scholarly journals Extended Spectrum Beta-Lactamases Producers among Gram-negative Bacteria from Clinical and Environmental Sources in Two Tertiary Hospitals in Makurdi, Nigeria

2020 ◽  
pp. 42-53
Author(s):  
Florence Bose Omoregbe ◽  
Obasola Ezekiel Fagade
Keyword(s):  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Disc Diffusion ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Extended Spectrum Beta-Lactamases (ESBLs) enzymes are produced by many Gram-negative bacteria to nearly all antibiotics. Clinical bacteria isolates were obtained from various clinical samples from the two healthcare facilities. Sewer wastewater and sediments were also collected from both hospitals using standard sampling techniques and bacteria isolated using pour plate technique. Multiple drug resistant patterns were determined using disc diffusion technique. Antibiotics sensitivity of the isolates was verified using disc diffusion method. Detection of ESBL producing bacteria was done using double disc synergy test. Data obtained were analysed using descriptive statistics. Clinical bacteria (403) were obtained, out of which 299 were confirmed Gram-negative, 218 from Federal Medical Centre (FMC) and 81 from Benue State Teaching Hospital (BSUTH). Thirty-nine Gram-negative bacteria were also isolated from the environmental samples. The ESBL producers in clinical isolates were 69 (FMC) and 42 (BSUTH) while in environmental isolates they were eight and four respectively. Out of a total of 338 environmental and clinical isolates from the two hospitals, 216 shown resistance/intermediate resistance to Ceftazidime. Of these 216, 123(36.39%) were positive for ESBLs production.- space From FMC, ESBLs producing bacteria are highly sensitive to imipenem with sensitivity frequency of 62 while they were highly resistant to ceftazidime with a frequency of 52. Age groups 0-5 had the highest percentage distribution of 21.43% and 10.14% from BSUTH and FMC respectively. ESBLs producing bacteria showed multidrug resistance.

scholarly journals CO-PRODUCTION OF EXTENDED-SPECTRUM BETA-LACTAMASES AND METALLO BETA-LACTAMASES AMONG MULTI-DRUG RESISTANT GRAM-NEGATIVE BACTERIA ISOLATES COLLECTED FROM TERTIARY HOSPITALS IN OYO STATE, NIGERIA

2020 ◽  
Vol 4 (3) ◽  
pp. 230-241
Author(s):  
Olumuyiwa Alabi ◽  
Abiola Obisesan ◽  
Mary Taiwo ◽  
Rhoda Adewuyi
Keyword(s):  
Phylogenetic Tree ◽  
Health Concern ◽  
Gram Negative Bacteria ◽  
Drug Resistant ◽  
Disc Diffusion ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tertiary Hospitals

Extended-spectrum beta-lactamases (ESBLs) and metallo beta-lactamases (MBLs) are compromising the chemotherapeutic use of cephalosporins and carbapenems respectively. This study investigated the burden of ESBLs and MBLs co-production among multi-drug resistant (MDR) Gram-negative bacteria collected from two tertiary hospitals in Oyo State. A total of 240 non-duplicated clinical isolates of Escherichia coli, Klebsiella spp. and Pseudomonas spp. were collected from the Microbiology units of two tertiary hospitals in Oyo State and their identities authenticated using standard identification techniques. Antimicrobial susceptibility testing was carried out by disc-diffusion method and isolates exhibiting resistance to ≥3 classes of antibiotics selected as MDR strains. ESBL and MBL production was detected by double-disc synergy test (DDST) and combined-disc-diffusion test (CDDT) respectively. Selected beta-lactamase genes were detected by PCR, amplicons sent out for sequencing and phylogenetic tree of the sequences constructed using Mega X software. MDR was exhibited by 43.8% of the isolates. ESBLs and MBLs were produced by 32.4% and 7.6% of the MDR isolates respectively. Co-production of ESBL and MBL was observed in 6.7% of the MDR isolates. BlaCTX-M-15 (67.7%), blaTEM-1 (55.9%), blaSHV-1 (47.1%), co-existing blaTEM + blaSHV, blaTEM + blaCTX-M, blaCTX-M + blaSHV (each in 5.9%) and blaCTX-M +blaTEM + blaSHV (26.5%) were detected among the ESBL-producers. MBL genes were not detected among the MBL-producers. Only blaTEM-1 sequences showed two different claudes on the phylogenetic tree. The occurrence of MDR isolates co-harbouring different classes of beta-lactamse genes observed in this study is of public health concern and hence, requires stricter control of antibiotic use.

scholarly journals Carbapenemase Producers among Gram Negative Bacteria from Environmental and Clinical Samples in Makurdi, Nigeria

2020 ◽  
pp. 11-20
Author(s):  
F. B. Omoregbe ◽  
O. E. Fagade
Keyword(s):  
Environmental Samples ◽  
University Teaching ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Disc Diffusion ◽  
Environmental Isolates ◽  
Biochemical Tests ◽  
Gram Negative

