scholarly journals Analysis of blood stream infections: Antimicrobial susceptibility and associated types of extended spectrum β-lactamases

2020 ◽  
Vol 19 (6) ◽  
pp. 1285-1293
Author(s):  
Lorina I. Badger-Emeka ◽  
Zainab Yaseen Al-Jaziri ◽  
Naheed Kausar ◽  
Nora Ahmad Al-Muhainy ◽  
Edric Estrella
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Blood Stream ◽  
Susceptibility Test ◽  
Automated System ◽  
Antimicrobial Susceptibility Test ◽  
Isolation And Identification ◽  
Blood Stream Infections ◽  
E Coli ◽  
Extended Spectrum

Purpose: To investigate the antimicrobial susceptibility and extended spectrum β-lactamase (ESBL) production by clinical isolates of Escherichia coli (ESBL-EC) and Klebsiella species (ESBL-KP) associated with blood stream infections (BSIs).Methods: Bacteria isolation and identification were carried out using basic bacteriological and biochemical techniques. Antimicrobial susceptibility test was performed according to the guidelines of the Clinical Laboratory Standard Institute (CLSI). Vitek 2 Compact automated system was used toconfirm the identifications (ID) and antimicrobial susceptibility test (AST). The ESBL produced by E. coli and K. pneumoniae isolates were  phenotypically characterised using Modified Double Disc Synergy Test (MDDST), as recommended by CLSI.Results: All (100 %) isolates were sensitive to imipenem and meropenem, while susceptibility to other antibiotics varied. ESBL genotypes, viz, blaTEM, blaSHV and blaCTX were encountered in the BSIs. For ESBL-EC, TEM, SHV and CTX producers accounted for 33, 16.67 and 58.3 %,  respectively, while 75, 91.7 and 100 % of ESBL-KP were TEM, SHV and CTX producers, respectively. In ESBL-KP, 67 % coexisted with all three genotypes (blaTEM, blaSHV, and blaCTX, while 8.3 % of ESBL-EC coexisted with the three encoding genes (CTX, SHV and TEM).Conclusion: ESBL E. coli and K. pneumoniae associated with BSI have been identified as TEM, SHV and CXT producers, with more ESBL-KP coexisting with all three than ESBL-EC. Keywords: β-Lactamases, Genes, Klebsiella pneumoniae, Escherichia coli

scholarly journals Comparative Antimicrobial Susceptibility Profiles of Uropathogenic Extended-Spectrum ß-Lactamase Producing Strains of Klebsiella pneumonia and Escherichia coli by the CLSI and EUCAST Methodologies

2020 ◽  
Author(s):  
Doğan Akdoğan ◽  
Mustafa Güzel ◽  
Orhan Akpınar ◽  
Altan Aksoy ◽  
Yasemin Genç Bahçe
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Susceptibility Test ◽  
Klebsiella Pneumonia ◽  
Test Results ◽  
Poor Agreement ◽  
Antimicrobial Susceptibility Test ◽  
E Coli ◽  
Extended Spectrum ◽  
Kappa Agreement

Aims: The lack of information about the inter variability of the test results obtained by CLSI and EUCAST requires further clarifications to interpret antimicrobial susceptibility patterns better. This study aimed to compare the CLSI and EUCAST interpretations of the antimicrobial susceptibility test results of the ESBL–producing uropathogenic Escherichia coli and Klebsiella pneumonia strains. Methods: After obtaining 157 ESBL-producing E. coli and 95, ESBL-producing K. pneumonia isolates from the urine specimens of the patients, Kirby-Bauer’s disc diffusion method was used for conducting antimicrobial susceptibility test. The test procedures and the interpretation of the results were carried out according to the year 2017 versions of both of the two guidelines. For the statistical comparison of concordance between the two guidelines, the Kappa coefficients and the concordance rates were calculated. Results: The results were graded in the range from perfect to poor agreement. For E. coli, interpretations of the AST results revealed a moderate to perfect agreement between both methods. Weighted Kappa agreement scores in the range from 0.42 to 1. The agreement for AMC, TPZ30/6, ceftazidime 10, meropenem, and aztreonam was poor without any inconsistencies. For Klebsiella, the kappa agreement score was in the range from 0.25 to 1. It was incompatible with AMC, TPZ 30/6, ceftazidime 10, aztreonam; there was poor agreement for cefepime, amikacin and ertapenem. Conclusions: Our results showed agreement between the two guidelines for uropathogenic extended-spectrum ß-lactamase producing Escherichia coli and Klebsiella pneumoniae but also showed inconsistencies between two guidelines. Therefore, the results of our study contribute to the comparison of these guidelines for interpreting antibiotic susceptibilities.

