Antibiotic coresistance among extended-spectrum beta lactamase-producing urinary isolates in a tertiary medical center: A prospective study

2012 ◽  
Vol 3 (1) ◽  
pp. 53 ◽  
Author(s):  
Nibedita Das ◽  
AK Borthakur
Keyword(s):  
Prospective Study ◽  
Medical Center ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
A Prospective Study ◽  
Urinary Isolates

scholarly journals Extended-Spectrum Beta-Lactamase Bacteria From Urine Isolates in Children

2015 ◽  
Vol 20 (5) ◽  
pp. 373-377
Author(s):  
Lisa A. Degnan ◽  
Aaron M. Milstone ◽  
Marie Diener-West ◽  
Carlton K. K. Lee
Keyword(s):  
Risk Factors ◽  
Medical Center ◽  
Empiric Antibiotic Therapy ◽  
Control Group ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Increased Risk ◽  
Urinary Isolates

OBJECTIVES: Multidrug-resistant Gram-negative bacteria, including extended-spectrum beta-lactamase (ESBL)–producing organisms, are a growing problem. The primary objective of this study was to describe the proportion of children with ESBL-producing urinary isolates at a tertiary medical center as well as these organisms' susceptibility patterns. The secondary objective was to identify the risk factors for acquiring ESBL urinary pathogens. METHODS: This retrospective study evaluated a cohort of children with ESBL urinary isolates, admitted to a tertiary children's hospital during a 6-year period. The proportion of patients with an ESBL-producing urinary isolate among all patients who grew a Gram-negative isolate is described together with the organism's susceptibility pattern. Patients with non-ESBL Gram-negative urinary organisms were used as a control group for identifying patient risk factors for ESBL. RESULTS: A total of 7.8% (29 of 370) of patients in our cohort grew Gram-negative urinary isolates with an ESBL strain. Most of the ESBL organisms isolated were sensitive to carbapenems (100% of ESBL organisms susceptible to ertapenem and 93.8% susceptible to meropenem) and amikacin (92.3% of ESBL organisms susceptible). Patients with longer hospitalization, recent antibiotic use, and recent intensive care unit admission were found to be at increased risk for ESBL organisms in the urine. CONCLUSIONS: When selecting empiric antibiotic therapy for suspected urinary tract infection in children, it may be prudent to consider the risk factors identified for acquiring an ESBL urinary pathogen.

scholarly journals Extended-Spectrum Beta-Lactamase Producing Bacteria: Epidemiology, Risk Factors, Diagnostic Methodology, and Antimicrobial Susceptibility Profile: A Prospective Study at a University Hospital in Western Saudi Arabia

2019 ◽  
Vol 9 (2) ◽  
pp. 5-18
Author(s):  
Dalal Mohammad Alashari ◽  
Maha Mahmoud Al-Alawi ◽  
Asif Ahmad Jiman-Fatani
Keyword(s):  
Risk Factors ◽  
Multidrug Resistance ◽  
Prospective Study ◽  
Antimicrobial Susceptibility ◽  
University Hospital ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Vitek 2 ◽  
A Prospective Study

Objective: To study the prevalence and incidence of extended-spectrum beta-lactamase -producing microorganisms, microbiological characteristics and antimicrobial-susceptibility patterns. Methods: A prospective study involving all cases of extended-spectrum beta-lactamase -producing microorganisms among all bacteriological samples collected over a 1-year period from 11 November 2015 to 10 November 2016, in the Clinical and Molecular Microbiology Laboratory at King Abdulaziz University Hospital, Jeddah. Detection of extended-spectrum beta-lactamase-producing microorganisms and antimicrobial-susceptibility profiles were done using automated Vitek 2 system. Clinical data such as recent use of antibiotics or invasive devices were investigated as risk factors for multidrug resistance. Results: The prevalence of extended-spectrum beta-lactamase-producing microorganisms was 5.4% (95% CI = 4.7% – 6.2%); for an incidence = 54 per 1,000 isolates-years. Distribution by species showed 70.0% Escherichia coli, 28.5% Klebsiella pneumoniae and 1.5% Proteus mirabilis. Vitek 2 system showed 6% of false positive ESBL detections by reference to confirmatory E-test. Antimicrobial- susceptibility tests showed that 86.5% of beta-lactamase-producing strains were resistant to ≥ 1 other antimicrobial class and 20% were multidrug resistant. Univariate logistic regression showed that the presence of multidrug resistance was significantly predicted by age (OR = 1.02; P = 0.026), use of urinary catheter (OR = 2.05; P = 0.046) and number of devices used (OR = 1.60; P = 0.046); only age (OR = 1.02; P = 0.022) was significant in the multivariate model. Conclusion: Clinicians and microbiologists should maintain a high level of alertness and contribute for effective screening and adequate treatment of infections caused by beta-lactamase-producing organisms according to international guidelines and the local epidemiological picture.

