scholarly journals The Magnitude and Drug Resistance Profile of Extended Spectrum Β-Lactamase (Esbl) Producing Gram-Negative Bacteria from Different Inanimate Objects at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

2021 ◽  
Author(s):  
Asegedech Asmamaw Jemberu ◽  
Kassu Desta Tullu ◽  
Yimtubeznash Woldeamanuel Mulate
Keyword(s):  
Drug Resistance ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Gram Negative ◽  
Resistance Profile ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital ◽  
Drug Resistance Profile

Abstract Background: Infections caused by gram-negative bacteria are causing morbidity and mortality worldwide. The production of extended-spectrum β-lactamases (ESBLs) is an important mechanism that is responsible for resistance to the third-generation cephalosporin. The purpose of this study was to determine the magnitude and drug resistance profile of ESBL producing gram-negative bacteria isolated from various inanimate objects at Tikur Anbessa Specialized Hospital. Methods: Laboratory based cross-sectional study was conducted involving a total of 216 isolates from January to March 2019. The samples were taken from different inanimate objects at Tikur Anbessa Specialized Hospital using pre-moistened sterile swabs. Screening of ESBLs was done using ESBL CHROME agar and confirmed with combined disk diffusion test. Antimicrobial susceptibility testing was done by disc diffusion method. The data were analyzed using SPSS software version 20 and descriptive statistical tests were performed. Results: 33/216 (15.3%) isolates were found to be ESBL producers based on the confirmatory test (combined disk method). Different ESBL producing gram-negative bacteria were isolated from the various inanimate objects of TASH including, Klebsiella ozaenae, Klebsiella oxytoca, Klebsiella pneumoniae, Klebsiella rhinoscleromatis, Citrobacter spp, Escherichia coli, Serriatia spp and Acinetobacter spp. The isolates were found to be 100% resistant to ceftazidime and ceftriaxone. Conclusion: It is worrisome to detect ESBL producing gram-negative bacteria from the inanimate objects of TASH, calling for systematic screening of inanimate objects for ESBL and other multidrug-resistant bacteria in the hospital. Furthermore, strengthening the infection prevention practice is vital to halt the transmission of these microorganisms.

Prevalence and Antibiogram of Extended-Spectrum Beta-Lactamase Producing Gram-negative Bacteria Isolated from Septicemic Neonates in a Tertiary Care Hospital

KYAMC Journal ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 171-175
Author(s):  
Tania Rahman ◽  
Momtaz Begum ◽  
Sharmeen Sultana ◽  
SM Shamsuzzaman
Keyword(s):  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Blood Samples ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

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

scholarly journals A high prevalence of multi-drug resistant Gram-negative bacilli in a Nepali tertiary care hospital and associated widespread distribution of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-encoding genes

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Sulochana Manandhar ◽  
Raphael M. Zellweger ◽  
Nhukesh Maharjan ◽  
Sabina Dongol ◽  
Krishna G. Prajapati ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Tertiary Care ◽  
Multi Drug Resistance ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Global Public Health ◽  
Gram Negative ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence

Abstract Background Multi-drug resistance (MDR) and extensive-drug resistance (XDR) associated with extended-spectrum beta-lactamases (ESBLs) and carbapenemases in Gram-negative bacteria are global public health concerns. Data on circulating antimicrobial resistance (AMR) genes in Gram-negative bacteria and their correlation with MDR and ESBL phenotypes from Nepal is scarce. Methods A retrospective study was performed investigating the distribution of ESBL and carbapenemase genes and their potential association with ESBL and MDR phenotypes in E. coli, Klebsiella spp., Enterobacter spp. and Acinetobacter spp. isolated in a major tertiary hospital in Kathmandu, Nepal, between 2012 and 2018. Results During this period, the hospital isolated 719 E. coli, 532 Klebsiella spp., 520 Enterobacter spp. and 382 Acinetobacter spp.; 1955/2153 (90.1%) of isolates were MDR and half (1080/2153) were ESBL producers. Upon PCR amplification, blaTEM (1281/1771; 72%), blaCTXM-1 (930/1771; 53%) and blaCTXM-8 (419/1771; 24%) were the most prevalent ESBL genes in the enteric bacilli. BlaOXA and blaOXA-51 were the most common blaOXA family genes in the enteric bacilli (918/1771; 25%) and Acinetobacter spp. (218/382; 57%) respectively. Sixteen percent (342/2153) of all isolates and 20% (357/1771) of enteric bacilli harboured blaNDM-1 and blaKPC carbapenemase genes respectively. Of enteric bacilli, Enterobacter spp. was the most frequently positive for blaKPC gene (201/337; 60%). The presence of each blaCTX-M and blaOXA were significantly associated with non-susceptibility to third generation cephalosporins (OR 14.7, p < 0.001 and OR 2.3, p < 0.05, respectively).The presence of each blaTEM, blaCTXM and blaOXA family genes were significantly associated with ESBL positivity (OR 2.96, p < 0.001; OR 14.2, p < 0.001 and OR 1.3, p < 0.05 respectively) and being MDR (OR 1.96, p < 0.001; OR 5.9, p < 0.001 and OR 2.3, p < 0.001 respectively). Conclusions This study documents an alarming level of AMR with high prevalence of MDR ESBL- and carbapenemase-positive ESKAPE microorganisms in our clinical setting. These data suggest a scenario where the clinical management of infected patients is increasingly difficult and requires the use of last-resort antimicrobials, which in turn is likely to intensify the magnitude of global AMR crisis.

scholarly journals Klebsiella Pneumoniae in Septicemic Neonates with Special Reference to Extended Spectrum β-lactamase, AmpC, Metallo β-lactamase Production and Multiple Drug Resistance in Tertiary Care Hospital

2015 ◽  
Vol 7 (01) ◽  
pp. 032-037 ◽  
Author(s):  
Shivali V Gajul ◽  
Shivajirao T Mohite ◽  
Smita S Mangalgi ◽  
Sanjay M Wavare ◽  
Satish V Kakade
Keyword(s):  
Drug Resistance ◽  
Klebsiella Pneumoniae ◽  
Antimicrobial Susceptibility ◽  
Multiple Drug Resistance ◽  
Confirmatory Test ◽  
Diffusion Method ◽  
Multiple Drug ◽  
Neonatal Septicemia ◽  
Extended Spectrum ◽  
Disk Method

ABSTRACT Background: β-lactamases viz., extended spectrum β-lactamase (ESBL), AmpC, and metallo β-lactamase (MBL) production in Klebsiella pneumoniae has led to a serious concern about septicemic neonates in Neonatal Intensive Care Units due to high resistance against commonly used antimicrobials Purpose:To study the prevalence of ESBL, AmpC, and MBL production in K. pneumoniae isolates in neonatal septicemia, to check antimicrobial susceptibility to various drugs including tigecycline; and to assess burden of multiple drug resistance (MDR). Materials and Methods: Total 24 clinical isolates of K. pneumoniae isolated from 318 blood samples of suspected cases of neonatal septicemia were studied. Isolates were screened for ESBL, AmpC, and MBL production by Clinical and Laboratory Standards Institute (CLSI) disk method, AmpC cefoxitin screen, and imipenem, meropenem, ceftazidime disk screen respectively; and confirmation was done by CLSI phenotypic disk confirmatory test, AmpC sterile disk method, and imipenem ethylenediamine tetracetic acid double disk synergy test respectively. Antimicrobial susceptibility was determined by Kirby-Bauer's disk diffusion method. Efficacy of tigecycline was evaluated using United States Food and Drug Administration guidelines. Results: Of the 24 K. pneumoniae isolates, co-production of AmpC + MBL was found in more number of isolates (67%) (P < 0.0001) compared to single enzyme production (ESBL and MBL 8% both, AmpC 12.5%). Rate of resistance for penicillins and cephalosporins was highest. Susceptibility was more for imipenem, co-trimoxazole, and meropenem. Nonsusceptibility to tigecycline was low (21%). A total of 23 (96%) isolates were MDR. Conclusions: Routine detection of ESBL, AmpC, and MBL is required in laboratories. Carbapenems should be kept as a last resort drugs. Trend of tigecycline susceptibility has been noted in the study. Continued monitoring of susceptibility pattern is necessary to detect true burden of resistance for proper management.