Carbapenem-resistant Gram negative bacteria in healthcare setting is an important medical problem and a major threat. These Gram negative bacteria are rapidly spreading worldwide. Clinical bacteria isolates were obtained from clinical samples Urine, High Vaginal Swab (HVS), Wound Swab (WS), Stools, Ear Swab (ES), Endocervical Swab (ECS), Sputum and Blood, from two tertiary hospitals. Environmental samples were also collected from both hospitals using standard sampling techniques. Multiple drug resistant (MDR) patterns were determined using disc diffusion technique. Biochemical tests were used in the identification. Antibiotics sensitivity of clinical and environmental isolates was verified using disc diffusion method. Detection of carbapenemase producing bacteria was done using double disc synergy test and modified Hodge test. Data obtained were analysed using descriptive statistics. Clinical bacteria (403) obtained were distributed 271 Federal Medical Centre(FMC) and 132 Benue State University Teaching Hospital (BSUTH) out of which 299 were confirmed Gram negative, 218 (FMC) and 81 (BSUTH), respectively. Thirty-nine Gram negative bacteria were also isolated from the environmental samples. A higher percentage of carbapenemase producers (12.8%) were found in environmental isolates compared to 2.7% in clinical isolates. Any levels of resistance to carbapenems calls for the need to reduce the indiscriminate use of this group of antibiotics and monitoring both in the hospitals and environment.

scholarly journals Antimicrobial Resistance Patterns in Clinical Isolates of Enterobacteriaceae from a Tertiary Care Hospital, Kathmandu, Nepal

2018 ◽  
Vol 1 (2) ◽  
pp. 74-78
Author(s):  
Ram Prasad Adhikari ◽  
Subha Shrestha ◽  
Junu Richhinbung Rai ◽  
Ritu Amatya
Keyword(s):  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
College Teaching ◽  
Clinical Isolates ◽  
High Rate ◽  
Clinical Samples ◽  
Care Hospital ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Introduction: Multidrug resistance among Enterobacteriaceae is in increasing trend these days. The objective of this study was to determine the antibiogram of clinical isolates of Enterobacteriaceae with special reference to multidrug resistance and  extended spectrum beta-lactamases production.Materials and Methods: A descriptive cross sectional study was conducted over a period of six months (February -July, 2017) in the microbiology laboratory of Nepal Medical College Teaching Hospital, Kathmandu, Nepal. A total of 936 bacterial isolates of Enterobacteriaceae from clinical specimens were processed for antimicrobial susceptibility testing and screened for multidrug resistance. ESBL production was detected among potential isolates by combination disk diffusion test.Results: The rate of multidrug resistance and extended spectrum beta-lactamases production was 54.2% and 23.8% respectively. Of the total ESBL producers 92.4% were multidrug resistance. The rate of multidrug resistance and extended spectrum beta-lactamases production were higher in organisms isolated from clinical samples collected from inpatients. High rate of multidrug resistance and extended spectrum beta-lactamases production was seen in E. coli (54.4% & 27.7%), Klebsiella spp. (67.1% & 28.2%) and Citrobacter spp. (70.3% & 10.9%). The antimicrobial resistance rate was highest against ampicillin (76.7%) followed by cefixime (54. 0%), ceftazidime (51.5%), ceftriaxone (51.0%), cotrimoxazole (48.7%), ciprofloxacin (43.9%) and ofloxacin (41.1%).Conclusions:  Multidrug resistance is common among Enterobacteriaceae. These bacteria have high rate of resistance against commonly used groups of antibiotics like cephalosporins and quinolones. Continuous monitoring, surveillance of antimicrobial resistance, proper infection control and practices are important to combat with these issues.

scholarly journals Phenotypic characterization of beta-lactamases producing Gram-negative bacteria in a tertiary hospital, Nepal

2019 ◽  
Vol 7 (1) ◽  
pp. 74-81
Author(s):  
Elina Maharjan ◽  
Pooja Shakya ◽  
Balkrishna Bhattachan ◽  
Bharat Prasad Baral ◽  
Dhiraj Shrestha
Keyword(s):  
Tertiary Hospital ◽  
Diffusion Method ◽  
Phenotypic Characterization ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Beta Lactamase ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Disk Method ◽  
Esbl Producers

Infections caused by beta-lactamases producing Gram-negative bacteria are increasing, thus posing a challenge to the management of such infections. The surveillance data of such bacteria is limited in Nepal so this study aimed to detect the beta-lactamase producing Gram-negative bacteria in a tertiary setting. A total of 604 clinical samples, including urine, blood, sputum and body fluids, were cultured and identified by the routine standard laboratory protocols. Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method following Clinical and Laboratory Standard Institute guidelines (2014). Extended-spectrum beta-lactamases (ESBL) producers were identified by combined disk method and metallo-beta-lactamases (MBL) producers were identified by Imipenem- EDTA combined disk method. Out of 604 samples, 282 (46.7%) samples showed significant growth, of which 229 (81.2%) were Gram-negative bacteria. Of 229 Gram-negative bacteria, 200 (87.3%) were multidrug resistant, 67 (29.3%) were ESBL producers and 16 (7.0%) were MBL producers. Klebsiella pneumoniae were among higher ESBL producers and Pseudomonas aeruginosa were among higher MBL producers. The findings suggest higher antibacterial resistance among Gram-negative bacteria with the added burden of beta-lactamase production. Imipenem was effective against 125 of 229 Gram-negative bacteria tested. Thus, imipenem can be the drug of choice for empirical management. The higher multidrug resistance and higher beta-lactamases production among Gram-negative bacteria warrant the continuous monitoring, surveillance, early detection, and infection control practices of such bacteria

