scholarly journals High prevalence rate of extended-spectrum beta-lactamases (ESBL) among Enterobacteriaceae in a small Brazilian public hospital

2011 ◽  
Vol 47 (4) ◽  
pp. 701-707 ◽  
Author(s):  
Adriane Lenhard-Vidal ◽  
Rosilene Fressatti Cardoso ◽  
Rubia Andreia Falleiros de Pádua ◽  
Vera Lúcia Dias Siqueira

The production of extended-spectrum beta-lactamases (ESBL) is considered one of the most important resistance mechanisms that impair antimicrobial treatment of infections caused by Enterobacteriaceae. Data on culture and susceptibility tests were collected from the Clinical Analyses and Research Laboratory charts reporting on patients admitted to the University Hospital of Maringá (HUM) from January 2004 to December 2009. The following Enterobacteriaceae were selected: Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter spp. and Proteus mirabilis. All tests were performed according to the recommendations of the Clinical and Laboratory Standards Institute (biochemical identification; susceptibility tests; initial screening and phenotypic confirmatory tests for ESBL). For Enterobacter spp. isolates, a disk approximation test was carried out, adding a cefepime disk. Seven hundred samples were analyzed, and E. coli was the most prevalent bacteria (n= 356). ESBLs were detected phenotypically in 7.3% of E. coli, 61.7% of K. pneumoniae, 33.3% of K. oxytoca, 7.1% of P. mirabilis, and 13.4% of Enterobacter spp samples. Overall ESBL prevalence reached 22% when all producers were taken together. Although HUM is considered a small-sized hospital, it showed high levels of resistance to antimicrobial agents, similar to those observed in bigger hospitals, which demonstrated the need for careful epidemiological surveillance.

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Ngom B ◽  
◽  
Wade SF ◽  
Diop TA ◽  
Diagne R ◽  
...  

Introduction: Some strains of Escherichia coli and Klebsiella pneumoniae produce Extended Spectrum Beta-Lactamases (ESBL) may be responsible for various infections such as urinary infections. These Sick people are treated in the very serious cases by association antibiotics to class to betalactamins, aminosids and quinolons. But proliferation of multi-drug resistant strains involves decreasing therapeutic success. That’s why epidemiological study must be done in all laboratories of bacteriology. Purpose: The aim of the study was to research the resistance phenotypes of our E. coli and K. pneumoniae ESBL strains compared to others families of antibiotics. Material and methods: Thirty two (32) Extended Spectrum betalactamases E. coli and K. pneumoniae strains isolated from either hospitalized patients or sick people who came for consultation were studied. Susceptibility to antimicrobial agents was determined using an antibiotic disk (Bio-Rad) diffusion method on Mueller-Hinton agar (Bio-Rad). The results were interpreted according to the Standards of the French Antibiogram Committee (CA-SFM). Results: The study showed that most of these strains were multi-drug resistant. They were resistant to many beta-lactamines antibiotics. E. coli strains were also resistant at 70,34% to aminosids, at 96,72% to quinolons, at 58,3% to cotrimoxazol, at 26,1% to chloramphénicol and at 21,4% to colistin ; about K. pneumoniae, they were resistant at 72,6% to aminosids, at 88,95% to quinolons, at 86,7% to cotrimoxazol, at 44,4% to chloramphénicol and at 25% to colistin. But all these strains were sensitive at 100% to l’imipenem.


2009 ◽  
Vol 4 (01) ◽  
pp. 024-029 ◽  
Author(s):  
Srujana Mohanty ◽  
Rajni Gaind ◽  
Rajeev Ranjan ◽  
Monorama Deb

Background: Extended-spectrum beta-lactamases (ESBLs) may not always be detected in routine susceptibility tests. This study reports the performance of the cefepime-clavulanate ESBL Etest for the detection of ESBLs in Enterobacteriaceae, including those producing AmpC enzyme. Methodology:  Consecutive non-duplicate isolates of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolated from bloodstream infections from January to June 2008 were tested for ESBL by both the standard CLSI double-disk diffusion method using ceftazidime and cefotaxime disks and Etests using ceftazidime/ceftazidime-clavulanate, cefotaxime/cefotaxime-clavulanate and cefepime/cefepime-clavulanate gradients. Isolates were also tested for the presence of transferable AmpC beta-lactamase by AmpC disk test and the efficacies of the different Etests in detecting ESBL production were compared.   Results: A total of 113 bacterial isolates (61 K. pneumoniae, 50 E. coli, and 2 P. mirabilis) were recovered. Respectively, 42 (37.2%) and 55 (48.7%) isolates were positive for ESBL by the ceftazidime-clavulanate and cefotaxime-clavulanate combined disk tests.  The cefepime/cefepime-clavulanate Etest strip detected the maximum number of isolates (70/113, 61.9 %) as ESBL-positive compared to the ceftazidime/ceftazidime-clavulanate and cefotaxime/cefotaxime-clavulanate strips, which detected 57 (50.4%) isolates each as ESBL-positive. All three ESBL Etest strips were equally effective in detecting ESBL in the isolates that were AmpC negative. In the 66 (58.4%) isolates that co-produced AmpC in addition to the ESBL enzymes, cefepime/cefepime-clavulanate Etest strip detected ESBL in an additional 13 (11.4%) isolates as compared to the other ESBL Etest strips. Conclusions: Cefepime-clavulanate ESBL Etest is a suitable substitute to test for ESBL production, especially in organisms producing AmpC beta-lactamases.  


