scholarly journals Detection of Carbapenemase Production in Clinical Isolates of Escherichia coli and Klebsiella Species

2021 ◽  
Vol 10 (11) ◽  
pp. 438-450
Author(s):  
Harvinder Kaur Sneha Mohan ◽  
Tarana Sarwat Dalip K. Kakru
Keyword(s):  
Escherichia Coli ◽  
Carbapenem Resistance ◽  
Polymyxin B ◽  
Clinical Isolates ◽  
Resistant Bacteria ◽  
Bacterial Strains ◽  
Klebsiella Species ◽  
Cross Sectional ◽  
E Coli ◽  
Carbapenem Resistant

The increasingly frequent application of carbapenemases induces a selective pressure on bacteria to acquire resistance against carbapenems. A large variety of carbapenemases have been identified in Enterobacteriaceae. The emergence of carbapenemases in E. coli and Klebsiella species possess a serious therapeutic problem in hospitals because carbapenems are often antibiotics of last resort for the treatment of serious infections caused by multidrug-resistant bacteria. The main aim of this study to determine the carbapenem-resistant strains of Escherichia coli and Klebsiella species. Detection of carbapenemase enzyme in the carbapenem-resistant Escherichia coli and Klebsiella species. This is a cross-sectional study, performed in the bacteriological laboratory. A total of 204 strains of Escherichia coli and 122 strains of Klebsiella species were isolated from patients admitted & attending the OPD at Sharda Hospital during the study period. The identification of the clinical isolates was based on morphological and biochemicals characterization. Result: Among the total number of bacterial growth received during the study period, the E. coli (204) was more in number as compared to other bacterial strains followed by Klebsiella species (122), Pseudomonas species (117), Staphylococcus aureus (100) and Enterococcus species (80). Among the following specimen i.e, urine (58.8%), was highly received during the study period followed by pus (15.3%) and sputum (7.5%). Colistin (100%) and Polymyxin B (100%) is found to be the most sensitive drug. Gentamicin (19.6%) and Cefuroxime (12.2%) are the least sensitive drugs. In the present study, we found that the Klebsiella species (75%) and Escherichia coli (64%) was the major reason of carbapenemase production but the organisms incidentally were susceptible to colistin and polymyxins (100%) followed by other antibiotics. This is a welcome finding in times of increasing carbapenem resistance & is reason enough to suggest the use of Polymyxins in the health care settings where the carbapenems to be used for the treatment of infections caused by Enterobacteriaceae.

scholarly journals Susceptibility of Tigecycline against Carbapenem Resistant Enterobacteriaceae

2021 ◽  
Keyword(s):  
Escherichia Coli ◽  
Respiratory Tract ◽  
Antimicrobial Susceptibility ◽  
Bacterial Infections ◽  
Large Family ◽  
Klebsiella Species ◽  
Cross Sectional ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Carbapenem Resistant Enterobacteriaceae

Background: Enterobacteriaceae, a large family of Gram-negative bacteria, are one of the commonest etiological agents causing serious bacterial infections to humans. Carbapenems are the group of antibiotics with a broad spectrum of antimicrobial action. Infections caused due to Carbapenem resistant Enterobacteriaceae (CRE) are a huge challenge for existing medical practice. Therefore, this project aimed to find out the antimicrobial susceptibility pattern of Tigecycline against CRE. Methods: This cross-sectional study with non-probability consecutive sampling was done at Ziauddin Hospital Microbiology Laboratory from 15th August 2017 to 15th April 2018. Accordingly, 151 isolates of CRE were collected from cultures of blood, respiratory tract, wound pus and other body fluids. The growth inhibition zones were measured following the Food and Drug Administration (FDA) disk diffusion breakpoint criteria. Frequencies and percentages were computed for gender, microorganism, and antimicrobial susceptibility. Chi-squared test was applied and p≤ 0.05 was considered as statistically significant. Results: Klebsiella species were most commonly isolated pathogen, 67.5% (n=102) followed by Escherichia coli (E. coli) 23.2% (n=35), Enterobacter 7.3% (n=11) and Serratia species 2% (n=3). Tigecycline was 97% (34 /35) sensitive for E. coli, 86.3% (88/102) for Klebsiella species), 91% (10/11) for Enterobacter species, and 100% for Serratia species. Klebsiella species showed the highest rate of resistance to tigecycline i.e., 13.7% of the total Klebsiella isolates. Conclusion: Among the Enterobacteriaceae family, Klebsiella species have the greatest ability to acquire resistance. Tigecycline showed good activity against isolates of CRE recovered from infections of skin, soft tissue, intra-abdomen, lower respiratory tract and blood stream. Keywords: Carbapenems; beta-Lactamases; Anti-Bacterial Agents; Tigecycline; Klebsiella; Escherichia coli.

