Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli and Klebsiella species in pediatric patients visiting International Friendship Children's Hospital, Kathmandu, Nepal

2019 ◽  
Author(s):  
Karuna Kayastha ◽  
Binod Dhungel ◽  
Shovana Karki ◽  
Bipin Adhikari ◽  
Megha Raj Banjara ◽  
...  
Keyword(s):  
Clinical Samples ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Children's Hospital ◽  
Extended Spectrum ◽  
Children’S Hospital ◽  
Esbl Producers

Abstract Background Emergence of antibiotic resistance among pathogenic strains has spread due to production of β-lactamases, which can lead to failure of empirical therapy in clinical settings. Inappropriate use of antibiotics, particularly third generation cephalosporins has contributed to the development of antimicrobial resistance (AMR). This study aims to determine the prevalence of Extended Spectrum β-Lactamase (ESBL) production in E. coli and Klebsiella species isolated from various clinical samples. Methods This cross-sectional study was conducted at International Friendship Children's Hospital, Kathmandu, Nepal from August 2017 to January 2018. Various clinical samples that included urine, pus, Cerebro-Spinal Fluid (CSF), body fluids, wound swab, endotracheal tip, catheter tip and blood were processed for culture. Following sufficient incubation, isolates were identified by colony morphology, gram staining and necessary biochemical tests. Identified bacterial isolates were then tested for antibiotic susceptibility test by modified Kirby Bauer disc diffusion method, and were subjected to Extended Spectrum Beta Lactamase (ESBL) screening by using 30µg cefotaxime and ceftazidime. ESBL production was confirmed by combination disc method. Results From a total of 103 non-duplicated clinical isolates, E. coli (n=79), Klebsiella pneumoniae (n=18) and K. oxytoca (n=6) were isolated from different clinical specimens. Majority (62.1%; 64/103) exhibited Multi-Drug Resistance (MDR) and 28.2% (29/103) were ESBL producers. All of ESBL producing isolates were resistant towards ampicillin, cefotaxime, ceftriaxone, ceftazidime. Most ESBL producers were found to be susceptible towards imipenem (89.7%; 26/29), nitrofurantoin (82.8%; 24/29), piperacillin/tazobactam (79.3%; 23/29), and Amikacin (72.4%; 21/29). Conclusions High prevalence of multi-drug resistant ESBL organisms found in this study warrants restricting empirical treatment of the bacterial infection. Identification of ESBL producers in routine treatment of infectious diseases can reduce unnecessary and inappropriate antimicrobial use and can reduce the preventable morbidity and mortality.

scholarly journals Extended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella Species in Pediatric Patients Visiting International Friendship Children’s Hospital, Kathmandu, Nepal

2020 ◽  
Vol 13 ◽  
pp. 117863372090979 ◽  
Author(s):  
Karuna Kayastha ◽  
Binod Dhungel ◽  
Shovana Karki ◽  
Bipin Adhikari ◽  
Megha Raj Banjara ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pediatric Patients ◽  
Diffusion Method ◽  
Esbl Production ◽  
Klebsiella Species ◽  
Children's Hospital ◽  
Extended Spectrum ◽  
Routine Identification ◽  
Children’S Hospital ◽  
Esbl Producers

Introduction: Emergence and spread of antimicrobial resistance (AMR) is a global threat and significantly affects the treatment options for common infectious diseases. Inappropriate use of antibiotics, particularly third-generation cephalosporins, has contributed to the development of AMR. This study aims to determine the prevalence of extended-spectrum β-lactamase (ESBL) production in Escherichia coli and Klebsiella species isolated from various clinical samples. Methods: This cross-sectional study was conducted at International Friendship Children’s Hospital, Kathmandu, Nepal, from August 2017 to January 2018. A total of 1443 samples that included urine, pus, wound swab, endotracheal tip, catheter tip, and blood were collected from pediatric patients below 15 years and processed by standard microbiological methods. Following sufficient incubation, isolates were identified by colony morphology, gram staining, and necessary biochemical tests. Identified bacterial isolates were then tested for antibiotic susceptibility test by modified Kirby-Bauer disk diffusion method and were subjected to ESBL screening by using 30 µg cefotaxime and ceftazidime. The ESBL production was confirmed by combination disk method. Results: From a total of 103 nonduplicated clinical isolates, E. coli (n = 79), Klebsiella pneumoniae (n = 18), and Klebsiella oxytoca (n = 6) were isolated from different clinical specimens. Of which, 64 (62.1%) exhibited multidrug resistance, and 29 (28.2%) were ESBL producers. All ESBL-producing isolates were resistant toward ampicillin, cefotaxime, ceftriaxone, and ceftazidime. Most ESBL producers were susceptible toward imipenem (89.7%; 26/29), nitrofurantoin (82.8%; 24/29), piperacillin/tazobactam (79.3%; 23/29), and amikacin (72.4%; 21/29). Conclusions: A high prevalence of multidrug-resistant ESBL organisms was found in this study among pediatric patients. Treatment based on their routine identification and susceptibility to specific antibiotics is critical to halt the spread of AMR and ESBL.