scholarly journals Antimicrobial susceptibility and diarrheagenic diagnosis of Escherichia coli and Salmonella enterica isolated from feral pigeons (Columba livia) captured in Fortaleza, Brazil

2018 ◽  
Vol 38 (11) ◽  
pp. 2150-2154 ◽  
Author(s):  
Ruben V. Horn ◽  
Windleyanne G.A. Bezerra ◽  
Elisângela S. Lopes ◽  
Régis S.C. Teixeira ◽  
Isaac N.G. Silva ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Clavulanic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Columba Livia ◽  
Susceptibility Test ◽  
Antimicrobial Susceptibility Test ◽  
E Coli ◽  
Feral Pigeons

ABSTRACT: This study aimed to isolate Escherichia coli and Salmonella enterica from captured feral pigeons in Fortaleza, Brazil, and, in addition to evaluate the antimicrobial susceptibility profiles and diagnose diarrheagenic E. coli strains. Pigeons were captured in four public locations in Fortaleza with three techniques. Individual cloacal swab samples were collected and submitted to bacterial isolation, biochemical identification and antimicrobial susceptibility test. Disk diffusion technique was used with twelve antibiotics. E. coli strains were submitted to DNA extraction followed by PCR to diagnose five diarrheagenic pathotypes. A total of 124 birds were captured. One bird was positive for Salmonella enterica (0.81%) and 121 (97.58%) were positive for E. coli. Among these, 110 isolates were submitted to antimicrobial susceptibility test and 28.18% (31/110) presented resistance to at least one antibiotic. Resistance to azithromycin was the most frequent (21.82%), followed by tetracycline (10.91%) and sulfamethoxazole with trimethoprim (8.9%). Multidrug resistance, calculated as a resistance to at least 3 antimicrobial classes, was identified in 3.64% (4/110) of strains. The maximum number of antimicrobial classes to which one strain was resistant was seven. Results demonstrated nine different resistance profiles and the most frequent was tetracycline and sulfamethoxazole with trimethoprim (4 strains), followed by chloramphenicol, azithromycin, tetracycline and sulfamethoxazole with trimethoprim (3 strains). Amoxicillin with clavulanic acid and tobramycin presented lowest levels of antimicrobial resistance, to which none of the tested strains were resistant. A single strain was positive for the eltB gene, which is a diagnostic tool to identify the Enterotoxigenic E. coli (ETEC) pathotype. None of the other investigated genes (stx1, stx2, estA, eaeA, ipaH, aatA and aaiC) were identified. The single isolate of S. enterica was a rough strain of Salmonella enterica subsp. enterica, but serotype identification was not possible. However, this isolate presented resistance to amoxicillin, amoxicillin with clavulanic acid, tetracycline and sulfamethoxazole with trimethoprim. Therefore, captured feral pigeons of Fortaleza presented a low prevalence of S. enterica and diarrheagenic E. coli. Considering the investigated pathogens, our results suggest a good health status and a low public health risk. However, important antimicrobial resistance profiles were identified.

scholarly journals Characterization of antimicrobial susceptibility, extended-spectrum β-lactamase genes and phylogenetic groups of Shigatoxin producing Escherichia coli isolated from patients with diarrhea in Iran

