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Yoon C, Kim J, Jang W, Ko JW, Kim J, Pai H, Lee Y, Kim B. Clinical and microbiological characteristics of female patients with acute pyelonephritis who experienced urinary tract infections within the previous year. J Infect Public Health 2024; 17:349-358. [PMID: 38198967 DOI: 10.1016/j.jiph.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 11/26/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND This study aimed to examine the clinical and microbiological characteristics of female patients with recurrent acute pyelonephritis (APN). METHODS A retrospective cohort study was conducted at a tertiary care hospital in South Korea from July 2019 to December 2021. All female patients aged ≥ 19 years who were diagnosed with community-acquired APN on admission were enrolled. The recurrent group included patients with APN who experienced urinary tract infections within the previous year. The clinical characteristics, types of causative organisms, major antibiotic resistance, and molecular characteristics of Escherichia coli strains were compared between the recurrent and non-recurrent groups. RESULTS A total of 285 patients with APN were analyzed, including 41 (14.4%) in the recurrent group. Compared to the non-recurrent group, the recurrent group had a higher Charlson Comorbidity Index (1.8 ± 2.1 vs. 1.1 ± 1.5; P = 0.01) and a higher proportion of bladder abnormalities, such as neurogenic bladder (12.2% vs. 2.0%; P = 0.001) and urinary catheterization (12.2% vs. 1.6%; P < 0.001). Escherichia coli was the most common causative organism in both groups. The proportion of Klebsiella pneumoniae (17.1% vs. 4.7%; P = 0.007) and Pseudomonas aeruginosa (5.7% vs. 0.5%; P = 0.014) as a causative organism was higher in the recurrent group. Regarding the microbiological characteristics of Escherichia coli, there were no significant differences in the proportion of antibiotic resistance, phylogenetic groups, resistance genes, and virulence factors between the two groups. Multivariable analysis showed that neurogenic bladder and a history of admission or antibiotic use during 1 year prior to inclusion were significantly associated with recurrent APN. CONCLUSIONS The proportion of causative organisms except Escherichia coli was higher in the recurrent group than in the non-recurrent group. Neurogenic bladder and a history of admission or antibiotic use during 1 year prior to inclusion were risk factors for recurrent APN.
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Affiliation(s)
- Choseok Yoon
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Jeoungyeon Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Wooyoung Jang
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Ji Won Ko
- School of Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Jinnam Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Hyunjoo Pai
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Yangsoon Lee
- Department of Laboratory Medicine, Hanyang University College of Medicine, Seoul, South Korea
| | - Bongyoung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, South Korea.
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Moussa B, Hmami F, Arhoun B, El Fakir S, Massik AM, Belchkar S, Hibaoui L, Oumokhtar B. Intense Intestinal Carriage of Carbapenemase-Producing Klebsiella pneumoniae Co-harboring OXA-48, KPC, VIM, and NDM Among Preterm Neonates in a Moroccan Neonatal Intensive Care Unit. Cureus 2023; 15:e50095. [PMID: 38186478 PMCID: PMC10770769 DOI: 10.7759/cureus.50095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2023] [Indexed: 01/09/2024] Open
Abstract
INTRODUCTION This study aimed to investigate the prevalence and the carbapenemase production ability of Klebsiella pneumoniae isolates from premature neonates' intestinal tracts in a Moroccan neonatal intensive care unit Methodology: Active rectal screening was performed among 339 preterm infants. The collected isolates were subjected to antibiotic susceptibility testing, phenotypic analysis of carbapenemase production, and molecular detection of carbapenemase genes. RESULTS Out of 293 K. pneumoniae isolates collected, 31.05% (91) were resistant to carbapenem and produced carbapenemase, resulting in a 22.12% rate of intestinal carriage. Among the carbapenem-resistant K. pneumoniae isolates, 40.65% (37) had co-harbored carbapenemase genes. All isolates contained the blaOXA-48 gene, and the blaNDM, blaVIM, and blaKPC genes were detected in 30.76%, 9.89%, and 2.19% of the isolates, respectively. Out of 30.76% of these isolates had both the blaOXA-48 and blaNDM genes, 8.79% had both blaOXA-48 and blaVIM, and only 2.20% had both blaOXA-48 and blaKPC genes. Furthermore, 88.57% of carbapenem-resistantK. pneumoniae isolates co-harboring carbapenemase genes were genetically related strains. CONCLUSIONS This study revealed a high prevalence of intestinal carriage of carbapenem-resistant K. pneumoniae. Therefore, implementing effective screening and diagnostic measures, and focusing on antimicrobial stewardship are essential to preventing the spread of these resistant strains and minimizing the risk they pose to premature infants.
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Affiliation(s)
- Benboubker Moussa
- Human Pathology Biomedicine and Environment Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Fouzia Hmami
- Neonatal Intensive Care Unit, University Hospital Hassan II, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Btissam Arhoun
- Microbiology and Molecular Biology Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Samira El Fakir
- Department of Epidemiology and Public Health, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Abdelhamid M Massik
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Salim Belchkar
- Epidemiology and Health Science Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Lahbib Hibaoui
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
| | - Bouchra Oumokhtar
- Microbiology and Molecular Biology Laboratory, Microorganisms Team, Genomics and Oncogene Factors, Faculty of Medicine and Pharmacy, Sidi Mohammed Ben Abdellah University, Fez, MAR
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Moussa B, Oumokhtar B, Arhoune B, Massik A, Elfakir S, Khalis M, Soudi H, Hmami F. Gut acquisition of Extended-spectrum β-lactamases-producing Klebsiella pneumoniae in preterm neonates: Critical role of enteral feeding, and endotracheal tubes in the neonatal intensive care unit (NICU). PLoS One 2023; 18:e0293949. [PMID: 37934752 PMCID: PMC10629629 DOI: 10.1371/journal.pone.0293949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 10/05/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Klebsiella spp. can colonize the intestine of preterm neonates, and over-growth has been associated with necrotizing enterocolitis, hospital-acquired infections, and late-onset sepsis. This could lead us to suggest that the clinical pertinence of intestinal colonization with ESBL in preterm neonates appears to be important. We conducted this study to characterize the genetic proprieties of ESBL-producing Klebsiella pneumoniae (ESBL-KP) under clinical isolates and to describe the risk factors for the intestinal tract acquisition event during hospitalization. METHODS One hundred and thirteen premature infants were recruited from the neonatal intensive care unit (NICU). All newborns are issued from the birth suites of the pregnancy department. Two rectal swabs were planned to define K. Pneumoniae intestinal carriage status. ESBL-KP was confirmed by Brilliance ESBL selective chromogenic Agar. Antimicrobial susceptibility testing including phenotypic testing and genotypic detection of the most commonly described ESBL genes was done. Logistic regression models were performed to find the variables associated with the acquisition event of ESBL-KP. RESULTS A total of 62 (54.86%) premature neonates were colonized with ESBL-KP. The rate of blaSHV, blaTEM, blaCTX-M1, blaCTX-M2, blaCTX-M9, and blaOXA-48 genes among the isolates was 82, 48, 93.5, 4.8, 11.2 and 3.22%, respectively. We found that ESBLs K. Pneumoniae isolates were 100% resistant to amoxicillin, clavulanic acid-amoxicillin, cefotaxime, ceftazidime, and gentamicin. The regression model is for a given significant association between the tract intestinal of ESBL-KP acquisition events and the use of enteral tube feeding (OR = 38.46, 95% CI: 7.86-188.20, p-Value: 0.001), and endotracheal tubes (OR = 4.86, 95% CI: 1.37-17.19, p-Value 0.014). CONCLUSION Our finding supposes that the enteral feeding tube and endotracheal tube might have a critical role in colonizing the intestinal tract of preterm infants. This highlights the current status of both practices that will require updated procedures in the NICU.
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Affiliation(s)
- Benboubker Moussa
- Faculty of Medicine and Pharmacy, Human Pathology Biomedicine and Environment Laboratory, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Bouchra Oumokhtar
- Faculty of Medicine and Pharmacy, Human Pathology Biomedicine and Environment Laboratory, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Btissam Arhoune
- Faculty of Medicine and Pharmacy, Microbiology and Molecular Biology Laboratory, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Abdelhamid Massik
- Faculty of Medicine and Pharmacy, Microbiology and Molecular Biology Laboratory, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Samira Elfakir
- Faculty of Medicine and Pharmacy, Departement of Epidemiology and Public Health, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Mohamed Khalis
- International School of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Hammad Soudi
- Faculty of Medicine and Pharmacy, Departement of Epidemiology and Public Health, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Fouzia Hmami
- Faculty of Medicine and Pharmacy, Human Pathology Biomedicine and Environment Laboratory, Sidi Mohammed Ben Abdellah University, Fez, Morocco
- Neonatal Intensive Care Unit, University Hospital Hassan II, Fez, Morocco
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Venne DM, Hartley DM, Malchione MD, Koch M, Britto AY, Goodman JL. Review and analysis of the overlapping threats of carbapenem and polymyxin resistant E. coli and Klebsiella in Africa. Antimicrob Resist Infect Control 2023; 12:29. [PMID: 37013626 PMCID: PMC10071777 DOI: 10.1186/s13756-023-01220-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 02/18/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Carbapenem-resistant Enterobacterales are among the most serious antimicrobial resistance (AMR) threats. Emerging resistance to polymyxins raises the specter of untreatable infections. These resistant organisms have spread globally but, as indicated in WHO reports, the surveillance needed to identify and track them is insufficient, particularly in less resourced countries. This study employs comprehensive search strategies with data extraction, meta-analysis and mapping to help address gaps in the understanding of the risks of carbapenem and polymyxin resistance in the nations of Africa. METHODS Three comprehensive Boolean searches were constructed and utilized to query scientific and medical databases as well as grey literature sources through the end of 2019. Search results were screened to exclude irrelevant results and remaining studies were examined for relevant information regarding carbapenem and/or polymyxin(s) susceptibility and/or resistance amongst E. coli and Klebsiella isolates from humans. Such data and study characteristics were extracted and coded, and the resulting data was analyzed and geographically mapped. RESULTS Our analysis yielded 1341 reports documenting carbapenem resistance in 40 of 54 nations. Resistance among E. coli was estimated as high (> 5%) in 3, moderate (1-5%) in 8 and low (< 1%) in 14 nations with at least 100 representative isolates from 2010 to 2019, while present in 9 others with insufficient isolates to support estimates. Carbapenem resistance was generally higher among Klebsiella: high in 10 nations, moderate in 6, low in 6, and present in 11 with insufficient isolates for estimates. While much less information was available concerning polymyxins, we found 341 reports from 33 of 54 nations, documenting resistance in 23. Resistance among E. coli was high in 2 nations, moderate in 1 and low in 6, while present in 10 with insufficient isolates for estimates. Among Klebsiella, resistance was low in 8 nations and present in 8 with insufficient isolates for estimates. The most widespread associated genotypes were, for carbapenems, blaOXA-48, blaNDM-1 and blaOXA-181 and, for polymyxins, mcr-1, mgrB, and phoPQ/pmrAB. Overlapping carbapenem and polymyxin resistance was documented in 23 nations. CONCLUSIONS While numerous data gaps remain, these data show that significant carbapenem resistance is widespread in Africa and polymyxin resistance is also widely distributed, indicating the need to support robust AMR surveillance, antimicrobial stewardship and infection control in a manner that also addresses broader animal and environmental health dimensions.
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Affiliation(s)
- Danielle M Venne
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
| | - David M Hartley
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children's Hospital, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, OH, 45229, USA
| | - Marissa D Malchione
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
- Sabin Vaccine Institute, Influenza Vaccine Innovation, 2175 K St NW, Washington, DC, 20037, USA
| | - Michala Koch
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
| | - Anjali Y Britto
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA
| | - Jesse L Goodman
- Center on Medical Product Access, Safety and Stewardship, Georgetown University, 3900 Reservoir Road, Washington, DC, 20057, USA.
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Fazza O, Favard Ennachachibi M, Ennassiri H, Hmyene A. Antibiotic Susceptibility of β-Glucuronidase-Positive Escherichia coli Isolated from Poultry Products in Morocco. INTERNATIONAL JOURNAL OF FOOD SCIENCE 2023; 2023:7862168. [PMID: 37051460 PMCID: PMC10085649 DOI: 10.1155/2023/7862168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 04/05/2023]
Abstract
Poultry products are one of the main foodstuffs consumed in Morocco. The deterioration of their hygienic quality and the emergence of antibiotic resistance are the major public health problems. This study was carried out to determine the level of emergence of antibiotic resistance. For that, between May 2021 and June 2022, poultry products (e.g., minced meat, sausage, and meat) were collected aseptically in sterile bags from retail stores in different cities of Morocco, labeled, and transported in chilled conditions to the laboratory. The bacterial analysis was performed within 24 hours. Isolation and identification of Escherichia coli were performed according to the Moroccan standard NM ISO 16649 2018. Antimicrobial susceptibility determination of 23 antibiotics was tested using the Kirby-Bauer disk diffusion method. The results showed a high level of antimicrobial resistance to amoxicillin (58%), amoxicillin-clavulanic acid (54%), piperacillin (63%), trimethoprim (32%), nalidixic acid (46%), and ofloxacin (43%). 58 isolates (60%) were positive for beta-lactamase class A (penicillinase) test detection, and 2 isolates (3%) produced extended-spectrum beta-lactamases. The high level of resistance demonstrated in this study should alert health organizations in the country. An establishment of surveillance programs to control the use and the administration of antibiotics in the poultry field and initiation of reliable methods to follow up on the latest updates on the emergence of bacterial resistance is a necessity.