scholarly journals Multidrug-Resistant, Including Extended-Spectrum Beta Lactamase-Producing and Quinolone-Resistant, Escherichia coli Isolated from Poultry and Domestic Pigs in Dar es Salaam, Tanzania

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 406
Author(s):  
Zuhura I. Kimera ◽  
Fauster X. Mgaya ◽  
Gerald Misinzo ◽  
Stephen E. Mshana ◽  
Nyambura Moremi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistant ◽  
Antibiotics Resistance ◽  
Beta Lactamase ◽  
Domestic Pigs ◽  
Extended Spectrum Beta Lactamase ◽  
Phenotypic Profile ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

We determined the phenotypic profile of multidrug-resistant (MDR) Escherichia coli isolated from 698 samples (390 and 308 from poultry and domestic pigs, respectively). In total, 562 Enterobacteria were isolated. About 80.5% of the isolates were E. coli. Occurrence of E. coli was significantly higher among domestic pigs (73.1%) than in poultry (60.5%) (p = 0.000). In both poultry and domestic pigs, E. coli isolates were highly resistant to tetracycline (63.5%), nalidixic acid (53.7%), ampicillin (52.3%), and trimethoprim/sulfamethoxazole (50.9%). About 51.6%, 65.3%, and 53.7% of E. coli were MDR, extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), and quinolone-resistant, respectively. A total of 68% of the extended-spectrum beta lactamase (ESBL) producers were also resistant to quinolones. For all tested antibiotics, resistance was significantly higher in ESBL-producing and quinolone-resistant isolates than the non-ESBL producers and non-quinolone-resistant E. coli. Eight isolates were resistant to eight classes of antimicrobials. We compared phenotypic with genotypic results of 20 MDR E. coli isolates, ESBL producers, and quinolone-resistant strains and found 80% harbored blaCTX-M, 15% aac(6)-lb-cr, 10% qnrB, and 5% qepA. None harbored TEM, SHV, qnrA, qnrS, qnrC, or qnrD. The observed pattern and level of resistance render this portfolio of antibiotics ineffective for their intended use.

scholarly journals PREVALENCE OF CEPHALOSPORIN-RESISTANT GRAM-NEGATIVE BACILLI FROM CLINICAL SAMPLES

2016 ◽  
pp. 176
Author(s):  
Kavi Aniis ◽  
Rajamanikandan Kcp ◽  
Arvind Prasanth D
Keyword(s):  
Clinical Samples ◽  
Beta Lactamase ◽  
Bacterial Isolates ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Lactam Ring ◽  
Esbl Producers

<p>ABSTRACT<br />Objective: Beta-lactams are the group of antibiotics that contain a ring called as “beta-lactam ring,” which is responsible for the antibacterial activity.<br />The presence of resistance among Gram-negative organisms is due to the production of beta-lactamases enzymes that hydrolysis the beta-lactam ring<br />thereby conferring resistance to the organism. This study is undertaken to determine the prevalence of extended-spectrum beta-lactamase (ESBL)<br />producing Gram-negative organism from clinical samples.<br />Methods: A total of 112 clinical samples were taken for this study. The combined disc synergistic test (CDST) was used for the phenotypic detection<br />of ESBL producers from the clinical samples. The genotypic identification of ESBL producers was carried out by alkaline lysis method by isolation of<br />plasmid DNA.<br />Result: A total of 87 bacterial isolates were isolated and identified. Among them, Klebsiella (41%) was the predominant organism followed by<br />Escherichia coli (33%), Proteus (10%), Pseudomonas (10%), and Serratia (6%). Among the various bacterial isolates, Klebsiella showed a higher<br />percentage of resistance. The CDST showed that 8 isolates of Klebsiella, 3 isolates of E. coli, and 1 isolate of Pseudomonas were found to be ESBL<br />producers. The genotypic confirmation showed that the two bacterial isolates, namely, Klebsiella and E. coli were found to possess temoniera (TEM)<br />gene which was the 400-500 bp conferring resistance to the antibiotics.<br />Conclusion: The results of this study suggest that early detection of ESBL producing Gram-negative organism is a very important step in planning the<br />therapy of patient in Hospitals. CDST continues to be a good indicator in the detection of ESBL producers.<br />Keywords: Beta-lactamases, Gram-negative bacilli, Extended-spectrum beta-lactamase, Resistance, Combined disc synergistic test.</p><p> </p>

scholarly journals PREVALENCE OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE MEMBERS ISOLATED FROM CLINICALLY SUSPECTED PATIENTS

