scholarly journals The prevalence of ESBL and AmpC β-lactamases in uropathogenic isolates of Escherichia coli in a tertiary care hospital in Southwest Iran

2020 ◽  
Author(s):  
Mohammad Motamedifar ◽  
Samane Mohebi ◽  
Mahtab Hadadi ◽  
Hamideh Amirzadegan

Abstract Objectives: The spread of extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases (AmpC) in Escherichia coli ( E. coli) is an important public health concern and ESBL-producing bacteria are commonly reported in uropathogenic Escherichia coli (UPEC). The aim of this study is to determine the molecular detection of AmpC and ESBLs, among clinical E. coli isolated from inpatients who presented with symptomatic urinary tract infection (UTI) in Shiraz, the southwest of Iran. Results: Among total 177 urinary isolates, the analysis showed that 46.3% of the isolates were ESBLs positive and that fifteen strains revealed the AmpC cluster genes. Among all ESBL-positive E. coli isolates, the CTX-M was the most prevalent ESBL type (68.2%), and in AmpC-positive isolates, fifteen isolates (88.2%) were positive for CITM cluster gene and two (11.7%) were positive for DHAM cluster gene. ACCM, FOXM , EBCM and MOXM cluster genes were not found in this study. Our findings revealed that the prevalence of AmpC β-lactamases is rising in Iran, leading to failure in treatment. Therefore, the current study recommended that accurate and precise methods and guidelines should be designed for detection of antibiotic-resistant mechanisms because it is very important for the treatment and prevention of such isolates.

Gut Pathogens ◽  
2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Mahoko Ikeda ◽  
Tatsuya Kobayashi ◽  
Fumie Fujimoto ◽  
Yuta Okada ◽  
Yoshimi Higurashi ◽  
...  

Abstract Background Although Escherichia coli is the most frequently isolated microorganism in acute biliary tract infections with bacteremia, data regarding its virulence are limited. Results Information on cases of bacteremia in acute biliary tract infection in a retrospective study was collected from 2013 to 2015 at a tertiary care hospital in Japan. Factors related to the severity of infection were investigated, including patient background, phylogenetic typing, and virulence factors of E. coli, such as adhesion, invasion, toxins, and iron acquisition. In total, 72 E. coli strains were identified in 71 cases, most of which primarily belonged to the B2 phylogroup (68.1%). The presence of the iutA gene (77.3% in the non-severe group, 46.4% in the severe group, P = 0.011) and the ibeA gene (9.1% in the non-severe group, and 35.7% in the severe group, P = 0.012) was significantly associated with the severity of infection. Among the patient characteristics, diabetes mellitus with organ involvement and alkaline phosphatase were different in the severe and non-severe groups. Conclusions We showed that bacteremic E. coli strains from acute biliary tract infections belonged to the virulent (B2) phylogroup. The prevalence of the iutA and ibeA genes between the two groups of bacteremia severity was significantly different.


Author(s):  
Anubhuti Khare ◽  
Saroj Kothari ◽  
Vaibhav Misra

Background: Antimicrobial resistance is a serious problem worldwide and differs from region to region. This study was planned to determine the incidence and sensitivity pattern of Klebsiella pneumoniae (K. pneumoniae), Escherichia coli (E. coli) and Pseudomonas aeruginosa (P. aeruginosa) in our region and discuss the general issues related to antimicrobial resistance.Methods: Prospective study was carried out between March to October 2015. Samples of urine, blood, pus, CSF and miscellaneous samples (fluids, swabs, sputum and stool) were collected from indoor and outdoor patients for isolation and antimicrobial susceptibility of K. pneumoniae, E. coli and P. aeruginosa in the Department of Microbiology G.R. Medical College, Gwalior (MP).Results: Out of the 5000 samples analyzed 1684 showed growth. K. pneumoniae (38.50%), E. coli (33.29%) and P. aeruginosa (28.19%) constituited a total of 805 isolates. Both E.coli and K. pneumoniae showed highest sensitivity for doxycycline (75%; 67% resp.) and second highest for levofloxacin (70%; 64% resp.), whereas, P. aeruginosa showed highest 57% sensitivity for amikacin followed by 48% for levofloxacin. β-lactam antibiotics and aminoglycosides showed high mean resistance (K.pneumoniae-83%, E.coli-79%, P. aeruginosa-86.4%) and (K. pneumoniae-75%, E. coli-61%, P. aeruginosa-70%) resp.Conclusions: The data indicates high resistance among the gram-negative bacteria for β-lactam and aminoglycoside antibiotics. Increasing resistance to doxycycline and flouroquinolones for K. pneumoniae and E. coli and multidrug resistance to P. aeruginosa is a cause of concern in this region. Thus, there is a need to stop misuse of antibiotics with immediate effect and to implement a strong antimicrobial stewardship program.