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Affiliation(s)
- Oumaima Fazza
- Laboratory of Biochemistry, Environment and Agri-Food, Faculty of Sciences and Technology Mohammedia, University Hassan II, Casablanca, Morocco
| | | | - Houda Ennassiri
- Charles Nicolle Laboratory of Environment and Food Safety, Casablanca, Morocco
| | - Abdelaziz Hmyene
- Laboratory of Biochemistry, Environment and Agri-Food, Faculty of Sciences and Technology Mohammedia, University Hassan II, Casablanca, Morocco
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Kim B, Kim J, Jo HU, Kwon KT, Ryu SY, Wie SH, Kim J, Park SY, Hong KW, Kim HI, Kim HA, Kim MH, Bae MH, Sohn YH, Kim J, Lee Y, Pai H. Changes in the characteristics of community-onset fluoroquinolone-resistant Escherichia coli isolates causing community-acquired acute pyelonephritis in South Korea. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2022; 55:678-685. [PMID: 35140038 DOI: 10.1016/j.jmii.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 12/16/2021] [Accepted: 01/06/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE This study aimed to examine the changes in the characteristics of community-onset fluoroquinolone-resistant (FQ-R) Escherichia coli isolates causing community-acquired acute pyelonephritis (APN) in South Korea. METHODS Blood or urine samples were prospectively collected from patients aged ≥15 years with community-acquired APN who were admitted to one of the eight Korean hospitals included in this study between September 2017 and August 2018. Phylogenetic typing, multilocus sequence typing, and molecular characterization of β-lactamase resistance and plasmid-mediated quinolone resistance (PMQR) determinants were performed. The data were compared with those from a previous study with the same design conducted in 2010-2011. RESULTS A total of 300 and 346 isolates were identified in 2010-2011 and 2017-2018, respectively. Among them, 76 (22.0%) and 77 (25.7%) FQ-R isolates were identified in 2010-2011 and 2017-2018, respectively. A significantly higher antimicrobial resistance against third-to fourth-generation cephalosporins, including cefotaxime (23.9% vs. 77.9%, P < 0.001), were observed among FQ-R isolates in 2017-2018 than among those in 2010-2011. A higher proportion of ST131 isolates (27.6% vs. 66.2%, P < 0.001), as well as isolates that had extended-spectrum β-lactamase (ESBL)/plasmid-mediated AmpC β-lactamase (PABL) (23.7% vs. 79.2%, P < 0.001), was observed in 2017-2018 than in 2010-2011. Further, more PMQR determinants (11.8% vs. 40.8%, P < 0.001) were observed in 2017-2018 than in 2010-2011. CONCLUSIONS Among uropathogenic FQ-R E. coli isolates in South Korea, the prevalence of ST131 and the proportion of isolates containing ESBL and/or PMQR determinants have increased.
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Affiliation(s)
- Bongyoung Kim
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
| | - Jeoungyeon Kim
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - Hyun-Uk Jo
- Department of Urology, Good Moonhwa Hospital, Busan, South Korea
| | - Ki Tae Kwon
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Seong-Yeol Ryu
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Seong-Heon Wie
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Jieun Kim
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - Se Yoon Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University, Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Kyung-Wook Hong
- Division of Infectious Diseases, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, South Korea
| | - Hye In Kim
- Department of Internal Medicine, Daegu Fatima Hospital, Daegu, South Korea
| | - Hyun Ah Kim
- Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea
| | - Mi-Hee Kim
- Division of Infectious Diseases, Department of Internal Medicine, St. Vincent Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Mi Hyun Bae
- Department of Laboratory Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | | | - Jieun Kim
- Department of Laboratory Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Yangsoon Lee
- Department of Laboratory Medicine, College of Medicine, Hanyang University, Seoul, South Korea
| | - Hyunjoo Pai
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea.
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Nguyen PTL, Tran HTM, Tran HA, Pham TD, Luong TM, Nguyen TH, Nguyen LTP, Nguyen TTT, Hoang HTA, Nguyen C, Tran DN, Dang AD, Suzuki M, Le TV, Bañuls AL, Choisy M, Van Doorn RH, Tran HH. Carriage of Plasmid-Mediated Colistin Resistance-1-Positive Escherichia coli in Humans, Animals, and Environment on Farms in Vietnam. Am J Trop Med Hyg 2022; 107:65-71. [PMID: 35895375 PMCID: PMC9294698 DOI: 10.4269/ajtmh.21-1203] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/27/2022] [Indexed: 07/30/2023] Open
Abstract
Plasmid-Mediated Colistin Resistance 1 (mcr-1) was first reported in 2015 and is a great concern to human health. In this study, we investigated the prevalence of mcr-1 and mcr-1-positive Escherichia coli (MCRPEC) and the association in infection status among various reservoirs connected to livestock. The study was conducted in 70 poultry and swine farms in a commune in Ha Nam province, northern Vietnam. Samples were collected from farmers, food animals, domestic animals, and farm environments (flies and wastewater) for polymerase chain reaction (PCR) screening for mcr-1 gene and species identification of PCR positive isolates. Among 379 obtained mcr-1 positives isolates, Escherichia coli was the major identified, varying from 50% (2/4) in dog feces to 100% (31/31) in humans feces isolates. The prevalence of MCRPEC was 14.4% (20/139), 49.7% (96/193), 31.3% (25/80), 36.7% (40/109), 26.9% (18/67), and 3.9% (2/51) in humans, chickens, pigs, flies, wastewater, and dogs, respectively. The study identified association between MCRPEC infection status in humans and flies (OR = 3.4), between flies and chickens (OR = 5.3), and between flies and pigs (OR = 9.0). Farmers' age and farm livestock unit were also associated factors of MCRPEC infection status in humans (OR = 5.1 and 1.05, respectively). These findings bring new knowledge on antibiotic resistance in livestock setting and important suggestions on potential role of flies in the transmission of mcr-1 resistance gene.
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Affiliation(s)
| | | | | | - Thai Duy Pham
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Tan Minh Luong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Thanh Ha Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | | | | | | | - Chi Nguyen
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
- Association of Public Health Laboratories, Silver Spring, Maryland
| | - Duong Nhu Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Anh Duc Dang
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Masato Suzuki
- National Institute of Infectious Diseases, Tokyo, Japan
| | - Thanh Viet Le
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom
| | - Anne-Laure Bañuls
- MIVEGEC (IRD-CNRS-Université de Montpellier), LMI DRISA, Centre IRD, Montpellier, France
| | - Marc Choisy
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Rogier H. Van Doorn
- Oxford University Clinical Research Unit, Hanoi, Vietnam
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom
| | - Huy Hoang Tran
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
- Hanoi Medical University, Hanoi, Vietnam
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Nejjari C, El Achhab Y, Benaouda A, Abdelfattah C. Antimicrobial resistance among GLASS pathogens in Morocco: an epidemiological scoping review. BMC Infect Dis 2022; 22:438. [PMID: 35525923 PMCID: PMC9077917 DOI: 10.1186/s12879-022-07412-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Monitoring of antimicrobial resistance (AMR) is of great importance due to the frequency of strains becoming increasingly resistant to antibiotics. This review, using a public health focused approach, which aims to understand and describe the current status of AMR in Morocco in relation to WHO priority pathogens and treatment guidelines. METHODS PubMed, ScienceDirect and Google Scholar Databases and grey literature are searched published articles on antimicrobial drug resistance data for GLASS priority pathogens isolated from Morocco between January 2011 and December 2021. Articles are screened using strict inclusion/exclusion criteria. AMR data is extracted with medians and IQR of resistance rates. RESULTS Forty-nine articles are included in the final analysis. The most reported bacterium is Escherichia coli with median resistance rates of 90.9%, 64.0%, and 56.0%, for amoxicillin, amoxicillin-clavulanic acid, and co-trimoxazole, respectively. Colistin had the lowest median resistance with 0.1%. A median resistance of 63.0% is calculated for amoxicillin-clavulanic acid in Klebsiella pneumonia. Imipenem resistance with a median of 74.5% is reported for Acinetobacter baumannii. AMR data for Streptococcus pneumonie does not exceed 50.0% as a median. CONCLUSIONS Whilst resistance rates are high for most of GLASS pathogens, there are deficient data to draw vigorous conclusions about the current status AMR in Morocco. The recently join to the GLASS system surveillance will begin to address this data gap.
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Affiliation(s)
- Chakib Nejjari
- International School of Public Health, Mohammed VI University of Health Sciences (UM6SS), Casablanca, Morocco
| | - Youness El Achhab
- Laboratory of Epidemiology, Clinical Research and Community Health, Faculty of Medicine and Pharmacy of Fez, University Sidi Mohamed Ben Abdellah, Km 2.2 Rte Sidi Harazem, B.P 1893, Fez, Morocco. .,CRMEF Fez-Meknes, Rue Kuwait, B.P 49, Fez, Morocco.
| | - Amina Benaouda
- Department of Microbiology, Cheikh Zayed International University Hospital, Rabat, Morocco
| | - Chakib Abdelfattah
- Department of Infectious Diseases, Faculty of Medicine, University Hassan II, Casablanca, Morocco
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9
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Ahmed HA, Ibrahim EHS, Abdelhaliem E, Elariny EYT. Biotyping, Virulotyping and Biofilm Formation Ability of ESBL-Klebsiella pneumoniae Isolates from Nosocomial Infections. J Appl Microbiol 2022; 132:4555-4568. [PMID: 35384170 DOI: 10.1111/jam.15563] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 03/05/2022] [Accepted: 03/23/2022] [Indexed: 11/30/2022]
Abstract
The aim of this study was to investigate the frequency, molecular characterization, virulence genes, resistance genes and antimicrobial profile of nosocomial extended spectrum beta lactamase producing Klebsiella species. A total of 22 (12.2%) K. pneumoniae strains were isolated from 180 clinical samples collected from hospitalized patients in Egypt. K. pneumoniae biotypes were B1 (72.8%), B3 (13.6%) and B4 (13.6%). The isolates were classified for the capsular serotypes, 86.4% (20/22) were of K1 serotype, while only two isolates (13.64%) were of K2 serotype. Hypermucoviscous K. pneumoniae isolates accounted for 68.2%. Biofilm formation ability of K. pneumoniae was determined by microtitre plate method. The majority of the isolates (40.9%) were moderate biofilm producers, while 27.3% were strong biofilm producers. All K. pneumoniae strains were positive for fimH and traT genes, while magA was identified in only 63.6% of the isolates. The antibiotic susceptibility profile of the isolates (n=22) was determined by the disc diffusion technique using 23 different antibiotics. Streptomycin and imipenem are the most effective antibiotics against 22 tested K. pneumoniae isolates with sensitivity rates of 63.64% and 54.54%, respectively. All tested K. pneumoniae isolates showed high resistance to amoxicillin∕clavulanate (100%), cefuroxime (100%) and ceftazidime (95.45%). Extended spectrum beta lactamases (ESBL) production and the presence of ESBL related genes were tested in the isolates. All the isolates tested positive for blaVIM, NDM1, and blaTEM, while only 81.8 percent tested positive for the blaSHV gene. Increasing antimicrobial resistance in K. pneumoniae causing nosocomial infections limits the use of antimicrobial agents for treatment. Furthermore, the spread of biofilm, multiple drug resistant and ESBL-producing K. pneumoniae isolates is a public threat for hospitalized patients.
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Affiliation(s)
- Heba A Ahmed
- Department of Zoonoses, Faculty of Veterinary Medicine, Zagazig University, Sharkia Governorate, Zagazig City, Egypt
| | - Eman H S Ibrahim
- Department of Microbiology, Faculty of Science, Zagazig University, Sharkia Governorate, Egypt
| | - Ekram Abdelhaliem
- Cytology and Molecular genetics, Faculty of Science,, Zagazig University, Sharkia Governorate, Egypt
| | - Eman Y T Elariny
- Department of Microbiology, Faculty of Science, Zagazig University, Sharkia Governorate, Egypt
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10
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Ibrahim ME, Algak TB, Abbas M, Elamin BK. Emergence of bla TEM, bla CTX-M, bla SHV and bla OXA genes in multidrug-resistant Enterobacteriaceae and Acinetobacter baumannii in Saudi Arabia. Exp Ther Med 2021; 22:1450. [PMID: 34721692 PMCID: PMC8549092 DOI: 10.3892/etm.2021.10885] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 09/07/2021] [Indexed: 01/09/2023] Open
Abstract
Multidrug-resistant (MDR) patterns due to extended-spectrum β-lactamase (ESBL) production in pathogenic bacteria are now becoming prevalent in hospitals worldwide, posing a public health challenge. The aim of the present study was to determine the antibiotic susceptibility patterns and distribution of the bla TEM, bla CTX-M, bla SHV and bla OXA ESBL resistance genes in MDREnterobacteriaceae and Acinetobacter baumannii (A. baumannii). A cross-sectional study was conducted between September 2017 and August 2018 in the King Abdullah Hospital (Bisha, Saudi Arabia). Bacterial isolates were collected from the clinical samples of patients; these were identified and screened for ESBL production and their antibiotic susceptibility was examined using standard microbiology methods. Multiplex-PCR runs were performed to identify genes encoding ESBL producers. DNA sequencing analysis was used to identify the specific gene variants. Of the 274 isolates, 173 (63.1%) exhibited MDR patterns to different antibiotics. A. baumannii revealed the highest resistance rates for cefuroxime (100%), gentamicin (88%) and amikacin (86%). Klebsiella pneumoniae (K. pneumoniae) isolates had the highest resistance rates for cefuroxime (98%), aztreonam and trimethoprim/sulfamethoxazole (87% for each). Escherichia coli (E. coli) exhibited high resistance rates for trimethoprim/sulfamethoxazole (92%) and cefuroxime (87%). Of the 173 MDR isolates, 78 (45.1%) exhibited ESBL production. Of these, 88.9% (72/78) carried ESBL genes. The most prevalent gene-encoding isolates were bla TEM (84.7%), followed by bla CTX-M (33.3%), bla SHV (2.7%) and bla OXA-1 (1.4%). A single bla TEM gene was predominantly produced by K. pneumoniae (60.7%), A. baumannii (78.9%) and Proteus mirabilis (80%), whereas bla CTX-M was harbored by E. coli (33.3%). The co-existence of two different genes in a single bacterium was revealed in 22.2% of isolates, commonly between bla TEM and bla CTX-M (19.4%). Sequencing analysis revealed that bla CTX-M-15 and bla TEM-1 were predominant variants of the bla CTX-M and bla TEM genes, respectively. The present study revealed a diversity of ESBL genes in Gram-negative bacterial isolates, with bla TEM being the most prevalent type. The emergence of various ESBL genes with several co-existing genotypes is alarming, rendering extensive surveillance studies necessary to understand the transmission and epidemiology of such resistant gene-carrying isolates.
