Prevalence of CTX-M-Type β-Lactamases in Multi-Drug Resistant Escherichia coli Isolates from North of Iran, Rasht (original) (raw)
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TURKISH JOURNAL OF MEDICAL SCIENCES, 2016
Background/aim: Extended spectrum beta lactamase (ESBL) production among E. coli is one of the principal mechanisms that augment resistance to antibiotics. In the current study the molecular detection of class A beta lactamases among uropathogenic Escherichia coli was evaluated. Materials and methods: A total of 355 urine samples were collected from a tertiary care hospital in Peshawar. The ESBL production among E. coli isolates was detected by using the disc synergy diffusion method. Moreover, the molecular detection of bla TEM-1 and bla CTX-M-1 ESBLs, the antibiotic resistance pattern, and the minimum inhibitory concentrations (MICs) were also documented. Results: Among the 355 urine samples, 157 isolates were E. coli, and 23.56% of the isolates were ESBL E. coli. Among phenotypic ESBL producers, bla CTX-M-1 and bla TEM-1 were found in 59.45% and 40.54% of the isolates, respectively. A high resistance rate was observed against aztreonam (97.29%), while the lowest resistance was observed against imipenem (2.7%). The MICs of ESBLs E. coli for ceftriaxone, ciprofloxacin, and gentamicin was >512 µg/mL, 4 µg/mL to 128 µg/mL, and 1 µg/mL to 14 µg/mL respectively. Conclusion: The present study showed that bla CTX-M-1 ESBL production is more prevalent in our clinical E. coli isolates. More often the ESBLs were resistant to commonly used antibiotics.
Journal of Medical Microbiology and Infectious Diseases, 2014
Introduction: Extended spectrum beta-lactamase (ESBL) producing Escherichia coli generate a major problem for clinical therapeutics and epidemiological study. The incidence of ESBL producing strains among clinical isolates has been steadily increasing during the past few years, and remains an important cause of failure of therapy with cephalosporins. The aim of this study was to determine the antimicrobial susceptibility pattern and prevalence of ESBLs in E. coli isolates taken from different clinical specimens by phenotypic and genotypic techniques. Methods: In this descriptive study, a total of 100 E. coli isolates collected from different clinical specimens were used. The antibiotic resistance pattern to twelve antimicrobial agents was determined by disk diffusion method. The ESBLs producing strains were confirmed by double-disk-diffusion test, and the CTX-M, TEM, SHV, and OXA were detected by PCR. Results: The prevalence of ESBL producing E. coli was 56%. The results show that 95% of ESBL producing E. coli isolates tested were resistant to ceftriaxone and cefotaxime, 93% for ceftazidime, 86% for azithromycin, 79% for cefazolin and 43% to imipenem. Among the ESBL producing E. coli, 48%, 30% and 11% were positive for CTX-M, TEM and SHV genes, respectively. OXA was not found in all isolates. Conclusion: ESBL producing isolates of E. coli have been increasingly recognized and there is a need to carefully formulate therapeutic strategies to control infections in teaching Hospitals. The high percentage of drug resistance in ESBL producing E. coli suggests that routine detection of ESBL is required by reliable laboratory methods.
Iranian Journal of Pathology, 2021
Background & Objective: Escherichia coli (E. coli) is a leading cause of urinary tract infections becoming resistant against beta-lactams and cephalosporins through different mechanisms, including ESBL production due to the presence of ESBL specific genes, including blaCTX-M and blaTEM. The purpose of the present study was to detect the uropathogenic E. coli strains producing the ESBL. Methods: A total of 100 isolates of uropathogenic E. coli were randomly selected in a period of 6 months and their resistances to a number of antibiotics including amoxicillin, amikacin, gentamicin, ciprofloxacin, ceftazidime, cefotaxime, ceftriaxone, ceftizoxime, nalidixic acid, and nitrofurantoin were determined. Then, DDT test was used to detect the presence of ESBL. Finally, the presence of blaCTX-M and blaTEM resistance genes was analyzed by PCR method. Results: The resistance profile of bacterial isolates to the antibiotics was as follows: amoxicillin: 16.7%, amikacin: 7.8%, gentamicin: 20.3%, c...
SVOA Microbiology, 2020
Background and Aim: The increasing use of beta-lactam antimicrobials in the treatment of bacterial infections has increased resistance to them. One of the current problems in the treatment of nosocomial infections is the resistance of enzymes to broad-spectrum beta-lactamases (ESBL) among clinical isolates, especially Escherichia coli. Therefore, the aim of this study was to identify the molecular identification of CTX-M-1 genes in the E. coli strains isolated from urinary tract infections in Zanjan hospitals. Materials and Methods: In this descriptive-analytical study of the study of 289 cases of urinary tract infection in Zanjan medical centers in 2019, 100 isolates of E. coli were identified by standard bacteriological methods. Antibiotic susceptibility of the isolates was determined by disk diffusion method and ESBL-producing isolates were identified by combined disk method. The bacterial DNA was then extracted and studied by PCR using specific gene primers. Results: The most resistant to ampicillin (73%) and tetracycline (49%) were the most sensitive to amikacin (90%) and nitrofu-rantoin (89%), respectively. A total of 50 samples were identified as the final ESBL producer. 39 specimens of E. coli bacteria had the CTX-M-1 gene. Conclusion: The genes studied in this study were all located on the chromosome of E. coli bacteria. Therefore, further inves-tigation of ESBL genes such as CTX-M-1 gene seems necessary to control this bacterium.