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Erfaneh Jafari ◽  
Mana Oloomi ◽  
Saeid Bouzari
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Antimicrobial Susceptibility ◽  
Shiga Toxin ◽  
Dna Analysis ◽  
Food Contamination ◽  
Susceptibility Test ◽  
Antimicrobial Susceptibility Test ◽  
Phylogenetic Groups ◽  
Extended Spectrum

Abstract Background Shiga toxin‐producing Escherichia coli (STEC) are among common foodborne bacterial pathogens and healthy livestock are the main source of this bacterium. Severe diseases attribute to two types of cytotoxin Stx1 and Stx2, which are also called Shiga toxin (Stx). Infection of humans with STEC may result in Acute diarrhea with or without bleeding, hemorrhagic colitis (HC) and the hemolytic uremic syndrome (HUS). As antibiotic resistance is increasingly being reported among STEC isolates obtained from livestock and patients worldwide, in this study the pattern of antibiotic resistance in clinical isolates was determined. Methods Stool samples were collected from patients with diarrhea. All samples were cultured and identified by biochemical and molecular tests. Antimicrobial susceptibility test and assessment of extended-spectrum β-lactamase (ESBL)-related genes were conducted. Moreover, phylogenetic groups were analyzed using quadruplex PCR, and DNA analysis assessed multi-locus sequence types (MLST). Results Out of 340 E. coli samples, 174 were identified as STEC by PCR. Antimicrobial susceptibility test results showed that, 99.4%, 96% and 93.1% of isolates were susceptible to imipenem/ertapenem, piperacillin–tazobactam and amikacin, respectively. The highest resistance was towards ampicillin (68.4%), followed by trimethoprim–sulfamethoxazole (59.8%), and tetracycline (57.5%). A total of 106 (60.9%) isolates were multidrug resistance (MDR) and 40.8% of isolates were determined to be extended spectrum β-lactamase producers. In 94.4% of isolates, genes responsible for ESBL production could be detected, and blaTEM was the most prevalent, followed by blaCTX-M9. Furthermore, phylogenetic grouping revealed that majority of STEC strains belonged to Group C, followed by Groups E, B2 and A. MLST unveiled diverse ST types. Conclusion A periodical surveillance studies and thorough understanding of antibiotic resistant profiles in STEC isolates could help select effective antibiotic treatment for patients and develop strategies to effectively manage food contamination and human infections.

scholarly journals 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)

2010 ◽  
Vol 54 (7) ◽  
pp. 3043-3046 ◽  
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.

scholarly journals Antimicrobial Susceptibility Profile of Extended Spectrum β-Lactamase (ESBL) Producing Escherichia coli from Various Clinical Samples

2014 ◽  
Vol 7 ◽  
pp. IDRT.S13820 ◽  
Author(s):  
Dinesh Kumar ◽  
Amit Kumar Singh ◽  
Mohammad Rashid Ali ◽  
Yogesh Chander
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Clinical Laboratory ◽  
Multi Drug Resistance ◽  
Clinical Samples ◽  
E Coli ◽  
Antimicrobial Sensitivity ◽  
Extended Spectrum ◽  
Common Causes ◽  
Hospital Acquired

Background Extended spectrum β-lactamase (ESBL) producing Escherichia coli has tremendously increased worldwide and it is one of the most common causes of morbidity and mortality associated with hospital-acquired infections. This could be attributed to association of multi drug resistance in ESBL producing isolates. The present study was aimed to determine the antimicrobial sensitivity profile of ESBL producing E. coli isolates from various clinical samples. Materials and Methods Clinical samples, which consist of pus, urine, blood, cerebrospinal fluid (CSF), stool, sputum, swabs, and different body fluids, are included in the study. Samples were processed and identified as per routine laboratory protocol. ESBL screening and confirmation along with antimicrobial susceptibility test was done according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Results Out of 180 third generation cephalosporins resistant E. coli, 100 (55.55%) isolates were ESBL producers showing a greater degree of resistance to antibiotics. Conclusion The prevalence of ESBL is increasing day by day in nearly every center of different countries and necessary steps to prevent the spread and emergence of resistance should be taken.

