scholarly journals Extended Spectrum Beta Lactamases Detection and Multiple Antibiotic Resistance Indexing of Escherichia Coli from Urine Samples of Patients from a Referral Hospital of Eastern Nepal

2015 ◽  
Vol 3 (3) ◽  
pp. 423-426 ◽  
Author(s):  
A. Chakrawarti ◽  
P. Dongol ◽  
H. Khanal ◽  
P. Subba ◽  
J.J. Benerjee

Background: Escherichia coli is the most common causative agent of urinary tract infection. Antibiotic resistance among uropathogens has become a prominent public health problem. Multidrug resistance bacteria have limited the therapeutic possibilities by producing Extended Spectrum Beta Lactamases (ESBL). Objective: Since routine monitoring of ESBL producers are not conducted in clinical laboratories their true prevalence is still unknown. So the objective of this research was to assess multiple antibiotic resistance (MAR) indices and determine ESBL production among Escherichia coli isolated from urine samples. Methods: Standard microbiological techniques and antibiotic sensitivity test were performed by Kirby Bauer disc diffusion method to identify E. coli. ESBL screening was done by using Ceftriaxone, Aztreonam, Cefotaxime, Ceftazidime and Cefpodoxime whereas confirmation by combined disc assay. SPSS 16 software was used to analyze data. Results: 86.95% E. coli isolates were MDR strains. 27 isolates had multiple antibiotic resistance (MAR) index of 0.2 and 5 isolates had MAR index of 0.7. E. coli isolates showed higher degree of resistance towards Amoxicillin (100%) while 100% were sensitive towards Gentamicin followed by Nitrofurantoin (62.31%). The reliable screening agent for ESBL detection with sensitivity 100% and positive predictive value of 80% was Cefotaxime. Combined disc assay detected 12/69 (17.31%) of E. coli isolates as confirmed ESBL producers. Conclusion: The ubiquity of ESBL-producing E. coli was observed emphasizing the necessity of regular surveillance of ESBL producing clinical isolates in clinical samples to minimize multi-drug resistance strains and avert the ineffectiveness of antimicrobial agent for good health practices.\Int J Appl Sci Biotechnol, Vol 3(3): 423-426

2021 ◽  
Vol 37 (2) ◽  
pp. 56-73
Author(s):  
F Iseghohi ◽  
J.C Igwe ◽  
M Galadima ◽  
A.F Kuta ◽  
A.M Abdullahi ◽  
...  

Globally, urinary tract infections are one of the most common infections in need of urgent clinical attention. The prevalence of extended spectrum beta-lactamases (ESBL)- producing Escherichia coli isolated from urine samples of some UTI patients and s of apparently healthy individuals in Minna, Nigeria, is investigated. Standard microbiological techniques were used to conduct this study. A total of 170 catch midstream urine samples submitted to the Medical Microbiology Laboratories of 4 different hospitals (and samples from healthy individuals) were randomly collected for 5 months and examined for microbial growths. Female patients (65.9%) submitted more urine samples for UTI test than their male counterpart (34.1%). The age ranges of 21 -30 (26.5%) and 31 - 40 (25.3%) had the highest percentages of infection rate while those within the ages 1- 10 (3.5%) and ≥ 71 (2.3%) were the least infected. This study observed a prevalence of 23.5% of E. coli in Minna metropolis and a significant number (30%) of healthy individuals (HI) was observed to harbor the E. coli in their urine. The isolates were highly susceptible to Gentamicin (65%), Ofloxacin (65%), Tetracycline (62.5%), Cotrimoxazole (62.5%), and Streptomycin (57.5%). Mildly susceptible to Pefloxacin (37.5%), Chloramphenicol (37.5%), and Ciprofloxacin (35%). There were significant resistance to most of the beta-lactames tested [Cefuroxime (80%), Amoxicillin (42.5%), Augmentin (40), Cefotaxime (20%) and Ceftaxidime (7.5%)]. Two of the isolates were resistant to all the 13 antibiotics tested; 70% (28) of the isolates had multiple antibiotics resistance index (MARI) ≥0.3. Multidrug resistance was expressed in 37.5% of the isolates tested. The study showed a vast resistant pool in the environment. Only 25% of the E. coli isolated from the urine samples produced beta-lactamases phenotypically, most of which expressed resistance to more than 5 of the antibiotics tested and had MARI of ≥ 0.5. Further evaluation showed that 25% (10/40) of the E. coli isolated from the UTI patients in Minna, Nigeria, were ESBL- producers and could harbor one or two of the genes. TEM gene was expressed in 70% (7) of the isolates that produced ESBL phenotypically, 60% 6) harbored CTXM gene, 20% (2) had the OXA gene while none of the bacteria harbored the SHV gene. The study established a 5.9% ESBL prevalence among the E. coli isolated from UTI in the environment studied. This study established that E. coli is one of the prevalent bacteri urea majorly isolated from UTI patients in Minna. The prevalent E. coli are multidrug resistant and could harbor more than one ESBL gene . keywords: Escherichia coli, Minna, UTI, ESBL, Multidrug resistance


