scholarly journals Prevalence of Extended Spectrum Beta Lactamases (ESBL) and Metallo Beta Lactamases (MBL) Mediated Resistance in Gram Negative Bacterial Pathogens

2018 ◽  
Vol 4 ◽  
pp. 49-54 ◽  
Author(s):  
Pramila Pathak ◽  
Nandalal Jaishi ◽  
Binod Kumar Yadav ◽  
Pradeep Kumar Shah
Keyword(s):  
Drug Resistance ◽  
Hospital Setting ◽  
Multi Drug Resistance ◽  
Microbiological Analysis ◽  
Bacterial Isolates ◽  
Biochemical Tests ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Clinical Specimens ◽  
Extended Spectrum

Objectives: This study was conducted to determine the prevalence of multi-drug resistance (MDR) along with Extended Spectrum β-lactamase (ESBL) and Metallo β-lactamase (MBL) producing gram negative bacterial isolates among the patients attending Shahid Gangalal National Heart Centre, Kathmandu, Nepal.Methods: This cross-sectional study was carried out from June to December; 2016. Altogether 977 clinical specimens were processed for analysis of bacteriological profile and the isolates were identified by culture, morphological and biochemical tests. Antibiotic susceptibility testing of the isolates was performed by Kirby Bauer disc diffusion methods following Clinical and Laboratories Standard Institute guideline and the isolates were tested for ESBL and MBL by combined disk method.Results: out of 977 clinical specimens, 254 (25.99%) were found to be gram negative bacterial isolates, among them Klebsiella pneumoniae 83 (32.67%) was the most predominant organism followed by E. coli 51 (20.07%), Pseudomonas aeruginosa 36 (14.17%), K. oxytoca 32 (12.59%), Proteus mirabilis 13 (5.11%) and P. vulgaris 13 (5.11%), Acinetobacter spp. 11 (4.33%), Citrobacter spp. 10 (3.93%) and Enterobacter spp. 5 (1.96%) respectively. 83 (32.67%) isolates were found to be MDR, 38(14.96%) were positive for ESBL while 19 (7.48%) were MBL producer.Conclusion: The determent drug resistance among ESBL and MBL producers, reflect the extensive use of antibiotics possessing difficulties in therapeutic potions in hospital setting which might be overcome by proper microbiological analysis of pathogenic isolates and judicious use of antibiotics for emergence of resistance strains.

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 Antibiotic susceptibility profile of bacterial pathogens isolated from febrile children under 5 years of age in Nanoro, Burkina Faso.

2020 ◽  
Author(s):  
Massa dit Achille BONKO ◽  
Marc Christian Tahita ◽  
Francois Kiemde ◽  
Palpouguini Lompo ◽  
Sibidou Yougbaré ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Burkina Faso ◽  
Antibiotic Susceptibility ◽  
Bacterial Species ◽  
Penicillin G ◽  
Multi Drug Resistance ◽  
Bacterial Isolates ◽  
Study Region ◽  
Clinical Specimens ◽  
Children Under 5

Abstract Background: The curative power of antimicrobials is severely threatened due to emerging resistance to first-line antibiotics worldwide. With a limited reserve of antibiotics, increasing antimicrobial resistance has become a global concern, but there is a paucity of such data in Burkina Faso, and the West African region in general. Therefore, this study aims to determine the antibiotic susceptibility profile of bacterial species isolated from febrile children under 5 years of age in Nanoro (Burkina Faso). Methods: Clinical specimens (blood, stool, and urine) were collected from 1099 febrile children attending the peripheral health facilities and the referral hospital in Nanoro. Bacterial isolates from these clinical specimens were assessed for their susceptibility against commonly used antibiotics by standard disc diffusion procedure and minimal inhibitory concentration method (when appropriate). Results: In total, 141 bacterial strains were recovered from 127 febrile children of which 65 strains were isolated from blood, 65 from the stool, and 11 from urine. Predominant bacterial isolates were Salmonella species (56.7%; 80/141) followed by Escherichia coli (33.3%; 47/141). Antibiotic susceptibility testing revealed Salmonella species were highly resistant to ampicillin (70%; 56/80), trimethoprim-sulfamethoxazole (65%; 52/80), and chloramphenicol (63.8%; 51/80). E. coli isolates were highly resistant to trimethoprim-sulfamethoxazole (100%), ampicillin (100%), ciprofloxacin (71.4%; 10/14), amoxicillin-clavulanate (64.3%; 9/14), ceftriaxone (64.3%; 9/14), and gentamycin (50%; 7/14). Moreover, 7 out of 14 E. coli isolates were producers of the ß-lactamase enzyme, suggesting multi-drug resistance against b-lactam as well as non-b-lactam antibiotics. S. pneumoniae isolates were fully resistant to tetracycline and 50% to penicillin G. Multi-drug resistance was observed in 54.6% (59/108) of the isolates of which 56 (54.9%) were Gram-negative bacteria and 3 (50.0%) Gram-positive bacteria.Conclusions: The antibiotic susceptibility profiling showed an alarming high resistance to commonly used antibiotics to treat bacterial infections in the study region. The work prompts the need to expand antibiotic resistance surveillance studies in Burkina Faso, and probably the whole region (West Africa). Moreover, it implies the need of a revision of the antibiotic-treatment guidelines by the Ministry of Health in Burkina Faso to avoid further development of resistance.

