids sequenced. We used comparative genomics to describe the genetic diversity of a plasmid encoding a FOX-5 β-lactamase relative to the whole-genome diversity of 11E. coliandKlebsiellaisolates that carry this plasmid. Our findings demonstrate the utility of whole-genome sequencing for tracking of plasmid and antibiotic resistance gene distribution in health care settings.

Molecular characterization of DHA-1–producing Klebsiella pneumoniae isolates collected during a 4-year period in an intensive care unit

2014 ◽  
Vol 80 (2) ◽  
pp. 159-161 ◽  
Author(s):  
Fabrice Compain ◽  
Dominique Decré ◽  
Jean-Pierre Fulgencio ◽  
Sfia Berraho ◽  
Guillaume Arlet ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Molecular Characterization

Risk Factors for Gastrointestinal Colonization by ESBLProducing Klebsiella pneumoniae and Escherichia coli in Anaesthesiology and Reanimation Intensive Care Unit

2013 ◽  
Vol 47 (2) ◽  
pp. 223-229 ◽  
Author(s):  
Serpil OĞUZ MIZRAKÇI ◽  
Bilgin ARDA ◽  
Hüseyin Aytaç ERDEM ◽  
Mehmet UYAR ◽  
Alper TÜNGER ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Gastrointestinal Colonization

Acquisition of extended-spectrum β-lactamase producing Escherichia coli strains in male and female infants admitted to a neonatal intensive care unit: molecular epidemiology and analysis of risk factors

2010 ◽  
Vol 59 (8) ◽  
pp. 948-954 ◽  
Author(s):  
Shazi Shakil ◽  
Mohammad Akram ◽  
Syed M. Ali ◽  
Asad U. Khan
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Male And Female ◽  
E Coli ◽  
Factors Associated ◽  
Northern India ◽  
Advanced Generation

Extended-spectrum β-lactamases (ESBLs) are bacterial enzymes that confer resistance to advanced generation cephalosporins and can lead to therapeutic failures. There has been no analysis of factors associated with the risk of acquisition of ESBLs in neonates in an intensive care unit from northern India. The CTX-M ESBL enzymes impart resistance against advanced generation cephalosporins (e.g. cefotaxime) and CTX-M variants have become the most prevalent ESBLs worldwide. The CTX-M-15 enzyme in particular is increasingly being reported from Escherichia coli isolates from northern India together with TEM-1. Moreover, E. coli is the most common cause of neonatal sepsis. Accordingly, this study aimed to: (i) characterize the mode of transmission of bla CTX-M and bla TEM among ESBL-producing E. coli strains isolated from patients admitted to a neonatal intensive care unit (NICU), and (ii) identify factors associated with the acquisition of the said strains in male and female neonates. A total of 97 ESBL-producers was identified among 266 E. coli strains isolated from 238 neonates. The isolates were screened for bla CTX-M, bla TEM, armA, rmtA and rmtB, the last three genes being responsible for aminoglycoside resistance. PCR amplified bla CTX-M genes were cloned and sequenced. Five bla CTX-M-15, two rmtB, two bla TEM-1 and thirteen class1 integrons were detected. All the bla CTX-M-15 positive isolates, except one, were clonally related. Both univariate and multivariate analyses of factors for the acquisition of the said strains were performed with respect to the sex of the neonates. ‘Length of stay in the NICU’ was found to be the single independent factor associated with ESBL acquisition. In conclusion, our data suggest that male neonates who are colonized or infected by ESBL-producing E. coli have a longer stay in the NICU compared to their female counterparts. This prolonged stay may be due to male neonates becoming colonized/infected earlier than their female counterparts. Plasmid-mediated-conjugal transfer was found to be the mechanism of transfer of the bla CTX-M-15 resistance marker in the described setting.

scholarly journals Emergence of Nosocomial Pneumonia Caused by Colistin-Resistant Escherichia coli in Patients Admitted to Chest Intensive Care Unit

Antibiotics ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 226 ◽  
Author(s):  
Mohamed A. El-Mokhtar ◽  
Enas Daef ◽  
Aliae A. R. Mohamed Hussein ◽  
Maiada K. Hashem ◽  
Hebatallah M. Hassan
Keyword(s):  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Pneumonia ◽  
Resistance Rate ◽  
University Hospital ◽  
Colistin Resistance ◽  
E Coli ◽  
Extended Spectrum ◽  
Resistant Strains

(1) Background: Colistin is a last-resort antibiotic used in treating multidrug-resistant Gram-negative infections. The growing emergence of colistin resistance in Escherichia coli (E. coli) represents a serious health threat, particularly to intensive care unit (ICU) patients. (2) Methods: In this work, we investigated the emergence of colistin resistance in 140 nosocomial E. coli isolated from patients with pneumonia and admitted to the chest ICU over 36 months. Virulence and resistance-related genes and E. coli pathotypes in colistin-resistant and colistin-sensitive isolates were determined. (3) Results: Colistin resistance was observed in 21/140 (15%) of the nosocomial E. coli isolates. The MIC50 of the resistant strains was 4 mg/L, while MIC90 was 16 mg/L. Colistin-resistant isolates were also co-resistant to amoxicillin, amoxicillin/clavulanic, aztreonam, ciprofloxacin, and chloramphenicol. The mechanism of colistin resistance was represented by the presence of mcr-1 in all resistant strains. Respectively, 42.9% and 36.1% of colistin-resistant and colistin-sensitive groups were extended-spectrum β-lactamase (ESBL) producers, while 23.8% and 21% were metallo β-lactamase (MBL) producers. blaTEM-type was the most frequently detected ESBL gene, while blaIMP-type was the most common MBL in both groups. Importantly, most resistant strains showed a significantly high prevalence of astA (76.2%), aggR (76.2%), and pic (52.4%) virulence-related genes. Enteroaggregative E. coli (76%) was the most frequently detected genotype among the colistin-resistant strains. (4) Conclusion: The high colistin resistance rate observed in E. coli strains isolated from patients with nosocomial pneumonia in our university hospital is worrisome. These isolates carry different drug resistance and virulence-related genes. Our results indicate the need for careful monitoring of colistin resistance in our university hospital. Furthermore, infection control policies restricting the unnecessary use of extended-spectrum cephalosporins and carbapenems are necessary.

Sign in / Sign up

Export Citation Format

Share Document