2021 ◽  
Vol 37 (2) ◽  
pp. 56-73
Author(s):  
F Iseghohi ◽  
J.C Igwe ◽  
M Galadima ◽  
A.F Kuta ◽  
A.M Abdullahi ◽  
...  

Globally, urinary tract infections are one of the most common infections in need of urgent clinical attention. The prevalence of extended spectrum beta-lactamases (ESBL)- producing Escherichia coli isolated from urine samples of some UTI patients and s of apparently healthy individuals in Minna, Nigeria, is investigated. Standard microbiological techniques were used to conduct this study. A total of 170 catch midstream urine samples submitted to the Medical Microbiology Laboratories of 4 different hospitals (and samples from healthy individuals) were randomly collected for 5 months and examined for microbial growths. Female patients (65.9%) submitted more urine samples for UTI test than their male counterpart (34.1%). The age ranges of 21 -30 (26.5%) and 31 - 40 (25.3%) had the highest percentages of infection rate while those within the ages 1- 10 (3.5%) and ≥ 71 (2.3%) were the least infected. This study observed a prevalence of 23.5% of E. coli in Minna metropolis and a significant number (30%) of healthy individuals (HI) was observed to harbor the E. coli in their urine. The isolates were highly susceptible to Gentamicin (65%), Ofloxacin (65%), Tetracycline (62.5%), Cotrimoxazole (62.5%), and Streptomycin (57.5%). Mildly susceptible to Pefloxacin (37.5%), Chloramphenicol (37.5%), and Ciprofloxacin (35%). There were significant resistance to most of the beta-lactames tested [Cefuroxime (80%), Amoxicillin (42.5%), Augmentin (40), Cefotaxime (20%) and Ceftaxidime (7.5%)]. Two of the isolates were resistant to all the 13 antibiotics tested; 70% (28) of the isolates had multiple antibiotics resistance index (MARI) ≥0.3. Multidrug resistance was expressed in 37.5% of the isolates tested. The study showed a vast resistant pool in the environment. Only 25% of the E. coli isolated from the urine samples produced beta-lactamases phenotypically, most of which expressed resistance to more than 5 of the antibiotics tested and had MARI of ≥ 0.5. Further evaluation showed that 25% (10/40) of the E. coli isolated from the UTI patients in Minna, Nigeria, were ESBL- producers and could harbor one or two of the genes. TEM gene was expressed in 70% (7) of the isolates that produced ESBL phenotypically, 60% 6) harbored CTXM gene, 20% (2) had the OXA gene while none of the bacteria harbored the SHV gene. The study established a 5.9% ESBL prevalence among the E. coli isolated from UTI in the environment studied. This study established that E. coli is one of the prevalent bacteri urea majorly isolated from UTI patients in Minna. The prevalent E. coli are multidrug resistant and could harbor more than one ESBL gene . keywords: Escherichia coli, Minna, UTI, ESBL, Multidrug resistance


Author(s):  
Thalita M. FREIRE ◽  
Elana F. CHAVES ◽  
José M. ALCÂNTARA-NETO ◽  
Paulo P. SOUSA ◽  
Jorge N. RODRIGUES ◽  
...  

Objective: To assess the microbiological profile of culture results of patients admitted in a public university hospital from Fortaleza, Brazil. Methods: This is a descriptive and prospective study with patients being followed up in an antimicrobial stewardship program and in use of reserve or strategic antimicrobial agents, which had cultures requested between May and November 2017. Data was obtained from the patient’s records, registered and analyzed using Excel spreadsheets and Graph Pad Prism statistical software. Results: Male patients (60.2%), non-elderly (63.6%), with hospital discharge clinical outcome (84.7%) and kidney transplant specialty (35.6%) prevailed. We analyzed the result of 490 cultures, with a higher frequency of urine cultures (35.3%) and blood cultures (34.7%) than others cultures. The specialty with most requests was kidney and liver transplant. 19.8% of the cultures were positive, predominantly gram-negative bacilli (72.2%), especially in the urine cultures of transplant patients. Microbiological analysis showed that Klebsiella pneumoniae (49.1%) and Escherichia coli (39.6%) were the bacteria most frequently found. Regarding the microbial resistance profile, we identified carbapenemase producing bacteria (16.7%), Extended spectrum beta-lactamases (ESBL; 33.3%) within the group of gramnegative bacilli and Vancomycin-resistence enterococcus (VRE; 13.5%) within the group of gram-positive cocci. Conclusions: The study enabled the knowledge of the profile of microorganisms isolated in the wards under study, which is of fundamental importance for local epidemiological studies and for the control of microbial resistance.