2020 ◽  
Vol 8 (1) ◽  
pp. 45-51
Author(s):  
Kabita Giri ◽  
Bijay Kumar Shrestha ◽  
Jenish Shakya ◽  
Shiv Nandan Sah ◽  
Hemanta Khanal

Urinary tract infections (UTIs) caused by drug resistant (DR) Uropathogenic Escherichia coli have become a significant worldwide public health problem. Green tea (Camellia sinensis), has been reported to have antimicrobial activities against various pathogenic bacteria. The main aim of our study was to estimate the antibacterial effect of green tea extract against drug resistant Uropathogenic E. coli isolated from urine samples of patients visiting in tertiary care hospital from eastern Nepal. During the study 360 urine samples were collected from UTI suspected patients visiting a tertiary care hospital of Biratnagar. Urine samples were cultured by using semi-quantitative culture technique and bacteria was identified by standard microbiological procedure. Antibiotic susceptibility testing was done by Kirby-Bauer Disk Diffusion method according to NCCLS (2011) guidelines. The antibacterial effect of green tea extract was performed by preparing the 95% ethanol extract in Soxhlet apparatus which was dispensed in DMSO solution and sterilized by membrane filtration. Antibacterial activity of Green Tea Extract against MDR Uropathogenic Escherichia coli was performed by making different concentration of green tea. The overall prevalence of E. coli was 27.22% in study population whereas the prevalence of MDR E. coli was 21.08%. All the isolated E. coli exhibited 100% sensitivity towards Nitrofurantoin and it was still a drug of choice for the treatment of Urinary tract infection caused by E. coli. The green tea extracts exhibited effective antibacterial activity against MDR E. coli. The MIC of Green Tea Extract was found to be 600µg/ml for 24 MDR isolates and 1000µg/ml for remaining 11 isolates. Based on the present study it is concluded that Green Tea extracts have great potential as an antimicrobial agent against E. coli. Int. J. Appl. Sci. Biotechnol. Vol 8(1): 45-51


2014 ◽  
Vol 8 (09) ◽  
pp. 1129-1136 ◽  
Author(s):  
Ali Mohammed Somily ◽  
Hanan A Habib ◽  
Muhammad M Absar ◽  
Muhammad Z Arshad ◽  
Kutubu Manneh ◽  
...  

Introduction: The increasing frequency  and antibiotic resistance among extended-spectrum β-lactamases (ESBLs)-producing bacteria are posing a serious threat. This study sought to investigate the frequency and antibiotic susceptibility of ESBL-producing E. coli and K. pneumoniae at a tertiary care hospital. Methodology: Data were collected from samples sent to the microbiology laboratory between 2006 and 2010 at King Khalid University Hospital, Riyadh. ESBLs were confirmed using Etest strips of cefotaxime/cefotaxime + clavulanic acid, ceftazidime/ceftazidime + clavulanic acid, and cefepime/cefepime + clavulanate. Results: Out of 17,105 samples, 1,076 (6.3%) ESBL-producing isolates of E. coli (808) and K. pneumoniae (268) were confirmed. Among these, 680 (63.2%) isolates were found in urine samples, followed by 287 (26.7%) in superficial swabs, deep wounds swabs, tissues and sterile body fluids, 71 (6.6%) in respiratory, and 38 (3.5%) in blood samples. The overall frequency rates of ESBL E. coli and K. pneumoniae were 6.6% and 5.5%, respectively. The frequency of ESBL-producing E. coli and K. pneumoniae increased significantly during the study period. E. coli resistance against cotrimoxazole was 71.1%, followed by ciprofloxacin (68.2%) and gentamicin (47%). Similarly, 62.7% of K. pneumoniae isolates were resistant to gentamicin, 59.5% to cotrimoxazole, and 49.8% to ciprofloxacin. There was no statistically significant change in antimicrobial resistance over the study period. Conclusions: Although the frequency rates of ESBL-producing E. coli and K. pneumoniae increased, no change in the anti-microbial susceptibility was observed over the study period.