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Affiliation(s)
- Mutasim E. Ibrahim
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Asir 61922, Kingdom of Saudi Arabia,Correspondence to: Dr Mutasim E. Ibrahim, Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, 9054 King Saud Road, Bisha, Asir 61922, Kingdom of Saudi Arabia ;
| | - Tarig B. Algak
- Department of Basic Medical Sciences (Pathology Unit), College of Medicine, University of Bisha, Bisha, Asir 61922, Kingdom of Saudi Arabia
| | - Mohammed Abbas
- Department of Pediatrics, College of Medicine, Arabian Gulf University, Manama 26671, Kingdom of Bahrain
| | - Bahaeldin K. Elamin
- Department of Basic Medical Sciences (Microbiology Unit), College of Medicine, University of Bisha, Bisha, Asir 61922, Kingdom of Saudi Arabia,Department of Medical Microbiology, Faculty of Medical Laboratory Sciences, University of Khartoum, Khartoum 11115, Republic of Sudan
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11
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Ahmadi M, Ranjbar R, Behzadi P, Mohammadian T. Virulence factors, antibiotic resistance patterns, and molecular types of clinical isolates of Klebsiella Pneumoniae. Expert Rev Anti Infect Ther 2021; 20:463-472. [PMID: 34612762 DOI: 10.1080/14787210.2022.1990040] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Klebsiella pneumoniae is armed with a wide range of antibiotic resistance mechanisms that mostly challenge effective treatment. The aims of the current study were to identify the clinical strains of K. pneumoniaealso to determine their phenotypes and molecular characterization related to antimicrobial resistance and virulence genes. RESEARCH DESIGN AND METHODS In this investigation, clinical specimens from different hospitals located in Tehran, Iran, were collected during a nine-month period (December 2018 to August 2019). The K. pneumoniae strains were isolated and identified through standard microbial and biochemical assays. Additionally, disk diffusion, combined disk, Modified Hodge Test (MHT) and PCR were performed for antibiotic resistance and virulence gene analysis, respectively. RESULTS Eighty-four isolates of K. pneumoniae were subjected to the study. According to the combined disk and modified Hodge test results, 27 (52%) and 15 pathotypes (62.5%) out of resistant strains of isolated K. pneumoniae were detected as ESBL and KPC producers. The virulence genes of mrkD (94%) and magA (11%) were the highest and lowest among isolates, respectively. CONCLUSIONS The high prevalence of antibiotic resistance and virulence genes in conjunction with a significant relationship between the strains revealed a high pathogenic capacity of the isolated pathotypes of K. pneumoniae.
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Affiliation(s)
- Mitra Ahmadi
- Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Payam Behzadi
- Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Taher Mohammadian
- Department of Microbiology, Shahr-e-Qods Branch, Islamic Azad University, Tehran, Iran
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Oktaviani Sulikah SR, Hasanah M, Setyarini W, Parathon H, Kitagawa K, Nakanishi N, Nomoto R, Osawa K, Kinoshita S, Hirai I, Shirakawa T, Kuntaman K. Occurrence of Carriage of Multidrug Resistant Enterobacteriaceae among Pregnant Women in the Primary Health Center and Hospital Setting in Surabaya, Indonesia. Microb Drug Resist 2021; 28:48-55. [PMID: 34348048 DOI: 10.1089/mdr.2020.0506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: The incidence of healthy individuals carrying multidrug resistant Enterobacteriaceae, including extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E), especially extended-spectrum β-lactamase producing Escherichia coli (ESBL-EC) and extended-spectrum β-lactamase producing Klebsiella pneumoniae (ESBL-KP), is increasing worldwide. Although ESBL-E causes early or late onset of neonatal sepsis, the prevalence of ESBL-E carriage among pregnant women in Indonesia is not clear. In the present study, we compared the occurrence of carriage of ESBL-E among pregnant women in a primary health center (PHC) versus two hospitals. Materials and Methods: We collected rectal swab samples from 200 pregnant women who visited a PHC or were admitted to two hospitals in Surabaya, Indonesia from July to October 2018. The ESBL-E strains were isolated from the samples and phenotypically and genotypically analyzed. Results: ESBL-E strains were isolated from 25 (24.8%) pregnant women who visited the PHC and 49 (49.5%) pregnant women who were admitted to the hospitals. The rate of ESBL-E carriage of pregnant women in the hospitals was significantly higher than that in the PHC. Among the 74 isolated ESBL-E strains, ESBL-EC was most frequently isolated (62 strains), followed by ESBL-KP (12 strains). In addition, blaCTX-M-15 was the most frequent ESBL gene type of the isolated ESBL-E strains. Conclusions: Our results revealed the high occurrence of ESBL-E carriage in pregnant women, especially those who were admitted to the hospitals.
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Affiliation(s)
| | - Miratul Hasanah
- Post-Graduate Master Program on Tropical Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Wahyu Setyarini
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Hari Parathon
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
| | - Koichi Kitagawa
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Noriko Nakanishi
- Department of Infectious Diseases, Kobe Institute of Health, Kobe, Japan
| | - Ryohei Nomoto
- Department of Infectious Diseases, Kobe Institute of Health, Kobe, Japan
| | - Kayo Osawa
- Department of Medical Technology, Kobe Tokiwa University, Kobe, Japan
| | - Shohiro Kinoshita
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Itaru Hirai
- Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Toshiro Shirakawa
- Division of Advanced Medical Science, Kobe University Graduate School of Science, Technology and Innovation, Kobe, Japan
| | - Kuntaman Kuntaman
- Department of Clinical Microbiology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Dr. Soetomo Academic General Hospital, Surabaya, Indonesia
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El Hamzaoui N, Barguigua A, Larouz S, Maouloua M. Epidemiology of burn wound bacterial infections at a Meknes hospital, Morocco. New Microbes New Infect 2020; 38:100764. [PMID: 33163199 PMCID: PMC7600360 DOI: 10.1016/j.nmni.2020.100764] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 09/13/2020] [Accepted: 09/14/2020] [Indexed: 11/24/2022] Open
Abstract
This study aimed to determine the prevalence of burn wound infection in the ward of Burns and Plastic Surgery at Mohammed V Hospital, Meknes, Morocco, and to determine the pathogenic bacterial species responsible for this infection as well as the susceptibility of these isolates to various antibiotics. Over the 1-year study period, 126 patients were admitted. The main sources of burns were flames (52.38%) and hot water (28.57%); 71% had burns with 11% to 40% burn surface and 48.41% had burns between 11% and 20% total burn surface. The mean ± SD duration of hospitalization was 22.15 ± 13.84 days after injury. Eighty-six patients were found to have at least one positive culture requiring treatment and were thus included in this study. The predominant bacteria isolated were Staphylococcus aureus (33.85%), followed by Pseudomonas spp. (18.46%), Acinetobacter baumannii (15.38%), Klebsiella pneumoniae (13.85%), Escherichia coli (8.46%) and Proteus mirabilis (4.42%). Disc-diffusion susceptibility testing indicated a high prevalence of resistance to various antimicrobial agents. Among the Staphylococcus aureus and Enterobacteriaceae strains isolated, 86.36% were methicillin resistant and 48.64% were extended-spectrum β-lactamase producers respectively.
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Affiliation(s)
- N El Hamzaoui
- Laboratory of Medical Microbiology, Mohammed V Hospital, Meknes, Morocco
| | - A Barguigua
- Laboratory of Biotechnology and Sustainable Development of Natural Resources, Polydisciplinary Faculty, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | - S Larouz
- Service of Burns and Plastic Surgery, Mohammed V Hospital, Meknes, Morocco
| | - M Maouloua
- Laboratory of Medical Microbiology, Mohammed V Hospital, Meknes, Morocco
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14
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Genomic and phylogenetic analysis of a community-acquired extended-spectrum β-lactamase-producing Escherichia coli ST429 strain recovered from a urinary tract infection. J Glob Antimicrob Resist 2020; 22:656-658. [PMID: 32619687 DOI: 10.1016/j.jgar.2020.06.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/06/2020] [Accepted: 06/12/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES Escherichia coli is one of the most prevalent bacterial pathogens causing urinary tract infections (UTIs). The increasing dissemination of extended-spectrum β-lactamase (ESBL)-producing E. coli in the community renders clinical treatment difficult. Here we report the complete genome sequence of a blaCTX-M-15-carrying E. coli strain (EC28) isolated from a urine sample of a female outpatient with UTI. METHODS The whole genome sequence of E. coli strain EC28 was determined using both a MinION™ sequencer and an Illumina NovaSeq 6000 system. De novo hybrid assembly of the short Illumina reads and long MinION reads was performed using Unicycler. Multilocus sequence typing (MLST), antimicrobial resistance genes (ARGs), plasmid replicons and phylogenetic relationship were analysed using the BacWGSTdb database. RESULTS The genome sequence of E. coli strain EC28 consists of six contigs comprising 5260 133 bp, including one chromosome and five plasmids. According to MLST analysis, EC28 belongs to ST429. Six ARGs were identified, including blaCTX-M-15 located on a 63,295-bp IncI2-type plasmid. Twenty-three phylogenetically related E. coli ST429 strains were identified in the NCBI GenBank database, none recovered from China. The closest relative was an isolate recovered from Japan in 2009 that differed by 146 cgMLST loci. CONCLUSION Here we report the first complete genome sequence of an ESBL-producing E. coli ST429 strain isolated from the community in China. The genome sequence of EC28 can be used as a reference sequence for comparative analysis, including acquisition and mobilisation of blaCTX-M genes in community-acquired E. coli strains.
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15
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Prevalence of extended-spectrum beta-lactamases in uropathogenic Enterobacteriaceae isolated from a community setting, Meknes, Morocco. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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16
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Malek Jamshidi MR, Zandi H, Eftekhar F. Correlation of quinolone-resistance, qnr genes and integron carriage in multidrug-resistant community isolates of Klebsiella spp. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2020; 22:1387-1391. [PMID: 32133055 DOI: 10.22038/ijbms.2019.13985] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objectives Plasmid-mediated quinolone resistance (PMQR) determinants and integrons have a considerable contribution to bacterial drug resistance in Gram-negative pathogens. We studied the prevalence of PMQR genes and integron carriage in multidrug-resistant community isolates of Klebsiella spp. Materials and Methods Two hundred and fifty Klebsiella spp. isolates were collected from outpatient specimens between August 2015 and October 2017 in Yazd central Laboratory, Iran. Antibiotic susceptibility was determined against 17 antibiotics and minimum inhibitory concentration (MIC) of ciprofloxacin was measured by E-test. Polymerase chain reaction (PCR) was employed for detection of qnrA, qnrB, qnrS, aac(6')-Ib-cr, oqxAB and qepA genes. Results Disc diffusion results showed that 17 isolates (6.8%) were multidrug resistant (MDR), two of which were Klebsiella oxytoca and 15 were Klebsiella pneumoniae. MIC measurements revealed 11 ciprofloxacin-resistant isolates (including the two K. oxytoca), three intermediately-resistant and three ciprofloxacin-susceptible isolates. All ciprofloxacin-resistant and intermediately-resistant isolates carried at least one and up to four PMQR genes. The most prevalent PMQR gene was oqxAB (93.75%) followed by aac(6')-ib-cr (50.0%), qnrB (25.0%) and qnrS (18.75%) but qnrA and qepA were not detected. Class 1 integron was observed in 14 (82.3%) isolates including nine ciprofloxacin-resistant, two intermediately-resistant, and three susceptible isolates. Class 2 and 3 integrons were not observed. Conclusion Presence of MDR, multiple PMQR determinants as well as class 1 integron in community isolates of Klebsiella spp. can be an important source of transmission of these opportunistic pathogens.