scholarly journals Identification of a Cluster of Extended-spectrum Beta-Lactamase–Producing Klebsiella pneumoniae Sequence Type 101 Isolated From Food and Humans

2020 ◽  
Author(s):  
Lisandra Aguilar-Bultet ◽  
Claudia Bagutti ◽  
Adrian Egli ◽  
Monica Alt ◽  
Laura Maurer Pekerman ◽  
...  
Keyword(s):  
Klebsiella Pneumoniae ◽  
Prospective Study ◽  
Sequence Type ◽  
Clinical Samples ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
And Migration ◽  
A Prospective Study

Abstract We report a cluster of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae sequence type 101, derived from 1 poultry and 2 clinical samples collected within the setting of a prospective study designed to determine the diversity and migration of ESBL-producing Enterobacterales between humans, foodstuffs, and wastewater.

scholarly journals Extended-Spectrum Beta-Lactamases among Enterobacter Isolates Obtained in Tel Aviv, Israel

2005 ◽  
Vol 49 (3) ◽  
pp. 1150-1156 ◽  
Author(s):  
Jacob Schlesinger ◽  
Shiri Navon-Venezia ◽  
Inna Chmelnitsky ◽  
Orly Hammer-Münz ◽  
Azita Leavitt ◽  
...  
Keyword(s):  
Medical Center ◽  
Gene Families ◽  
Beta Lactamase ◽  
Pcr Screening ◽  
Colony Hybridization ◽  
Extended Spectrum Beta Lactamase ◽  
Tel Aviv ◽  
Clonal Relatedness ◽  
Extended Spectrum ◽  
Pcr Products

ABSTRACT The extended-spectrum beta-lactamase (ESBL)-producing phenotype is frequent among Enterobacter isolates at the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. We examined the clonal relatedness and characterized the ESBLs of a collection of these strains. Clonal relatedness was determined by pulsed-field gel electrophoresis. Isoelectric focusing (IEF) and transconjugation experiments were performed. ESBL gene families were screened by colony hybridization and PCR for bla TEM, bla SHV, bla CTX-M, bla IBC, bla PER, bla OXA, bla VEB, and bla SFO; and the PCR products were sequenced. The 17 Enterobacter isolates studied comprised 15 distinct genotypes. All isolates showed at least one IEF band (range, one to five bands) whose appearance was suppressed by addition of clavulanate; pIs ranged from 5.4 to ≥8.2. Colony hybridization identified at least one family of beta-lactamase genes in 11 isolates: 10 harbored bla TEM and 9 harbored bla SHV. PCR screening and sequence analysis of the PCR products for bla TEM, bla SHV, and bla CTX-M identified TEM-1 in 11 isolates, SHV-12 in 7 isolates, SHV-1 in 1 isolate, a CTX-M-2-like gene in 2 isolates, and CTX-M-26 in 1 isolate. In transconjugation experiments with four isolates harboring bla TEM-1 and bla SHV-12, both genes were simultaneously transferred to the recipient strain Escherichia coli HB101. Plasmid mapping, PCR, and Southern analysis with TEM- and SHV-specific probes demonstrated that a single transferred plasmid carried both the TEM-1 and the SHV-12 genes. The widespread presence of ESBLs among Enterobacter isolates in Tel Aviv is likely due not to clonal spread but, rather, to plasmid-mediated transfer, at times simultaneously, of genes encoding several types of enzymes. The dominant ESBL identified was SHV-12.

