scholarly journals Phenotypic Characterization of Extended Spectrum Beta-lactamase, Class C Cephalosporinase and Carbapenemase-Producing Klebsiella Species Isolated from Patients Consulted at Four Yaounde-Based Hospitals.

2021 ◽  
Author(s):  
Emilia Enjema Lyonga Mbamyah ◽  
Mangum Patience Kumcho ◽  
Michel Toukam ◽  
Dieudonné Sedena ◽  
Florence Anjabie Enyeji ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Opportunistic Infections ◽  
Acquired Resistance ◽  
Multidrug Resistant ◽  
Phenotypic Characterization ◽  
Beta Lactamase ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Class C

Abstract Background: Klebsiella spp. are bacteria of medical importance for their role in opportunistic infections. These infections are often difficult to treat because of acquired resistance to one or several families of antimicrobials. The present study aimed at detecting Extended Spectrum Beta-lactamase (ESBL), Class C cephalosporinase (AmpC) and carbapenemase resistant phenotypes of Klebsiella spp. isolated from patients consulted at four Yaounde-based hospitals. Results: The frequency of the species isolated was Klebsiella pneumoniae (69%), K. oxytoca (14%), K. ozaenae (12%) and K. rhinoscleromatis (5%). Isolates were most resistant to penicillins (90%), sulphonamides (84%), cepaholosporins (80%), and least resistant to carbapenems (10.2%). Three isolates namely: two K. oxytoca and one K. pneumoniae were resistant to all twenty-eight (28) antibiotics tested. Klebsiella pneumoniae was the species with the most multidrug resistant isolates (59.4%). Most isolates (83.6%) expressed at least one resistance phenotype, while 63.6% of the isolates expressed all three phenotypes. Many of the isolates were ESBL producers (71.6%), while fewer isolates were carbapenemase (26.7%) and AmpC (6.6%) producers. Three carbapenemases (Klebsiella pneumoniae carbapenemase-KPC, Metallo-Beta Lactamase-MBL and OXA-48) were detected from 26.7% of the isolates and the combination KPC and MBL were the most detected phenotypes (12.9%). Conclusion: These results reveal that resistance of Klebsiella spp. to cephalosporins is high and this may be exacerbated as a result of the co-expression of AmpC and carbapenemases. About a quarter of the isolates had acquired carbapenemases that confer resistance to all beta-lactamases and carbapenems which constitute last line drugs. The resistance burden is further strengthened in isolates that acquired more than one carbapenemase aggravating associated patient morbidity and mortality. Therefore, it is necessary to continue monitoring antimicrobial resistance of local strains for better informed decisions on empirical treatment guide and better patient care.

scholarly journals Extended Spectrum Beta Lactamase (ESBL) Producing Klebsiella pneumoniae , a therapeutic challenge.

2015 ◽  
Vol 13 (1) ◽  
pp. 22-25
Author(s):  
Raina Chaudhary ◽  
Sabita Bhatt Bhatt ◽  
Eva Piya
Keyword(s):  
Klebsiella Pneumoniae ◽  
Multidrug Resistant ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Esbl Producer ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Sensitivity Pattern

Introduction: Klebsiella pneumoniae is one of the most common Gram negative bacteria encountered byclinicians worldwide as a cause of infections in human. Most of the infections are acquired in hospital settingtherefore, it is reported to be the amongst the 10 most common nosocomial pathogen in various studies. Nowadays,Klebsiella pneumoniae infections are complicated by increase in Extended Spectrum Beta Lactamase (ESBL)producing isolates. Therefore, this study is being conducted with the objective to fi nd out the prevalence ofESBL producing Klebsiella pneumoniaein various clinical samples and to fi nd out there sensitivity pattern.Methods: A total of 100 Klebsiella pneumoniae were isolated from various samples during the period of April2013 to November 2013 in Microbiology Unit of Shree Birendra Hospital. All the isolates were identifi ed withtheir sensitivity pattern according to standard methodology. Combination disc diffusion method was followedfor identifi cation of ESBL.Results: Out of total 100 isolates of Klebsiella pneumoniae21% were ESBL producer.ESBL producer isolatesshowed 100% sensitivity to Imepenem followed by Amikacin 57.1% and Chloramphenicol 47.6%. All theESBL isolates were resistant to both Cefotaxime and Ceftazidime.Conclusions: ESBL producer Klebsiella pneumoniae isolates were multidrug resistant. Continuous surveillanceand timely intervention with discouraging the use of cephalosporin group of antibiotics is mandatory.doi:  http://dx.doi.org/10.3126/mjsbh.v13i1.12996 

scholarly journals Molecular characterization of bla TEM and bla CTX-M in Multi-Drug Resistance E. coli isolated from Country Chicken and Country Chicken Eggs in Poultry Farms of Malaysia