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Affiliation(s)
| | - Hengameh Zandi
- Department of Microbiology, Research Center for Food Hygiene and Safety, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Fereshteh Eftekhar
- Department of Microbiology, Faculty of Life Sciences and Technology, Shahid Beheshti University, Tehran, Iran
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17
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Onanuga A, Mahindroo J, Singh S, Taneja N. Phenotypic and molecular characterization of antimicrobial resistant Escherichia coli from urinary tract infections in Port-Harcourt, Nigeria. Pan Afr Med J 2019; 34:144. [PMID: 32010423 PMCID: PMC6969895 DOI: 10.11604/pamj.2019.34.144.18182] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 11/01/2019] [Indexed: 12/11/2022] Open
Abstract
Introduction Multidrug resistance among Escherichia coli causing Urinary Tract Infections (UTIs) is a major public health problem, threatening the effective treatment of UTIs. This study investigated the phenotypic and molecular characteristics of E. coli associated with UTIs in Port-Harcourt, Nigeria. Methods Twenty-five non-duplicate isolates of E. coli from UTIs patients at the University of Port-Harcourt Teaching Hospital, Nigeria were identified using Matrix-Assisted Laser Desorption Ionization Time-of-Flight (MALDI-TOF) Mass Spectrometry. The antimicrobial susceptibility patterns were determined using Kirby-Bauer disc diffusion technique. Phenotypic expression of Extended Spectrum Beta Lactamases (ESBLs) and AmpC beta-lactamase were determined using standard laboratory methods and polymerase chain reaction (PCR) was used to detect ESBLs, AmpC, Quinolones and Aminoglycosides resistance genes. Results The isolates exhibited high rates of resistance to co-trimoxazole (76%), nalidixic acid (68%), ciprofloxacin (60%), gentamicin (44%) and low resistance to cefotaxime (20%) but were fully susceptible to cefoperazone/sulbactam, amikacin, nitrofurantoin, colistin and carbapenems. Phenotypic expression of ESBLs was recorded in 6(24%) isolates while genotypic detection revealed the highest prevalence of blaTEM 22(88%), followed by blaCTX-M-15 16(64%), blaSHV 7(28%) and blaOXA-1 6(24%) while AmpC (blaCMY-2) gene was detected in 8(32%) isolates. Amongst the quinolone resistant isolates, qnr variants (qnrB, qnrD and qnrS) and aac(6')-Ib genes were detected in 7(28%) and 3(12%) isolates respectively while all gentamicin resistant isolates possessed the aacC2 gene. The co-expression of blaCTX-M-15 with quinolones and aminoglycoside genes were 20% and 40% respectively. The prevalence of multiple drug resistance was 52%. Conclusion A high proportion of the studied E. coli isolates co-expressed ESBLs, quinolones and aminoglycosides resistance genes which call for prompt antibiotic stewardship and preventive strategies to limit the spread of these genes.
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Affiliation(s)
- Adebola Onanuga
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.,Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaspreet Mahindroo
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shreya Singh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Yazdansetad S, Alkhudhairy MK, Najafpour R, Farajtabrizi E, Al-Mosawi RM, Saki M, Jafarzadeh E, Izadpour F, Ameri A. Preliminary survey of extended-spectrum β-lactamases (ESBLs) in nosocomial uropathogen Klebsiella pneumoniae in north-central Iran. Heliyon 2019; 5:e02349. [PMID: 31687535 PMCID: PMC6819946 DOI: 10.1016/j.heliyon.2019.e02349] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/03/2019] [Accepted: 08/16/2019] [Indexed: 02/07/2023] Open
Abstract
Infections caused by extended-spectrum β-lactamases (ESBLs) producing bacteria, including Klebsiella pneumoniae have increasingly subjected to therapeutic limitations and patients with these infections are at high risk for treatment failure, long hospital stays, high health care costs, and high mortality. The aim of this study was to screen the prevalence of the blaTEM,blaCTX-M and blaSHV ESBL genes in K. pneumoniae strains isolated from nosocomial urinary tract infections (UTIs). During the March 2016 to December 2017, one hundred isolates of K. pneumoniae were collected from urine specimens of patients suffering from nosocomial UTI referred to Khatam Al-Anbia hospital in Shahrud, north-central Iran. All isolates were identified by standard bacteriological tests. The pattern of antibiotic susceptibility was determined according to the CLSI guidelines. The presence of the ESBLs was investigated using the double-disc synergy test (DDST). Polymerase chain reaction technique was used to detect the blaTEM, blaCTX-M and blaSHV genes in DDST positive isolates. Most isolates showed remarkable resistance to tested antibiotics with highest rate against nitrofurantoin (75%) and trimethoprim/sulfamethoxazole (65%). The imipenem was the most effective antibiotic against K. pneumoniae isolates. ESBL phenotype was detected in 50 (50%) of isolates. The prevalence of blaTEM, blaCTX-M and blaSHV genes among 50 ESBLs-positive isolates was 25 (50%), 15 (30%) and 35 (70%) respectively. The blaTEM and blaSHV genes were seen in 25 isolates (50%) simultaneously. The findings of this study indicated the 50% frequency rate of ESBL-producing K. pneumoniae in our geographic region. Since the treatment of infections caused by this bacterium is associated with many limitations, this high prevalence is a warning sign to adopt new control policies to prevent further spread of this microorganism.
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Affiliation(s)
- Sajjad Yazdansetad
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Microbiology, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Miaad K. Alkhudhairy
- Community Health Department, College of Health and Medical Techniques, Al-Furat Al-Awsat Technical University, Kufa, Iraq
| | - Reza Najafpour
- Department of Microbiology, Qom Branch, Islamic Azad University, Qom, Iran
| | - Elika Farajtabrizi
- Department of Microbiology, Qom Branch, Islamic Azad University, Qom, Iran
| | - Reham M. Al-Mosawi
- Department of Microbiology, Dentistry College of Basic Science, Basrah University, Basrah, Iraq
| | - Morteza Saki
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Corresponding author.
| | - Elham Jafarzadeh
- Department of Laboratory Sciences, Taleghani Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farokh Izadpour
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Department of Microbiology, Emam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Atefeh Ameri
- Department of Laboratory Sciences, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Barguigua A, Rguibi Idrissi H, Nayme K, Timinouni M. Virulence and Antibiotic Resistance Patterns in E. coli, Morocco. ECOHEALTH 2019; 16:570-575. [PMID: 30895488 DOI: 10.1007/s10393-019-01404-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 12/22/2018] [Accepted: 01/18/2019] [Indexed: 06/09/2023]
Abstract
Of 28 non-duplicate isolates of Escherichia coli recovered from yellow-legged Larus michahellis in Morocco, 92.86% were resistant to more than three antibiotics and 71.4% were multidrug resistant. Phylogenetic group A was most predominant (57.14%), followed by B1 (18%), B2 (14.28%) and F (10.71%). One isolate was resistant to ertapenem and contained the blaOXA-48 gene. The plasmid-mediated quinolone resistance determinants were detected in nine isolates (aac(6')-Ib-cr, qnrS1, qnrB1). Thirteen isolates carried one of the Shiga toxin E. coli-associated genes: stx1 (n = 6), stx2 (n = 5) and eae (n = 2) genes. Our data support the idea that gull feces may create potential public health risk.
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Affiliation(s)
- Abouddihaj Barguigua
- Laboratory of Biotechnology and Sustainable Development of Natural Resources, Polydisciplinary Faculty, Sultan Moulay Slimane University, Bd Ibn Khaldoun, 23000, Beni Mellal, Morocco.
| | - Hamid Rguibi Idrissi
- Laboratory of Biodiversity, Ecology and Genome, Centre of Research "Plant and Microbial Biotechnology, Biodiversity and Environment, Faculty of Sciences, University Mohammed V, Rabat, Morocco
| | - Kaoutar Nayme
- Molecular Bacteriology Laboratory, Pasteur Institute of Morocco, 1, Place Louis Pasteur, 20360, Casablanca, Morocco
| | - Mohammed Timinouni
- Molecular Bacteriology Laboratory, Pasteur Institute of Morocco, 1, Place Louis Pasteur, 20360, Casablanca, Morocco
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Eghbalpoor F, Habibi M, Azizi O, Asadi Karam MR, Bouzari S. Antibiotic resistance, virulence and genetic diversity of Klebsiella pneumoniae in community- and hospital-acquired urinary tract infections in Iran. Acta Microbiol Immunol Hung 2019; 66:349-366. [PMID: 30803251 DOI: 10.1556/030.66.2019.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Klebsiella pneumoniae is among the most important causes of urinary tract infection (UTI). The aim of this study was to investigate the prevalence and correlation of antibiotic resistance with virulence characteristics and genetic diversity in K. pneumoniae isolated from UTIs in Iran. Phenotypic tests and antibiotic susceptibility were carried out on the isolates. Detection of the virulence and extended-spectrum β-lactamase (ESBL) genes was performed by polymerase chain reaction. Pulsed-field gel electrophoresis (PFGE) was used for exploring the genomic relatedness. Hemolysin, biofilm, and hypermucoviscosity formation were observed in 87.1%, 86.4%, and 12.1% of isolates, respectively. The antibiotic resistance rate of K. pneumoniae isolates ranged from 12.1% for meropenem to 100% for amoxicillin. The prevalence of virulence genes ranged from 1.4% for cnf-1 to 100% for mrkD, fimH, kpn, and entB genes. In this study, 91.7%, 33.3%, and 4.2% of phenotypically ESBL-producers were positive for blaCTX-M, blaTEM, and blaSHV genes, respectively. An association was observed between the presence of traT, fyuA, or cnf-1 genes with antibiotic resistance. Two clone types were obtained by PFGE that indicate different K. pneumoniae clones in community- and hospital-acquired UTIs. The findings of this study are valuable in development of treatment strategies against UTIs in Iran.
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Affiliation(s)
- Fatemeh Eghbalpoor
- 1 Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | - Mehri Habibi
- 1 Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | - Omid Azizi
- 2 Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | | | - Saeid Bouzari
- 1 Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
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21
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Pinto L, Torres C, Gil C, Nunes-Miranda JD, Santos HM, Borges V, Gomes JP, Silva C, Vieira L, Pereira JE, Poeta P, Igrejas G. Multiomics Assessment of Gene Expression in a Clinical Strain of CTX-M-15-Producing ST131 Escherichia coli. Front Microbiol 2019; 10:831. [PMID: 31130921 PMCID: PMC6509150 DOI: 10.3389/fmicb.2019.00831] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 04/01/2019] [Indexed: 12/28/2022] Open
Abstract
Extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli strain C999 was isolated of a Spanish patient with urinary tract infection. Previous genotyping indicated that this strain presented a multidrug-resistance phenotype and carried beta-lactamase genes encoding CTX-M-15, TEM-1, and OXA-1 enzymes. The whole-cell proteome, and the membrane, cytoplasmic, periplasmic and extracellular sub-proteomes of C999 were obtained in this work by two-dimensional gel electrophoresis (2DE) followed by fingerprint sequencing through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF/MS). A total of 602 proteins were identified in the different cell fractions, several of which are related to stress response systems, cellular responses, and antibiotic and drug responses, consistent with the multidrug-resistance phenotype. In parallel, whole genome sequencing (WGS) and RNA sequencing (RNA-Seq) was done to identify and quantify the genes present and expressing. The in silico prediction following WGS confirmed our strain as being serotype O25:H4 and sequence type ST131. The presence of proteins related to antibiotic resistance and virulence in an O25:H4-ST131 E. coli clone are serious indicators of the continued threat of antibiotic resistance spread amongst healthcare institutions. On a positive note, a multiomics approach can facilitate surveillance and more detailed characterization of virulent bacterial clones from hospital environments.
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Affiliation(s)
- Luís Pinto
- Department of Genetics and Biotechnology, School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Functional Genomics and Proteomics Unit, School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Veterinary Science Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Carmen Torres
- Área de Bioquímica y Biología Molecular, Universidad de La Rioja, Logroño, Spain
| | - Concha Gil
- Departamento de Microbiologia II, Facultad de Farmacia, Universidad Complutense de Madrid, Madrid, Spain
| | - Júlio D Nunes-Miranda
- Department of Genetics and Biotechnology, School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Functional Genomics and Proteomics Unit, School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Hugo M Santos
- LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - Vítor Borges
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
| | - João P Gomes
- Bioinformatics Unit, Department of Infectious Diseases, National Institute of Health, Lisbon, Portugal
| | - Catarina Silva
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal
| | - Luís Vieira
- Technology and Innovation Unit, Department of Human Genetics, National Institute of Health, Lisbon, Portugal
| | - José E Pereira
- Veterinary Science Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Patrícia Poeta
- Veterinary Science Department, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
| | - Gilberto Igrejas
- Department of Genetics and Biotechnology, School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Functional Genomics and Proteomics Unit, School of Life and Environment Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,LAQV-REQUIMTE, Faculty of Science and Technology, Nova University of Lisbon, Lisbon, Portugal
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22
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Mobasseri G, Teh CSJ, Ooi PT, Tan SC, Thong KL. Molecular Characterization of Multidrug-Resistant and Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolated from Swine Farms in Malaysia. Microb Drug Resist 2019; 25:1087-1098. [PMID: 30844323 DOI: 10.1089/mdr.2018.0184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aims: The high prevalence of multidrug resistance (MDR) and extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae associated with nosocomial infections has caused serious therapeutic challenges. The objectives of this study were to determine the genotypic and phenotypic characteristics of K. pneumoniae strains isolated from Malaysian swine farms and the transferability of ESBL genes by plasmids. Results: A total of 50 K. pneumoniae strains were isolated from 389 samples, which were collected from healthy and unhealthy pigs (swine rectum and oral cavities), healthy farmers (human rectum, urine, and nasal cavities), farm's environment, and animal feeds from seven Malaysian swine farms. Antimicrobial susceptibility analysis of these 50 K. pneumoniae strains showed that the majority (86%) were resistant to tetracycline, while 44% and 36% of these strains were MDR and ESBL producers, respectively. PCR and DNA sequencing of the amplicons showed the occurrence of blaTEM (15/18), blaSHV (15/18), blaCTX-M-1 group (7/18), and blaCTX-M-2 group (2/18), while only class 1 integron-encoded integrase was detected. Conjugation experiments and plasmid analysis indicated that the majority of the ESBL genes were plasmid encoded and the plasmids in 11 strains were conjugative. Genotyping by pulsed-field gel electrophoresis and repetitive extragenic palindrome-polymerase chain reaction (REP-PCR) showed that these 50 strains were genetically diverse with 44 pulsotypes and 43 REP-PCR subtypes. Conclusions: ESBL-producing K. pneumoniae strains showed high resistance to tetracycline as this antibiotic is used for prophylaxis and therapeutic purposes at the swine farms. The findings in this study have drawn attention to the issue of increasing MDR in animal husbandry and it should be taken seriously to prevent the spread and treatment failure due to antimicrobial resistance.