scholarly journals Magnitude and antimicrobial susceptibility patterns of extended-spectrum β-lactamase producing Enterobacteriaceae recovered from environmental samples at Tikur Anbessa Specialized Hospital, Ethiopia

2020 ◽  
Author(s):  
Shemse Sebre Muktar ◽  
Woldaregay Erku ◽  
Wude Mihret ◽  
Aminu Seman ◽  
Tewachw Awoke ◽  
...  
Keyword(s):  
High Resistance ◽  
Antimicrobial Susceptibility ◽  
Hospital Environment ◽  
Diffusion Method ◽  
Resistance Level ◽  
Cross Sectional ◽  
Extended Spectrum ◽  
Specialized Hospital ◽  
Tikur Anbessa Specialized Hospital ◽  
Susceptibility Patterns

Abstract Background The hospital environment especially the intensive care units (ICUs) contributes to the spread of extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae, which are contributing to increasing morbidity and mortality rates. We aimed to assess the rate of environmental contamination of ESBL producing Enterobacteriaceae and their antimicrobial susceptibility patterns. Methods A Cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) from June to July, 2018. A total of 65 environmental swab were taken from inanimate items. All isolates from the inanimate environment were cultured by using ESBL ChromoSelect Agar and identified using conventional bacteriological methods. All ESBL producing Enterobacteriaceae isolates were tested for their antimicrobial susceptibility using the disc diffusion method according to the methods and interpretive criteria of the Clinical and Laboratory Standards Institute (CLSI). Results From a total of 65 environmental swab samples, 16 (24.6%) were ESBL producing Enterobacteriaceae. The most predominant ESBL producing isolates were E. coli (8/16, 50%) and Klebsiella spp (6/16, 37.6%). The Pediatrics and Medical-Surgical ICU exhibited the highest ESBL producing Enterobacteriaceae, each with (37.5%, 6/16). Linens and ventilators were associated with high rates of ESBL isolates positivity each with equal 31.3% detection rate. ESBL producing Enterobacteriaceae isolates had significantly high resistance level to ampicillin (100%), ceftazidime (93.8%), cefepime (87.5%) and cefotaxime (86.7%). However, low resistance level was recorded against amikacin (18.8%). Conclusion The appearance of ESBL producing Enterobacteriaceae among ICUs hospital environment is posing a serious threat for the control of nosocomial infections. The high resistance found from this study shows the need for policies for devising infection control procedures and screening policies for ESBL on a routine basis.

scholarly journals Prevalence of Extended Spectrum b-Lactamases (ESBL) Producers Among Gram-Negative Bacilli in Wound Infection

2016 ◽  
Vol 15 (1) ◽  
pp. 26-30
Author(s):  
Abu Hena Md Saiful Karim Chowdhury ◽  
Md Anwar Husain ◽  
Nasima Akter ◽  
Khan Mashrequl Alam ◽  
Arup Kanti Dewanjee ◽  
...  
Keyword(s):  
Wound Infection ◽  
Confirmatory Test ◽  
Base Line ◽  
Gram Negative Bacteria ◽  
Test Results ◽  
Bacterial Strains ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Severe Infections ◽  
Esbl Producers

Background: Extended Spectrum b -Lactameses Producing Organisms (ESBLs) are increasing in number and causing more severe infections because of their continuous mutation and multidrug resistance property with limited therapeutic option.Aims and Objectives: Present study was undertaken to detect the prevalence of the ESBLs producing bacteria in wound infection, so as to provide a base line data in treating them & prevent unnecessary use of antibioticsMethods: Isolated gram-negative bacteria initially screened by Minimum Inhibitory Concentration (MIC) ESBLs breakpoints. Then suspected ESBLs producers were confirmed by Phenotypic confirmatory test. Results: 105 (One hundred five) (91.30%) bacterial strains were isolated from 115 samples of wound swab & pus from different patients were studied of which 84(80.00%) were Gram-negative and 21(20.00%) were Gram-positive. Among the isolated Gram-negative bacteria 79(94.05%) were found suspected ESBLs producers of which 54(68.35%) were found as confirmed ESBL producers. The prevalence of ESBLs producing organisms in the present study were found to be 64.29% and Klebsiella spp as most prevalent ESBLs producers.Conclusion: It is essential to report ESBL production along with routine sensitivity reporting, which will help the clinician in prescribing the proper antibiotics.Chatt  Shi Hosp Med Coll J; Vol.15 (1); Jan 2016; Page 26-30

scholarly journals Comparison Between Phenotypic Confirmatory Test & Double Disc Synergy Test in Detection of Extended Spectrum b-Lactamases Producers Among Gram-Negative Bacilli

