scholarly journals Nosocomial infection and characterization of extended-spectrum β-lactamases-producing Enterobacteriaceae in Northeast Brazil

2011 ◽  
Vol 44 (4) ◽  
pp. 441-446 ◽  
Author(s):  
Afonso Gomes Abreu ◽  
Sirlei Garcia Marques ◽  
Valério Monteiro-Neto ◽  
Roberto Morais Luz de Carvalho ◽  
Azizedite Guedes Gonçalves
Keyword(s):  
Klebsiella Pneumoniae ◽  
Nosocomial Infection ◽  
Klebsiella Oxytoca ◽  
Detection Methods ◽  
Northeast Brazil ◽  
Esbl Production ◽  
Extended Spectrum ◽  
Disk Method ◽  
Esbl Producers

INTRODUCTION: Extended spectrum β-lactamases (ESBLs) are enzymes that degrade β-lactam antibiotics and have been reported to be an important cause of nosocomial infection in worldwide. METHODS: During 2009, 659 enterobacteria strains were isolated from different clinical specimens and tested for ESBL production. The disk approximation test, combined disk method and addition of clavulanic acid were used for phenotypic detection of the ESBL-producing strains and PCR for detection of the blaTEM and blaCTX-M genes. RESULTS: Among the isolates, 125 were ESBL producers. The blaCTX-M and blaTEM genes were detected in 90.4% and 75% of the strains, respectively. Most strains were isolated from urine. Klebsiella pneumoniae was the most prevalent organism. Microorganisms presented high resistance to the antibiotics. CONCLUSIONS: These results support the need for extending ESBL detection methods to different pathogens of the Enterobacteriaceae family because these methods are only currently standardized by the CLSI for Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. Carbapenems were the antibiotic class of choice for the treatment of infections caused by ESBL-producing Enterobacteriaceae.

scholarly journals Risk factors for and mortality of extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections

2009 ◽  
Vol 51 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Silvana Vargas Superti ◽  
Gustavo Augusti ◽  
Alexandre Prehn Zavascki
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Risk Factor ◽  
Klebsiella Pneumoniae ◽  
Bloodstream Infections ◽  
Blood Cultures ◽  
Esbl Production ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

A case-control study, involving patients with positive blood cultures for Klebsiella pneumoniae (KP) or Escherichia coli (EC) EC and controls with positive blood cultures for non-ESBL-KP or EC, was performed to assess risk factors for extended-spectrum-β-lactamase (ESBL) production from nosocomial bloodstream infections (BSIs). Mortality among patients with BSIs was also assessed. The study included 145 patients (81, 59.5% with K. pneumoniae and 64, 44.1% with E. coli BSI); 51 (35.2%) isolates were ESBL producers and 94 (64.8%) nonproducers. Forty-five (55.6%) K. pneumoniae isolates were ESBL producers, while only six (9.4%) E. coli isolates produced the enzyme. Multivariate analysis showed that recent exposure to piperacillin-tazobactam (adjusted Odds Ratio [aOR] 6.2; 95%CI 1.1-34.7) was a risk factor for ESBL BSI. K. pneumoniae was significantly more likely to be an ESBL-producing isolate than E. coli (aOR 6.7; 95%CI 2.3-20.2). No cephalosporin class was independently associated with ESBLs BSI; however, in a secondary model considering all oxymino-cephalosporins as a single variable, a significant association was demonstrated (aOR 3.7; 95%CI 1.3-10.8). Overall 60-day mortality was significantly higher among ESBL-producing organisms. The finding that piperacillin-tazobactam use is a risk factor for ESBL-production in KP or EC BSIs requires attention, since this drug can be recommended to limit the use of third-generation cephalosporins.

scholarly journals Increased Serum Resistance in Klebsiella pneumoniae Strains Producing Extended-Spectrum β-Lactamases

2004 ◽  
Vol 48 (9) ◽  
pp. 3477-3482 ◽  
Author(s):  
H. Sahly ◽  
H. Aucken ◽  
V. J. Benedí ◽  
C. Forestier ◽  
V. Fussing ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Bactericidal Effect ◽  
Serum Resistance ◽  
Esbl Production ◽  
Pathogenic Potential ◽  
Extended Spectrum ◽  
Resistant Strains ◽  
Esbl Producers