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Affiliation(s)
- Golnaz Mobasseri
- Faculty of Science, Institute of Biological Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peck Toung Ooi
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Shiang Chiet Tan
- Faculty of Science, Institute of Biological Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Kwai Lin Thong
- Faculty of Science, Institute of Biological Science, University of Malaya, Kuala Lumpur, Malaysia
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Asadi Karam MR, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Mol Immunol 2019; 108:56-67. [PMID: 30784763 DOI: 10.1016/j.molimm.2019.02.007] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 02/02/2019] [Accepted: 02/12/2019] [Indexed: 12/13/2022]
Abstract
Urinary tract infections (UTIs) are recognized as one of the most common infectious diseases in the world that can be divided to different types. Uropathogenic Escherichia coli (UPEC) strains are the most prevalent causative agent of UTIs that applied different virulence factors such as fimbriae, capsule, iron scavenger receptors, flagella, toxins, and lipopolysaccharide for their pathogenicity in the urinary tract. Despite the high pathogenicity of UPEC strains, host utilizes different immune systems such as innate and adaptive immunity for eradication of them from the urinary tract. The routine therapy of UTIs is based on the use of antibiotics such as β-lactams, trimethoprim, nitrofurantoin and quinolones in many countries. Unfortunately, the widespread and misuse of these antibiotics resulted in the increasing rate of resistance to them in the societies. Increasing antibiotic resistance and their side effects on human body show the need to develop alternative strategies such as vaccine against UTIs. Developing a vaccine against UTI pathogens will have an important role in reduction the mortality rate as well as reducing economic costs. Different vaccines based on the whole cells (killed or live-attenuated vaccines) and antigens (subunits, toxins and conjugatedvaccines) have been evaluated against UTIs pathogens. Furthermore, other therapeutic strategies such as the use of probiotics and antimicrobial peptides are considered against UTIs. Despite the extensive efforts, limited success has been achieved and more studies are needed to reach an alternative of antibiotics for treatment of UTIs.
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Affiliation(s)
| | - Mehri Habibi
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran, 13164, Iran.
| | - Saeid Bouzari
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran, 13164, Iran.
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24
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Brisola MC, Crecencio RB, Bitner DS, Frigo A, Rampazzo L, Stefani LM, Faria GA. Escherichia coli used as a biomarker of antimicrobial resistance in pig farms of Southern Brazil. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 647:362-368. [PMID: 30081373 DOI: 10.1016/j.scitotenv.2018.07.438] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 05/29/2018] [Accepted: 07/30/2018] [Indexed: 06/08/2023]
Abstract
The objective of this study was to verify the presence of antimicrobial resistant strains of Escherichia coli in pig farms and to use it as a biomarker to evaluate phenotypic and genotypic profiles of antimicrobial susceptibility, as well as the presence of Extended Spectrum Beta-lactamases (ESBLs) and fluoroquinolone resistance genes. Several samples (n = 306) collected from swine farms (n = 100) of Southern Brazil were used for E. coli isolation: 103 of swine feces, 105 of water, and 98 of soil. E. coli isolates were submitted to the disk-diffusion test to verify their antimicrobial susceptibility, to disk-approximation test to detect ESBL-producers, and to PCR analysis to search for ESBLs genes (blaCTY-M2, blaSHV-1, blaTEM-1, blaCTX-M2, blaOXA-1, blaPSE-1) and quinolone resistance genes (qnrA, qnrB and qnrS). The percentage of E. coli isolates found in feces, water and soil samples was 66.02%, 30.48% and 35.71%, respectively. The highest percentages of resistance were obtained for sulfamethoxazole associated with trimethoprim (63.70%), colistin (45.19%) and enrofloxacin (39.26%). Regarding the levels of multidrug resistance, 37.04% of the isolates were resistant to three or more classes of antimicrobials. The most common profile (16%) of multirresistance was GEM-SUT-ENO-COL. The index of multiple resistance to antimicrobials (IRMA) was above 0.2 in 78% of the multiresistant isolates. Out of 135 E. coli isolates, 7.41% was ESBL-producers, of which 50% showed the blaCMY-M2 gene, 40% the blaTEM-1 and 70% the qnrS gene. Of non-ESBL-producing strains resistant to enrofloxacin, 13.04% were positives for qnrS gene. These results demonstrated the presence of fecal contamination in the environment, in addition to high resistance indexes for several antimicrobials, including beta-lactams and fluoroquinolones, which was confirmed by the genetic detection of ESBLs and qnr genes.
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Affiliation(s)
- Maiara Cristiane Brisola
- Post Graduation Program in Animal Science, State University of Santa Catarina (UDESC), Western Center of Education, Chapecó, Santa Catarina, Brazil.
| | - Regiane Boaretto Crecencio
- Post Graduation Program in Animal Science, State University of Santa Catarina (UDESC), Western Center of Education, Chapecó, Santa Catarina, Brazil
| | - Dinael Simão Bitner
- Graduate in Animal Science, State University of Santa Catarina (UDESC), Western Center of Education, Chapecó, Santa Catarina, Brazil
| | - Angélica Frigo
- Graduate in Animal Science, State University of Santa Catarina (UDESC), Western Center of Education, Chapecó, Santa Catarina, Brazil
| | - Luana Rampazzo
- Graduate in Animal Science, State University of Santa Catarina (UDESC), Western Center of Education, Chapecó, Santa Catarina, Brazil
| | - Lenita Moura Stefani
- Department of Animal Science, State University of Santa Catarina (UDESC), Western Center of Education, Chapecó, Santa Catarina, Brazil
| | - Gláucia Amorim Faria
- Department of Mathematics, Paulista State University Júlio de Mesquita Filho (UNESP), Ilha Solteira, São Paulo, Brazil
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25
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The emergence of colistin-resistant Klebsiella pneumoniae strains from swine in Malaysia. J Glob Antimicrob Resist 2019; 17:227-232. [PMID: 30611928 DOI: 10.1016/j.jgar.2018.12.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Colistin is the last line of therapy for infections caused by multidrug-resistant Gram-negative bacteria. The objective of this study was to determine the phenotypic and genotypic characteristics of colistin-resistant Klebsiella pneumoniae (K. pneumoniae) isolated from swine samples in Malaysia. METHODS A total of 46 swine K. pneumoniae strains isolated from 2013-2015 in Malaysia were analysed for the production of extended-spectrum β-lactamases and carbapenemase. The resistance traits and genetic diversity of these strains were characterised by polymerase chain reaction, conjugation, plasmid analysis, and pulsed-field gel electrophoresis. RESULTS Nineteen of 46 strains were multidrug resistant while 13 were resistant to colistin. The majority of colistin-resistant strains harboured blaTEM gene (92.3%), followed by blaSHV (69.23%), blaCTXM-1 (38.46%), and blaMCR-1 (23.08%). All three colistin-resistant strains had transferable plasmids and the colistin resistance gene blaMCR-1. Genotyping by pulsed-field gel electrophoresis showed high genetic diversity among the K. pneumoniae and that the colistin-resistant K. pneumoniae strains were heterogenous. CONCLUSION It is believed that this is the first report of colistin-resistant K. pneumoniae among swine strains associated with mcr-1 plasmid in Malaysia. Due to the emergence of β-lactam, carbapenem and colistin resistance, the use of colistin in animal husbandry and agriculture should be avoided to prevent treatment failure.
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26
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Palmieri M, Schicklin S, Pelegrin AC, Chatellier S, Franceschi C, Mirande C, Park YJ, van Belkum A. Phenotypic and Genomic Characterization of AmpC-Producing Klebsiella pneumoniae From Korea. Ann Lab Med 2018; 38:367-370. [PMID: 29611388 PMCID: PMC5895867 DOI: 10.3343/alm.2018.38.4.367] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 11/14/2017] [Accepted: 02/09/2018] [Indexed: 11/21/2022] Open
Abstract
The prevalence of multidrug-resistant gram-negative bacteria has continuously increased over the past few years; bacterial strains producing AmpC β-lactamases and/or extended-spectrum β-lactamases (ESBLs) are of particular concern. We combined high-resolution whole genome sequencing and phenotypic data to elucidate the mechanisms of resistance to cephamycin and β-lactamase in Korean Klebsiella pneumoniae strains, in which no AmpC-encoding genes were detected by PCR. We identified several genes that alone or in combination can potentially explain the resistance phenotype. We showed that different mechanisms could explain the resistance phenotype, emphasizing the limitations of the PCR and the importance of distinguishing closely-related gene variants.
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Affiliation(s)
- Mattia Palmieri
- bioMérieux, Data Analytics Unit, La Balme Les Grottes, France
| | | | | | | | | | - Caroline Mirande
- bioMérieux, Clinical Unit, R&D Microbiology, La Balme Les Grottes, France
| | - Yeon Joon Park
- Department of Laboratory Medicine, College of Medicine, Catholic University of Korea, Seoul, Korea
| | - Alex van Belkum
- bioMérieux, Data Analytics Unit, La Balme Les Grottes, France.
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Liu X, Liu H, Wang L, Peng Q, Li Y, Zhou H, Li Q. Molecular Characterization of Extended-Spectrum β-Lactamase-Producing Multidrug Resistant Escherichia coli From Swine in Northwest China. Front Microbiol 2018; 9:1756. [PMID: 30123199 PMCID: PMC6085443 DOI: 10.3389/fmicb.2018.01756] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/13/2018] [Indexed: 11/26/2022] Open
Abstract
Objectives: The aim of the present study was to explore the prevalence and molecular characterization of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli collected from pig farms in Northwest China. Methods: Between May 2015 and June 2017, a total of 456 E. coli isolates were collected from fecal samples of healthy and diarrheal pigs in Northwest China to screen the ESBL producers. The β-lactamases, plasmid-mediated quinolone resistance (PMQR) genes and virulence genes among ESBL producers were corroborated by PCR and sequencing. Finally, ESBL producers were further grouped according to phylogenetic background and genetic relatedness. Results: Forty-four (9.6%) out of the 456 E. coli isolates were identified as ESBL-producing isolates. All ESBL producers exhibited multidrug resistance (MDR) phenotype, and more than 90% of the ESBL producers were resistant to amoxicillin, amoxicillin-clavulanic acid, oxytetracycline, enrofloxacin and sulfamethoxazole/trimethoprim. All ESBL producers harbored at least one type of β-lactamase, with blaCTX−M, blaTEM, blaSHV, blaOXA−48, and blaKPC−2 being detected in forty, thirty, seven, four, two and one isolates, respectively. Sequencing revealed the most common blaCTX−M subtype was blaCTX−M−14 (n = 24), followed by blaCTX−M−15 (n = 14), blaCTX−M−64 (n = 11), blaCTX−M−9 (n = 10) and blaCTX−M−123 (n = 9). qnrS (n = 23) was the predominant PMQR gene, and all PMQR genes were detected in co-existence with β-lactamase genes. estA (n = 18) and F4 (n = 18) were the most prevalent enterotoxin and fimbrial adhesin, respectively, and 27 different virotypes were found with respect to the association of enterotoxins and fimbrial adhesins. Twenty-four different sequence types (STs) were identified among 44 ESBL producers, and clones ST405, ST10 and ST648 were strongly present in more than one-third (34.1%) of ESBL producers. Conclusion: All ESBL-producing E. coli isolates exhibited MDR phenotype, and showed high prevalence of β-lactamase and PMQR genes. Especially, one isolate harbored ESBL genes blaTEM, blaSHV, blaCTX−M−9, blaCTX−M−14, blaCTX−M−64, and carbapenemase gene blaOXA−48 and blaKPC−2, as well as PMQR genes qnrS, qnrB, qnrD, qepA and aac(6')-Ib-cr.
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Affiliation(s)
- Xiaoqiang Liu
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Haixia Liu
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Le Wang
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Qian Peng
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Yinqian Li
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Hongchao Zhou
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
| | - Qinfan Li
- Department of Basic Veterinary, College of Veterinary Medicine, Northwest A&F University, Yangling, China
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Shahbazi S, Asadi Karam MR, Habibi M, Talebi A, Bouzari S. Distribution of extended-spectrum β-lactam, quinolone and carbapenem resistance genes, and genetic diversity among uropathogenic Escherichia coli isolates in Tehran, Iran. J Glob Antimicrob Resist 2018; 14:118-125. [PMID: 29581075 DOI: 10.1016/j.jgar.2018.03.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Antimicrobial resistance among uropathogenic Escherichia coli (UPEC) is increasing. The aim of this study was to evaluate antimicrobial resistance in UPEC isolates and its correlation with virulence factors. METHODS A total of 120 E. coli isolates were collected from patients with urinary tract infection in Tehran, Iran. Biofilm formation and antimicrobial susceptibility were determined by phenotypic tests. The combination disk diffusion test and modified Hodge test (MHT) were performed for phenotypic detection of extended-spectrum β-lactamases (ESBLs) and carbapenemases, respectively. PCR was used for the detection of virulence genes, ESBL-encoding genes, and quinolone (qnr) and carbapenem resistance genes. Pulsed-field gel electrophoresis (PFGE) was performed to explore the genetic relatedness among isolates. RESULTS Most isolates exhibited biofilm formation, and different frequencies of virulence genes were observed. There was a high rate of resistance, especially multidrug resistance, to most of the antimicrobial agents tested. Phenotypically, 67.5% of the isolates produced an ESBL and were resistant to different antimicrobial classes. In total, 83.3% of the isolates harboured ESBL genes, especially blaTEM and blaCTX-M, and 32.5% were positive for the quinolone resistance genes qnrS and qnrB. All isolates were negative for carbapenemases by the MHT and PCR. These results indicate the association between the presence of various virulence genes and antimicrobial susceptibility. PFGE analysis showed that there was great clonal diversity among the selected isolates, with 17 isolates divided into five clusters. CONCLUSIONS These results indicate that the high antimicrobial resistance among UPEC isolates is alarming and requires urgent attention.