2018 ◽  
Vol 11 (5) ◽  
pp. 364 ◽  
Author(s):  
Moorthy Kannaiyan ◽  
Gedif Meseret Abebe ◽  
Chinnasamy Kanimozhi ◽  
Punitha Thambidurai ◽  
Saranya Ashokapuram Selvam ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Antibiotic Sensitivity ◽  
Enterobacter Aerogenes ◽  
Clinical Problem ◽  
Clinical Samples ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Genotypic Identification ◽  
Esbl Producers

 Objective: Emergence of extended-spectrum beta-lactamases (ESBLs) production poses another clinical problem with Gram-negative bacterial infections. The present study was aimed to evaluate the ESBL producers among various clinical samples of clinically suspected patients.Methods: A total of 1279 samples (urine [918], pus [207] and stool [154]) were collected and 465 isolates (Escherichia coli [320], Enterobacter aerogenes [119] and Klebsiella pneumoniae [26]) were isolated and screened for the presence of ESBL producers using combination disc method and double disc synergy test.Results: Of the 465 culture positive isolates, 130 (E. coli 93 [29.06%], E. aerogenes 35 [29.41%] and K. pneumoniae 2 [7.69%]) were identified as ESBL producers. Among the three Enterobacteriaceae members, E. coli 93 (29.06%) was found to be predominant ESBL producer next in order E. aerogenes 35 (29.41%) and K. pneumoniae 2 (7.69%). Maximum number of ESBL producers were recovered from urine (n=111) followed by pus (n=14) and stool (n=5). All the ESBL-producing isolates were subjected to antibiotic sensitivity test using 10 different antibiotics. ESBL producers were chiefly resistance to ceftriaxone followed by ceftazidime and cefotaxime. Of 130 ESBL producers, 15 (E. coli (8), E. aerogenes (6) and K. pneumoniae (1)] strains were selected for genotypic identification. Among, only two strains of E. aerogenes were positive isolates for CTX-M type ESBL in polymerase chain reaction.Conclusion: This study concluded that among Enterobacteriaceae members, E. coli was the predominant ESBL producers and urine was noted as the prime source for the ESBL positive isolates when compared to other source. Genotypic identification was the best method to differentiate ESBL types which were essential to provide proper treatment.

scholarly journals Antibiotics Profile, Prevalence of Extended-Spectrum Beta-Lactamase (ESBL), and Multidrug-Resistant Enterobacteriaceae from Different Clinical Samples in Khartoum State, Sudan

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ehssan H. Moglad
Keyword(s):  
Tracheal Aspirate ◽  
Multidrug Resistant ◽  
Vaginal Swab ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Biochemical Tests ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Different Sources

One of the global requirements for controlling the occurrence of resistance to antimicrobial drugs is to understanding the resistivity profile of various clinical isolates. Therefore, this study aimed to deliver the indication of different resistant profiles of clinically isolated Enterobacteriaceae from different sources of samples from Khartoum state, Sudan, and to determine the prevalence rate of extended-spectrum beta-lactamase (ESBL), multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) bacteria. A total of 144 Gram-negative bacteria were collected from different sources (vaginal swab, urine, catheter tip, sputum, blood, tracheal aspirate, pus, stool, pleural fluid, and throat swab). Samples were subcultured and identified according to their cultural characteristics and biochemical tests. Antimicrobial susceptibility test was performed for twenty-four antibiotics from eleven categories against all isolated Enterobacteriaceae according to the recommendation of Clinical and Laboratory Standards Institute (CLSI). The result showed that out of 144 isolates, Escherichia coli and Klebsiella pneumoniae were predominant isolates with the percentage of 47.9 and 25%, respectively. The prevalence of ESBL was higher in K. pneumonia (38.9%) than E. coli (34.8%). All isolated E. coli were sensitive to nitrofurantoin and tigecycline. There was a high prevalence of MDR Enterobacteriaceae, and only one isolate was XDR, while PDR was zero for all isolated bacteria. Active antimicrobial-resistant (AMR) observation through constant data sharing and management of all stakeholders is crucial to recognize and control the AMR global burden. Also, effective antibiotic stewardship procedures would be applied to limit the unreasonable expenditure of antibiotics in Sudan.