scholarly journals Prevalence of Extended Spectrum Beta Lactamase Producing Bacteria in Two Surgical Wards of a General Hospital

2019 ◽  
Vol 73 (1) ◽  
pp. 40-46
Author(s):  
Baiba Zandersone ◽  
Elita Medvedja ◽  
Arnolds Jezupovs ◽  
Iveta Līduma ◽  
Solvita Selderiņa ◽  
...  
Keyword(s):  
Bacterial Species ◽  
Beta Lactamase ◽  
Bacterial Isolates ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Number Of Patients ◽  
Discharge From Hospital ◽  
A Prospective Study ◽  
Hospital Wards

Abstract Colonisation of gastrointestinal tract by extended spectrum beta lactamase (ESBL)-producing Gram-negative bacteria is a source for infections. The present work is a prospective study in Latvia aimed to determine the role of two surgical profile wards in transmission of ESBL-producing bacteria. Differences between hospital wards were not analysed due to low number of patients. We have also determined a correlation between the duration of hospitalisation and risk of ESBL colonisation. Tests for ESBL-producing bacteria were made twice for 136 patients — upon admission and upon discharge from the hospital. Of them, 21 (15.4%) patients already were ESBL-positive at the time of admission and 115 (84.6%) patients were ESBL-negative. Upon discharge from hospital, 45 (33.1%) patients were ESBL-positive, one patient was ESBL-negative, and 25 (18.4%) of ESBL-positive cases had emerged during hospitalisation. In total, 46 (33.8%) from 136 patients were ESBL-positive and ESBL was positive in 51 bacterial isolates. On discharge from hospital, the newly acquired ESBL-positive bacterial isolates were K. pneumoniae (n = 18), E. coli (n = 7) and P. mirabilis (n = 3). The prevalence of ESBL-positive E. coli from all detected E. coli was 7.0% and from all Klebsiella spp. — 88.9% in gut flora. Analysis of patientassociated wound infections did not show correlation between the ESBL-producing gut microbiota and the bacterial species involved in wound infection.

scholarly journals Foreign Travel Is a Major Risk Factor for Colonization with Escherichia coli Producing CTX-M-Type Extended-Spectrum β-Lactamases: a Prospective Study with Swedish Volunteers

2010 ◽  
Vol 54 (9) ◽  
pp. 3564-3568 ◽  
Author(s):  
Thomas Tängdén ◽  
Otto Cars ◽  
Åsa Melhus ◽  
Elisabeth Löwdin
Keyword(s):  
Escherichia Coli ◽  
Risk Factor ◽  
Prospective Study ◽  
International Travel ◽  
Major Risk Factor ◽  
Additional Risk Factor ◽  
Extended Spectrum Beta Lactamase ◽  
Foreign Travel ◽  
Extended Spectrum ◽  
A Prospective Study

ABSTRACT Foreign travel has been suggested to be a risk factor for the acquisition of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. To our knowledge, this has not previously been demonstrated in a prospective study. Healthy volunteers traveling outside Northern Europe were enrolled. Rectal swabs and data on potential travel-associated risk factors were collected before and after traveling. A total of 105 volunteers were enrolled. Four of them did not complete the study, and one participant carried ESBL-producing Escherichia coli before travel. Twenty-four of 100 participants with negative pretravel samples were colonized with ESBL-producing Escherichia coli after the trip. All strains produced CTX-M enzymes, mostly CTX-M-15, and some coproduced TEM or SHV enzymes. Coresistance to several antibiotic subclasses was common. Travel to India was associated with the highest risk for the acquisition of ESBLs (88%; n = 7). Gastroenteritis during the trip was an additional risk factor (P = 0.003). Five of 21 volunteers who completed the follow-up after 6 months had persistent colonization with ESBLs. This is the first prospective study demonstrating that international travel is a major risk factor for colonization with ESBL-producing Enterobacteriaceae. Considering the high acquisition rate of 24%, it is obvious that global efforts are needed to meet the emergence and spread of CTX-M enzymes and other antimicrobial resistances.

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