Discrepancy between colistin and polymyxin B susceptibility results among Escherichia coli and Klebsiella pneumoniae clinical isolates

2021 ◽  
Author(s):  
Serap Süzük Yıldız ◽  
Can Hüseyin Hekimoğlu ◽  
Zekiye Bakkaloğlu ◽  
Emine Alp
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Polymyxin B ◽  
Multidrug Resistant ◽  
Clinical Isolates ◽  
Resistant Bacteria ◽  
Major Error ◽  
E Coli ◽  
Microdilution Method ◽  
Broth Microdilution Method

AbstractThe selection of therapeutic agent to be used for the treatment of multidrug-resistant bacteria is a major concern. Polymyxin B use has been commenced in Turkey, although its clinical breakpoint is not listed in the EUCAST. This study aimed to determine the correlation between the MIC values of polymyxin B and colistin. A total of 505 isolates, including 122 isolates of Escherichia coli and 383 isolates of Klebsiella pneumoniae were included in the present study. All the isolates were assessed for colistin and polymyxin B using the broth microdilution method. The categorical agreement in the E. coli isolates was 98.4%, and the rate of very major error was 33.3%. The categorical agreement in the K. pneumoniae isolates was 99.5%, the rate of major error was 0.36%, and the rate of very major error was 0.98%. In the evaluation of the essential agreement, 1.6% error in E. coli and 2.3% error in K. pneumoniae were observed. It was concluded that polymyxin B should never be used in the treatment of the isolates reported as colistin-resistant, and if the MIC values are above 4 mg/L in E. coli and K. pneumoniae. Our results indicate importance of reporting both polymyxin B and colistin susceptibility results of clinical isolates.

scholarly journals ESBL Activity, MDR, and Carbapenem Resistance among Predominant Enterobacterales Isolated in 2019

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 744
Author(s):  
Altaf Bandy ◽  
Bilal Tantry
Keyword(s):  
Escherichia Coli ◽  
Saudi Arabia ◽  
Antimicrobial Resistance ◽  
Carbapenem Resistance ◽  
Resistant Bacteria ◽  
Sociodemographic Characteristics ◽  
Chi Square ◽  
E Coli ◽  
Chi Square Test ◽  
Resistance Rates

Antimicrobial-resistance in Enterobacterales is a serious concern in Saudi Arabia. The present study retrospectively analyzed the antibiograms of Enterobacterales identified from 1 January 2019 to 31 December 2019 from a referral hospital in the Aljouf region of Saudi Arabia. The revised document of the Centers for Disease Control (CDC) CR-2015 and Magiorakos et al.’s document were used to define carbapenem resistance and classify resistant bacteria, respectively. The association of carbapenem resistance, MDR, and ESBL with various sociodemographic characteristics was assessed by the chi-square test and odds ratios. In total, 617 Enterobacterales were identified. The predominant (n = 533 (86.4%)) isolates consisted of 232 (37.6%), 200 (32.4%), and 101 (16.4%) Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis, respectively. In general, 432 (81.0%) and 128 (24.0%) isolates were of MDR and ESBL, respectively. The MDR strains were recovered in higher frequency from intensive care units (OR = 3.24 (1.78–5.91); p < 0.01). E. coli and K. pneumoniae resistance rates to imipenem (2.55 (1.21–5.37); p < 0.01) and meropenem (2.18 (1.01–4.67); p < 0.04), respectively, were significantly higher in winter. The data emphasize that MDR isolates among Enterobacterales are highly prevalent. The studied Enterobacterales exhibited seasonal variation in antimicrobial resistance rates towards carbapenems and ESBL activity.