2018 ◽  
Vol 10 (02) ◽  
pp. 149-154
Author(s):  
Anjali Agarwal ◽  
Jyoti Srivastava ◽  
Ujjwal Maheshwari ◽  
Mohd Iftikhar

ABSTRACT BACKGROUND: Carbapenemase-producing microorganisms are becoming a major concern among hospital-acquired infections. There is also increased multidrug resistance seen among these isolates. AIMS: We have conducted this study to determine the prevalence of New Delhi metallo-beta-lactamase-1 (NDM-1) gene-producing Escherichia coli among hospitalized patients in a tertiary care hospital in Northern India. SETTINGS AND DESIGN: The study was conducted in the Department of Microbiology with the tertiary care hospital settings. It was a prospective cross-sectional observational study conducted during January 2014–August 2014. MATERIALS AND METHODS: A total of 500 nonduplicate E. coli samples were processed. The isolates with reduced susceptibility to ertapenem, i.e., zone diameter between 19 and 21 mm, were considered carbapenemase producers. These isolates were subjected to modified Hodge test for phenotypic confirmation. Polymerase chain reaction was performed on all the screened isolates for molecular detection of NDM-1 gene. STATISTICAL ANALYSIS USED: Chi-square test was used to analyze the data and P < 0.05 was considered statistically significant. RESULTS: Out of 500 E. coli isolates, 61 (12.2%) were screened for carbapenemase production. 47 (9.4%) isolates were positive by modified Hodge test and 36 (7.2%) isolates showed the presence of blaNDM-1 gene (P < 0.05). CONCLUSION: There is an increased prevalence of NDM-1 gene-producing E. coli isolates. These carbapenemase-producing isolates are more resistant to other group of antibiotics (aminoglycosides, fluoroquinolones along with β-lactam group). Early detection of blaNDM-1 gene can help in choosing the effective treatment options for hospitalized patients in time, thereby reducing the risk of mortality.


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.


2004 ◽  
Vol 48 (5) ◽  
pp. 1520-1525 ◽  
Author(s):  
Keith S. Kaye ◽  
Howard S. Gold ◽  
Mitchell J. Schwaber ◽  
Lata Venkataraman ◽  
Youlin Qi ◽  
...  

ABSTRACT This study analyzed the enzymatic basis and molecular epidemiology of amoxicillin-clavulanate-resistant Escherichia coli isolated by the microbiology laboratory of a United States tertiary care hospital. From October 1998 to December 1999, all E. coli isolates were screened for ampicillin-sulbactam resistance. Of 283 isolates that tested resistant to ampicillin-sulbactam, 69 unique patient isolates were also resistant to amoxicillin-clavulanate by disk diffusion testing (zone diameter ≤ 13 mm). These amoxicillin-clavulanate-resistant E. coli isolates underwent agar dilution testing, pulsed-field gel electrophoresis, PCR analysis, and isoelectric focusing. The mean age of study patients was 52 years; 78% were female. Among the isolates, 12 were nosocomial (rate of amoxicillin-clavulanate resistance = 4.7%) and 57 were community acquired (rate of amoxicillin-clavulanate resistance = 2.8%). No predominant strain was identified. By agar dilution testing, 67 isolates were nonsusceptible (39 resistant and 28 intermediate) to amoxicillin-clavulanate and 37 were piperacillin-tazobactam resistant but only 8 were ceftazidime resistant (ceftazidime MIC ≥ 32 μg/ml). Two isolates were susceptible to amoxicillin-clavulanic acid by agar dilution, although they were resistant by disk diffusion testing. The distribution of β-lactamases was as follows: the TEM type alone was found in 52 isolates, the AmpC type was found in 4 isolates (2 identified as containing CMY-2), the TEM type and CMY-2 were found in 2 isolates, and the OXA type was found in 1 isolate. Also, there was one isolate with the TEM type and the SHV type and one with the TEM type and a second, unidentified enzyme. Among the isolates with TEM-type enzymes, two extended-spectrum β-lactamase-producing isolates were identified but two isolates with inhibitor-resistant TEM (IRT) enzymes (one with TEM-34 [IRT-6] and the other with a novel enzyme [tentatively assigned the designation TEM-122]) were more interesting.