scholarly journals Antibiotic susceptibility profile of bacterial pathogens isolated from febrile children under 5 years of age in Nanoro, Burkina Faso

2020 ◽  
Author(s):  
Massa dit Achille BONKO ◽  
Marc Christian Tahita ◽  
Francois Kiemde ◽  
Palpouguini Lompo ◽  
Sibidou Yougbaré ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Burkina Faso ◽  
Antibiotic Susceptibility ◽  
Bacterial Species ◽  
Penicillin G ◽  
Multi Drug Resistance ◽  
Bacterial Isolates ◽  
Study Region ◽  
Clinical Specimens ◽  
Children Under 5

Abstract Background: The curative power of antimicrobials is severely threatened due to emerging resistance to first-line antibiotics worldwide. With a limited reserve of antibiotics, increasing antimicrobial resistance has become a global concern, but there is a paucity of such data in Burkina Faso, and the West African region in general. Therefore, this study aims to determine the antibiotic susceptibility profile of bacterial species isolated from febrile children under 5 years of age in Nanoro (Burkina Faso). Methods: Clinical specimens (blood, stool, and urine) were collected from 1099 febrile children attending the peripheral health facilities and the referral hospital in Nanoro. Bacterial isolates from these clinical specimens were assessed for their susceptibility against commonly used antibiotics by standard disc diffusion procedure and minimal inhibitory concentration method (when appropriate). Results: In total, 141 bacterial strains were recovered from 127 febrile children of which 65 strains were isolated from blood, 65 from the stool, and 11 from urine. Predominant bacterial isolates were Salmonella species (56.7%; 80/141) followed by Escherichia coli (33.3%; 47/141). Antibiotic susceptibility testing revealed Salmonella species were highly resistant to ampicillin (70%; 56/80), trimethoprim-sulfamethoxazole (65%; 52/80), and chloramphenicol (63.8%; 51/80). E. coli isolates were highly resistant to trimethoprim-sulfamethoxazole (100%), ampicillin (100%), ciprofloxacin (71.4%; 10/14), amoxicillin-clavulanate (64.3%; 9/14), ceftriaxone (64.3%; 9/14), and gentamycin (50%; 7/14). Moreover, 7 out of 14 E. coli isolates were producers of the ß-lactamase enzyme, suggesting multi-drug resistance against b-lactam as well as non-b-lactam antibiotics. S. pneumoniae isolates were fully resistant to tetracycline and 50% to penicillin G. Multi-drug resistance was observed in 54.6% (59/108) of the isolates of which 56 (54.9%) were Gram-negative bacteria and 3 (50.0%) Gram-positive bacteria.Conclusions: The antibiotic susceptibility profiling showed an alarming high resistance to commonly used antibiotics to treat bacterial infections in the study region. The work prompts the need to expand antibiotic resistance surveillance studies in Burkina Faso, and probably the whole region (West Africa).

scholarly journals Bacterial profile and multi-drug resistance pattern of bacterial isolates among septicemia suspected cases: a meta-analysis report in Ethiopia

2021 ◽  
Vol 45 (3) ◽  
pp. 167-178
Author(s):  
Mengistu Abayneh ◽  
Shewangizaw HaileMariam ◽  
Molla Asnake
Keyword(s):  
Drug Resistance ◽  
Blood Culture ◽  
Meta Analysis ◽  
Multi Drug Resistance ◽  
Resistance Pattern ◽  
Bacterial Isolates ◽  
Gram Positive ◽  
Gram Negative ◽  
Drug Resistance Pattern ◽  
Culture Positive