Author(s):  
Yuji Watanabe ◽  
Masafumi Seki

Antimicrobial stewardship team (AST) and Infection Control Team (ICT) have recently been linked Infectious diseases (ID) physicians, and implemented in clinical settings in Japan. The microbiological effects of an AST and ICT, in addition to Diagnostic stewardship team (DST) supported by ID physicians in our tertiary hospital were shown in significant reduction of antibiotic resistance of Escherichia coli (E coli) including extended spectrum beta-lactamases (ESBL)-producing E coli.


2014 ◽  
Vol 6 (01) ◽  
pp. 007-013 ◽  
Author(s):  
Sridhar PN Rao ◽  
Prasad Subba Rama ◽  
Vishwanath Gurushanthappa ◽  
Radhakrishna Manipura ◽  
Krishna Srinivasan

ABSTRACT Background: There are sporadic reports on detection of extended-spectrum beta-lactamases (ESBL) producers from Karnataka; hence, this is a first multicentric study across Karnataka state to determine the prevalence of ESBL production among clinical isolates of Escherichia coli and Klebsiella pneumoniaei. Aims and objectives: To determine the prevalence of ESBL producing clinical isolates of E. coli and K. pneumoniae from five geographically distributed centers across Karnataka, to study the susceptibility of ESBL producing isolates to other beta-lactam and beta-lactam-beta-lactamase inhibitors and to demonstrate transferability of plasmids coding for ESBL phenotype. Materials and Methods: Two hundred isolates of E. coli and K. pneumoniae each were collected from each of the five centers (Bellary, Dharwad, Davangere, Kolar and Mangalore). They were screened for resistance to screening agents (ceftazidime, cefotaxime, ceftriaxone, aztreonam) and positive isolates were confirmed for ESBL production by test described by Clinical and Laboratory Standards Institute . Co-production of ESBL and AmpC beta-lactamase was identified by using amino-phenylboronic acid disk method. Susceptibility of ESBL producers to beta-lactam antibiotics and beta-lactamase inhibitors was performed. Transferability of plasmids was performed by conjugation experiment. Results: Overall prevalence of ESBL production among E. coli and K. pneumoniae across five centers of the state was 57.5%. ESBL production was found to be 61.4% among E. coli and 46.2% among K. pneumoniae. ESBL production was significantly more among E. coli than K. pneumoniae. Significant variations in distribution of ESBL across the state was observed among E. coli isolates, but not among K. pneumoniae isolates. All ESBL producers demonstrated minimum inhibitory concentration levels ≥2 μg/ml towards cefotaxime, ceftazidime and ceftriaxone. Conclusion: Overall prevalence of ESBL production among clinical isolates of E. coli and K. pneumoniae across Karnataka state was high. The prevalence of ESBL production was significantly higher with E. coli than K. pneumoniae isolates. Higher rates of resistance to ceftriaxone and cefotaxime than to ceftazidime suggests the possibility of presence of CTX-M type ESBLs. Of all the beta-lactam/beta-lactamase inhibitor combinations tested, cefepime-tazobactam demonstrated highest in-vitro activity against ESBL producers. There was no statistical difference in the transferability of plasmids among E. coli and K. pneumoniae.


