Antibiotic Resistance Profiles and Molecular Characteristics of Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli and Klebsiella pneumoniae Isolated From Shrimp Aquaculture Farms in Kerala, India

This study was undertaken to evaluate the prevalence of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae in selected shrimp aquaculture farms (n = 37) in Kerala, South India and to characterize the isolates using molecular tools. Overall, a low prevalence of ESBL-producers was found in the farms, most likely due to the reduced antibiotic usage in the shrimp farming sector. Out of the 261 samples (77 shrimp and 92 each of water and sediment), 14 (5.4%) tested positive for ESBL-E. coli or ESBL-K. pneumoniae. A total of 32 ESBL-E. coli and 15 ESBL- K. pneumoniae were recovered from these samples. All ESBL isolates were cefotaxime-resistant with minimal inhibitory concentration (MIC) ≥32 μg/ml. Of all isolates, 9 (28.1%) E. coli and 13 (86.7%) K. pneumoniae showed simultaneous resistance to tetracycline, ciprofloxacin, and trimethoprim-sulfamethoxazole. PCR analysis identified CTX-M group 1 (blaCTX–M–15) as the predominant ESBL genotype in both E. coli (23, 71.9%) and K. pneumoniae (15, 100%). Other beta-lactamase genes detected were as follows: blaTEM and blaSHV (11 K. pneumoniae), blaCTX–M group 9 (9 E. coli), and blaCMY–2 (2 E. coli). Further screening for AMR genes identified tetA and tetB (13, 40.6%), sul1 (11, 34.4%), sul2 (9, 28.1%), catA and cmlA (11, 34.4%), qepA and aac(6′)-Ib-cr (9, 28.1%) and strAB and aadA1 (2, 6.3%) in E. coli, and qnrB (13, 86.7%), qnrS (3, 20%), oqxB (13, 86.7%), tetA (13, 86.7%), and sul2 (13, 86.7%) in K. pneumoniae isolates. Phylogenetic groups identified among E. coli isolates included B1 (4, 12.5%), B2 (6, 18.8%), C (10, 31.3%), D (3, 9.4%), and E (9, 28.1%). PCR-based replicon typing (PBRT) showed the predominance of IncFIA and IncFIB plasmids in E. coli; however, in K. pneumoniae, the major replicon type detected was IncHI1. Invariably, all isolates of K. pneumoniae harbored virulence-associated genes viz., iutA, entB, and mrkD. Epidemiological typing by pulsed-field gel electrophoresis (PFGE) revealed that E. coli isolates recovered from different farms were genetically unrelated, whereas isolates of K. pneumoniae showed considerable genetic relatedness. In conclusion, our findings provide evidence that shrimp aquaculture environments can act as reservoirs of multi-drug resistant E. coli and K. pneumoniae.

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Antibiogram of Extended Spectrum Beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae isolated from Hospital Samples

Bangladesh Journal of Medical Microbiology ◽

10.3329/bjmm.v4i1.8467 ◽

1970 ◽

Vol 4 (1) ◽

pp. 32-36 ◽

Cited By ~ 11

Author(s):

Iraj Alipourfard ◽

Nilufar Yeasmin Nili

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Diffusion Method ◽

Resistant Bacteria ◽

Molecular Characteristics ◽

Significant Implication ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum

Extended spectrum beta-lactmase (ESBL) producing organisms create a major problem for clinical therapeutics. The frequency of ESBL producing strains among clinical isolates has been steadily increasing over the past few years resulting in limitation of the therapeutic options. These resistant bacteria are emerging world wide as a threat to human health in both the community and hospital settings. -lactamase production by several organisms is the most important mechanism of resistance to beta-lactam antibiotics, such as penicillins and cephalosporins. This study was done to determine the susceptibility of different antimicrobials to ESBL producing Escherichia coli and Klebsiella pneumoniae isolated from wound swabs, blood, urine, fluid, tracheal aspirates and sputum in Shahid Bahonar Hospital of Tehran from July, 2007 to June, 2008. A total of 115 ESBLproducing isolates were obtained from outdoor and indoor patients. Out of 115 isolates, 60% were E. coli and 40% were K. pneumoniae. All ESBL-producing isolates were confirmed using the Clinical and Laboratory Standards Institute (CLSI)-approved double-disk diffusion method. 29.6% of these isolates were collected from medical wards and 24.3% were collected from outdoor. Urine (70.4%) was the main source of ESBL-producing isolates from all patients, followed by blood (16.5%). All isolates were susceptible to both imipenem and meropenem. Of all isolates, 93.9% were susceptible to amikacin. The cephalosporins (1-4 generations) were almost 100% resistant. For Nitrofurantoin, 57.4% were sensitive. High rate resistance (74.8%) was observed to all quinolones tested. Aztreonam, Ampicillin, Co-amoxyclav and Ampicillin/Sulbactam were 100% resistant. This study shows that the frequency of ESBL producing strains of E. coli and K. pneumoniae is high in both hospital and community levels and it has a significant implication for patients’ management. Advance drug resistance surveillance and molecular characteristics of ESBL isolates is necessary to guide the appropriate and judicious antibiotic use. Key words: Extended spectrum beta-lactamase (ESBL), Drug sensitivity, Escherichia coli, Klebseilla pneumoniae DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8467 BJMM 2011; 4(1): 32-36

