scholarly journals Trends in Carriage of Extended Spectrum β-Lactamase and Carbapenemase Producing Enterobacteria Among HIV Infected Patients and Their Antimicrobial Susceptibility Patterns in Western-Cameroon

Author(s):  
Laure Brigitte Kouitcheu Mabeku ◽  
Arnauld EFON EKANGOUO ◽  
Jeannette Euranie Kouam Mewa

Abstract Background: In Cameroon, studies on the prevalence of extended-spectrum beta-lactamase-producing Enterobacteriaceae (E-ESBLs) and carbapenemase-producing Enterobacteriaceae (CPE) among HIV infected individuals has not been investigated despite the progressively risen prevalence of HIV infection. The present study is intended determinate the magnitude of ESBL-E and CPE carriage among HIV-infected individuals. Methods: Accordingly, 152 urine, 29 stool, 8 blood, 105 vaginal exudates and 14 wound swab sample were collected from 204 HIV negative and 104 HIV positive patients attending the Regional Hospital of Bafoussam-Cameroon from September 2016 to June 2017. From these specimen, Enterobacteriaceae were isolated based on their morphological features, Gram staining and biochemical characteristics using API 20E galleries (Biomerieux, France). For each HIV infected patient, the CD4 lymphocytes were measured using cytometric technique. The antimicrobial susceptibility was determined by Kirby-Bauer disc diffusion test against 11 antibiotics from β-lactam class. ESBL and CP in suspected strains was confirmed by double disk synergy test and combination disk test.Results: The prevalence of Enterobacteriaceae infection among HIV positive patients was 46.15% versus 27.47% among HIV-negative ones (P=0.0014). Among HIV positive patients, urine (47.91%), vaginal exudates (31.25%) and blood (4.16%) specimens were mostly colonialized and Escherichia coli (37.5%) the predominant species. The rate of Enterobacteraceae infection according to CD4 count range was 20.83%, 37.5%, 35.42% and 6.25% respectively for patients with CD4 T lymphocyte range up to 500, ]300-500], ]100-300] and < 100 cells/mm3. The overall resistance rates were 27.72 and 34.66% respectively among isolates from HIV negative and positive patients. The prevalence of ESBL, AmpC and carbapenemase producing Enterobacteriaceae infection was 16.34, 12.5, and 4.81% respectively among HIV infected patients versus 8.62, 8.65 and 0% among HIV uninfected patients (p = 0.0055). Conclusion: Our findings showed that HIV positive patients are significantly more affected by Enterobacteriaceae infection than negative ones and that the rate of these bacterial infection likely increases with decrease CD4 counts. The present study also indicates that HIV positive patients are more likely to be infected by highly resistant organisms and had the highest carriage rate of ESBL, AmpC and carbapenemase producing Enterobacteriaceae compared to uninfected individuals in Western-Cameroon.

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 171-175
Author(s):  
Tania Rahman ◽  
Momtaz Begum ◽  
Sharmeen Sultana ◽  
SM Shamsuzzaman

Background: In recent years, Extended-spectrum beta-lactamase (ESBL) producing microorganisms have complicated treatment of infections due to resistance of ESBL producing strains to a wide range of antimicrobials. Objective: Target of this study was to determine the prevalence of ESBL producing gramnegative bacteria in neonatal sepsis cases and to reveal the antimicrobial susceptibility pattern of those isolated ESBL producers. Materials and Methods: This cross sectional study was carried out in Dhaka Medical College Hospital (DMCH) over a period of 12 months from January to December in 2016. Following isolation and identification of gram-negative bacteria from blood samples of suspected septicemic neonates, antimicrobial susceptibility test was performed by Kirby Bauer disk-diffusion method and ESBL producers were detected by Double Disk Synergy (DDS) test. Results: Among 52 Gram-negative bacteria isolated from 106 blood samples, 34.61% ESBL producers were detected and Enterobacter spp. (45%) was predominant followed by Klebsiella pneumoniae (33.33%). None of the ESBL producers was resistant to colistin and tigecycline. All ESBL producing Acinetobacter baumannii, 77.78% and 66.67% of ESBL producing Enterobacter spp and Klebsiella spp. respectively showed resistance to meropenem. All ESBL producers were resistant to piperacillintazobactam. Conclusion: Appropriate measures should be taken to prevent the spread of ESBL producing strains by combining strategies for infection prevention, control and rational use of antibiotics. KYAMC Journal Vol. 11, No.-4, January 2021, Page 171-175


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.