ABSTRACT The aim of this study was to determine whether there is an association between serum resistance, O serotypes, and the production of extended-spectrum β-lactamases (ESBLs) in Klebsiella pneumoniae. Ninety ESBL-producing and 178 non-ESBL-producing K. pneumoniae isolates gathered in five European countries were O serotyped and tested for sensitivity to the serum's bactericidal effect. The frequency of serum-resistant isolates was higher among ESBL-producing strains (30%; 27/90 isolates) than among non-ESBL-producing strains (17.9%; 32/178 isolates) (P = 0.037; odds ratio [OR] = 1.96; 95% confidence interval [95% CI] = 1.08 to 3.53). Although O1 was the most common O serotype in both Klebsiella groups, its frequency among ESBL-producing strains was significantly higher (59%; 53/90 isolates) than among non-ESBL producers (36%; 64/178 isolates) (P = 0.0006; OR = 2.5; 95% CI = 1.52 to 4.29). Furthermore, the prevalence of the O1 serotype was higher among serum-resistant strains of both ESBL-producing (74%; 20/27isolates) and non-ESBL producers (75%; 24/32 isolates) than among serum-sensitive ESBL producers (52.4%; 33/63 isolates) and non-ESBL producers (27.4%; 40/146 isolates). Serum resistance among ESBL-producing strains (36%; 17/47 isolates) versus non-ESBL-producing strains (16%; 27/166 isolates) was also significantly higher after the exclusion of clonal strains (P = 0.0056; OR = 2.9; 95% CI = 1.41 to 6.01). Sixteen ESBL types were detected, among which the frequency of serum resistance was significantly lower among the SHV-producing strains (9/48 isolates) than among the TEM producers (16/35 isolates) (P = 0.016; OR = 3.65; CI = 1.3 to 9.7). Curing ESBL-coding plasmids did not influence the serum resistance of the bacteria; all six plasmid-cured derivatives maintained serum resistance. The present findings suggest that ESBL-producing strains have a greater pathogenic potential than non-ESBL-producing strains, but the linkage between O serotypes, serum resistance, and ESBL production remains unclear at this stage.

PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF EXTENDED SPECTRUM ?-LACTAMASE (ESBL) PRODUCING GRAM NEGATIVE BACILLI (KLEBSIELLA PNEUMONIA) IN A TERTIARY CARE TEACHING HOSPITAL, IN SOUTHERN-WEST KOTA DISTRICT OF RAJASTHAN (INDIA).

2021 ◽  
Vol 5 (4) ◽  
Author(s):  
Gopal Lal Meena ◽  
Ghanshyam Soni ◽  
Deepak Maheshwari
Keyword(s):  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Klebsiella Pneumonia ◽  
Esbl Production ◽  
Gram Negative ◽  
Medical College ◽  
Extended Spectrum ◽  
Sensitivity Pattern ◽  
Synergy Test ◽  
Esbl Producers

Background and Objectives: The resistance to broad spectrum ?-lactams which is mediated by the extended spectrum beta lactamase (ESBL) enzyme is an increasing problem now-a-days. This resistance mechanism has been responsible for nosocomial outbreaks, serious therapeutic failure if it is not detected on time and the outbreak of multidrug resistant, gram negative pathogens that need expensive control measures. Aim: To know the prevalence of ESBL production in klebsiella pneumoniae and antibiotic sensitivity pattern to 3rd generation of cephalosporins in Govt. Medical College Kota. Material and Methods: The study was conducted in Department of Microbiology, Kota Medical College, Kota, Rajasthan, from dec.2018 to dec.2019. Due permission from institutional ethical committee was obtained. This is descriptive observational study. All data were collected and analyzed with the help of suitable statistical parameters. A total of 101 consecutive, nonrepetitive, gram negative isolates, which were resistant to one of the third generation cephalosporins (cefotaxime,ceftriaxone or ceftazidime) were selected as “Suspicious for ESBL production” as recommended by the Clinical and Laboratory Standards Institute (CLSI). These isolates were confirmed for ESBL production by the double disc synergy test (DDST) and the phenotypic confirmatory disc diffusion test (PCDDT) and they were further confirmed by the E-test ESBL strip randomly.  Result: Out of the 101 isolates by double disc synergy test (DDST) 45.54% (46) of Klebsiella pneumoniae isolates were ESBL producers, while PCDDT detected 58.41% (59) Klebsiella pneumoniae isolates as ESBL producers (p value<0.05). Randomly selected isolates were further confirmed by the E-test ESBL strip, which showed a highly significant correlation with PCDDT. Key words: Antimicrobial Susceptibility, Klebsiella pneumoniae, Gram Negative bacilli, Cephalosporins