2020 ◽  
Vol 2 (1) ◽  
pp. 78
Keyword(s):  
Multidrug Resistance ◽  
Multidrug Resistant ◽  
Disk Diffusion ◽  
Phenotypic Characterization ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Chicken Eggs

Over the years, multidrug-resistant Escherichia coli has contributed to the development of extended-spectrum beta-lactamase (ESBLs), which evolved primarily from poultry in every corner of the world. The unregulated use of antibiotics commonly administered to poultry products to prevent any subclinical infections that lead to multidrug resistance (MDR) that is due to acquired bacteria resistance. The main aim of this study is to investigate the prevalence in Malaysia of multidrug-resistant, extended-spectrum beta-lactamase (ESBL) producing E.coli from poultry country chicken and country eggs. In several states of Malaysia, fifty samples from country chicken and country chicken eggs were extracted randomly from chosen poultry. The sample was taken from May to June 2019. The samples were tested using traditional microbiological techniques for the presence of E. coli. Antibiotics susceptibility test using 5 forms of β-lactam antibiotics was used using the double-disk diffusion screening, and confirmation of the test is performed by a combination disk diffusion process to establish the strains generating the ESBL. Although, the phenotypic characterization of bla TEM and bla CTX-M ESBL was carried out using PCR and SDS methods. Twenty of the fifty samples collected were classified as E.coli (20/50), suggesting 40%. The results of the distribution of the β-lactamases genes were reported as bla TEM, bla CTX-M with results of 75% (3/4), and 100% (4/4), respectively. The findings indicate a high prevalence of multidrug resistance as the most prevalent of all ESBL genes in ESBL infections with CTX-M genes. Consequently, effective monitoring of MDR infections, in particular resistance to β-lactamases in poultry chicken, can predict the potential for ESBL infections in humans and animals.

scholarly journals Bloodstream infections in children caused by extended spectrum beta-lactamase-producing Klebsiella pneumoniae

2012 ◽  
Vol 64 (4) ◽  
pp. 1339-1347
Author(s):  
Deana Medic ◽  
Vera Gusman ◽  
Mira Mihajlovic-Ukropina ◽  
Zora Jelesic ◽  
Biljana Milosavljevic
Keyword(s):  
Klebsiella Pneumoniae ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Beta Lactamase ◽  
Antimicrobial Drugs ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Vojvodina Province

The aim of this study is to determine the prevalence of extended spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae strains isolated from blood in children and their susceptibility to antimicrobial drugs commonly used in the therapy. The study was conducted at the Institute of Public Health of Vojvodina Province, Serbia, in a two-year period, from January 2009 to December 2010. A total of 424 non-duplicate strains were isolated from the blood of pediatric patients hospitalized in various wards in the Institute of Health Care of Children and Youth of Vojvodina Province. Fifty isolates of Klebsiella pneumoniae were reported. The frequency of isolation of Klebsiella pneumoniae was 27/222 (12.2%) and 23/202 (11.3%) isolates in 2009 and 2010, respectively. There was a high prevalence of ESBL-producing Klebsiella pneumoniae, 76% (38/50), and 17 isolates (44.7%) were multidrug resistant (MDR). Further drug resistance surveillance in hospitals and the molecular characterization of ESBL-positive isolates in our country is necessary.

scholarly journals Outbreak of Extended Spectrum Beta Lactamase Producing Klebsiella Species Causing Neonatal Sepsis at Patan Hospital in Nepal

2015 ◽  
Vol 1 (1) ◽  
pp. 20-25
Author(s):  
Puja Amatya ◽  
Suchita Joshi ◽  
Shrijana Shrestha
Keyword(s):  
Infection Control ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Control Measures ◽  
Beta Lactamase ◽  
Plain Language ◽  
Klebsiella Species ◽  
Extended Spectrum Beta Lactamase ◽  
Infection Control Measures ◽  
Extended Spectrum

Introductions: Klebsiella sepsis is the most important nosocomial infection in neonates. The objectives of this study were to review an outbreak in a neonatal unit caused by Klebsiella species, to identify the source of the infections, and to identify infection control measures for eradication and prevention of these infections. Methods: The case notes and investigation reports of all sepsis cases admitted in neonatal units of Patan hospital from July to December 2011 caused by Klebsiella species were retrospectively reviewed. The demographic profile, risk factors along with clinical features and management of sepsis were reviewed. Results: Twenty three out of 37 neonatal blood cultures grew Klebsiella species. Thirty one were K. pneumoniae and six K. oxytoca. Seventeen of the 31 (55%) K. pneumoniae isolates were multidrug resistant and extended spectrum beta lactamase producers. Eighteen of 23 (78%) neonates with Klebsiella sepsis died. After extensive cleaning methods and identifying an intermittently leaking roof in one of the nurseries below a vescicovaginal fistula room of gynecological ward above, the infection outbreak was finally controlled. Conclusions: Infections with extended spectrum beta lactamase producing Klebsiella spp. are a threat in neonatal units because of limited treatment options for these multidrug resistant organisms. Identification of the source and control of the outbreak can be a challenge. Plain Language Summary: The study was done to review an outbreak caused by Klebsiella species, to identify the source of the infections along with infection control measures for eradication and prevention of these infections in neonate unit. Identification of the source and eradication of the outbreak of Klebsiella species can be a challenge. Hand washing remains one of the most important methods to prevent cross infections and nosocomial infections. DOI: http://dx.doi.org/10.3126/jpahs.v1i1.13011 Journal of Patan Academy of Health Sciences. 2014 Jun;1(1):20-25 