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Incidence and Antimicrobial Susceptibility of Escherichia coli and Klebsiella pneumoniae with Extended-Spectrum β-Lactamases in Community- and Hospital-Associated Intra-Abdominal Infections in Europe: Results of the 2008 Study for Monitoring Antimicrobial Resistance Trends (SMART)

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00265-10 ◽

2010 ◽

Vol 54 (7) ◽

pp. 3043-3046 ◽

Cited By ~ 58

Author(s):

Stephen P. Hawser ◽

Samuel K. Bouchillon ◽

Daryl J. Hoban ◽

Robert E. Badal ◽

Rafael Cantón ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Klebsiella Pneumoniae ◽

Antimicrobial Susceptibility ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Abdominal Infections

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.

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Prevalence of Extended Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella species from Urinary Specimens of Children attending Friendship International Children’s Hospital

Nepal Journal of Biotechnology ◽

10.3126/njb.v5i1.18868 ◽

2017 ◽

Vol 5 (1) ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Ujjwal Rimal ◽

Shovana Thapa ◽

Roshani Maharjan

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Beta Lactamase ◽

Disc Diffusion ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Significant Bacteriuria ◽

Klebsiella Spp ◽

Esbl Producers

Extended-spectrum β-lactamase producing E. coli and K. pneumoniae is a serious threat to the patients. These organisms are major extended spectrum beta lactamase (ESBL) producers. The objective of this study was to determine the prevalence of Extended spectrum β- lactamase producing strains of Escherichia coli and Klebsiella spp isolates from the urine sample of children visiting International Friendship Children Hospital. During the seven months, between June 2016 to December 2016, 1018 mid-stream urine samples(MSU) were collected from patients suspected of having UTI. The samples were investigated by conventional semi-quantitative culture technique and identification of E. coli and Klebsiella spp. was done by microscopy and biochemical test. Antibiotic susceptibility test of isolates was performed by modified Kirby Bauer Disc diffusion test. ESBL screening test was done by using 3rd generation Cephalosporin and confirmation done by combination disc diffusion method. Out of total 1018 MSU samples investigated, 200(19.64%) isolates of E. coli and 28(2.7%) isolates of Klebsiella spp. making a total of 228(22.39%) were found to cause significant bacteriuria. 76(33.33%) isolates, from those causing significant bacteriuria, were Multi-drug resistant organisms. Out of 228 isolates, 54(23.68%) were ESBL producers, that includes 51(25.5%) Escherichia coli and 3(12.5%) Klebsiella pneumoniae. ESBL producers were more common in in-patient (36.17%) than out-patient (20.44%). Most of the ESBL producers were resistance to amoxicillin, followed by Cotrimoxazole and Ciprofloxacin respectively. They were highly sensitive to Imipenem, Tigecycline, Amikacin, Piperacillin-Tazobactam, and Nitrofurantoin. High prevalence of ESBL producing E. coli and Klebsiella pneumoniae was found among children. Regular and routine monitoring of ESBL producing isolates is essential.Nepal Journal of Biotechnology. Dec. 2017 Vol. 5, No. 1: 32-38

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Prevalence of Escherichia coli and Klebsiella pneumoniae, Producing Extended-Spectrum Beta-Lactamase (ESBLs) from Clinical Specimen in Khuzestan, Iran

Gene Cell and Tissue ◽

10.5812/gct.112377 ◽

2021 ◽

Vol In Press (In Press) ◽

Author(s):