Abstract Background Bloodstream infections (BSIs) are one of the most common infections seen in all age groups and in all locations. The current knowledge on the patterns of bacterial profile, and its antibiotic resistance are essential to design and implement appropriate interventions. This study was conducted to assess the prevalence and multi-drug resistance pattern of bacterial isolates among septicemia and/or bacteremia suspected cases in Ethiopia. Methods Searching was conducted in databases of PubMed, Research Gate, Scopus and Google Scholar. In addition, manual searching is also conducted in bibliographies of included studies and in other meta-analysis studies. Required data were extracted from articles published up to 2020 on the bacterial profile of septicemia in Ethiopia, and analyzed using comprehensive meta-analysis version 3.3.0 software. Results A total of 5,823 septicemia suspected cases were extracted from 18 included studies and the overall blood culture positive rate of 31.9% (95% CI: 0.261–0.382). Of these, the overall Gram positive and Gram negative isolates was 57.8% (95% CI: 0.534–0.584) and 42.2% (95% CI: 0.416–0.466), respectively. Among Gram positives, predominantly reported isolates was Staphylococcus  aureus (47.9%: 480 of 1,003), followed by Coagulase-Negative Staphylococcus (42.7%: 428 of 1,003), whereas among Gram negatives, the most frequently reported isolates was Klebsiella species (29.8%: 218 of 731), followed by Escherichia  coli (23.1%: 169 of 731). Significant levels of resistance was reported against ampicillin, amoxicillin, ceftriaxone, co-trimoxazole and tetracycline with a pooled resistance range of 40.6–55.3% in Gram positive and 52.8–85.7% in Gram negative isolates. The pooled estimates of multi-drugs resistance (MDR) was (66.8%) among Gram positives and (80.5%) among Gram negatives, with the overall MDR rate of (74.2%). Conclusions The reported blood culture positive rates among septicemia cases were relatively high. Second, the level of drug and multi-drug resistant isolates against commonly prescribed antibiotics was significant. However, the scarcity of data on culture confirmed septicemia cases as well as patterns of antimicrobial resistance may overshadow the problem.

scholarly journals Evaluation of eazyplex® SuperBug CRE Test for Beta-Lactamase Genes Detection in Klebsiella spp. and P. aeruginosa Strains

2019 ◽  
Vol 77 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Alicja Sękowska ◽  
Tomasz Bogiel ◽  
Eugenia Gospodarek-Komkowska
Keyword(s):  
Drug Resistance ◽  
Resistance Mechanisms ◽  
Multi Drug Resistance ◽  
Lamp Method ◽  
Beta Lactamase ◽  
Beta Lactam ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Genes Encoding ◽  
Klebsiella Spp

AbstractThe multi-drug resistance of Gram-negative rods is one of the most important issues of present medicine. In recent years, more and more strains resistant to the majority or to all possible therapeutic options have been isolated—especially Klebsiella spp. and Pseudomonas spp. representatives. It is very important to detect strains with these phenotypes as quickly and reliably as possible. The aim of the study was to evaluate the usefulness of eazyplex® SuperBug CRE test (Amplex Diagnostics) for the detection of the most important beta-lactam resistance genes. eazyplex® SuperBug CRE test is based on the loop-mediated isothermal amplification (LAMP) method, and detects genes for the following beta-lactamases: KPC, NDM-1, VIM, OXA-48, CTX-M1, CTX-M9 and OXA-181. The study involved 87 strains. For all of the positive strains in the LAMP method, additional PCR were performed to increase the spectrum of ESBLs detected by the genes encoding for enzymes belonging to TEM and SHV families. The results obtained by the tested method and standard PCR were consistent for all Klebsiella spp. strains. The discrepancy between the evaluated test and PCR results was observed for one P. aeruginosa strain. The eazyplex® SuperBug CRE test can be used for quick detection of the most important beta-lactam resistance mechanisms amongst Gram-negative rods.

scholarly journals Extended-spectrum Beta-lactamase and AmpC beta-lactamases producing gram negative bacilli isolated from clinical specimens at International Clinical Laboratories, Addis Ababa, Ethiopia