2019 ◽  
Vol 6 ◽  
pp. 76-81
Author(s):  
Manita Tumbahangphe ◽  
Bijay Kumar Shrestha ◽  
Jenish Shakya ◽  
Hemanta Khanal

Objectives: The main objective of this study was to determine the prevalence of Escherichia coli among urinary tract infection (UTI) suspected patients visiting tertiary care hospital and to assess the biofilm producing ability of E. coli isolates. Methods: A prospective cross-sectional study was carried out in Biratnagar Metropolitan city, Eastern Nepal from December 2018 to May 2019. During the study 400 urine samples were collected from UTI suspected patients visiting a tertiary care hospital of Biratnagar. Urine samples were cultured by using semi-quantitative culture technique and identified. Antibiotic susceptibility testing was done by Kirby-Bauer Disk Diffusion method according to CLSI (2011) guidelines. Biofilm assays were performed by microtitre plate method. Results: This study reported 15% prevalence of E. coli out of 400 urine samples. 100% of E. coli isolates showed resistance to both Ampicillin and Amoxicillin while 100% were sensitive to Chloramphenicol. 70% (42/60) isolates were Multi Drug Resistance (MDR)E. coli. The maximum isolates (86.66%) were found to be biofilm producers by microtitre plate method. Resistance to other antibiotics such as Nalidixic acid (71.11% vs 46.66%), Norfloxacin (53.33% vs 46.66%), Cotrimoxazole (42.22% vs 26.66%) was comparatively higher among biofilm producers than non-biofilm producers. There was a significance of association between biofilm and MDR (p<0.05). Conclusion: There is relation between the ability of biofilm formation and drug resistance in the bacterium resulting to the failure of antibacterial drugs.


2013 ◽  
Vol 2 (2) ◽  
pp. 46-51
Author(s):  
MR Kabir ◽  
MA Hossain ◽  
MM Alam ◽  
SK Paul ◽  
Z Begum ◽  
...  

Escherichia coli (E. coli) is an important group of pathogens associated with diarrhea among children. Despite the fact that diarrhaegenic Escherichia coli (DEC) has been identified as a major etiologic agent of childhood diarrhea, only a few studies have been performed in Bangladesh to identify these organisms. The objective of this study was to determine the frequency and antimicrobial susceptibility of DEC obtained from patients with acute diarrhea. To detect DEC in patients with acute diarrhea, a total of 300 stool specimens were tested by multiplex polymerase chain reaction (PCR). The antimicrobial susceptibility of DEC were tested by Kirby-Bauer disc diffusion technique as per recommendation of CLSI (Clinical and Laboratory Standards Institute), 2010. Out of 300 stool specimens collected from patients with acute diarrhea, the DEC was detected in 18% (54/300) cases. The dominating strain was Enterotoxigenic E. coli ( ETEC) (13%, 39/300), followed by Enteroaggregative E. coli (EAEC) (5%, 15/300) and no Enterohemorrhagic E. coli (EHEC), Enteroinvasive E. coli ( EIEC) and Enteropathogenic E. coli ( EPEC) could be detected. Detected ETEC were 100% sensitive to Ceftriaxone, Nitrofurantioin, Amikacin, 94% sensitive to Nalidixic acid, 89% sensitive to Gentamycin, 83% sensitive to Ciprofloxacin, 79% sensitive to Cephalexin, 39% sensitive to Amoxycillin, 46% sensitive to Tetracyclin and 31% sensitive to Cotrimoxazole. Detected EAEC were 100% sensitive to Ceftriaxone, Nitrofurantioin, Amikacin, Nalidixic acid, 90% sensitive to Gentamycin and Ciprofloxacin, 85% sensitive to Cephalexin, 41% sensitive to Amoxycillin, 49% sensitive to Tetracycline and 31% sensitive to Cotrimoxazole. Both ETEC and EAEC isolates exhibited decreased susceptibility for Amoxycillin, Tetracycline and Cotrimoxazole. Our results revealed that ETEC and EAEC, had significant association with acute diarrhea and should be considered as potential pathogens. Guidelines for appropriate use of antibiotics in tertiary care hospitals need updating. DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16698 Community Based Medical Journal 2013 July: Vol.02 No 02: 46-51


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