Infection and Drug Resistance
Background: The emergence and spread of extended-spectrum β-lactamases (ESBLs), especially CTX-M, is an important public health problem with serious implications for low-income countries where second-line treatment is often unavailable. Knowledge of the local prevalence of ESBL is critical to define appropriate empirical therapeutic strategies for multidrug-resistant (MDR) organisms. This study aimed to assess and characterize the presence of ESBL and especially CTX-M-producing Escherichia coli MDR isolates from patients with urinary tract infections (UTIs) and bacteremia in a rural hospital in Mozambique. Materials and methods: One hundred and fifty-one E. coli isolates from bacteremia and UTI in children were screened for CTX-M, TEM, SHV and OXA β-lactamases by polymerase chain reaction and sequencing. Isolates carrying CTX-M group 1 β-lactamases were further studied. The resistance to other antibiotic families was determined by phenotypic and genotypic methods, the location of the bla CTX-M gene and the epidemiology of the isolates were studied, and extensive plasmid characterization was performed. Results: Approximately 11% (17/151) of E. coli isolates causing bacteremia and UTI were ESBL producers. CTX-M-15 was the most frequently detected ESBL, accounting for 75% of the total isolates characterized. The bla CTX-M gene is located in different plasmids belonging to different incompatibility groups and can be found in non-epidemiologically related isolates, indicating the high capacity of this resistance determinant to spread widely. Conclusion: Our data suggest the presence of a co-selection of third-generation cephalosporinresistant determinants in the study area despite limited access to these antibiotics. This highlights the importance of continuous surveillance of antimicrobial resistance of both genetic elements of resistance and resistant isolates in order to monitor the emergence and trends of ESBL-producing isolates to promote adequate therapeutic strategies for the management of MDR bacterial infections.
Archives of Clinical Infectious Diseases, 2014
Background: Escherichia coli is the most important as well as the most common bacteria causing urinary tract infections (UTIs) and its resistance to common antibiotics is increasing. Extended-spectrum beta-lactamase (ESBL) producer E. coli strains can resist against the third-generation and fourth-generation cephalosporins. Objectives: This study aimed to evaluate the resistance profile of E. coli isolated from patients with UTIs referred to Imam Khomeini and Baqiyatallah Hospitals, Tehran, Iran, through phenotypic and molecular methods. Materials and Methods: During 2010-2011, 180 urine samples of patients with UTIs from Imam Khomeini and Baqiyatallah Hospitals were collected. Based on the standard bacteriologic tests, E. coli isolates were identified. Resistance to common antibiotics was tested by the Kirby-Bauer method and reconfirmed by determining minimum inhibitory concentration (MIC) through microdilution method. Further phenotypic double-disk synergy test (DDST) was performed to screen the ESBL producer strains. Resistance genes related to ESBL and qnrA were evaluated by Polymerase chain Reaction (PCR). Results: A total of 100 E. coli strains were examined by antibiogram and the rates of resistance to the tested antibiotics were as follows: 100% to penicillin and amoxicillin, 77% to amoxicillin-clavulanic acid, 72% to ceftazidime, 69% to cefotaxime, 47% to cefoxitin, 46% to ceftriaxone, 43% to cephalexin, 27% to aztreonam, 53% to nalidixic acid, 51% to ciprofloxacin, and 2% to imipenem. The MIC to ciprofloxacin, cefazolin, and ceftriaxone were ≥ 0.249, ≥ 0.508, and ≥ 0.044, respectively. Moreover, 20% of E. coli isolates were ESBL-producing isolates by DDST. The frequency of bla CTX-M, bla TEM, bla SHV, and qnrA genes was 87%, 82%, 65%, and 39%, respectively. Conclusions: Considering the high prevalence of ESBL genes (bla CTX-M, 87%; and bla TEM, 82%), fluoroquinolones may be used as an alternative drug in treatment, although resistance to this family is increasing as well. As a result, this increasing trend should be prevented using appropriate guidelines for prescription.
The Occurrence of Multidrug Resistant E. Coli which Produce ESBL and Cause Urinary Tract Infections
Journal of Applied Microbiology and Biochemistry
Urinary tract infection (UTI) is caused by Gram-negative bacteria such as Escherichia coli, Klebsiella species, Enterobacter species, Proteus species and Gram-positive bacteria like Enterococcus species, and Staphylococcus saprophyticus. E. coli is the most common organism causing both community as well as hospital acquired UTI. The aim of this study was to determine the occurrence of multidrug resistant strains among UTI caused by E. coli isolates against commonly used antimicrobial agents and the possible role of extended spectrum beta-lactamases (ESBL) in E. coli resistance to antibiotics.