2020 ◽  
Vol 21 (10) ◽  
Author(s):  
FRESHINTA JELLIA WIBISONO ◽  
BAMBANG SUMIARTO ◽  
TRI UNTARI ◽  
Mustofa Helmi Effendi ◽  
DIAN AYU PERMATASARI ◽  
...  

Abstract. Wibisono FJ, Sumiarto B, Untari T, Effendi MH, Permatasari DA, Witaningrum AM. 2020. Short Communication: Pattern of antibiotic resistance on extended-spectrum beta-lactamases genes producing Escherichia coli on laying hens in Blitar, Indonesia. Biodiversitas 21: 4631-4635. The aims of this study were to determine the susceptibility pattern of phenotypic antibiotics on extended-spectrum beta-lactamases (ESBL) genes and genotype profiles of ESBL producing Escherichia coli strains isolated from cloacal samples of laying hens in Blitar. A total of 165 cloacal swab samples were successfully isolated 145 E. coli strains during the study taken from 5 subdistricts in Blitar. All the strains were examined for antibiotic resistance patterns by disk diffusion method with double-disk synergy test (DDST), followed testing with VITEK® 2 methods, molecular identification of ESBL coding genes using PCR. The results of this study showed that the characterization of nucleotide analysis from PCR amplification of ESBL-producing E. coli bacteria isolated from laying hens in Blitar showed that eight isolates were the dominant of CTX gene, followed by the TEM encoding gene of two isolates, and the SHV coding gene as much as one isolate. The presence of more than 1 encoding genes in the E. coli bacterial isolate was seen in 1 isolate, where the isolate carried the CTX gene and the SHV gene as well. All ESBL producing E. coli isolates were resistant to amoxicillin, ampicillin, cefazolin, cefotaxime, and ceftriaxone, and these ESBL isolates were more than 70% resistant to gentamicin, aztreonam, and trimethoprim/sulfamethoxazole. These results indicated that poultry is a potential reservoir for ESBL-producing E. coli. The presence of ESBL-producing E. coli in poultry requires strengthening antibiotic policy. This is important because the regulation of antibiotic use in poultry is gaining momentum to increase animal productivity and food safety in Blitar, Indonesia.


2021 ◽  
Vol 13 (18) ◽  
pp. 10174
Author(s):  
Katarzyna Wolny-Koładka ◽  
Marek Zdaniewicz

The aim of the study was to determine the drug resistance profile and to assess the presence of genes responsible for the production of extended-spectrum beta-lactamases in Escherichia coli isolated from energy-processed hop sediment with the addition of bulking agents. Antibiotic resistance was determined by the disk diffusion method and the PCR technique to detect genes determining the extended-spectrum beta-lactamases (ESBLs) mechanism. A total of 100 strains of E. coli were collected. The highest resistance was found to aztreonam, tetracycline, ampicillin, ticarcillin, and ceftazidime. The bacteria collected were most often resistant to even 10 antibiotics at the same time and 15 MDR strains were found. The ESBL mechanism was determined in 14 isolates. Among the studied genes responsible for beta-lactamase production, blaTEM was the most common (64%). The study revealed that the analysed material was colonised by multi-drug-resistant strains of E. coli, which pose a threat to public health. The obtained results encourage further studies to monitor the spread of drug resistance in E. coli.


2018 ◽  
Vol 14 (30) ◽  
pp. 323
Author(s):  
Wassiyath Mousse ◽  
Haziz Sina ◽  
Mamadou Wele ◽  
Nicodeme Chabi ◽  
Durand Dah Nouvlessounon ◽  
...  

Urinary tract infections are the second common reason of medical consultations and antibiotics prescription. Escherichia coli is known to cause most urinary tract infections. The aim of this study was to characterize and determine the antibiotic resistance profile of E. coli extended-spectrum βlactamases (ESBL) producer strains isolated from urine samples. The urine samples collected came from hospitalized and non-hospitalized patient referred to Hubert Koutoukou Manga (HKM), National and University Hospital Center (Cotonou, Benin). The resistance to antibiotics was determined according to the disk diffusion method. The production of penicillinase and ESBLs was researched respectively by the acidimetric test and double disk synergy method. The presences of genes encoding βlactamases were detected by Polymerase Chain Reaction (PCR). Our data revealed that 60 % of E. coli strains (101) were isolated from female patients. Also, 69.31 % of the strains were isolated from non-hospitalized patients. The high resistance levels were recorded with amoxicillin (96.04 %) and amoxicillin + clavulanic acid (66.34 %). Twenty percent (20%) of strains were ESBLs. Among ESBLs strains, 70% comes from non-hospitalized patients. Eighty percent of E. coli strains produced penicillinase among which 25 % were ESBL producers. All the ESBL producers strains carried blaTEM gene whereas only 30 % carried the blaSHV gene. This study updates the data on the prevalence to antibiotic resistance of E. coli ESBL producers strains for better management of urinary tract infections.