Molecular Detection of Extended Spectrum Beta-lactamase Resistance in Escherichia coli from Poultry Droppings in Keffi, Nigeria

2019 ◽  
pp. 1-9
Author(s):  
S. C. Tama ◽  
Y. B. Ngwai ◽  
I. H. Nkene ◽  
R. H. Abimiku
Keyword(s):  
Molecular Detection ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Microbiological Methods ◽  
Amoxicillin Clavulanic Acid ◽  
Synergy Test ◽  
Poultry Droppings

Objectives: The present study reports extended-spectrum beta-lactamase (ESBL) production in E. coli isolates from poultry droppings from selected poultry farms in Keffi, Nigeria. Methods: Seventy-five (75) samples of poultry droppings were collected, and E. coli was isolated using standard microbiological methods. Antibiotic susceptibility testing and minimum inhibitory concentrations were evaluated as described by the Clinical and Laboratory Standards Institute (CLSI). Phenotypic confirmation of ESBL production by the isolates was carried out using double disc synergy test.  Molecular detection of ESBL genes was carried out using Polymerase Chain Reaction (PCR) method. Results: All (100%) samples had E. coli. Antimicrobial resistance in the isolates were as follows: imipenem (12.0%), gentamicin (20.0%), cefoxitin (37.3%), cefotaxime (41.3%), ceftazidime (44.0%), ciprofloxacin (48.0%), amoxicillin/clavulanic acid (58.7%), streptomycin (92.0%),  sulphamethoxazole/trimethoprim (92.0%) and ampicillin (98.7%). Joint resistance to ampicillin, sulphamethoxazole/trimethoprim-streptomycin was the commonest resistance phenotype at 10.6%. Multiple antibiotic resistance (MAR) was observed in 97.3% (73/75) of the isolates; and the most common MAR indices were 0.7 (21.9%), 0.5 (17.8%), 0.4 (16.4%), 0.8 (11.1%) and 0.3 (10.9%). Twenty three (46.9%) of the 49 cefotaxime/ceftazidime isolates were confirmed ESBL producers. Twenty-two of the 23 ESBL positive isolates (95.7%) carried the bla genes as follows: 95.5% (21/22) for blaSHV; 68.2% (15/22) for blaTEM; and 50.0% (11/22) for blaCTX-M. Eleven (50%) of the 22 isolates carried two bla genes (blaSHV and blaCTX-M, blaTEM and blaCTX-M and blaTEM and blaSHV). Conclusion: The E. coli isolates were less resistant to imipenem, gentamicin and cefoxitin; most isolates were MAR, with resistance to 7 antibiotics being the most predominant. In addition, the blaSHV gene was the most common ESBL gene detected in confirmed ESBL-producing E. coli isolates.

scholarly journals Beta Lactamase Genes of Extended Spectrum Beta Lactamase Producing Escherichia coli from Anorectal Sepsis Cases in Bangladesh

2016 ◽  
Vol 30 (1-2) ◽  
pp. 23-29
Author(s):  
Sheikh Shahidul Islam ◽  
Md Abdul Malek ◽  
AKM Fazlul Haque ◽  
Kaisar Ali Talukder ◽  
Marufa Zerin Akhter
Keyword(s):  
Multidrug Resistant ◽  
Diffusion Method ◽  
Pcr Analysis ◽  
Beta Lactamase ◽  
Disc Diffusion ◽  
Esbl Production ◽  
Disc Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

A microbiological study was carried out to determine the prevalence of extended spectrum beta lactamase (ESBL) producing E. coli in anorectal sepsis patients in Bangladesh. One hundred specimens of pus, swab, or exudates from anorectal sepsis cases were studied. All the 61 isolates of E. coli were found to be highly resistant to most of the drugs used. Among these, 14 multidrug resistant E. coli were examined for ESBL production by double disc diffusion method. Six of these were found to be ESBL positive. PCR analysis revealed that 3 of the 6 isolates had coexistence of blaSHV, blaOXA and blaCTXM-1 genes. Two of the isolates had only blaSHV gene, whereas 1 isolate had a combination of blaTEM and blaSHV genes. Three of these were resistant to all the drugs tested, while two were sensitive to getamicin and one to ciprofloxacin. None of the E. coli strains possessed blaCTXM-2, blaCTXM-8, blaCTXM-9, and qnr genes.Bangladesh J Microbiol, Volume 30, Number 1-2,June-Dec 2013, pp 23-29

scholarly journals Prevalence of Extended Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella species from Urinary Specimens of Children attending Friendship International Children’s Hospital

