scholarly journals Comparative Antimicrobial Susceptibility Profiles of Uropathogenic Extended-Spectrum ß-Lactamase Producing Strains of Klebsiella pneumonia and Escherichia coli by the CLSI and EUCAST Methodologies

Author(s):  
Doğan Akdoğan ◽  
Mustafa Güzel ◽  
Orhan Akpınar ◽  
Altan Aksoy ◽  
Yasemin Genç Bahçe

Aims: The lack of information about the inter variability of the test results obtained by CLSI and EUCAST requires further clarifications to interpret antimicrobial susceptibility patterns better. This study aimed to compare the CLSI and EUCAST interpretations of the antimicrobial susceptibility test results of the ESBL–producing uropathogenic Escherichia coli and Klebsiella pneumonia strains. Methods: After obtaining 157 ESBL-producing E. coli and 95, ESBL-producing K. pneumonia isolates from the urine specimens of the patients, Kirby-Bauer’s disc diffusion method was used for conducting antimicrobial susceptibility test. The test procedures and the interpretation of the results were carried out according to the year 2017 versions of both of the two guidelines. For the statistical comparison of concordance between the two guidelines, the Kappa coefficients and the concordance rates were calculated. Results: The results were graded in the range from perfect to poor agreement. For E. coli, interpretations of the AST results revealed a moderate to perfect agreement between both methods. Weighted Kappa agreement scores in the range from 0.42 to 1. The agreement for AMC, TPZ30/6, ceftazidime 10, meropenem, and aztreonam was poor without any inconsistencies. For Klebsiella, the kappa agreement score was in the range from 0.25 to 1. It was incompatible with AMC, TPZ 30/6, ceftazidime 10, aztreonam; there was poor agreement for cefepime, amikacin and ertapenem. Conclusions: Our results showed agreement between the two guidelines for uropathogenic extended-spectrum ß-lactamase producing Escherichia coli and Klebsiella pneumoniae but also showed inconsistencies between two guidelines. Therefore, the results of our study contribute to the comparison of these guidelines for interpreting antibiotic susceptibilities.

2020 ◽  
Vol 19 (6) ◽  
pp. 1285-1293
Author(s):  
Lorina I. Badger-Emeka ◽  
Zainab Yaseen Al-Jaziri ◽  
Naheed Kausar ◽  
Nora Ahmad Al-Muhainy ◽  
Edric Estrella

Purpose: To investigate the antimicrobial susceptibility and extended spectrum β-lactamase (ESBL) production by clinical isolates of Escherichia coli (ESBL-EC) and Klebsiella species (ESBL-KP) associated with blood stream infections (BSIs).Methods: Bacteria isolation and identification were carried out using basic bacteriological and biochemical techniques. Antimicrobial susceptibility test was performed according to the guidelines of the Clinical Laboratory Standard Institute (CLSI). Vitek 2 Compact automated system was used toconfirm the identifications (ID) and antimicrobial susceptibility test (AST). The ESBL produced by E. coli and K. pneumoniae isolates were  phenotypically characterised using Modified Double Disc Synergy Test (MDDST), as recommended by CLSI.Results: All (100 %) isolates were sensitive to imipenem and meropenem, while susceptibility to other antibiotics varied. ESBL genotypes, viz, blaTEM, blaSHV and blaCTX were encountered in the BSIs. For ESBL-EC, TEM, SHV and CTX producers accounted for 33, 16.67 and 58.3 %,  respectively, while 75, 91.7 and 100 % of ESBL-KP were TEM, SHV and CTX producers, respectively. In ESBL-KP, 67 % coexisted with all three genotypes (blaTEM, blaSHV, and blaCTX, while 8.3 % of ESBL-EC coexisted with the three encoding genes (CTX, SHV and TEM).Conclusion: ESBL E. coli and K. pneumoniae associated with BSI have been identified as TEM, SHV and CXT producers, with more ESBL-KP coexisting with all three than ESBL-EC. Keywords: β-Lactamases, Genes, Klebsiella pneumoniae, Escherichia coli


2018 ◽  
Vol 38 (11) ◽  
pp. 2150-2154 ◽  
Author(s):  
Ruben V. Horn ◽  
Windleyanne G.A. Bezerra ◽  
Elisângela S. Lopes ◽  
Régis S.C. Teixeira ◽  
Isaac N.G. Silva ◽  
...  

ABSTRACT: This study aimed to isolate Escherichia coli and Salmonella enterica from captured feral pigeons in Fortaleza, Brazil, and, in addition to evaluate the antimicrobial susceptibility profiles and diagnose diarrheagenic E. coli strains. Pigeons were captured in four public locations in Fortaleza with three techniques. Individual cloacal swab samples were collected and submitted to bacterial isolation, biochemical identification and antimicrobial susceptibility test. Disk diffusion technique was used with twelve antibiotics. E. coli strains were submitted to DNA extraction followed by PCR to diagnose five diarrheagenic pathotypes. A total of 124 birds were captured. One bird was positive for Salmonella enterica (0.81%) and 121 (97.58%) were positive for E. coli. Among these, 110 isolates were submitted to antimicrobial susceptibility test and 28.18% (31/110) presented resistance to at least one antibiotic. Resistance to azithromycin was the most frequent (21.82%), followed by tetracycline (10.91%) and sulfamethoxazole with trimethoprim (8.9%). Multidrug resistance, calculated as a resistance to at least 3 antimicrobial classes, was identified in 3.64% (4/110) of strains. The maximum number of antimicrobial classes to which one strain was resistant was seven. Results demonstrated nine different resistance profiles and the most frequent was tetracycline and sulfamethoxazole with trimethoprim (4 strains), followed by chloramphenicol, azithromycin, tetracycline and sulfamethoxazole with trimethoprim (3 strains). Amoxicillin with clavulanic acid and tobramycin presented lowest levels of antimicrobial resistance, to which none of the tested strains were resistant. A single strain was positive for the eltB gene, which is a diagnostic tool to identify the Enterotoxigenic E. coli (ETEC) pathotype. None of the other investigated genes (stx1, stx2, estA, eaeA, ipaH, aatA and aaiC) were identified. The single isolate of S. enterica was a rough strain of Salmonella enterica subsp. enterica, but serotype identification was not possible. However, this isolate presented resistance to amoxicillin, amoxicillin with clavulanic acid, tetracycline and sulfamethoxazole with trimethoprim. Therefore, captured feral pigeons of Fortaleza presented a low prevalence of S. enterica and diarrheagenic E. coli. Considering the investigated pathogens, our results suggest a good health status and a low public health risk. However, important antimicrobial resistance profiles were identified.