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241984
Author(s):  
Saba Gebremichael Tekele ◽  
Dejenie Shiferaw Teklu ◽  
Kassu Desta Tullu ◽  
Samuel Kinde Birru ◽  
Melese Hailu Legese
Keyword(s):  
Addis Ababa ◽  
Bacterial Species ◽  
Automated System ◽  
Beta Lactamase ◽  
Cross Sectional ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Clinical Specimens ◽  
Clinical Laboratories ◽  
Extended Spectrum

Background Extended spectrum Beta-lactamases (ESBLs) and AmpC beta-lactamases (AmpC) are the common enzymes produced by gram negative bacilli, which are their main mechanisms of resistance to all generations of cephalosporins. Hence, this study aimed to determine the magnitude of ESBLs and AmpC producing gram negative bacilli (GNB) isolated from clinical specimens at International clinical Laboratories in Addis Ababa, Ethiopia. Methods A cross sectional study was conducted from January to May 2018. From different clinical specimens, 338 GNB were isolated and characterized. Bacterial species identification, antimicrobial susceptibility testing and screening for ESBLs and AmpC production were performed using Phoenix automated system (BD phoenix100). ESBLs production was confirmed using a combination disc method. All Cefoxitin resistant and confirmed ESBLs producing GNB were confirmed for AmpC beta-lactamases production by AmpC confirmatory Neo-Sensitabs discs (ROSCO tablet). Data were analyzed using SPSS version 20 software. Results E. coli 66.0% (224/338) followed by K. pneumoniae 12.1% (41/338) were GNB most frequently isolated. The overall magnitude of ESBLs producing GNB was 38.8% (131/338) and the extent of AmpC beta-lactamase producing GNB was 2.4% (8/338). Majority of ESBLs and AmpC beta-lactamases producing GNB were isolated from urine specimens 47.5% (116/338). Ampicillin (75.4%), amoxicillin with clavulanic acid (64.0%) and sulfamethoxazole-trimethoprim (55.6%) were most the antibiotics to which resistance was most commonly found. The multidrug resistance (MDR) level of GNB was 74.0% (250/338). Of ESBLs and AmpC beta-lactamases producing GNB, 99.3% were MDR (p < 0.05). Conclusion The high magnitude of ESBLs and AmpC beta-lactamases producing GNB calls the needs of strong intervention to minimize further occurrence and spread of such GNB. More importantly, the MDR level was high which suggests continuous monitoring & reviewing of antimicrobial policy in hospitals and the country at large.

scholarly journals High Prevalence of Multi-Drug Resistance and Extended Spectrum Beta Lactamase Production in Non-Fermenting Gram-Negative Bacilli in Ethiopia

2019 ◽  
Vol 12 ◽  
pp. 117863371988495 ◽  
Author(s):  
Adane Bitew
Keyword(s):  
Drug Resistance ◽  
Bacterial Species ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Drug Resistant ◽  
Acinetobacter Species ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum

Background: Emergence of resistance to multiple antimicrobial agents in Non-Fermenting Gram-Negative Bacilli is a major problem to public health, as it limits drug treatment options against infections. The aim of this study was to determine the prevalence of multi-drug resistance and extended spectrum beta lactamase production in Non-Fermenting Gram-Negative Bacilli. Materials and methods: Different clinical samples were collected and processed following standard procedures. Each sample was then inoculated onto culture media. Identification, drug susceptibility testing, and extended spectrum beta lactamase production of the isolates were carried out by using the VITEK 2 compact system. Results: Among 996 clinical samples, 135 samples yielded Non-Fermenting Gram-Negative Bacilli of which Pseudomonas and Acinetobacter species were the commonest isolates. The overall drug resistance rates of Non-Fermenting Gram-Negative Bacilli were above 80% against ampicillin (89.6%), cefuroxime axetil (88.9%), nitrofurantoin (85.9%), cefalotin (84.4%), cefoxitin (83.7%), cefazolin (83.0%), and cefuroxime (83.0%). Tobramycin with a resistance rate of 19.3% was the most active antimicrobial agent. Out of 135 isolates, 81.5% were multi-drug resistant of which 13.3% were extensively drug resistant and 10.4% were pandrug resistant. Extended spectrum beta lactamase production was detected in 48.9% of the isolates. Conclusions: The spectrum of bacterial species isolated was diverse. The isolates demonstrated high level of drug resistance in different classes of antibiotics. The magnitude of multi-drug resistance and the level of extended spectrum beta lactamase production were high. Hence, further studies on multi-drug resistant and extended spectrum beta lactamase producing Non-Fermenting Gram-Negative Bacilli both in the community and in hospital setting are essential.

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