Prevalence of Extended Spectrum ß-Lactamase Producing Klebsiella Pneumoniae Isolates in A Tertiary Care Hospital in Bangladesh

2020 ◽  
Vol 6 (2) ◽  
pp. 101-104
Author(s):  
Suraiya Jahan Sonia ◽  
Tasnim Ahsan ◽  
Tafneen Farhana Ahmed ◽  
Shah Walia Nazneen ◽  
Kazi Hafiz Uddin ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Tertiary Care ◽  
Care Hospital ◽  
Esbl Production ◽  
College Hospital ◽  
Cross Sectional ◽  
Clinical Specimens ◽  
Medical College ◽  
Extended Spectrum ◽  
Esbl Producers

Background: Extended-spectrum β lactamases (ESBLs) continue to be a major challenge in clinical setups world over, conferring resistance to the expanded-spectrum cephalosporins. Objectives: The aim of this study was to determine the prevalence of extended spectrum β-lactamase (ESBL) in strains of Klebsiella pneumoniae isolated from different clinical specimens in Dhaka Medical College Hospital, Dhaka, Bangladesh. Methodology: This cross sectional study was carried out at the Department of Microbiology of Dhaka Medical College, Dhaka, Bangladesh from July 2016 to June 2017. Klebsiella pneumoniae were isolated from different clinical specimens from adult hospitalized patients. These isolates were screened for ESBL production according to Clinical and Laboratory Standards Institute (CLSI) guidelines. ESBL production was confirmed by the phenotypic confirmatory double disc synergy test (DDST). Results: Among the 500 collected samples 75 Klebsiella pneumoniae were isolated. Among them, 68 isolates were selected for confirmatory tests of ESBL according to CLSI guidelines. Finally, 19 isolates were confirmed as ESBL producers by DDST (25.33%). Conclusion: In the present study, a large number of isolates are found to be ESBL producers. Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 101-104

scholarly journals Heavy Metal Tolerance Trend in Extended-Spectrum β-Lactamase Encoding Strains Recovered from Food Samples

2021 ◽  
Vol 18 (9) ◽  
pp. 4718
Author(s):  
Kashaf Junaid ◽  
Hasan Ejaz ◽  
Iram Asim ◽  
Sonia Younas ◽  
Humaira Yasmeen ◽  
...  
Keyword(s):  
Heavy Metal ◽  
Metal Tolerance ◽  
Heavy Metal Tolerance ◽  
Heavy Metal Resistance ◽  
Metal Resistance ◽  
Food Samples ◽  
Esbl Production ◽  
Extended Spectrum ◽  
Retail Food ◽  
Esbl Producers

This study evaluates bacteriological profiles in ready-to-eat (RTE) foods and assesses antibiotic resistance, extended-spectrum β-lactamase (ESBL) production by gram-negative bacteria, and heavy metal tolerance. In total, 436 retail food samples were collected and cultured. The isolates were screened for ESBL production and molecular detection of ESBL-encoding genes. Furthermore, all isolates were evaluated for heavy metal tolerance. From 352 culture-positive samples, 406 g-negative bacteria were identified. Raw food samples were more often contaminated than refined food (84.71% vs. 76.32%). The predominant isolates were Klebsiella pneumoniae (n = 76), Enterobacter cloacae (n = 58), and Escherichia coli (n = 56). Overall, the percentage of ESBL producers was higher in raw food samples, although higher occurrences of ESBL-producing E. coli (p = 0.01) and Pseudomonas aeruginosa (p = 0.02) were observed in processed food samples. However, the prevalence of ESBL-producing Citrobacter freundii in raw food samples was high (p = 0.03). Among the isolates, 55% were blaCTX-M, 26% were blaSHV, and 19% were blaTEM. Notably, heavy metal resistance was highly prevalent in ESBL producers. These findings demonstrate that retail food samples are exposed to contaminants including antibiotics and heavy metals, endangering consumers.

scholarly journals Characterization of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates from the community in Morocco

2011 ◽  
Vol 60 (9) ◽  
pp. 1344-1352 ◽  
Author(s):  
Abouddihaj Barguigua ◽  
Fatima El Otmani ◽  
Mustapha Talmi ◽  
Fatna Bourjilat ◽  
Fatima Haouzane ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Extended Spectrum

The increased recurrence rate of liver abscess caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae

2019 ◽  
Author(s):  
Zhihui Chang ◽  
Yue Ren ◽  
Hairui Wang ◽  
Zhaoyu Liu
Keyword(s):  
Risk Factor ◽  
Klebsiella Pneumoniae ◽  
Recurrence Rate ◽  
Liver Abscess ◽  
Biliary Tract Disease ◽  
Gas Production ◽  
Esbl Production ◽  
Extended Spectrum ◽  
Recurrence Group

Abstract Background The pathogenic bacterium Klebsiella pneumoniae (KP) is the major causative agent of pyogenic liver abscess (PLA). But reports about the prognosis of KP-caused PLA (KPLA) are rare. This study aimed to ascertain the recurrence rate of KPLA after initial treatment, and its contributing factors.Methods The medical records data were retrospectively analyzed of KPLA patients who were admitted to Shengjing Hospital of China Medical University from January 2012 to January 2018. According to whether or not there was recurrence of KPLA during follow-up, the patients were divided into a ‘recurrence’ and a ‘non-recurrence’ group. The clinical and CT characteristics of patients were compared between the two groups, and those factors related to KPLA recurrence were further analyzed.Results A total of 110 patients who had first-time episodes of KPLA were included into the study. The average follow-up time was 3.65±2.18 years. Twenty (18.18%) KPLA patients experienced recurrence. Those in the recurrence group had a significantly greater incidence of extended-spectrum β-lactamase (ESBL) production compared to the non-recurrence group (30.0% vs 8.89%, P=0.018). Diabetes, biliary tract disease, and history of malignancy was not associated with recurrence (all P>0.05). No difference in the CT characteristics of KPLA (including abscess size, location, whether multilocular, gas production of KPLA, and thrombophlebitis) was found between the two groups. Multivariate regression analysis showed that ESBL production (OR, 6.3; 95% CI, 1.02–38.59; P=0.04) was an independent risk factor for the recurrence of KPLA.Conclusions KPLA has a high recurrence rate, and ESBL production is a risk factor for recurrent KPLA.

scholarly journals Klebsiella Pneumoniae in Septicemic Neonates with Special Reference to Extended Spectrum β-lactamase, AmpC, Metallo β-lactamase Production and Multiple Drug Resistance in Tertiary Care Hospital

2015 ◽  
Vol 7 (01) ◽  
pp. 032-037 ◽  
Author(s):  
Shivali V Gajul ◽  
Shivajirao T Mohite ◽  
Smita S Mangalgi ◽  
Sanjay M Wavare ◽  
Satish V Kakade
Keyword(s):  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Multiple Drug Resistance ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Neonatal Septicemia ◽  
Extended Spectrum ◽  
Disk Method

ABSTRACT Background: β-lactamases viz., extended spectrum β-lactamase (ESBL), AmpC, and metallo β-lactamase (MBL) production in Klebsiella pneumoniae has led to a serious concern about septicemic neonates in Neonatal Intensive Care Units due to high resistance against commonly used antimicrobials Purpose:To study the prevalence of ESBL, AmpC, and MBL production in K. pneumoniae isolates in neonatal septicemia, to check antimicrobial susceptibility to various drugs including tigecycline; and to assess burden of multiple drug resistance (MDR). Materials and Methods: Total 24 clinical isolates of K. pneumoniae isolated from 318 blood samples of suspected cases of neonatal septicemia were studied. Isolates were screened for ESBL, AmpC, and MBL production by Clinical and Laboratory Standards Institute (CLSI) disk method, AmpC cefoxitin screen, and imipenem, meropenem, ceftazidime disk screen respectively; and confirmation was done by CLSI phenotypic disk confirmatory test, AmpC sterile disk method, and imipenem ethylenediamine tetracetic acid double disk synergy test respectively. Antimicrobial susceptibility was determined by Kirby-Bauer's disk diffusion method. Efficacy of tigecycline was evaluated using United States Food and Drug Administration guidelines. Results: Of the 24 K. pneumoniae isolates, co-production of AmpC + MBL was found in more number of isolates (67%) (P < 0.0001) compared to single enzyme production (ESBL and MBL 8% both, AmpC 12.5%). Rate of resistance for penicillins and cephalosporins was highest. Susceptibility was more for imipenem, co-trimoxazole, and meropenem. Nonsusceptibility to tigecycline was low (21%). A total of 23 (96%) isolates were MDR. Conclusions: Routine detection of ESBL, AmpC, and MBL is required in laboratories. Carbapenems should be kept as a last resort drugs. Trend of tigecycline susceptibility has been noted in the study. Continued monitoring of susceptibility pattern is necessary to detect true burden of resistance for proper management.

Sign in / Sign up

Export Citation Format

Share Document