scholarly journals Extended Spectrem Beta Lactamases among Multi Drug Resistant Gram Negetive Bacilli Causing Urinry Tract Infection

2019 ◽  
Vol 5 (1) ◽  
pp. 25-28
Author(s):  
Ganga Sagar Bhattarai ◽  
Dipendra , Shrestha ◽  
Bishnu Raj Tiwari
Keyword(s):  
Urinary Tract ◽  
Tract Infection ◽  
Diffusion Method ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
The Status ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections ◽  
Esbl Producers

Extended Spectrum Beta Lactamases (ESBL), the main cause of resistance to broad spectrum β-lactams, among uropathogenic bacteria have increased over time raising a global concern in the therapeutic management of infections caused by these organisms. The study was carried out in Janamaitri Hospital, Kathmandu between December 2012 to May 2013 with an objective to determine the status of ESBL producing Gram negative bacilli isolated from the urine sample, collected from patients suspected of urinary tract infection. Gram negative bacilli isolated were tested for the presence of ESBL by combined disk and antibiotic susceptibility by Kirby Bauer disc diffusion method following Clinical and Laboratory Standard Institute guidelines. Among the total 1105 mid-stream urine samples, 256 Gram negative bacilli were isolated. By screening test using third generation cephalosporins, 156 isolates were screened as ESBL producers and 91 isolates were positive for ESBL test by combined disk method. Among the 91 (35.55%) ESBL producers, 70 (39.32%) Escherichia coli, 16 (44.44%) Klebsiella pneumoniae, and 5 (33.33%) Pseudomonas aeruginosa were found to be ESBL producers. Majority of ESBL producer showed resistance to ampicillin, co-trimoxazole, norfloxacin followed by ofloxacin. imipenem, amikacin and nitrofurantoin seemed to be the agent of choice for urinary tract infections when ESBL producers are susceptible to it. ESBL production found in these Gram negative bacilli with resultant microbial resistance to available cephalosporins and other agents may pose difficulties with the choice of therapeutic options for the treatment of severe infections. Keywords: UTI, Extended Spectrum Beta Lactamases, Gram negative bacilli

scholarly journals Prevalence of imipenem resistant gram-negative bacteria in a tertiary care hospital of Dhaka, Bangladesh

2022 ◽  
Vol 21 (1) ◽  
pp. 145-150
Author(s):  
Rabeya Nahar Ferdous ◽  
Md Atikur Rahman ◽  
Md Anowar Hussain ◽  
Nasrin Akhter ◽  
Palash Chandra Banik ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Clinical Isolates ◽  
Health Concern ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Gram Negative Bacteria ◽  
Care Hospital ◽  
Gram Negative

Objective: Imipenem resistant gram-negative bacteria (GNB) have become a major public health concern worldwide, including Bangladesh. The present study was performed to determine the frequency of imipenem resistant gram-negative bacteria (GNB), their antimicrobial susceptibility pattern. Materials and Methods: A total of three hundred and fifty clinical samples were collected from Bangladesh Institute of Health Sciences hospital (BIHS), Dhaka, Bangladesh, over a period of 12 months. Among 350 samples, 171 (48.86%) were from indoor patients, and 179 (51.14%) were from outdoor patients. The pathogens were isolated and identified by conventional methods and were screened for antibiotic susceptibility using the Kirby–Bauer disc diffusion method, including imipenem discs. A Chi-square test was employed for statistical analysis. Results and Discussion: Out of 350 clinical isolates, 246 showed resistance to imipenem (70.28%). Almost all of the imipenem resistant gram-negative bacteria showed the highest resistant pattern to cefepime (88.57%), amoxicillin (88.29%), cephalosporin (88.14%), cefoxitin (86%), tetracycline (84.42%), and the majority were resistant to levofloxacin (70.85%), doxycycline (70.57%), netilmicin (59.71%). But cotrimoxazole (13.42%) and tigecycline (11.43%) showed a lower resistance pattern. Statistical analysis exhibited imipenem resistant gram-negative isolates most commonly found in pus and urine samples, while Klebsiella spp (30.49%), Pseudomonas spp (26.83%) and E. coli (23.17%) were the most predominant pathogens. Conclusion: This is a retrospective study which study indicates a noteworthy rate of clinical isolates were imipenem resistant gram-negative bacteria in a well-defined tertiary care hospital, and most of these bacteria were also multidrug-resistant. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 145-150

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