Sahar Besharati Zadeh ◽

Pegah Shakib ◽

Mohammad Reza Zolfaghari ◽

Ahmad Farajzadeh Sheikh

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Klebsiella Pneumoniae ◽

Clinical Specimen ◽

Diffusion Method ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Sensitivity Pattern

Background: A major problem in the treatment of the infectious diseases healthcare centers is extended-spectrum beta-lactamase (ESBL)-producing bacteria. Objectives: The aim of present study was to identify the antibiotic sensitivity pattern and prevalence of the blaCTX, blaTEM, and blaSHV genes in Escherichia coli and Klebsiella pneumoniae strains. Methods: In this study, E. coli and K. pneumoniae specimens were collected in Shushtar hospitals, Khuzestan (southwest Iran), from March to October 2015. Sensitivity antibiotic pattern performed by disc diffusion method. Double disc synergy test (DDST) done for identifying ESBLs isolates and PCR for blaTEM, blaSHV, and blaCTX-M genes. Results: One hundred E. coli and 30 K. pneumoniae isolates were collected from different specimens. The highest rates of antibiotic resistance related to cefotaxime and aztreonam in E. coli and K. pneumoniae. ESBL-harboring K. pneumoniae and E. coli were 13.5 and 28%, respectively. Overall, bla TEM was the most prevalent ESBL gene. Conclusions: In this study, the rate of antibiotic resistance was high, and due to the carrying of coding genes on mobile genetic elements and the ability of these elements to carry genes that create resistance to other antibiotic families, identification and isolation of these isolates are essential to find effective antibiotics and eliminate the infection.

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Prevalence and patient related factors associated with Extended-Spectrum Beta-Lactamase producing Escherichia coli and Klebsiella pneumoniae carriage and infection among pediatric patients in Tanzania

Scientific Reports ◽

10.1038/s41598-021-02186-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nuru Letara ◽

James Samwel Ngocho ◽

Nahid Karami ◽

Sia E. Msuya ◽

Balthazar Nyombi ◽

...

Keyword(s):

Escherichia Coli ◽

Health Care ◽

Klebsiella Pneumoniae ◽

Pediatric Patients ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Factors Associated ◽

Extended Spectrum ◽

Very High

AbstractExtended-Spectrum Beta-Lactamase (ESBL) producing Enterobacteriaceae (EPE) is increasing worldwide, though less documented in low-income settings. Here we determined the prevalence of EPE infection and carriage, and patient factors associated with EPE-carriage among pediatric patients in three health care levels in Tanzania. Between January and April 2016, 350 febrile children (median age 21 months) seeking care at a university or a regional referral hospital, or a health centre in Moshi municipality, Tanzania, were included. Socio-demographic characteristics were collected using a questionnaire. Rectal swabs and blood cultures were collected from all children (n = 350) and urinary samples from 259 children at admission. ESBL-phenotype and antimicrobial susceptibility were determined for Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) isolates. Only one EPE case (E. coli) in blood and four in urine (one E. coli and three K. pneumoniae) were found, whereas (n = 90, 26%) of the children were colonized in feces (ESBL-E. coli; n = 76, ESBL-K. pneumoniae, n = 14). High resistance rates were seen in fecal ESBL-E. coli (n = 76) against trimethoprim-sulfamethoxazole (n = 69, 91%), gentamicin (n = 51, 67%), ciprofloxacin (n = 39, 51%) and chloramphenicol (n = 27, 35%) whereas most isolates were sensitive to amikacin (n = 71, 93%). Similar rates were seen for fecal ESBL-K. pneumoniae. Resistance to first line antibiotics were also very high in fecal E. coli not producing ESBL. No sociodemographic factor was associated with EPE-carriage. Children colonized with EPE were younger than 12 months (n = 43, 48%) and often treated with antibiotics (n = 40, 44%) in the previous two months. After adjustment for age children admitted to the intensive care unit had higher odds of EPE fecal carriage compared with those in the general wards (OR = 3.9, 95%CI = 1.4–10.4). Despite comparatively high rates of fecal EPE-carriage and previous antibiotic treatment, clinical EPE cases were rare in the febrile children. The very high resistant rates for the EPE and the non-ESBL producing E. coli to commonly used antibiotics are worrying and demand implementation of antibiotic stewardship programs in all levels of health care in Tanzania.