scholarly journals Isolation Of Extended-Spectrum B-Lactamase (ESBL) Producing Escherichia coli and Klebsiella pneumiae From Dr. Zainoel Abidin General Hospital, Aceh

2019 ◽  
Vol 4 (1) ◽  
pp. 16-22 ◽  
Author(s):  
Zinatul Hayati ◽  
Syamsul Rizal ◽  
Ridhia Putri
Keyword(s):  
Escherichia Coli ◽  
General Hospital ◽  
Clinical Specimen ◽  
Antibiotic Sensitivity ◽  
High Sensitivity ◽  
Clinical Microbiology Laboratory ◽  
Isolation And Identification ◽  
E Coli ◽  
Extended Spectrum ◽  
Sensitivity Pattern

Infection that occurs in Indonesia has increased more significantly than before, compared to the increasing bacterial multidrug resistance (MDR) as the cause of infection. A study conducted in 5 hospitals in Indonesia in 2013 showed that the prevalence rate of extended-spectrum β-lactamase (ESBL)-producing bacteria reached 32-68%. The objective of this study is to detect the prevalence and resistence pattern of ESBL-producing Escherichia coli and Klebsiella pneumoniae in Dr. Zainoel Abidin General Hospital, Banda Aceh. This study was conducted from 1 September 2016 to 31 December 2016. Specimen types included in this study were blood, sputum, urine, pus, mucosal swab, and another body fluids sample. The sampling method in this study was total sampling that is all clinical specimen examined in Clinical Microbiology Laboratory. Isolation and identification ESBL-producing bacteria was performed by VITEK-2 machine (Biomerieux). The result of this study is that a total 122 E. coli and K. pneumoniae were isolated. That consisted of 48 (39%) E. coli isolates and 74 (61%) K. pneumoniae isolates. From 48 E. coli isolates it was found out that 41 (85%) had ESBL phenotypes and from 74 K. pneumoniae isolates it was found out that 59 (80%) had ESBL phenotypes. In total, 100 (82%) isolates from 122 isolates had ESBL phenotypes. Distribution of ESBL-producing E. coli and K. pneumoniae based on sample was 24 (89%) isolates from the total of 27 urine isolates, 18 (95%) isolates from the total of 19 blood isolates, 28 (78%) isolates from the total of 36 sputum isolates, and 30 (75%) isolates from the total of 40 pus isolates. Antibiotic sensitivity pattern of the E. coli and K. pneumoniae isolates had high sensitivity to amycasin dan meropenem which was above 89%. Meanwhile, it also had sensitivity to Fosfomycin and Piperacyclin-Tazobactam by 80% and 77% respectively. Another antibiotic was less effective

scholarly journals Prevalence of Multidrug Resistance and Extended-Spectrum β-Lactamase Carriage of Clinical Uropathogenic Escherichia coli Isolates in Riyadh, Saudi Arabia

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Abdulaziz Alqasim ◽  
Ahmad Abu Jaffal ◽  
Abdullah A. Alyousef
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistance ◽  
Antimicrobial Susceptibility ◽  
Empirical Therapy ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence ◽  
Tertiary Healthcare ◽  
Polymerase Chain ◽  
Synergy Test