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Affiliation(s)
- Shahla Shahbazi
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 13164, Iran
| | | | - Mehri Habibi
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 13164, Iran.
| | - Atefeh Talebi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Bouzari
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 13164, Iran.
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29
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Maleki N, Tahanasab Z, Mobasherizadeh S, Rezaei A, Faghri J. Prevalence of CTX-M and TEM β-lactamases in Klebsiella pneumoniae Isolates from Patients with Urinary Tract Infection, Al-Zahra Hospital, Isfahan, Iran. Adv Biomed Res 2018; 7:10. [PMID: 29456981 PMCID: PMC5812061 DOI: 10.4103/abr.abr_17_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Extended-spectrum β-lactamase (ESBL)-producing is a significant resistant mechanism to β-lactams in Enterobacteriaceae, especially in Klebsiella pneumoniae. The main objectives of this study were to genetically characterize urinary clinical isolates of K. pneumoniae through the investigating of blaTEM, blaCTX-M and using molecular typing by Enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) method. We also determined the frequency of antibiotic resistance of K. pneumoniae strains to characterize the β-lactamases included. Materials and Methods: A cross-sectional study was carried out to evaluate 98 strains of K. pneumoniae isolated from urine culture of outpatients referred to Al-Zahra Hospital, Isfahan, Iran. Antibiotic susceptibility testing was performed using Kirby–Bauer's method. Screening of ESBLs was carried out using double-disk screening test. PCR technique was performed to detect TEM and CTX-M genes. The total DNA of each strain was tested by ERIC-PCR. Results: In 98 K. pneumoniae studied clinical isolates, 25.5% were ESBL producing and 44.9% multidrug-resistant (MDR). From 25 ESBL isolates, 23 (92%) cases showed MDR phenotype. In ESBL producing isolates, 23 (92%) were blaCTX-M and 19 (76%) blaTEM positive. The antimicrobial drug susceptibilities of ESBL isolates indicated high resistant rates for cefotaxime and ceftazidime. All 25 ESBL producing isolates were resistant to cefotaxime. Complex patterns of fingerprints isolates showed that 36% of the isolates were belonged to the cluster no 5. Conclusion: This study revealed high antimicrobial resistance rates among ESBL isolates which can lead to various health difficulties. Epidemiological data collection from patients is recommended to develop the strategies to manage antibiotic resistance.
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Affiliation(s)
- Nafiseh Maleki
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Tahanasab
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sina Mobasherizadeh
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Aliakbar Rezaei
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jamshid Faghri
- Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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30
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Saravanan M, Ramachandran B, Barabadi H. The prevalence and drug resistance pattern of extended spectrum β–lactamases (ESBLs) producing Enterobacteriaceae in Africa. Microb Pathog 2018; 114:180-192. [DOI: 10.1016/j.micpath.2017.11.061] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
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Jena J, Debata NK, Sahoo RK, Gaur M, Subudhi E. Molecular characterization of extended spectrum β-lactamase-producing Enterobacteriaceae strains isolated from a tertiary care hospital. Microb Pathog 2017; 115:112-116. [PMID: 29274456 DOI: 10.1016/j.micpath.2017.12.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/08/2017] [Accepted: 12/19/2017] [Indexed: 12/30/2022]
Abstract
Infectious diseases caused by ESBL producing Enterobacteriaceae are an emerging problem worldwide which increases the empirical treatment failure, hospital cost, rate of morbidity and mortality. This also leads to the Hospital infection outbreak. Present study was undertaken to determine the frequency of blaTEM, blaCTX-M and blaSHV genes among Enterobacteriaceae. A total of 751 non-repeated clinical isolates of Enterobacteriaceae family were included in this study. Antibiotic susceptibility test was done and minimal inhibitory concentration (MIC) against four antibiotics was carried out. Five hundred fifteen multi drug resistant isolates were tested for ESBL by CLSI confirmatory method. Isolates showing ESBL positive by phenotypic method were screened for blaTEM, blaCTX-M and blaSHV genes by monoplex PCR. Two blaTEM and two blaCTX-M amplified products were selected randomly for sequencing. Sequencing data was submitted to NCBI data base. Of the 515 MDR isolates, 140 showed ESBL production by phenotypic method. All the ESBL producing isolates showed resistant to ceftazidime (100%). IMP, TGC and CL drugs could be preferred for the treatment of ESBL producers as these drugs showed a lower rate of resistance. blaTEM gene was the predominant (96.42%) followed by blaCTX-M (75%) and blaSHV (17.85%). All the three bla genes were occurred in 22 (17.14%) isolates. All the phenotypically confirmed ESBL producers were found contain any one of the three bla genes. It is concluded from the study that the blaTEM was predominantly found in Enterobacteriaceae and blaCTX-M gene also seemed to emerging.
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Affiliation(s)
- Jayanti Jena
- Department of Microbiology, IMS & SUM Hospital, Siksha 'O' Anusandhan deemed to be University, India
| | - Nagen Kumar Debata
- Department of Microbiology, IMS & SUM Hospital, Siksha 'O' Anusandhan deemed to be University, India
| | - Rajesh Kumar Sahoo
- Centre for Biotechnology, Siksha 'O' Anusandhan deemed to be University, India
| | - Mahendra Gaur
- Centre for Biotechnology, Siksha 'O' Anusandhan deemed to be University, India
| | - Enketeswara Subudhi
- Centre for Biotechnology, Siksha 'O' Anusandhan deemed to be University, India.
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Aljanaby AAJ, Alhasnawi HMRJ. Phenotypic and Molecular Characterization of Multidrug Resistant Klebsiella pneumoniae Isolated from Different Clinical Sources in Al-Najaf Province-Iraq. Pak J Biol Sci 2017; 20:217-232. [PMID: 29023034 DOI: 10.3923/pjbs.2017.217.232] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND OBJECTIVE Burns infections and urinary tract infections are the most important prevalent diseases in Asian countries, such as Iraq. Klebsiella pneumoniae is one of the most important bacteria cause this type of infections especially in hospitals. Therefore, the aim of this study was to investigate the prevalence of multi-drug resistance K. pneumoniae and extended-spectrum beta-lactamases producing K. pneumoniae isolates from inpatients with urinary tract infection and burns infections in Al-Kufa hospital in Al-Najaf province, Iraq. MATERIALS AND METHODS A total of 285 clinical samples were collected from in-patients infected with urinary tract infection (141 urine samples) and burns infections (144 burns swabs). Fourteen different antibiotics were used by disc diffusion method and 13 antimicrobials resistance genes were used by PCR technique. RESULTS A total of 43 K. pneumoniae strains were isolated. The highest resistance rate was observed for amoxicillin 25 μg and amoxicillin+clavulanic acid 20+10 μg (97.67%) while the lowest resistance rate was observed for imipenem 10 μg (9.30%). The most common resistance associated-genes were blaSHV (86.04%) and at lower prevalence were IMP (9.30%). CONCLUSION Klebsiella pneumoniae strains isolated from burns infections were more virulent than those isolated from urinary tract infections.
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Kim YJ, Moon JS, Oh DH, Chon JW, Song BR, Lim JS, Heo EJ, Park HJ, Wee SH, Sung K. Genotypic characterization of ESBL-producing E. coli from imported meat in South Korea. Food Res Int 2017; 107:158-164. [PMID: 29580473 DOI: 10.1016/j.foodres.2017.12.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/04/2017] [Accepted: 12/08/2017] [Indexed: 11/26/2022]
Abstract
Twenty extended-spectrum β-lactamase (ESBL)-producing E. coli strains were isolated from imported meat in South Korea. ESBL strains of E. coli were detected in chicken (14/20) more often than in pork (6/20) and beef (0/20); the highest number (12/20) was detected in Brazilian meats. The blaCTX-M genes were predominant in meats from many countries. E. coli from pork imported from France produced the blaCTX-M-58 enzyme, which has never been documented previously in ESBL-producing bacteria from clinical or environmental sources. Additionally, the coexistence of the blaCTX-M-2 and blaOXA-1 enzymes in EC12-5 isolate was found for the first time in an ESBL E. coli isolate. A rare blaCTX-M type, blaCTX-M-25, was found in 40% of ESBL E. coli isolates. Phenotypic susceptibility testing showed that E. coli isolates were resistant to up to eleven antibiotics, including ciprofloxacin. For the first time, a new combination in an integron gene cassette, aacA4-cmlA6-qacEΔ1, was found in an E. coli isolate from poultry imported from Brazil. Three E. coli ST117 isolates, from an avian pathogenic lineage producing CTX-M-94, harbored fimH, fyuA, iutA, papC, rfc, and traT virulence genes and were not susceptible to quinolones. For the first time, rfc and papG virulence factors were detected in ESBL E. coli strains isolated from meat products. Even though E. coli CC21 and CC22 were obtained from meats from the USA and Brazil, respectively, they had a similarity coefficient higher than 99% in rep-PCR and the same MLST type (ST117), phenotypic antibiotic resistance pattern, integron gene (qacEΔ1), and plasmid DNA profile. This study indicates that imported meat products may be a source of ESBL-producing E. coli strains in South Korea.
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Affiliation(s)
- Young-Jo Kim
- Ministry of Food and Drug Safety, Chungcheongbuk-do, Republic of Korea
| | - Jin-San Moon
- Animal and Plant Quarantine Agency, Gyeongsangbuk-do, Republic of Korea
| | - Deog-Hwan Oh
- Department of Food Science and Biotechnology, Kangwon National University, Chuncheon, Republic of Korea
| | - Jung-Whan Chon
- Division of Microbiology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR, USA
| | - Bo-Ra Song
- Ministry of Food and Drug Safety, Chungcheongbuk-do, Republic of Korea
| | - Jong-Su Lim
- Animal and Plant Quarantine Agency, Gyeongsangbuk-do, Republic of Korea
| | - Eun-Jeong Heo
- Ministry of Food and Drug Safety, Chungcheongbuk-do, Republic of Korea
| | - Hyun-Jung Park
- Ministry of Food and Drug Safety, Chungcheongbuk-do, Republic of Korea
| | - Sung-Hwan Wee
- Animal and Plant Quarantine Agency, Gyeongsangbuk-do, Republic of Korea
| | - Kidon Sung
- Division of Microbiology, National Center for Toxicological Research, US Food and Drug Administration, Jefferson, AR, USA.
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Chen CM, Ke SC, Li CR, Wu YC, Chen TH, Lai CH, Wu XX, Wu LT. High Diversity of Antimicrobial Resistance Genes, Class 1 Integrons, and Genotypes of Multidrug-ResistantEscherichia coliin Beef Carcasses. Microb Drug Resist 2017; 23:915-924. [DOI: 10.1089/mdr.2016.0223] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Chih-Ming Chen
- Department of Health Food, Chung Chou University of Science and Technology, Changhua, Taiwan
- Department of Internal Medicine, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Se-Chin Ke
- Infection Control Office, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Chia-Ru Li
- Department of Medical Research, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Ying-Chen Wu
- Graduate Institute of Veterinary Pathology, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ter-Hsin Chen
- Graduate Institute of Veterinary Pathology, College of Veterinary Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Chih-Ho Lai
- Institute of Basic Medical Science, School of Medicine, China Medical University and Hospital, Taichung, Taiwan
- Department of Microbiology and Immunology, Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Xin-Xia Wu
- Department of Microbiology, The Institute of Medical Science, China Medical University Hospital, Taichung, Taiwan
| | - Lii-Tzu Wu
- Department of Microbiology, The Institute of Medical Science, China Medical University Hospital, Taichung, Taiwan
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Liu Y, Yang Y, Chen Y, Xia Z. Antimicrobial resistance profiles and genotypes of extended-spectrum β-lactamase- and AmpC β-lactamase-producing Klebsiella pneumoniae isolated from dogs in Beijing, China. J Glob Antimicrob Resist 2017; 10:219-222. [DOI: 10.1016/j.jgar.2017.06.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/09/2017] [Accepted: 06/09/2017] [Indexed: 11/30/2022] Open
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El-Badawy MF, Tawakol WM, Maghrabi IA, Mansy MS, Shohayeb MM, Ashour MS. Iodometric and Molecular Detection of ESBL Production Among Clinical Isolates ofE. coliFingerprinted by ERIC-PCR: The First Egyptian Report Declares the Emergence ofE. coliO25b-ST131clone HarboringblaGES. Microb Drug Resist 2017; 23:703-717. [DOI: 10.1089/mdr.2016.0181] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mohamed F. El-Badawy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Misr University for Science and Technology, Cairo, Egypt
- Department of Pharmaceutical Microbiology, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Wael M. Tawakol
- Department of Microbiology and Immunology, Faculty of Pharmacy, Misr University for Science and Technology, Cairo, Egypt
| | - Ibrahim A. Maghrabi
- Department of Clinical Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Moselhy S. Mansy
- Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
| | - Mohamed M. Shohayeb
- Department of Pharmaceutical Microbiology, College of Pharmacy, Taif University, Taif, Saudi Arabia
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Mohammed S. Ashour
- Department of Microbiology and Immunology, Faculty of Pharmacy, Al-Azhar University, Cairo, Egypt
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Mahanti A, Ghosh P, Samanta I, Joardar SN, Bandyopadhyay S, Bhattacharyya D, Banerjee J, Batabyal S, Sar TK, Dutta TK. Prevalence of CTX-M-Producing Klebsiella spp. in Broiler, Kuroiler, and Indigenous Poultry in West Bengal State, India. Microb Drug Resist 2017; 24:299-306. [PMID: 28829687 DOI: 10.1089/mdr.2016.0096] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study was undertaken to detect the prevalence of CTX-M-producing Klebsiella spp. in healthy broiler, indigenous, and kuroiler birds reared in West Bengal (India) during November 2014-February 2015. In addition to CTX-M gene, the study was also conducted to reveal the occurrence of other β-lactamase and class I integron genes in Klebsiella spp. isolates along with their clonal relationship. A total of 321 cloacal swabs from healthy broiler, indigenous, and kuroiler birds were collected from different places of West Bengal, India. Klebsiella spp. isolation rate varies among different types of poultry birds (43.8-72.3%). In total, 33 (10.7%) Klebsiella spp. isolates were detected phenotypically as CTX-M producers and all the isolates possessed blaCTX-M in polymerase chain reaction. Whereas 17 (51.5%) and 16 (48.5%) Klebsiella spp. isolates possessed blaSHV, and blaTEM with blaCTX-M, respectively. None of the CTX-M-producing Klebsiella spp. isolates in this study possessed class I integron gene. Randomly amplified polymorphic DNA-based phylogenetic tree revealed the presence of clonal relationship among the CTX-M-producing Klebsiella spp. isolates, recovered from broilers and indigenous birds. This study identified broilers and indigenous game birds as a potential reservoir of CTX-M-producing Klebsiella spp., which could be transmitted to the human food chain directly or indirectly.