2012 ◽  
Vol 56 (7) ◽  
pp. 4013-4017 ◽  
Author(s):  
Katerina Albrechtova ◽  
Monika Dolejska ◽  
Alois Cizek ◽  
Dagmar Tausova ◽  
Jiri Klimes ◽  
...  

ABSTRACTResistance inEscherichia coliisolates colonizing gastrointestinal tracts of dogs, cats, and their owners in Northern Kenya was investigated with an emphasis on extended-spectrum beta-lactamases (ESBLs). Totals of 47 (22%,n= 216), 2 (4%,n= 50), and 4 (17%,n= 23) CTX-M-15-producingE. coliisolates were obtained from dogs, cats, and humans, respectively. CTX-M-15-producingE. coliisolates with identical PFGE profiles were detected in animals and humans living in the same area.


2007 ◽  
Vol 56 (2) ◽  
pp. 241-249 ◽  
Author(s):  
Joachim Schmitt ◽  
Enno Jacobs ◽  
Herbert Schmidt

Between January and September 2003, 39 isolates of the family Enterobacteriaceae with phenotypically positive Vitek 1 extended-spectrum beta-lactamase (ESBL) test results were collected, originating from patients of two hospitals in Saxony, Germany. Plasmid DNA was isolated and screened by PCR for the presence of genes encoding beta-lactamases of SHV, TEM and CTX-M types. To differentiate ESBL and non-ESBL among SHV and TEM genes, detailed analysis of PCR products was performed. Twenty-four strains carried SHV-2, SHV-5 or SHV-12 genes. In a further 11 strains a CTX-M gene was detected. The CTX-M genes could be affiliated to the CTX-M-1 and CTX-M-9 cluster by RFLP analysis. In the case of four Klebsiella oxytoca isolates, hyperproduction of the chromosomal beta-lactamase K1 was inferred, because genes of the above-mentioned types were not detected. The strains contained plasmid DNA between 45 and 160 kb in size. Common plasmid restriction patterns among SHV-5 producers provided evidence of horizontal spread. Twenty strains had a MIC for cefotaxime of ⩽4 mg l−1, 18 strains had the same MIC for ceftazidime, and nine strains had this MIC of >4 mg l−1 for both antibiotics. The ESBL phenotypes often coincided with ciprofloxacin or gentamicin resistance.


2017 ◽  
Vol 22 (31) ◽  
Author(s):  
Tommaso Giani ◽  
Alberto Antonelli ◽  
Mariasofia Caltagirone ◽  
Carola Mauri ◽  
Jessica Nicchi ◽  
...  

Extended-spectrum beta-lactamases (ESBLs), AmpC-type beta-lactamases (ACBLs) and carbapenemases are among the most important resistance mechanisms in Enterobacteriaceae. This study investigated the presence of these resistance mechanisms in consecutive non-replicate isolates of Escherichia coli (n = 2,352), Klebsiella pneumoniae (n = 697), and Proteus mirabilis (n = 275) from an Italian nationwide cross-sectional survey carried out in October 2013. Overall, 15.3% of isolates were non-susceptible to extended-spectrum cephalosporins but susceptible to carbapenems (ESCR-carbaS), while 4.3% were also non-susceptible to carbapenems (ESCR-carbaR). ESCR-carbaS isolates were contributed by all three species, with higher proportions among isolates from inpatients (20.3%) but remarkable proportions also among those from outpatients (11.1%). Most ESCR-carbaS isolates were ESBL-positive (90.5%), and most of them were contributed by E. coli carrying bla CTX-M group 1 genes. Acquired ACBLs were less common and mostly detected in P. mirabilis. ESCR-carbaR isolates were mostly contributed by K. pneumoniae (25.1% and 7.7% among K. pneumoniae isolates from inpatients and outpatients, respectively), with bla KPC as the most common carbapenemase gene. Results showed an increasing trend for both ESBL and carbapenemase producers in comparison with previous Italian surveys, also among outpatients.


Author(s):  
Rafael Cantón ◽  
◽  
Elena Loza ◽  
Ricardo M. Arcay ◽  
Emilia Cercenado ◽  
...  