2019
Background & aim: Resistance to β-lactam antibiotics in the clinical isolates, in most cases is caused by βlactamase enzymes. In recent years, The incidence of broad-spectrum β-lactamase enzymes (ESBLs) among clinical isolates especially E.coli is greatly increased, since the β-lactamase have several subfamilies, using universal primers designed to detect the following complete families could be useful. β-lactamase producing enzymes (ESBLs) of E. coli has created many problems for patients. β-lactamase CTX-M-1 gene is the cause of resistance. The aim of this study was to evaluate CTX-M-1gene in E.coli. Methods: In this practical study, susceptibility of isolated bacteria to 13 antibiotics were indicated by disk diffusion method according to CLSI guidelines and strains were analyzed for the presence of widespread βlactamase enzymes via two-disc synergy method. Thus، the prevalence of CTX-M1 ESBL gene samples were determined using PCR and the data were analyzed using ANOVA. Results: A total of 200 isolates of E.coli were isolated. The presence of CTX-M-1 gene were also isolated using the PCR method. From 200 strains studied, 62 (31%), of strains produced ESBL. After PCR processing of 62 produced ESBL, 43 isolates (69.4%) were identified as CTX-M-1 genes. Also, antibiotic susceptibility test showed the highest percentage of resistance to Cotrimoxazole antibiotic (50%) and the lowest antibiotic resistance to imipenem (0%). Conclusion: The results of this study showed the high percentage of β-lactamase resistance among of E.coli strains. This is a serious public hazard that should be pointed out to measures for preventing this hazard. Considering the sensitivity of the studied beta-lactam resistant isolates and isolates in Iran to imipenem, a carbapenem with a non-beta-lactam antibiotic is recommended for the treatment of nosocomial infections caused by these strains.
2009
Urinary tract infections (UTI) are the most prevalent infections worldwide, mostly caused by Escherichia coli. These bacteria also produce enzymes called extended spectrum β β β β-lactamases (ESBL) which render penicillins and cephalosporins inactive. The present study included 116 E. coli, isolated from urine of in-patients suffering from UTI. Antibiotic susceptibility testing and ESBL detection were carried out according to Clinical Laboratory and Standards Institute (CLSI) criteria. Fifteen antibiotics were tested in this study. A total of 66 (56.9%) isolates were found to be ESBL producers. A total of 83% isolates were resistant to 4 or more antibiotics. Imipenem and meropenem showed high potency with 98 and 97% isolates being susceptible, respectively. Susceptibility to gentamicin was 48%, kanamycin 43%, both ofloxacin and enoxacin 38%, ciprofloxacin 35%, doxycycline 18% and to co-trimoxazole only 17%. This study reveals that E. coli isolated from UTI in this region are multi-drug resistant and produce ESBL in large proportions.
Libyan Journal of Medicine, 2015
Introduction: Multidrug resistance (MDR) and emergence of extended-spectrum b-lactamases (ESBLs) that mediate resistance to b-lactam drugs among Escherichia coli and other uropathogens have been reported worldwide. However, there is little information on the detection of ESBLs genes in E. coli from patients with urinary tract infections (UTIs) in the Arab countries using polymerase chain reaction (PCR), and in Libya such information is lacking. Methods: All patients attending Zawiya Teaching Hospital in Zawiya city between November 2012 and June 2013 suspected of having UTIs and from whom midstream urine samples were taken as part of the clinical workup were included in this prospective study. Samples were examined for uropathogens by standard bacteriological procedures. VITEK-2 automated microbiology system was used to identify the isolated uropathogens and determine the susceptibility of E. coli and Klebsiella spp. isolates to antimicrobials. In addition, phenotypically ESBLs-positive E. coli isolates were tested for ESBLs genes by PCR. Results: The present study enrolled 1,790 patients with UTIs. Uropathogens were found in 371 (20.7%) urine specimens examined. Mixed pathogens were detected in two specimens with 373 total pathogens isolated. E. coli and Klebsiella spp. were the predominant uropathogens at 55.8% (208/373) and 18.5% (69/373), respectively. Other pathogens were detected in 25.7% (96/373) of urine samples. Of the E. coli and Klebsiella spp. tested, 69.2 and 100% were resistant to ampicillin, 6.7 and 33.3% to ceftriaxone, and 23.1 and 17.4% to ciprofloxacin, respectively. MDR (resistance to ]3 antimicrobial groups) was found in 69 (33.2%) of E. coli and in 29 (42%) of Klebsiella spp. isolates. ESBLs were detected phenotypically in 14 (6.7%) of E. coli and in 15 (21.7%) of Klebsiella spp. isolates. Thirteen out of the 14 phenotypically ESBL-positive E. coli were positive for ESBL genes by PCR. bla TEM gene was detected in seven isolates, bla OXA gene in 10 isolates and bla CTX-M gene in six isolates. bla SHV gene was not detected in the present study. Conclusion: The isolation of MDR ESBL-producing uropathogens undoubtedly will limit the choices clinicians have to treat their patients with UTIs. Therefore, there is an urgent need for surveillance studies on antimicrobial resistance and prevalence of ESBLs among uropathogens to guide the clinical treatment of UTIs in Libya in the future.