2012 ◽  
Vol 4 (2) ◽  
pp. 28-31 ◽  
Author(s):  
Nawshad Muhammad Wahidur Rahman ◽  
Afzalunnessa Binte Lutfor ◽  
Sanya Tahmina Jhora ◽  
Mahmuda Yasmin ◽  
Jalaluddin Ashraful Haq

A total of 200, non-duplicate ESBL producing strains (171 Escherichia coli and 29 Klebsiella spp.) from three tertiary care hospitals were detected using screening test & double disc synergy test. All isolates were screened for the detection of CTX-M type Extended spectrum Beta-lactamase (ESBL) using PCR. Among them 133 (66.5%) were positive for CTX-M type ESBLs which include 114 (66.66%) E.coli and 19 (65.51%) Klebsiella spp. This is the first report of identifying CTX-M gene in ESBL producing Escherichia coli and Klebsiella species of different hospitals.DOI: http://dx.doi.org/10.3329/bjmm.v4i2.10829 


Author(s):  
S. C. Tama ◽  
Y. B. Ngwai ◽  
I. H. Nkene ◽  
R. H. Abimiku

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.


2015 ◽  
Vol 95 (3) ◽  
pp. 288-292 ◽  
Author(s):  
Jos� Medina-Polo ◽  
Ana Arr�bola-Pajares ◽  
Santiago P�rez-Cadavid ◽  
Ra�l Ben�tez-Sala ◽  
Raquel Sope�a-Sutil ◽  
...  

2016 ◽  
Vol 10 (10) ◽  
pp. 1135-1139 ◽  
Author(s):  
Ingrid Cécile Djuikoue ◽  
Paul-Louis Woerther ◽  
Michel Toukam ◽  
Charles Burdet ◽  
Etienne Ruppé ◽  
...  

Introduction: During the last decade, the prevalence of the intestinal carriage of extended spectrum beta-lactamases – producing Escherichia coli (ESBL-E. coli) has continued to increase worldwide in the community, especially in developing countries. Hence, we undertook a study to determine the ESBL-E. coli fecal carriage rate and the associated risk factors in Cameroonian women. Methodology: A total of 86 women suspected of community-acquired urinary tract infections (UTI) were included in 10 health structures from May 2011 to April 2012. After filling a questionnaire, they provided a stool sample that was plated on selective media for ESBL producing bacteria. The identification of strains was obtained with mass spectrometry and the antibiotic susceptibility by disk diffusion in agar media. The ESBL type was determined by PCR. The relative abundance of ESBL-E. coli was measured for positive samples. Eventually, the presence of antibiotics in stool was assessed. Results: The carriage rate of ESBL-E. coli was 57/86 (66.3%). Phenotypic and molecular characterization showed that all ESBL-E. coli strains contained group 1 CTX-M enzymes. Multivariate analysis showed that ESBL-E. coli fecal carriage was associated with the presence of antibiotics in stools (p < 0.05). Although not significant, mean ESBL relative abundance tended to be higher in patients with antibiotic exposure. Conclusions: Our results show that the carriage of ESBL-E. coli fecal carriage in women with UTI suspicion from the Cameroonian community is extremely high and associated with recent antibiotic intake.


2020 ◽  
Author(s):  
Emmanuel Chirwa ◽  
Georgina Mulundu ◽  
Kunda Ndashe ◽  
Kalo Kanongesha ◽  
Kaziwe Simpokolwe ◽  
...  

Urinary tract infections caused by Extended Spectrum Beta-Lactamase producing Escherichia coli are increasing globally and yet treatment still remains a challenge due to antibiotic resistance of the causative agent. The aim of the study was to determine the antimicrobial susceptibility pattern and detect the presence of blaCTX-M gene in Escherichia coli isolated from urinary tract infection patients at the University Teaching Hospital, Lusaka, Zambia. This was a cross-sectional study that involved the collection of urine samples from patients who were diagnosed with urinary tract infections. The samples were cultured on MacConkey agar complemented with cefotaxime and Polymerase Chain Reaction was performed to confirm the Extended-Spectrum Beta-Lactamase producers by detecting the CTX-M gene. Antimicrobial susceptibility tests were conducted using standard methods. A total of 327 urine samples were cultured and 15 (4.6%) of these samples were positive ESBL producers. The isolates showed complete resistance to ampicillin and cotrimoxazole. Multi drug-resistant Extended Spectrum Beta-Lactamase producing Escherichia coli was detected in 4.6 % of UTI patients at the University Teaching Hospital.


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