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Affiliation(s)
- Achintya Mahanti
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Pratik Ghosh
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Indranil Samanta
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Siddhartha Narayan Joardar
- 1 Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | | | | | - Jaydeep Banerjee
- 2 Eastern Regional Station, Indian Veterinary Research Institute , Kolkata, India
| | - Subhasis Batabyal
- 3 Department of Veterinary Biochemistry, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Tapas Kumar Sar
- 4 Department of Veterinary Pharmacology and Toxicology, West Bengal University of Animal and Fishery Sciences , Kolkata, India
| | - Tapan Kumar Dutta
- 5 Department of Veterinary Microbiology, Central Agricultural University , Aizawl, India
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Jena J, Sahoo RK, Debata NK, Subudhi E. Prevalence of TEM, SHV, and CTX-M genes of extended-spectrum β-lactamase-producing Escherichia coli strains isolated from urinary tract infections in adults. 3 Biotech 2017; 7:244. [PMID: 28710743 DOI: 10.1007/s13205-017-0879-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Accepted: 07/09/2017] [Indexed: 10/19/2022] Open
Abstract
Urinary tract infections (UTIs) are one of the major sources of widespread infectious diseases in the community as well as in the hospitals which increase the cause of morbidity and mortality. Prevalence of extended-spectrum-β-lactamase (ESBL)-producing uropathogenic E. coli isolates has been found to be increased rapidly across the world. The present study was undertaken to find out the frequency of bla TEM, bla CTX-M, and bla SHV genes among E. coli isolates from UTI and detect their sensitivity pattern. A total of 112 non-repeated E. coli isolates obtained from urine samples of UTI diagnosed patients were included in this study. Antibiotic susceptibility test was done by disc diffusion method. Seventy seven (68.75%) isolates were MDR and tested for ESBL. ESBL-positive isolates were screened for bla TEM, bla CTX-M, and bla SHV genes by monoplex PCR (polymerase chain reaction). Among 46 ESBL-producing E. coli isolates, 8.69% harboured all the three bla genes. The bla TEM was the predominant (93.47%) gene followed by bla CTX-M (82.6%) and bla SHV (4.34%). It can be concluded that the prevalence of MDR (multidrug resistance) ESBL-producing E. coli appears to be high and the highest identified gene was bla TEM. The knowledge of resistance pattern can help physician's select suitable empirical antibiotic regimens, so that antibiotics showing high-resistance pattern can be avoided.
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Genetic Determinants of Antibiotic Resistance in Hospital and Community Isolates of Klebsiella pneumoniae and Escherichia coli. Jundishapur J Microbiol 2017. [DOI: 10.5812/jjm.45678] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Dalhoff A, Schubert S, Vente A. Pharmacodynamics of Finafloxacin, Ciprofloxacin, and Levofloxacin in Serum and Urine against TEM- and SHV-Type Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Isolates from Patients with Urinary Tract Infections. Antimicrob Agents Chemother 2017; 61:e02446-16. [PMID: 28193648 PMCID: PMC5404535 DOI: 10.1128/aac.02446-16] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/31/2017] [Indexed: 12/17/2022] Open
Abstract
The pharmacodynamics of finafloxacin, ciprofloxacin, and levofloxacin against extended-spectrum-β-lactamase (ESBL)-producing Enterobacteriaceae isolates were compared. Since quinolones lose activity in acidic media, and particularly in urine, their activities were tested in parallel under conventional conditions and in acidic artificial urine. For this purpose, TEM- and SHV-type ESBL-producing Escherichia coli and Klebsiella pneumoniae strains and their wild-type counterparts were exposed in a modified Grasso model to simulated concentrations of drugs in serum and urine following oral doses of either finafloxacin at 800 mg once a day (q.d.), immediate-release ciprofloxacin at 500 mg twice a day (b.i.d.), extended-release ciprofloxacin at 1,000 mg q.d., or levofloxacin at 500 or 750 mg q.d. The concentrations of the drugs in urine were fitted by compartmental modeling. Bacteria were cultivated in Mueller-Hinton broth (MHB) at pH 7.2 or 5.8 or in artificial urine at pH 5.8. Bacteria were counted every 2 h until 10 h and at 24 h; the areas under the bacterial-count-versus-time curves were calculated. It was found that finafloxacin eliminated all strains within 2 h under all the conditions studied. At all doses studied, ciprofloxacin and levofloxacin were highly active against wild-type strains in MHB at pH 7.2 but lost activity in MHB, and particularly in urine, at pH 5.8. Viable counts of ESBL producers were reduced for 6 to 8 h by 3 log10 titers, but the bacteria regrew thereafter. Ciprofloxacin and levofloxacin were almost inactive against the SHV producer grown in artificial urine. We conclude that pharmacodynamic models using artificial urine may mirror the physiology of urinary tract infections more closely than those using conventional media. In contrast to ciprofloxacin and levofloxacin, finafloxacin gained activity in this model at an acidic pH, maintained activity in artificial urine, and was active against TEM and SHV producers.
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Affiliation(s)
- A Dalhoff
- University Hospital Kiel, Institute for Infection Medicine, Kiel, Germany
| | - S Schubert
- University Hospital Kiel, Institute for Infection Medicine, Kiel, Germany
| | - A Vente
- MerLion Pharmaceuticals, Berlin, Germany
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Sharma B, Parul, Verma AK, Jain U, Yadav JK, Singh R, Mishra R. Occurrence of multidrug resistant Escherichia coli in groundwater of Brij region (Uttar Pradesh) and its public health implications. Vet World 2017; 10:293-301. [PMID: 28435191 PMCID: PMC5387656 DOI: 10.14202/vetworld.2017.293-301] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 01/26/2017] [Indexed: 01/22/2023] Open
Abstract
AIM The study evaluates the microbial as well as physicochemical pollution of groundwater of Brij region of Uttar Pradesh, a major tourist destination in the country along with estimating the drug resistance evident in the isolated Escherichia coli. MATERIALS AND METHODS A total of 60 samples of groundwater were collected from six different sites and assessed for physicochemical (pH, color, taste, turbidity, total dissolved solids [TDS], total hardness [TH], chlorides, fluorides, nitrates, and iron) and microbiological parameters (standard plate count [SPC], most probable number test [MPN], E. coli). RESULTS A majority of the samples were found to be out of the range for most of the parameters except iron. Particularly, high values of TDS (up to 9000 ppm), TH (1500 mg/L), chlorides (3250 mg/L), fluorides (2.5 mg/L), and nitrates (100.2 mg/L) were observed at most of the sites in the region highlighting the fact that groundwater of the area is not potable. Samples were turbid and salty to taste. High SPC values, up to 3500 colony-forming unit/ml and coliforms beyond BIS range were found in 40% samples suggesting gross microbial contamination. Only 2 sites (G3 and G5) had low MPN values. Overall 16 (26.67%) E. coli were isolated with 3 (18.75%) producing red colonies on conge red agar, hence supposed to be pathogenic. No E. coli O157:H7 was isolated. High antimicrobial resistance was observed against amoxicillin and erythromycin, whereas E. coli isolates were sensitive toward cefotaxime-clavulanic acid and imipenem. 12 isolates (75%) were multidrug resistant (MDR) with MDR index >20%, and 2 isolates (12.5%) were found to be extended spectrum beta-lactamases positive. CONCLUSION Groundwater is considered to be a safe option for potable water but it is obvious from the findings of this study that considerable physicochemical and microbial contamination is there in groundwater samples of Brij region. The occurrence of MDR E. coli in these waters is a matter of great public health concern.
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Affiliation(s)
- Barkha Sharma
- Department of Epidemiology and Preventive Veterinary Medicine, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
| | - Parul
- Department of Veterinary Public Health, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
| | - A. K. Verma
- Department of Epidemiology and Preventive Veterinary Medicine, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
| | - Udit Jain
- Department of Veterinary Public Health, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
| | - Janaradan K. Yadav
- Department of Veterinary Public Health, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
| | - Ravneet Singh
- Department of Veterinary Public Health, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
| | - Raghvendra Mishra
- Department of Veterinary Public Health, College of Veterinary Science and Animal Husbandry, UP Pt Deen Dayal Upadhyay Veterinary University, Mathura - 281 001, Uttar Pradesh, India
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Nayme K, Barguigua A, Bouchrif B, Karraouan B, El Otmani F, Elmdaghri N, Zerouali K, Timinouni M. Genotypic characterization of quinolone resistant-Escherichia coli isolates from retail food in Morocco. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART. B, PESTICIDES, FOOD CONTAMINANTS, AND AGRICULTURAL WASTES 2017; 52:107-114. [PMID: 28099089 DOI: 10.1080/03601234.2016.1239985] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 08/24/2016] [Indexed: 06/06/2023]
Abstract
This study was conducted to assess the retail food as a possible vehicle for antimicrobial resistant, particularly quinolones resistant and pathogenic Escherichia coli. We determined the prevalence and characteristics of nalidixic acid (Nal) resistant E. coli isolates from diverse retail food samples. In all, 70 (28%) of 250 E. coli isolates studied were Nal-resistant E. coli and 91% of these were multi-drug resistant. Plasmid mediated quinolone resistance genes were identified in 32 isolates, including aac(6')-Ib-cr (n = 16), qnrS1 (n = 11) and qnrB19 (n = 7). Mutations in gyr A and par C genes were detected among 80% of the isolates, and the isolates showed substitution Ser83-Leu and Asp87-Asn in gyrA and Ser80-Ile in parC. In addition, three different gene cassettes were identified (aadA1, aadA7, aac(3)-Id) in 18%. Virulence-associated genes stx1, eae, sfa, hlyA and stx2 were found in six (8%), three (4%), two (3%), three (4%) and three (4%) isolates, respectively. E. coli isolates of phylogenetic group A were dominant (64%, 45/70). Pulsed field gel electrophoresis revealed none epidemiological relationship between these isolates. The results of this work report the higher frequency of Nal-resistant E. coli isolates from Moroccan retail food samples including MDR and pathogenic isolates.
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Affiliation(s)
- Kaotar Nayme
- a Molecular Bacteriology Laboratory, Institut Pasteur du Maroc , Casablanca , Morocco
- b Microbiology Laboratory, Faculty of Medicine and Pharmacy, University Hassan II , Casablanca , Morocco
| | - Abouddihaj Barguigua
- c Faculty of Medicine and Pharmacy, University Sultan Moulay Slimane , Beni Mellal , Morocco
| | - Brahim Bouchrif
- d Food Microbiology Laboratory, Institut Pasteur du Maroc , Casablanca , Morocco
| | - Bouchra Karraouan
- e Microbiology, Health and Environment Team Research, Department of Biology , Faculty of Sciences, ChouaibDoukkali University , El Jadida , Morocco
| | | | - Naima Elmdaghri
- a Molecular Bacteriology Laboratory, Institut Pasteur du Maroc , Casablanca , Morocco
- b Microbiology Laboratory, Faculty of Medicine and Pharmacy, University Hassan II , Casablanca , Morocco
- f University Hospital Center Ibn Rochd , Casablanca , Morocco
| | - Khalid Zerouali
- b Microbiology Laboratory, Faculty of Medicine and Pharmacy, University Hassan II , Casablanca , Morocco
- f University Hospital Center Ibn Rochd , Casablanca , Morocco
| | - Mohammed Timinouni
- a Molecular Bacteriology Laboratory, Institut Pasteur du Maroc , Casablanca , Morocco
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Arhoune B, Oumokhtar B, Hmami F, Barguigua A, Timinouni M, El Fakir S, Chami F, Bouharrou A. Rectal carriage of extended-spectrum β-lactamase- and carbapenemase-producing Enterobacteriaceae among hospitalised neonates in a neonatal intensive care unit in Fez, Morocco. J Glob Antimicrob Resist 2016; 8:90-96. [PMID: 28039104 DOI: 10.1016/j.jgar.2016.11.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/31/2016] [Accepted: 11/06/2016] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the faecal carriage and molecular epidemiology of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBLE) isolated from rectal samples of neonates hospitalised in a neonatal intensive care unit (NICU) of a university hospital in Fez, Morocco. METHODS From February-July 2013, all neonates hospitalised in the NICU were screened for ESBLE carriage at discharge. ESBLs were identified by double-disk synergy test, PCR and DNA sequencing analysis. ESBLE were analysed by pulsed-field gel electrophoresis (PFGE), and conjugation was performed by the broth mating method. RESULTS In this study, 169 Enterobacteriaceae were collected from 164 neonates. The prevalence of faecal carriage of ESBLE was 58.0% (98/169), predominantly Klebsiella pneumoniae (65/98; 66.3%). A high rate of multiresistance in ESBLE was noted. blaCTX-M-1 group (78.5%) was the most frequent ESBL gene detected, and all isolates harboured the CTX-M-15 variant. The prevalence of carbapenemase-producing Enterobacteriaceae was 1.8%, and blaOXA-48 was the only gene found in these isolates. Sequencing revealed subgroups corresponding to bla(CTX-M-15,TEM-1,TEM-104,SHV-1,SHV-44,SHV-49andSHV-133) genes. Conjugation experiments showed the transferability of blaCTX-M-15 and blaTEM, but not blaSHV. These genes were carried by a high-molecular-weight conjugative plasmid (ca. 125kb). PFGE profiles demonstrated high clonal dissemination of ESBL-positive strains in the NICU. CONCLUSIONS These results demonstrate the existence of high clonal transmission of ESBLE in a Moroccan NICU. This finding provides useful information to implement a screening policy for resistant Enterobacteriaceae among neonates hospitalised in this ward.