scholarly journals Genome-Wide Identification of Carbapenem-Resistant Gram- Negative Bacterial (CR-GNB) Isolates Retrieved From Hospitalized Patients in Bihar, India

2021 ◽  
Author(s):  
Namrata Kumari ◽  
Mukesh Kumar ◽  
Amit Katiyar ◽  
Abhay Kumar ◽  
Pallavi Priya ◽  
...  
Keyword(s):  
Resistance Genes ◽  
Carbapenem Resistance ◽  
Cross Sectional Study ◽  
Clinical Isolates ◽  
Cross Sectional ◽  
Gram Negative ◽  
Carbapenem Resistant ◽  
Genome Wide ◽  
Synergy Test ◽  
Global Threat

Abstract Carbapenemase-producing clinical isolates are becoming more common over the world, posing a severe public health danger, particularly in developing nations like India. Carbapenem-resistant Gram-negative bacterial (CR-GNB) infection has become a fast-expending global threat with limited antibiotic choice and significant mortality. The aim of this study was to highlight the carbapenem-resistance among clinical isolates of hospital admitted patients in Bihar, India. A cross-sectional study was conducted with 101 clinical isolates of E. coli, K. pneumoniae, A. baumannii, and P. aeruginosa. All GNB isolates were tested for their antimicrobial susceptibility using double disc synergy test / modified hodge test (DDST/MHT) and subsequently confirmed carbapenemase-producing isolates were evaluated for carbapenem-resistance genes using whole-genome sequencing (genotypically) method. The overall percentage of carbapenem-resistance among GNB was (17/101) 16.83%. The AMR analysis demonstrates a significantly high prevalence of blaCTX−M followed by blaSHV, blaTEM, blaOXA and blaNDM β-lactams carbapenem-resistance genes among clinical isolates of GNB. Co-occurrence of carbapenemase-encoding genes with blaNDM was found in 70.6% of carbapenemase-producing isolates. Our study highlights the mechanism of carbapenem-resistance to curb the overwhelming threat posed by emergence of drug-resistance in India.

Statewide surveillance of carbapenemase-producing carbapenem-resistant Escherichia coli and Klebsiella species in Washington state, October 2012–December 2017

2020 ◽  
Vol 41 (6) ◽  
pp. 716-722
Author(s):  
Mimi R. Precit ◽  
Kelly Kauber ◽  
William A. Glover ◽  
Scott J. Weissman ◽  
Tashina Robinson ◽  
...  
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Care ◽  
The United States ◽  
Case Definition ◽  
Washington State ◽  
Public Health Department ◽  
Klebsiella Species ◽  
E Coli ◽  
Carbapenem Resistant

AbstractBackground:Carbapenem-resistant Enterobacterales (CRE) are common causes of healthcare-associated infections and are often multidrug resistant with limited therapeutic options. Additionally, CRE can spread within and between healthcare facilities, amplifying potential harms.Objective:To better understand the burden, risk factors, and source of acquisition of carbapenemase genes in clinical Escherichia coli and Klebsiella spp isolates from patients in Washington to guide prevention efforts.Design:Multicenter prospective surveillance study.Methods:Escherichia coli and Klebsiella spp isolates meeting the Washington state CRE surveillance case definition were solicited from clinical laboratories and tested at Washington Public Health Laboratories using polymerase chain reaction (PCR) for the 5 most common carbapenemase genes: blaKPC, blaNDM, blaIMP, blaVIM, and blaOXA-48. Case patients positive by PCR were investigated by the public health department.Results:From October 2012 through December 2017, 363 carbapenem-resistant E. coli and Klebsiella spp isolates were tested. Overall, 45 of 115 carbapenem-resistant K. pneumoniae (39%), 1 of 8 K. oxytoca (12.5%), and 28 of 239 carbapenem-resistant E. coli (11.7%) were carbapenemase positive. Of 74 carbapenemase-positive isolates, blaKPC was most common (47%), followed by blaNDM (30%), blaOXA-48 (22%), and blaIMP (1%). Although all cases had healthcare exposure, blaKPC acquisition was associated with US health care, whereas non-blaKPC acquisition was associated with international health care or travel.Conclusions:We report that blaKPC, the most prevalent carbapenemase in the United States, accounts for nearly half of carbapenemase cases in Washington state and that most KPC-cases are likely acquired through in-state health care.