scholarly journals Orthopedic Implant-Associated Infection by Multidrug Resistant Enterobacteriaceae

2019 ◽  
Vol 8 (2) ◽  
pp. 220 ◽  
Author(s):  
Bernadette G. Pfang ◽  
Joaquín García-Cañete ◽  
Julia García-Lasheras ◽  
Antonio Blanco ◽  
Álvaro Auñón ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Infection Control ◽  
Multidrug Resistant ◽  
Implant Removal ◽  
Beta Lactamase ◽  
Orthopedic Implant ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Implant Retention ◽  
Clinical Records

Introduction: Orthopedic implant-associated infections caused by multidrug-resistant Enterobacteriaceae are a growing challenge for healthcare providers due to their increasing incidence and the difficulties of medical and surgical treatment. Material and Methods: A retrospective observational study of all cases of multidrug resistant Enterobacteriaceae orthopedic implant-associated infection diagnosed in a tertiary European hospital from December 2011 to November 2017 was carried out. Clinical records were reviewed using a previously designed protocol. Data analysis was performed with IBM® SPSS®, version 22. Results: 25 patients met inclusion criteria. The infected implants included 10 prosthetic joints, seven osteosyntheses, six combinations of prosthetic joint and osteosynthesis material, and two spacers. Of the multidrug resistant Enterobacteriaceae obtained on culture, 12 were extended-spectrum beta-lactamase-producing Escherichia coli, three OXA-48-producing Klebsiella pneumoniae, nine extended-spectrum beta-lactamase-producing Klebsiella pneumoniae, and one extended-spectrum beta-lactamase-producing Proteus mirabilis. Combination antimicrobial therapy was employed in all cases but two. Overall, 16 (64%) patients underwent implant removal. The rate of infection control in the overall implant removal group was 100% compared to 33% in the implant retention group. A strong relationship between implant removal and infection control was observed (p = 0.001). Discussion: Implant removal is strongly associated with infection control. However, in some cases, patient age and comorbidity contraindicate hardware extraction. Potential objectives for future studies should be geared towards targeting the population in which debridement, antibiotic therapy, and implant retention can be used as a first-line therapeutic strategy with a reasonable probability of achieving infection control.

scholarly journals Ventilator-associated Pneumonia: Multidrug Resistant Acinetobacter vs. Extended Spectrum Beta Lactamase-producing Klebsiella

2020 ◽  
Vol 14 (06) ◽  
pp. 660-663
Author(s):  
Mohammadreza Salehi ◽  
Sirous Jafari ◽  
Lida Ghafouri ◽  
Hossein Malekafzali Ardakani ◽  
Alireza Abdollahi ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Acinetobacter Baumannii ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
P Value ◽  
Ventilator Associated Pneumonia ◽  
Beta Lactamase ◽  
Healthcare Associated Infection ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Introduction: Ventilator-associated pneumonia (VAP) has been considered as a healthcare-associated infection with high mortality. Acinetobacter baumannii and Klebsiella pneumoniae are the common causes of VAPs around the world. Methodology: This research was a retrospective observational study in the intensive care unit (ICU) in a tertiary referral collegiate hospital in Tehran between March 2016 and May 2018. Patients who fulfilled VAP due to documented Multidrug Resistant Acinetobacter baumannii (MDR-AB) or Extended Spectrum Beta Lactamase-producing Klebsiella pneumoniae (ESBL-KP) criteria were enrolled. General demographic features, duration of hospital stay, antimicrobial treatment regimens, duration of ICU admission, the period of mechanical ventilation (MV) and 30-day mortality were documented and compared. Results: 210 patients were found with clinical, microbiological and radiological evidence of VAP. In total, 76 patients with MDR-AB and 76 patients with ESBL-KP infections were matched in the final analysis. Duration of hospitalization in the patients with MDR-AB was significantly more than that of patients infected with ESBL-KP (p-value: 0.045). Patients diagnosed with MDR-AB VAP had a 65.8% mortality rate compared to 42.1% in the ESBL-KP infection group (p = 0.003). Conclusions: Results of the present study demonstrated that VAPs caused by MDR-AB may be more hazardous than ESBL-KP VAPs because they could be accompanied by a longer hospitalization course and even a higher mortality.

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