2017 ◽  
Vol 5 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Ujjwal Rimal ◽  
Shovana Thapa ◽  
Roshani Maharjan
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Beta Lactamase ◽  
Disc Diffusion ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Significant Bacteriuria ◽  
Klebsiella Spp ◽  
Esbl Producers

Extended-spectrum β-lactamase producing E. coli and K. pneumoniae is a serious threat to the patients. These organisms are major extended spectrum beta lactamase (ESBL) producers. The objective of this study was to determine the prevalence of Extended spectrum β- lactamase producing strains of Escherichia coli and Klebsiella spp isolates from the urine sample of children visiting International Friendship Children Hospital. During the seven months, between June 2016 to December 2016, 1018 mid-stream urine samples(MSU) were collected from patients suspected of having UTI. The samples were investigated by conventional semi-quantitative culture technique and identification of E. coli and Klebsiella spp. was done by microscopy and biochemical test. Antibiotic susceptibility test of isolates was performed by modified Kirby Bauer Disc diffusion test. ESBL screening test was done by using 3rd generation Cephalosporin and confirmation done by combination disc diffusion method. Out of total 1018 MSU samples investigated, 200(19.64%) isolates of E. coli and 28(2.7%) isolates of Klebsiella spp. making a total of 228(22.39%) were found to cause significant bacteriuria. 76(33.33%) isolates, from those causing significant bacteriuria, were Multi-drug resistant organisms. Out of 228 isolates, 54(23.68%) were ESBL producers, that includes 51(25.5%) Escherichia coli and 3(12.5%) Klebsiella pneumoniae. ESBL producers were more common in in-patient (36.17%) than out-patient (20.44%). Most of the ESBL producers were resistance to amoxicillin, followed by Cotrimoxazole and Ciprofloxacin respectively. They were highly sensitive to Imipenem, Tigecycline, Amikacin, Piperacillin-Tazobactam, and Nitrofurantoin. High prevalence of ESBL producing E. coli and Klebsiella pneumoniae was found among children. Regular and routine monitoring of ESBL producing isolates is essential.Nepal Journal of Biotechnology. Dec. 2017 Vol. 5, No. 1: 32-38

scholarly journals Status of Extended Spectrum Beta-Lactamase (ESBL) Producing Bacteria Isolated from Surgical and Burn Wound at Tertiary Care Hospital in Dhaka City

2018 ◽  
Vol 5 (1) ◽  
pp. 21-26
Author(s):  
Mostaqimur Rahman ◽  
Hafiza Sultana ◽  
Md Abdullahil Mosawuir ◽  
Latifa Akhter ◽  
Md Abdullah Yusuf
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Surgical Wound ◽  
Burn Wound ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Proteus Species

Background: Surgical and burn wound infection are the most common infection in the hospital settings. Objective: The aim of the present study was to see the status of extended spectrum beta-lactamase (ESBL) producing bacteria isolated from patients presented with surgical and burn wound infection.Methodology: This cross-sectional study was conducted in the Department of Microbiology, BSMMU from January to December 2006, at a period of one year. This study was carried out to detect extended spectrum β-lactamase producing Gram negative bacteria rapidly by using a kit containing chromogenic cephalosporin directly from primary culture by comparison with phenotypic confirmatory method.Result: Total 181 samples were collected from patients with wound infections of which 170(93.9%) bacteria were isolated. Among individual samples ESBLs positive strains were highest in surgical wound which was 22(31.42%) and 24(28.24%) isolates respectively. From surgical wound swab ESBL was found 3(42.9%) isolates from Klebsiella species. ESBL producing E. coli was found in 12(35.3%) isolates. Pseudomonas species showed in 2(22.2%) isolates and 1(33.3%) isolate of Acinetobactor species. ESBL positive E. coli was found in 5(45.45%) isolates from burn wound. ESBL positive Proteus species was detected in 11(28.94%) isolates from burn wound.Conclusion: Most common bacteria isolated from the infected surgical and burn wound are E. coli and Proteus species, though Klebsiella species is the most common ESBL producing bacteria isolated from both infected surgical and burn wound.Bangladesh Journal of Infectious Diseases 2018;5(1):21-26

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