scholarly journals Antibiogram and recent incidence of multi-drug resistant carbapenemase producing Escherichia coli isolated from paediatric patients

2019 ◽  
Vol 36 (2) ◽  
Author(s):  
Sumbal Nosheen ◽  
Nadeem Irfan Bukhari ◽  
Hasan Ejaz ◽  
Nasir Abbas
Keyword(s):  
Escherichia Coli ◽  
Carbapenem Resistance ◽  
Drug Resistant ◽  
Bacterial Strains ◽  
Biochemical Tests ◽  
E Coli ◽  
Creative Commons ◽  
Paediatric Patients ◽  
Diffusion Technique ◽  
Open Access Article

Objective: To gauge the recent breadth of MDR E. coli along with antibiogram of carbapenemase producing (CP) E. coli among children from an institute which receives patients from all over Punjab. Methods: The bacterial strains of E. coli isolated from various specimens of patients were collected from April 2017 to August 2018 and processed using standard biochemical tests and API 20E system (bioMerieux). Phenotypic screening for CP E. coli was done by the modified Hodge test, whereas antibiotic susceptibility testing was done with Kirby-Bauer disc diffusion technique. Results: Total of 6,468 bacterial strains were isolated, out of which 1,552 (24%) were E. coli. Carbapenem resistance was observed in 245 (16%) strains, amongst which 113 (46%) were confirmed to be CP. E. coli isolated from males were higher as compared to females (p<0.05). Majority of the organisms were isolated from blood (37.2%) samples. The hospital discharged about 65% of patients, while 23% left against medical advice. Overall MDR amongst E. coli was 93.26%. Colistin sulphate (15.9%) and nitrofurantoin (16.8%) showed the most efficacy followed by amikacin (15%) and fosfomycin (10.6%). Conclusion: The isolation of high number of MDR E. coli amongst the paediatric patients is worrisome, which could serve as a potential source of horizontal genes transfer to other genera. doi: https://doi.org/10.12669/pjms.36.2.928 How to cite this:Nosheen S, Bukhari NI, Ejaz H, Abbas N. Antibiogram and recent incidence of multi-drug resistant carbapenemase producing Escherichia coli isolated from paediatric patients. Pak J Med Sci. 2020;36(2):---------. doi: https://doi.org/10.12669/pjms.36.2.928 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Molecular Detection of blaTEM, blaCTX-M and blaSHV Genes in Extended Spectrum β-Lactamase (ESBL) Escherichia Coli from Clinical Samples

2021 ◽  
Author(s):  
Mahesh Kumar Chaudhary ◽  
Indrani Jadhav ◽  
Megha Raj Banjara
Keyword(s):  
Escherichia Coli ◽  
Major Gene ◽  
Polymyxin B ◽  
Cross Sectional Study ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Resistant Bacteria ◽  
Microbiology Laboratory ◽  
Cross Sectional ◽  
Extended Spectrum