The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-producing E. coli) has recently increased worldwide. This study aims at determining the antimicrobial susceptibility patterns of a collection of clinical E. coli urine isolates and evaluating the ESBL carriage of these isolates at phenotypic and genotypic levels. A total of 100 E. coli urine isolates were collected at a tertiary healthcare centre in Riyadh from January 2018 to March 2018. Antimicrobial susceptibility testing was carried out for all isolates. ESBL production was characterized at phenotypic and genotypic levels using double-disc synergy test and polymerase chain reaction, respectively. Detection of different ESBL variants was performed using DNA sequencing. Of 100 E. coli isolates, 67 were associated with multidrug resistance (MDR) phenotype. All isolates showed variable resistance levels to all antibiotics used here expect to imipenem, where they were all imipenem-sensitive. 33 out of 100 E. coli isolates were positive for ESBLs by phenotypic and genotypic methods. Among all ESBL-positive E. coli isolates, the CTX-M was the most prevalent ESBL type (31/33 isolates; 93.94%). CTX-M-15 variant was detected in all isolates associated with CTX-M carriage. Multiple ESBL gene carriage was detected in 15/33 isolates (45.45%), where 11 (33.33%) isolates produced two different ESBL types while 4 isolates (12.12%) associated with carrying three different ESBL types. Our study documented the high antimicrobial resistance of ESBL-producing E. coli to many front-line antibiotics currently used to treat UTI patients, and this implies the need to continuously revise the local guidelines used for optimal empirical therapy for UTI patients. It also showed the high prevalence of ESBL carriage in E. coli urine isolates, with CTX-M-15 being the most predominant CTX-M variant.

scholarly journals Extended-Spectrum-β-Lactamase-Producing Escherichia coli Strains Isolated from Farm Animals from 1999 to 2002: Report from the Japanese Veterinary Antimicrobial Resistance Monitoring Program

2005 ◽  
Vol 49 (8) ◽  
pp. 3533-3537 ◽  
Author(s):  
Akemi Kojima ◽  
Yoshikazu Ishii ◽  
Kanako Ishihara ◽  
Hidetake Esaki ◽  
Tetsuo Asai ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Promoter Region ◽  
Monitoring Program ◽  
Farm Animals ◽  
Resistance Monitoring ◽  
E Coli ◽  
Extended Spectrum ◽  
Nationwide Surveillance

ABSTRACT A nationwide surveillance for antimicrobial susceptibility in Escherichia coli strains isolated from food-producing animals in Japan was conducted from 1999 to 2002. Eighteen cefazolin-resistant E. coli strains were isolated from broilers. Six were CTX-M-type producing, and eight were CMY-2 producing, while eight had mutations at the ampC promoter region.

scholarly journals Potential impact of novel diagnostics and treatments on the burden of antibiotic resistant in Escherichia coli

2016 ◽  
Author(s):  
Pierre Nouvellet ◽  
J.V. Robotham ◽  
N.R. Naylor ◽  
N. Woodford ◽  
Neil M. Ferguson
Keyword(s):  
Escherichia Coli ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Case Scenario ◽  
Worst Case ◽  
Blood Stream Infections ◽  
E Coli ◽  
Hospital Bed ◽  
The Impact ◽  
Excess Deaths

AbstractThe rising threat of antibiotic resistance in Europe and beyond is of increasing concern and is prompting renewed effort to better understand and mitigate their impact. Escherichia Coli blood stream infections are a more major concern in Europe given their incidence and severe associated outcomes. Additionally the level of 3rd generation cephalosporins and carbapenems resistance among those bacteraemia has significantly increased, limiting available treatment options. We estimated the current burden associated with E. coli blood stream infections in Europe at 17,000 (95%CI [8,000; 30,000]) excess deaths and 960,000 (95%CI [600,000; 1,450,000]) extra hospital bed days. From those, the contribution due to 3rd generation cephalosporins and carbapenems resistant strains reached 6,000 (95%CI [2,000; 12,000]) excess deaths, and 200,000 (95%CI [76,000; 420,000]) extra hospital bed stay. In the worst case scenario, we estimated the burden of E. coli blood stream infection in 2026 could increase over 4-fold, mostly resulting from an increase in the level of resistance rather than an increase in the incidence of blood stream infections. Finally, we estimated that the impact of combined novel diagnostics and treatments could substantially reduce the excess mortality by 18.5% to 55.5%, and length of stay by 13.2% to 75.6%.

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