Author(s):  
Abimbola Olumide Adekanmbi ◽  
Sandra Usidamen ◽  
Anthony Abiodun Onilude

AbstractInfection of the urinary tract ranks as one of the most common infections affecting people worldwide and its treatment is made complicated by the rising incidence of antibiotic resistance. This study aimed to detect extended spectrum beta-lactamase (ESBL) genes and antibiotic resistance profile of uropathogenic Escherichia coli (E. coli) recovered from patients attending a University Teaching hospital in Nigeria. Uropathogenic E. coli isolates were obtained from the culture collection of Department of Microbiology and Parasitology of the University Teaching hospital for a period of four months (October 2019–January, 2020). Antibiotic susceptibility testing was done using the disc diffusion method while phenotypic ESBL production was detected using double disc synergy test (DDST). Detection of β-lactamase genes was done using Real-Time PCR. Forty-nine E. coli isolates were recovered from 120 urine samples, with 24 (49%) being ESBL positive. The resistance to antibiotics in the ESBL producers was: ciprofloxacin (100%), cefotaxime (100%), cefpodoxime (100%), tetracycline (95.7%), ceftazidime (56.7%), amoxicillin-clavulanate (50%), gentamicin (33.3%), and imipenem (0%). All the ESBL producers carried blaTEM, blaCTX-M-1 and blaCTX-M-9, 75% (18/24) carried blaSHV, while blaCTX-M-2, blaCTX-M-8 and blaCTX-M-25 groups were detected in 20.8% (5/24) of the isolates. There was co-occurrence of CTX-M, SHV and TEM β-lactamases in 79.2% (19/24) isolates, while five isolates (20.8%) co-harbored blaCTX-M and blaTEM. This study showed a high level of multidrug resistance and ESBL gene carriage in uropathogenic E. coli obtained in this study, suggesting a likely review of therapeutic options in the treatment of UTI to clamp down on the rising cases of antibiotic resistance.


2021 ◽  
Vol 21 (2) ◽  
pp. 505-512
Author(s):  
Kehinde C Mofolorunsho ◽  
Hannah O Ocheni ◽  
Ruth F Aminu ◽  
Cornelius A Omatola ◽  
Olabisi O Olowonibi

Background: Escherichia coli and Klebsiella pneumoniae are commonly implicated in urinary tract infections accounting for majority of the antimicrobial resistance encountered in hospitals. Objectives: To determine the prevalence and antimicrobial susceptibility of extended-spectrum beta-lactamases (ESBLs) producing E. coli and K. pneumoniae among patients in Anyigba, Nigeria. Methods: This hospital-based cross-sectional study was conducted using urine samples from 200 patients of Grimmard Catholic hospital and Maria Goretti hospital. Urine samples were processed to identify ESBL-producing E. coli and K. pneu- moniae using standard microbiological techniques. Isolates were then tested against antimicrobial agents. Results: A total of 156 bacterial isolates were recovered consisting 128 of E. coli and 28 of K. pneumoniae. Extended spec- trum beta-lactamases production was observed in 69% of E. coli and 31% of K. pneumoniae. These pathogens were resistant to 3 or more antibiotics. Of the antimicrobials tested, cefotaxime demonstrated the highest rates of resistance (100%) for both ESBL-producing E. coli and K. pneumoniae. Fifty-four isolates of ESBL-producing E. coli showed a high level of resist- ance to amoxicillin clavulanic acid (83.3%), ciprofloxacin (83.3%), and ceftazidime (79.6%). ESBL-positive K. pneumoniae iso- lates were highly resistant to ciprofloxacin (75%), and amoxicillin clavulanic acid (83.3%). Cefoxitin (62.5%) and gentamicin (66.7%) showed substantially higher rates of resistance against these isolates while all 24 strains were resistant to imipenem. Conclusion: This study indicated the prevalence of ESBL-positive Gram-negative pathogens in these study sites and also demonstrated their resistance to a few antibiotics. This highlights the need for new antimicrobials that are potent and im- proved policy on use of antibiotics. Keywords: Antibiotic resistance; ESBLs; Escherichia coli; Klebsiella pneumoniae; Anyigba.


Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 447
Author(s):  
Barbara Kot ◽  
Agata Grużewska ◽  
Piotr Szweda ◽  
Jolanta Wicha ◽  
Urszula Parulska

The aim of this study was to determine antibiotic resistance patterns and the prevalence of uropathogenes causing urinary tract infections (UTIs) in patients hospitalized in January–June 2020 in central Poland. Antimicrobial susceptibility testing was performed using the disk-diffusion method. Escherichia coli (52.2%), Klebsiella pneumoniae (13.7%), Enterococcus faecalis (9.3%), E. faecium (6.2%), and Proteus mirabilis (4,3%) were most commonly isolated from urine samples. E. coli was significantly more frequent in women (58.6%) (p = 0.0089) and in the age group 0–18, while K. pneumoniae was more frequent in men (24.4%) (p = 0.0119) and in individuals aged 40–60 and >60. Gram-negative species showed resistance to ampicillin. K. pneumoniae were resistant to amoxicillin plus clavulanic acid (75.0%), piperacillin plus tazobactam (76.2%), cefotaxime (76.2%), cefuroxime (81.0%), ciprofloxacin (81.0%), and trimethoprim plus sulphamethoxazole (81.0%). Carbapenems were effective against all E. coli and P. mirabilis. Some K. pneumoniae (13.6%) produced metallo-β-lactamases (MBLs). E. coli (22.6%), K. pneumoniae (81.8%), and all E. faecium were multidrug-resistant (MDR). Some E. coli (26.2%), K. pneumoniae (63.6%), and P. mirabilis (14.3%) isolates produced extended-spectrum beta-lactamases (ESBL). Vancomycin-resistant E. faecium was also found. This study showed that the possibilities of UTIs therapy using available antibiotics become limited due to the increasing number of antibiotic-resistant uropathogens.


2020 ◽  
Vol 4 (3) ◽  
pp. 323-327
Author(s):  
Mamunu Abdulkadir SULAIMAN ◽  
H.S Muhammad ◽  
Aliyu Muhammad Sani ◽  
Aminu Ibrahim ◽  
Ibrahim Muhammad Hussain ◽  
...  

Multidrug resistance (MDR) exhibited by some strains of Escherichia coli may be due to acquiring mobile genetic element (R-plasmid) by the bacteria, or intrinsically induced by inappropriate use of antibiotics by the hosts.  Infection by such strains may result to prolonged illness and greater risk of death. The study evaluated the impact of curing on antibiotic resistance on selected clinical isolates of E. coli. Twenty clinical isolates of E. coli from our previous studies were re-characterized using conventional microbiological techniques. Antibiotic sensitivity testing was determined by disk diffusion method, MDR selected based on resistance to ≥ 2 classes of antibiotics. Multiple antibiotic resistance (MAR) index was determined as ratio of the number of antibiotic resisted to the total number of antibiotics tested and considered significant if ≥. 0.2. The isolates that showed significant MAR index were subjected to plasmid curing using acridine orange, thereafter, profiled for plasmid and the cured ones were re-tested against the antibiotics they initially resisted. Out of the 20 isolates, 19 (95%) were confirmed as E. coli, all (100%) of which were MDRs, which was highest against augmentin (78.9%) followed by amoxacillin (52.6%). However, after the plasmid curing only 6 (31.6%) out of the 19 isolates cured retained significant MAR index and the level of the significance had reduced drastically in 16 (84.2%) isolates. Conclusively, curing assay can completely eliminate R-plasmid acquired resistance. More studied on plasmid curing agents for possible augmentation of the agents into antibiotics may see the rise of successful antibiotic era again.


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