Abstract BackgroundExtended spectrum β-lactamases are the group of beta-lactamase enzymes which confer resistance to the oxyimino-cephalosporins and monobactams. Emergence of ESBL producing genes which possess a serious threat for the treatment of infections both in community and hospitals since it is found to be increasing trends of multidrug resistance. This study was focused to find out the ESBLs producing genes.MethodsThis was a cross-sectional study conducted over a period of 2 years (September 2018 to April 2020) at microbiology laboratory of Nepal Mediciti Hospital. Clinical samples were processed in microbiology laboratory and culture isolates were indetified and characterized by standard microbiological techniques. following standard procedures.Antibiotic susceptibility testing was performed by modified Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute. Extended spectrum beta-lactamases were phenotypically confirmed by combined disc method.ESBL producing genes i.e. blaTEM,blaCTX-M and blaSHV were confirmed by PCR.ResultsOf the 1449 total E.coli isolates, 323/1449(22.29%) isolates were multi -drug resistance.Among total MDR Escherichia coli isolates, 215/323(66.56%) isolates were ESBL producers. The maximum number of ESBL Escherichia coli was isolated from urine 194(90.23%), followed by sputum 12(5.58%), swab 5 (2.32%), pus 2 (0.93%) and blood 2 (0.93%).Antibiotic susceptibility pattern of ESBL E.coli producers showed highest sensitivity towards tigecycline (100%) followed by polymyxin b, colistin and meropenem.Out of 215 phenotypically confirmed ESBL E.coli,only 186(86.51%) isolates were found to positive by PCR.The last 29(13.49%) were negative for any of the resistant genes.Among the ESBL genotypes,most common was blaTEM 118(63.4%) followed by blaCTX-M 68(36.6%).ConclusionThe emergence of MDR and ESBL producing E.coli isolates with high antibiotic resistant rates to commonly used antibiotics and increased predominance of major gene types blaTEM is a serious concern to the clinicians as well as microbiologist. This study forwarded a real massage to all the clinicians for the emergence of XDR and PDR resistant bacteria and preservation of antibiotics for their proper use in near future, if past experience with MDR and ESBLs is any indicator.

scholarly journals Human MAIT cell cytolytic effector proteins synergize to overcome carbapenem resistance in Escherichia coli

2020 ◽  
Author(s):  
Caroline Boulouis ◽  
Wan Rong Sia ◽  
Muhammad Yaaseen Gulam ◽  
Jocelyn Qi Min Teo ◽  
Thanh Kha Phan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Activity ◽  
Bactericidal Activity ◽  
Granzyme B ◽  
Carbapenem Resistance ◽  
Effector Proteins ◽  
Resistant Bacteria ◽  
E Coli ◽  
Mait Cells ◽  
Mait Cell

AbstractMucosa-associated invariant T (MAIT) cells are abundant antimicrobial T cells in humans, and recognize antigens derived from the microbial riboflavin biosynthetic pathway presented by the MHC-Ib-related protein (MR1). However, the mechanisms responsible for MAIT cell antimicrobial activity are not fully understood, and the efficacy of these mechanisms against antibiotic resistant bacteria has not been explored. Here, we show that MAIT cells mediate MR1-restricted antimicrobial activity against E. coli clinical strains in a manner dependent on the activity of cytolytic proteins, but independent of production of pro-inflammatory cytokines or induction of apoptosis in infected cells. The combined action of the pore-forming antimicrobial protein granulysin and the serine protease granzyme B released in response to TCR-mediated recognition of MR1-presented antigen is essential to mediate control against both cell-associated and free-living E. coli. Furthermore, MAIT cell-mediated bacterial control extend to multidrug-resistant E. coli primary clinical isolates additionally resistant to carbapenems, a class of last resort antibiotics. Notably, high levels of granulysin and granzyme B in the MAIT cell secretomes directly damage bacterial cells by increasing their permeability, rendering initially resistant E. coli susceptible to the bactericidal activity of carbapenems. These findings define the role of cytolytic effector proteins in MAIT cell-mediated antimicrobial activity, and indicate that granulysin and granzyme B synergize to restore carbapenem bactericidal activity and overcome carbapenem resistance in E. coli.One Sentence SummaryPotent antimicrobial activity of human MAIT cells overcomes carbapenem-resistance in control of Escherichia coli

scholarly journals Carbapenem and colistin-resistant bacteria in North Lebanon: Coexistence of mcr-1 and NDM-4 genes in Escherichia coli