2010 ◽  
Vol 4 (08) ◽  
pp. 517-520 ◽  
Author(s):  
Juhi Taneja ◽  
Bibhabati Mishra ◽  
Archana Thakur ◽  
Vinita Dogra ◽  
Poonam Loomba

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.


Author(s):  
Erfaneh Jafari ◽  
Mana Oloomi ◽  
Saeid Bouzari

Abstract Background Shiga toxin‐producing Escherichia coli (STEC) are among common foodborne bacterial pathogens and healthy livestock are the main source of this bacterium. Severe diseases attribute to two types of cytotoxin Stx1 and Stx2, which are also called Shiga toxin (Stx). Infection of humans with STEC may result in Acute diarrhea with or without bleeding, hemorrhagic colitis (HC) and the hemolytic uremic syndrome (HUS). As antibiotic resistance is increasingly being reported among STEC isolates obtained from livestock and patients worldwide, in this study the pattern of antibiotic resistance in clinical isolates was determined. Methods Stool samples were collected from patients with diarrhea. All samples were cultured and identified by biochemical and molecular tests. Antimicrobial susceptibility test and assessment of extended-spectrum β-lactamase (ESBL)-related genes were conducted. Moreover, phylogenetic groups were analyzed using quadruplex PCR, and DNA analysis assessed multi-locus sequence types (MLST). Results Out of 340 E. coli samples, 174 were identified as STEC by PCR. Antimicrobial susceptibility test results showed that, 99.4%, 96% and 93.1% of isolates were susceptible to imipenem/ertapenem, piperacillin–tazobactam and amikacin, respectively. The highest resistance was towards ampicillin (68.4%), followed by trimethoprim–sulfamethoxazole (59.8%), and tetracycline (57.5%). A total of 106 (60.9%) isolates were multidrug resistance (MDR) and 40.8% of isolates were determined to be extended spectrum β-lactamase producers. In 94.4% of isolates, genes responsible for ESBL production could be detected, and blaTEM was the most prevalent, followed by blaCTX-M9. Furthermore, phylogenetic grouping revealed that majority of STEC strains belonged to Group C, followed by Groups E, B2 and A. MLST unveiled diverse ST types. Conclusion A periodical surveillance studies and thorough understanding of antibiotic resistant profiles in STEC isolates could help select effective antibiotic treatment for patients and develop strategies to effectively manage food contamination and human infections.


2010 ◽  
Vol 54 (7) ◽  
pp. 3043-3046 ◽  
Author(s):  
Stephen P. Hawser ◽  
Samuel K. Bouchillon ◽  
Daryl J. Hoban ◽  
Robert E. Badal ◽  
Rafael Cantón ◽  
...  

ABSTRACT From 2002 to 2008, there was a significant increase in extended-spectrum beta-lactamase (ESBL)-positive Escherichia coli isolates in European intra-abdominal infections, from 4.3% in 2002 to 11.8% in 2008 (P < 0.001), but not for ESBL-positive Klebsiella pneumoniae isolates (16.4% to 17.9% [P > 0.05]). Hospital-associated isolates were more common than community-associated isolates, at 14.0% versus 6.5%, respectively, for E. coli (P < 0.001) and 20.9% versus 5.3%, respectively, for K. pneumoniae (P < 0.01). Carbapenems were consistently the most active drugs tested.


2014 ◽  
Vol 7 ◽  
pp. IDRT.S13820 ◽  
Author(s):  
Dinesh Kumar ◽  
Amit Kumar Singh ◽  
Mohammad Rashid Ali ◽  
Yogesh Chander

Background Extended spectrum β-lactamase (ESBL) producing Escherichia coli has tremendously increased worldwide and it is one of the most common causes of morbidity and mortality associated with hospital-acquired infections. This could be attributed to association of multi drug resistance in ESBL producing isolates. The present study was aimed to determine the antimicrobial sensitivity profile of ESBL producing E. coli isolates from various clinical samples. Materials and Methods Clinical samples, which consist of pus, urine, blood, cerebrospinal fluid (CSF), stool, sputum, swabs, and different body fluids, are included in the study. Samples were processed and identified as per routine laboratory protocol. ESBL screening and confirmation along with antimicrobial susceptibility test was done according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Results Out of 180 third generation cephalosporins resistant E. coli, 100 (55.55%) isolates were ESBL producers showing a greater degree of resistance to antibiotics. Conclusion The prevalence of ESBL is increasing day by day in nearly every center of different countries and necessary steps to prevent the spread and emergence of resistance should be taken.


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