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The Occurrence and Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Isolated from Clinical Diagnostic Specimens of Equine Origin

Animals ◽

10.3390/ani10010028 ◽

2019 ◽

Vol 10 (1) ◽

pp. 28 ◽

Cited By ~ 1

Author(s):

Leta Elias ◽

David C. Gillis ◽

Tanya Gurrola-Rodriguez ◽

Jeong Ho Jeon ◽

Jung Hun Lee ◽

...

Keyword(s):

Escherichia Coli ◽

Pcr Analysis ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Esbl Gene ◽

Extended Spectrum ◽

Carbapenemase Gene ◽

Type Gene

Escherichia coli isolates were recovered from clinical specimens of equine patients admitted to the Texas A&M Veterinary Medical Teaching Hospital over a five-year period. Ceftiofur resistance was used as a marker for potential extended-spectrum beta-lactamase (ESBL)-activity, and of the 48 ceftiofur-resistant E. coli isolates, 27.08% (n = 13) were phenotypically ESBL-positive. Conventional PCR analysis followed by the large-scalebla Finder multiplex PCR detected the ESBL genes, CTX-M-1 and SHV, in seven out of the 13 isolates. Moreover, beta-lactamase genes of TEM-1-type, BER-type (AmpC), and OXA-type were also identified. Sequencing of these genes resulted in identification of a novel TEM-1-type gene, called blaTEM-233, and a study is currently underway to determine if this gene confers the ESBL phenotype. Furthermore, this report is the first to have found E. coli ST1308 in horses. This subtype, which has been reported in other herbivores, harbored the SHV-type ESBL gene. Finally, one out of 13 E. coli isolates was PCR-positive for the carbapenemase gene, blaIMP-1 despite the lack of phenotypically proven resistance to imipenem. With the identification of novel ESBL gene variant and the demonstrated expansion of E. coli sequence types in equine patients, this study underscores the need for more investigation of equines as reservoirs for ESBL-producing pathogens.

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Prevalence of Extended Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella pneumoniae Isolated from Urinary Tract Infected Patients Attending Tertiary Care Hospital of Central Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v15i3.22602 ◽

2019 ◽

Vol 15 (3) ◽

pp. 211-217

Author(s):

Surya Narayan Mahaseth ◽

Raj Kumari Sanjana ◽

Brajesh Kumar Jha ◽

Khilasa Pokharel

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urine Samples ◽

Beta Lactamase ◽

Initial Screening ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Esbl Producers

Background: Urinary tract infection (UTI) is one of the major health problems in Nepal. Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) are two important bacteria associated with UTI. This study was designed to assess the prevalence of extended spectrum beta-lactamase (ESBL) producing E. coli and K. pneumoniae in urinary isolates at College of Medical Sciences and Teaching Hospital, Bharatpur, Chitwan, Nepal. Methods: We aseptically received 5564 mid-stream urine samples of suspected UTI patients from September 2016 to August 2018. The randomly collected 5564 urine samples were processed by standard Microbiological guidelines as recommended by Clinical and Laboratory Standards Institute (CLSI). All isolates including E. coli and K. pneumoniae were identified using the specific biochemical and sugar fermentation tests. Antibiotic sensitivity test was performed for all the isolates against all commonly used antibiotics by modified Kirby-Bauer disk diffusion method and interpreted following CLSI guidelines. First performed initial screening method then confirmed for ESBL production by phenotypic confirmatory disc diffusion test (PCDDT). Results: Out of 5,564 urine specimens investigated, E. coli was isolated in 1219 (63.99%) and K. pneumoniae in 223 (11.70%) cases. Initial screening revealed 615 (50.45%) isolates of E. coli and 127 (56.95%) K. pneumoniae to be resistant. Further testing by PCDDT method confirmed 102 (16.58%) E. coli and 25 (19.68%) K. pneumoniae isolates to be ESBL producers. These ESBL producers’ uropathogens revealed high degree of resistance to cephalosporins (100%) and quinolones (52%-92%) group of antibiotics. Conclusions: In our study the prevalence of ESBL producing K. pneumoniae was found to be 19.68%, those of E. coli was to be 16.58% by PCDDT. In this study, all ESBL producing K. pneumoniae isolates were sensitive (100%) to meropenem and E. coli showed 98.04% sensitive to meropenem. Hence, for the treatment of these ESBL infections, currently, carbapenems are the recommended drug of choice.

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