2017 ◽  
Vol 15 (2) ◽  
pp. 3-8
Author(s):  
Abu Hena Md Saiful Karim Chowdhury ◽  
Sukumar Nandi ◽  
Mahbubur Rahman ◽  
ASM Ashanul Karim ◽  
Syeda Shanoor Hasina Mamtaz ◽  
...  
Keyword(s):  
Predictive Value ◽  
Low Cost ◽  
Standard Procedure ◽  
Confirmatory Test ◽  
Gram Negative Bacteria ◽  
Bacterial Strains ◽  
Gram Negative ◽  
Extended Spectrum ◽  
Major Interest ◽  
Synergy Test

Background: Extended-Spectrum b-Lactamases (ESBLs) producing bacteria are increasing in number and causing more severe infections because of their continuous mutation and multidrug resistance property which make its treatment difficult. Thus reliable, sensitive and low cost method to detect ESBLs producers, therefore, is of major interest. The present study was undertaken to compare the sensitivity between double disc synergy test & phenotypic confirmatory test to detect ESBLs producing bacteria.Methods: All the isolates were identified by standard procedure of identification & isolated gram-negative bacteria initially screened by Minimum Inhibitory Concentration (MIC) ESBLs breakpoints. Then suspected ESBLs producers are confirmed by double disc synergy test & phenotypic confirmatory test.Results: In the present study, total 176(74.89%) bacterial strains were isolated from 235 samples of wound swab & pus, and urine. Among the isolates, 150(85.23%) were gram-negative and 26(14.77%) were gram-positive bacteria. The gram-negative bacteria were screened for suspected ESBLs & then subjected to confirmatory test where Phenotypic Confirmatory Test (PCT) detected 89(62.68%) and Double Disc Synergy Test (DDST) detected 74(52.11%) ESBL producers. So 15(10.57%) isolates were missed by double disc synergy test. In this study, we determined sensitivity, specificity, positive predictive value & negative predictive value of Phenotypic Confirmatory Test (PCT) were 100%, 77.9%, 83.1% & 100% respectively and those of Double Disc Synergy Test (DDST) were 83.1%, 100%, 100%, and 77.9% respectively.Conclusion: Between these two tests, phenotypic confirmatory test found to be more sensitive procedure than double disc synergy test for the detection of ESBLs producing organisms.Chatt Maa Shi Hosp Med Coll J; Vol.15 (2); Jul 2016; Page 3-8

scholarly journals Extended Spectrum β-Lactamase (ESBL) Producing Multidrug Resistant Gram-Negative Bacteria from Various Clinical Specimens of Patients Visiting a Tertiary Care Hospital

2018 ◽  
Vol 4 ◽  
pp. 1-8
Author(s):  
Albert Ghimire ◽  
Bipesh Acharya ◽  
Reshma Tuladhar
Keyword(s):  
Susceptibility Testing ◽  
Multidrug Resistant ◽  
Hospitalized Patients ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative ◽  
Clinical Specimens ◽  
Extended Spectrum ◽  
Esbl Producers