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Affiliation(s)
- Btissam Arhoune
- Faculty of Medicine, Sidi Mohammed Ben Abdellah University, Fez, Morocco; Faculty of Sciences Dhar El Mahraz, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Bouchra Oumokhtar
- Faculty of Medicine, Sidi Mohammed Ben Abdellah University, Fez, Morocco.
| | - Fouzia Hmami
- Faculty of Medicine, Sidi Mohammed Ben Abdellah University, Fez, Morocco; Neonatal Intensive Care Unit, University Hospital Hassan II, Fez, Morocco
| | - Abouddihaj Barguigua
- Research Department, Pasteur Institute of Morocco, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Sultan Moulay Slimane University, Beni Mellal, Morocco
| | | | - Samira El Fakir
- Faculty of Medicine, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Fouzia Chami
- Faculty of Sciences Dhar El Mahraz, Sidi Mohammed Ben Abdellah University, Fez, Morocco
| | - Abdelhak Bouharrou
- Faculty of Medicine, Sidi Mohammed Ben Abdellah University, Fez, Morocco; Neonatal Intensive Care Unit, University Hospital Hassan II, Fez, Morocco
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Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Strains Isolated from Children with Urinary Tract Infections. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2016. [DOI: 10.5812/pedinfect.39000] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Latifpour M, Gholipour A, Damavandi MS. Prevalence of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolates in Nosocomial and Community-Acquired Urinary Tract Infections. Jundishapur J Microbiol 2016; 9:e31179. [PMID: 27226874 PMCID: PMC4877671 DOI: 10.5812/jjm.31179] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 12/23/2015] [Accepted: 01/12/2016] [Indexed: 12/02/2022] Open
Abstract
Background Klebsiella pneumoniae is a family member of Enterobacteriaceae. Isolates of K. pneumoniae produce enzymes that cause decomposition of third generation cephalosporins. These enzymes are known as extended-spectrum beta-lactamase (ESBL). Resistance of K. pneumoniae to beta-lactamase antibiotics is commonly mediated by beta-lactamase genes. Objectives The aim of this study was to identify the ESBL produced by K. pneumoniae isolates that cause community-acquired and nosocomial urinary tract infections within a one-year period (2013 to 2014) in Kashani and Hajar university hospitals of Shahrekord, Iran. Patients and Methods From 2013 to 2014, 150 strains of K. pneumoniae isolate from two different populations with nosocomial and community-acquired infections were collected. The strains were then investigated by double disk synergism and multiplex polymerase chain reaction (PCR). Results The study population of 150 patients with nosocomial and community-acquired infections were divided to two groups of 75 each. We found that 48 of the K. pneumoniae isolates in the patients with nosocomial infection and 39 isolates in those with community-acquired infections produced ESBL. The prevalence of TEM1, SHV1 and VEB1 in ESBL-producing isolates in nosocomial patients was 24%, 29.3% and 10.6%, and in community-acquired patients, 17.3%, 22.7% and 8%, respectively. Conclusions The prevalence of ESBL-producing K. pneumoniae isolate is of great concern; therefore, continuous investigation seems essential to monitor ESBL-producing bacteria in patients with nosocomial and community-acquired infections.
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Affiliation(s)
- Mohammad Latifpour
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
| | - Abolfazl Gholipour
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
- Corresponding author: Abolfazl Gholipour, Department of Microbiology and Immunology, Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran, E-mail:
| | - Mohammad Sadegh Damavandi
- Department of Microbiology and Immunology, Cellular and Molecular Research Center, Shahrekord University of Medical Sciences, Shahrekord, IR Iran
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Tillekeratne LG, Vidanagama D, Tippalagama R, Lewkebandara R, Joyce M, Nicholson BP, Nagahawatte A, Bodinayake CK, De Silva AD, Woods CW. Extended-spectrum ß-Lactamase-producing Enterobacteriaceae as a Common Cause of Urinary Tract Infections in Sri Lanka. Infect Chemother 2016; 48:160-165. [PMID: 27704730 PMCID: PMC5047996 DOI: 10.3947/ic.2016.48.3.160] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 05/17/2016] [Accepted: 05/23/2016] [Indexed: 11/24/2022] Open
Abstract
Background Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasingly reported as pathogens in urinary tract infections (UTIs). However, in Sri Lanka, the clinical and molecular epidemiology of ESBL-PE implicated in UTIs has not been well described. Materials and Methods We conducted prospective, laboratory-based surveillance from October to December 2013 at a tertiary care hospital in southern Sri Lanka and enrolled patients ≥1 year of age with clinically relevant UTIs due to ESBL-PE. Isolate identity, antimicrobial drug susceptibility, and ESBL production were determined. Presence of ß-lactamase genes, blaSHV, blaTEM, and blaCTX-M, was identified by polymerase chain reaction. Results During the study period, Enterobacteriaceae were detected in 184 urine samples, with 74 (40.2%) being ESBL producers. Among 47 patients with ESBL-PE who had medical records available, 38 (80.9%) had clinically significant UTIs. Most UTIs (63.2%) were community acquired and 34.2% were in patients with diabetes. Among 36 cultured ESBL-PE isolates, significant susceptibility (>80%) was only retained to amikacin and the carbapenems. The group 1 blaCTX-M gene was present in 90.0% of Escherichia coli isolates and all Klebsiella pneumoniae and Enterobacter cloacae isolates. The blaSHV and blaTEM genes were more common in K. pneumoniae (75% and 50%) and E. cloacae (50% and 50%) isolates than in E. coli (10% and 20%) isolates, respectively. Conclusion The majority of UTIs caused by ESBL-PE were acquired in the community and due to organisms carrying the group 1 CTX-M ß-lactamase. Further epidemiologic studies of infections due to ESBL-PE are urgently needed to better prevent and treat these infections in South Asia.
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Affiliation(s)
| | | | | | | | - Maria Joyce
- Durham Veteran Affairs Medical Center, Durham, NC, USA
| | | | - Ajith Nagahawatte
- Department of Microbiology, Ruhuna University Faculty of Medicine, Galle, Sri Lanka
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Relation between blaTEM, blaSHV and blaCTX-M genes and acute urinary tract infections. JOURNAL OF ACUTE DISEASE 2016. [DOI: 10.1016/j.joad.2015.07.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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El bouamri M, Arsalane L, Zerouali K, Katfy K, El kamouni Y, Zouhair S. Molecular characterization of extended spectrum β-lactamase-producing Escherichia coli in a university hospital in Morocco, North Africa. AFRICAN JOURNAL OF UROLOGY 2015. [DOI: 10.1016/j.afju.2015.02.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Mshana SE, Fritzenwanker M, Falgenhauer L, Domann E, Hain T, Chakraborty T, Imirzalioglu C. Molecular epidemiology and characterization of an outbreak causing Klebsiella pneumoniae clone carrying chromosomally located bla(CTX-M-15) at a German University-Hospital. BMC Microbiol 2015; 15:122. [PMID: 26077154 PMCID: PMC4469578 DOI: 10.1186/s12866-015-0460-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 06/01/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Multi-drug resistant Klebsiella pneumoniae strains are a common cause of health care associated infections worldwide. Clonal spread of Klebsiella pneumoniae isolates carrying plasmid mediated CTX-M-15 have been commonly reported. Limited data is available regarding dissemination of chromosomally encoded CTX-M-15 in Klebsiella pneumoniae worldwide. RESULTS We examined 23 non-repetitive ESBL-producing Klebsiella pneumoniae strains isolated from clinical specimens over a period of 4 months in a German University Hospital. All isolates were characterized to determine their genetic relatedness using Pulsed-Field Gel Electrophoresis (PFGE) and Multi Locus Sequence Typing (MLST). PFGE revealed three clusters (B1, B2, and B3) with a sub-cluster (A3) comprising of 10 isolates with an identical PFGE pattern. All strains of the cluster B3 with similar PFGE patterns were typed as ST101, indicating an outbreak situation. The ESBL allele bla CTX-M-15 was identified in 16 (69.6 %) of all isolates, including all of the outbreak strains. Within the A3 sub-cluster, the CTX-M-15 allele could not be transferred by conjugation. DNA hybridization studies suggested a chromosomal location of bla CTX-M-15. Whole genome sequencing located CTX-M-15 within a complete ISEcp-1 transposition unit inserted into an ORF encoding for a putative membrane protein. PCR-based analysis of the flanking regions demonstrated that insertion into this region is unique and present in all outbreak isolates. CONCLUSION This is the first characterization of a chromosomal insertion of bla CTX-M-15 in Klebsiella pneumonia ST101, a finding suggesting that in Enterobacteriaceae, chromosomal locations may also act as reservoirs for the spread of bla CTX-M-15 encoding transposition units.
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Affiliation(s)
- Stephen E Mshana
- Catholic University of Health and Allied Sciences, Weill Bugando School of Medicine Box, 1464, Mwanza, Tanzania.
| | - Moritz Fritzenwanker
- Institute of Medical Microbiology, Justus-Liebig University, , Schubertstrasse 81, 35392, Giessen, Germany. .,German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany.
| | - Linda Falgenhauer
- Institute of Medical Microbiology, Justus-Liebig University, , Schubertstrasse 81, 35392, Giessen, Germany. .,German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany.
| | - Eugen Domann
- Institute of Medical Microbiology, Justus-Liebig University, , Schubertstrasse 81, 35392, Giessen, Germany. .,German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany.
| | - Torsten Hain
- Institute of Medical Microbiology, Justus-Liebig University, , Schubertstrasse 81, 35392, Giessen, Germany. .,German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany.
| | - Trinad Chakraborty
- Institute of Medical Microbiology, Justus-Liebig University, , Schubertstrasse 81, 35392, Giessen, Germany. .,German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany.
| | - Can Imirzalioglu
- Institute of Medical Microbiology, Justus-Liebig University, , Schubertstrasse 81, 35392, Giessen, Germany. .,German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany.
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Warjri I, Dutta TK, Lalzampuia H, Chandra R. Detection and characterization of extended-spectrum β-lactamases (blaCTX-M-1 and blaSHV ) producing Escherichia coli, Salmonella spp. and Klebsiella pneumoniae isolated from humans in Mizoram. Vet World 2015; 8:599-604. [PMID: 27047141 PMCID: PMC4774719 DOI: 10.14202/vetworld.2015.599-604] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 04/05/2015] [Accepted: 04/11/2015] [Indexed: 12/01/2022] Open
Abstract
Aim: The present study was conducted to isolate and characterize the extended spectrum β-lactamases (ESBLs) producing enteric bacteria in human beings in Mizoram, India. Materials and Methods: Fecal samples were collected from human beings with or without the history of diarrhea from different hospitals of Mizoram. Samples were processed for isolation and identification of Escherichia coli, Salmonella and Klebsiella pneumoniae. All the isolates were subjected to antibiotic sensitivity assays. Phenotypically, ESBLs production ability was determined by double discs synergy test (DDST) method. ESBLs producing isolates were subjected to polymerase chain reaction (PCR) for detection of ESBLs genes. Plasmids were cured by acridine orange. Transfer of resistance from a donor to recipient strains was done by in vitro horizontal method. Results: A total of 414 enteric bacteria were isolated from 180 fecal samples (113 were from diarrheic patients and 67 were from non-diarrheic patients), of which 333 (80.44%), 52 (12.56%), and 29 (7.00%) were E. coli, K. pneumoniae and Salmonella spp., respectively. Double discs synergy test (DDST) exhibited 72 (21.62%) E. coli, 12 (23.08%) K. pneumoniae and 4 (13.79%) Salmonella spp. were ESBLs producers. Altogether, 24 (13.04%) isolates were found to be positive for at least one resistance genes under this study. A total of 36 (8.70%) E. coli, 4 (0.97%) K. pneumoniae and 2 (0.48%) Salmonella spp. were found to be positive for blaCTX-M-1 gene by PCR. Similarly, 5 (1.21%) E. coli and 4 (0.97%) K. pneumoniae isolates were found to be positive for blaSHV gene. A total of 3 (0.72%) K. pneumoniae isolates were recorded as positive for both blaCTX-M-1 and blaSHV genes. All the isolates were carrying plasmids ranging between 0.9 kb and ~30 kb. The resistance plasmid could not be transferred to a recipient by in vitro horizontal gene transfer method. Conclusion: ESBLs producing enteric bacteria are circulating in human population in North Eastern Region of India. Indiscriminate use of antibiotics should be avoided to control the menace of multidrug resistance bacteria in the environment, animals, and human beings.
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Affiliation(s)
- Iadarilin Warjri
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl, Mizoram, India
| | - T K Dutta
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl, Mizoram, India
| | - H Lalzampuia
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl, Mizoram, India
| | - Rajesh Chandra
- Department of Veterinary Microbiology, Central Agricultural University, Selesih, Aizawl, Mizoram, India
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