2021 ◽  
Vol 15 (07) ◽  
pp. 934-342
Author(s):  
Charbel Al-Bayssari ◽  
Tania Nawfal Dagher ◽  
Samar El Hamoui ◽  
Fadi Fenianos ◽  
Nehman Makdissy ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Resistance Genes ◽  
Multidrug Resistant ◽  
Resistant Bacteria ◽  
Ionization Time ◽  
E Coli ◽  
Flight Mass Spectrometry ◽  
Carbapenem Resistant ◽  
The Matrix

Introduction: The increasing incidence of infections caused by multidrug-resistant bacteria is considered a global health problem. This study aimed to investigate this resistance in Gram-negative bacteria isolated from patients hospitalized in North-Lebanon. Methodology: All isolates were identified using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic susceptibility testing was achieved using disk diffusion, E-test and Broth microdilution methods. Phenotypic detection of carbapenemase was carried out using the CarbaNP test. RT-PCR, standard-PCR and sequencing were performed to detect resistance genes and oprD gene. Conjugal transfer was carried out between our isolates and Escherichia coli J53 to detect the genetic localization of resistance genes. MLST was conducted to determine the genotype of each isolate. Results: Twenty-three carbapenem-resistant Enterobacterales of which eight colistin-resistant Escherichia coli, and Twenty carbapenem-resistant Pseudomonas aeruginosa were isolated. All isolates showed an imipenem MIC greater than 32 mg/mL with MICs for colistin greater than 2 mg/L for E. coli isolates. All the Enterobacterales isolates had at least one carbapenemase-encoding gene, with E. coli isolates coharboring blaNDM-4 and mcr-1 genes. Moreover, 16/20 Pseudomonas aeruginosa harbored the blaVIM-2 gene and 18/20 had mutations in the oprD gene. MLST revealed that the isolates belonged to several clones. Conclusions: We report here the first description in the world of clinical E. coli isolates coharboring blaNDM-4 and mcr-1 genes, and K. pneumoniae isolates producing NDM-6 and OXA-48 carbapenemases. Also, we describe the emergence of NDM-1-producing E. cloacae in Lebanon. Screening for these isolates is necessary to limit the spread of resistant microorganisms in hospitals.

scholarly journals Emergence of IncHI2 Plasmid-Harboring blaNDM-5 from Porcine Escherichia coli Isolates in Guangdong, China

Pathogens ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 954
Author(s):  
Zhenbao Ma ◽  
Zhenling Zeng ◽  
Jiao Liu ◽  
Chang Liu ◽  
Yu Pan ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Susceptibility Testing ◽  
Carbapenem Resistance ◽  
Guangdong Province ◽  
Whole Genome Sequence ◽  
Molecular Characteristics ◽  
E Coli ◽  
Carbapenem Resistant ◽  
Genetic Feature ◽  
Plasmid Backbone

Carbapenem resistance has posed potential harmful risks to human and animals. The objectives of this study were to understand the prevalence of blaNDM-5 in pigs and investigate the molecular characteristics of NDM-5-producing Escherichia coli isolates in Guangdong province in China. Carbapenem-resistant E. coli isolates were isolated from pigs and obtained using MacConkey plates containing 0.5 mg/L meropenem. Conjugation assay and antimicrobial susceptibility testing were conducted for the isolates and their transconjugants. Whole-genome sequence (WGS) was used to analyze the plasmid genetic feature. A total of five blaNDM-5-carrying E. coli isolates were obtained in the present investigations. They belonged to five ST types. The blaNDM-5 genes were found to be in IncX3 and IncHI2 plasmid. The IncX3 plasmid was 46,161 bp in size and identical to other reports. IncHI2 plasmid was 246,593 bp in size and similar to other IncHI2-ST3 plasmids. It consisted of a typical IncHI2 plasmid backbone region and a multiresistance region (MRR). The blaNDM-5 was closely associated with the IS3000-ISAba125-blaNDM-5-bleMBL-trpF-tat-IS26 unit. We first reported the blaNDM-5-carrying IncHI2 in E. coli isolates recovered from pigs and revealed the molecular characterization. Continued surveillance for the dissemination of blaNDM-5 among food-producing animals is required.

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