Objectives: The purpose of this study was to assess multidrug resistance and Extended Spectrum β-Lactamase (ESBL) production in Gram negative bacterial pathogens.Methods: The study included clinical specimens sent for routine culture and antibiotic susceptibility testing. A total of 469 different clinical specimens were processed according to the standard methodology. The isolates were identified by standard microbiological procedures and subjected to antimicrobial susceptibility testing by modified Kirby-Bauer disk diffusion method. Production of ESBL was determined by combined disk method.Results: Of the total sample processed, 80 (17.0%) Gram negative bacteria were isolated and 82.5% of them were multidrug resistant (MDR). From the total MDR isolates, 47% were ESBL positive. The higher rate of growth among Intensive Care Units (ICUs) patients was found statistically significant. Higher prevalence of MDR isolates was observed in blood and pus specimens. The majority of the ESBL producers were Escherichia coli (38.7%). Higher rate of ESBL producers was detected from blood (55.6%). Polymyxin B, imipenem and amikacin were the most effective antibiotics against Acinetobacter spp. and Pseudomonas aeruginosa whereas imipenem, amikacin, meropenem were the most effective antibiotics against Enterobacteriaceae.Conclusion: Higher prevalence of ESBL producing MDR Gram negative pathogens in hospitalized patients indicates these bacteria are important health care associated pathogens and requires proper infection control measures that check the transfer of MDR and β-lactamase producing bacterial pathogens among the hospitalized patients.

Phenotypic Characterisation of Klebseilla pneumoniae Carbapenemase and Metallo Beta-lactamase in Carbapenem Resistant Gram-negative Bacteria

2021 ◽  
Author(s):  
Thresia . ◽  
Surya Sankar ◽  
Siju Joseph ◽  
V.R. Ambily ◽  
Anu Bosewell ◽  
...  
Keyword(s):  
Confirmatory Test ◽  
Diffusion Method ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Disc Diffusion ◽  
Beta Lactam ◽  
Disc Diffusion Method ◽  
Gram Negative ◽  
E Coli ◽  
Carbapenem Resistant

Background: Antibiotic resistance is an emerging concern in the therapy of clinical infections worldwide. Previous studies conducted in our laboratory have confirmed an increase in the prevalence of extended spectrum beta-lactamase (ESBL) among the Gram-negative bacterial pathogens associated with dogs, which could act as a potential source for the transfer of these resistant pathogens or their genetic determinants to human. Since carbapenems are the last resort drugs against these resistant pathogens, the study was aimed to isolate and characterise carbapenem resistance among Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa) associated with common clinical infections in dogs.Methods: A total of 100 samples were collected from lesional skin, urine and anterior vagina of dogs presented to the Veterinary Hospitals of Kerala Veterinary and Animal Sciences University at Mannuthy and Thrissur. The samples were cultured onto Brain Heart Infusion Agar (BHIA), Eosin Methylene Blue (EMB) and Mac Conkey (MAC) for isolation of bacteria. Identification of the isolates was performed based on cultural, morphological and biochemical characteristics. The isolates were subjected to antimicrobial susceptibility test (ABST) against the 12 commonly used beta-lactam and non–beta-lactam group of antibiotics by disc diffusion method and further subjected to screening for ESBL double disc diffusion method. Carbapenem-resistant isolates were subjected to phenotypic confirmatory test for carbapenemase production employing Imipenem-EDTA and Ertapenem-boronic acid minimum inhibitory concentration (MIC) strip method.Result: Forty four Gram-negative bacterial isolates obtained were viz., E. coli (30), K. pneumonia (11) and P. aeruginosa (3) from the 100 samples. Apart from these, other isolates obtained were Staphylococcus spp. (53) and Bacillus spp. (2). All the Gram-negative isolates were subjected to ABST employing 12 common antibiotics belonging to beta-lactam and non-beta-lactam groups. Multidrug resistance (MDR) could be observed in 28 E. coli, 11 K. pneumoniae and three P. aeruginosa isolates. All the 42 MDR isolates showed positive results for ESBL production. A total of 14 isolates out of the 44 Gram-negative bacilli were found to be resistant to carbapenem either to imipenem, meropenem or ertapenem. Among the 14 Gram-negative isolates, nine turned out to be positive for metallo-beta-lactamase (MBL) and none for K. penumoniae carbapenemase (KPC) on phenotypic confirmatory test for detecting major carbapenemase enzymes. The present study documented that Gram- negative bacteria like E. coli, K. pneumoniae and P. aeruginosa isolated from dogs are showing an increase rate of resistance against carbapenems which are the last resort drugs against ESBL producers. Hence, there is an urgent need to curb the irrational and excessive use of antibiotics in veterinary sector.

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