Objective. To analyse the susceptibility to ceftolozane-tazobactam and comparators in Enterobacterales and Pseudomonas aeruginosa isolates recovered from intraabdominal (IAI), urinary (UTI), respiratory (RTI) and bloodstream infection (BSI) in the SMART (Study for Monitoring Antimicrobial Resistance Trends) study. Methods. The susceptibility of 5,351 isolates collected in 11 Spanish hospitals (2016-2018) were analysed (EUCAST-2020 criteria) by broth microdilution and were phenotypically studied for the presence of extended-spectrum beta-lactamases (ESBL). Ceftolozane-tazobactam and/or carbapenem resistant isolates were genetically characterized for ESBL and carbapenemases. Results. Escherichia coli was the most frequent pathogen (49.3% IAI, 54.9% UTI, 16.7% RTI and 50% BSI), followed by Klebsiella pneumoniae (11.9%, 19.1%, 13.1% and 15.4%, respectively). P. aeruginosa was isolated in 9.3%, 5.6%, 32% and 9%, respectively. The frequency of isolates with ESBLs (2016-2017) was: 30.5% K. pneumoniae, 8.6% E. coli, 2.3% Klebsiella oxytoca and 0.7% Proteus mirabilis. Ceftolozane-tazobactam was very active against non-ESBL-(99.3% susceptible) and ESBL-(95.2%) producing E. coli being less active against K. pneumoniae (98% and 43.1%, respectively) isolates. CTX-M-15 was the most prevalent ESBL in E. coli (27.5%) and K. pneumoniae (51.9%) frequently associated with OXA-48-like carbapenemase. Overall, 93% of P. aeruginosa isolates were susceptible to ceftolozane-tazobactam, preserving this activity (>75%) in isolates resistant to other beta-lactams except in those resistant to meropenen or ceftazidime-avibactam. GES-5, PER-1, VIM-1/2 were the most prevalent enzymes in isolates resistant to ceftolozane-tazobactam. Conclusions. Ceftolozane-tazobactam showed high activity rates against isolates recovered in the SMART study although it was affected in K. pneumoniae and P. aeruginosa isolates with ESBL and/or carbapenemases.


2021 ◽  
Vol 7 (1) ◽  
pp. 8
Author(s):  
Ni Luh Ranthi Kurniawathi ◽  
Indramawan Setyojatmiko ◽  
Ni Nyoman Sri Budayanti

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


2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Kotsoana Peter Montso ◽  
Sicelo Beauty Dlamini ◽  
Ajay Kumar ◽  
Collins Njie Ateba

Background. Extended spectrum beta-lactamases (ESBLs) producing Enterobacteriaceae cause severe infections in humans which leads to complicated diseases. There is increasing evidence that cattle contribute to the development and spread of multidrug resistant pathogens and this raises public health concern. Despite this, data on the concurrence of ESBL producing pathogens in cattle, especially in the North-West province are rare. Therefore, the aim of the present study was to isolate, identify and characterise ESBL producing E. coli and K. pneumoniae species from cattle faeces and raw beef samples. Results. A total of 151 samples comprising 55 faeces samples and 96 raw beef samples were collected and 259 nonreplicative potential isolates of Enterobacteriaceae were obtained. One hundred and ninety-six isolates were confirmed as E. coli (114; 44%) and K. pneumoniae (82; 32%) species through amplification of uspA and uidA and ntrA gene fragments, respectively. Antimicrobial susceptibility test revealed that large proportions (66.7–100%) of the isolates were resistant to Amoxicillin, Aztreonam, Ceftazidime, Cefotaxime, and Piperacillin and were multidrug resistant isolates. Cluster analysis of antibiotic inhibition zone diameter data revealed close similarities between isolates from different sources or species thus suggested a link in antibiotic exposures. The isolates showing phenotypic resistance against ESBL antimicrobial susceptibility tests were screened for the presence of ESBL gene determinants. It was observed that 53.1% of the isolates harboured ESBL gene determinants. The blaTEM, blaSHV and blaCTX-M genes were detected in E. coli isolates (85.5%, 69.6%, and 58%, respectively) while blaCTX-M and blaOXA were detected in K. pneumoniae (40% and 42.9%, respectively). All the genetically confirmed ESBL producing E. coli and K. pneumoniae isolates were subjected to Enterobacterial Repetitive Intergenic Consensus (ERIC) PCR analysis. Fingerprinting data revealed great similarities between isolates from different areas and sources which indicates cross-contamination between cattle and beef. Conclusion. This study revealed that cattle and its associated food products, beef in particular, harbour ESBL producing pathogens. And this warrants a need to enforce hygiene measures and to develop other mitigation strategies to minimise the spread of antibiotic resistant pathogens from animals to human.


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