Background: This research aimed to estimate the prevalence of extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBL-PE) in stool samples of patients with different types of cancer. Materials and Methods: Stool samples or deep rectal swabs were collected from cancer cases from January 2017 to December 2018. After species identification, in order to detect ESBL-PE, double-disk synergy test (DD test) was used. Disk diffusion procedure was conducted to determine the susceptibility of bacteria to antimicrobials. Lastly, antibiotic resistance genes including bla genes were characterized via polymerase chain reaction (PCR). Findings: Among 100 patients enrolled in this study, 50 (50%) were ESBL carriers. Escherichia coli was the most prevalent bacterium isolated (85%). Genotyping of EBSL-PE encoding genes using PCR showed that the prevalence rates of bla CTX-M and bla CTX-M-15 genes were 94 (47 of 50) and 90% (45 of 50), respectively, which were higher than those of bla TEM (80%, 40 of 50) and bla SHV genes (34%, 17of 50). There was no significant association between ESBL-PE fecal carriage and age (p= .68), sex (p = .49), time of diagnosis (p= .21), antibiotic therapy for the past three months (p= .77), and history of chemotherapy (p= .49). Finally, it was determined that cancer type was an associated risk factor for ESBL-PE fecal carriage in cancer patients. Conclusion: This research emphasizes regular bacterial monitoring, and that antibiotic stewardship plans ought to be performed among cancer patients to prohibit further spread of ESBL-PE with confined therapeutic options.
Background: Urinary Tract Infection (UTI) is the most common bacterial infection in the world. E. coli is the predominant Pathogen. This study evaluates the prevalence of ESBL in E. colis isolated from patients with urinary tract infections with phenotypic and genotypic methods.Methods: This descriptive-analytical study was done on 155 isolates of E. coli isolated from patients with urinary tract infection who had received the study consent. After accurate identification of E. coli strains. ESBL production for Escherichia coli isolates which are resistant to ceftriaxone or ceftazidime was evaluated by CDT method. TEM, SHV and CTX-M genes were identified by PCR.Results: The results showed that 30 strains from 155 strains of E. coli had ESBL. Strains of ESBL producer were more in males was lower in educated persons. 38.9% of ESBL producer had antibiotic use, 29.9% -producing Escherichia hospitalization and 31.6% uti history. The highest level of drug allergy in the ESBL was related to nitrofurantoin, and the highest resistance was related to cefazolin, co-trimoxazole. The CTX-M and the CTX-M15 gene were found in 92.7% and 57.1% of cases, respectively; also the SHV and TEM genes were not found in any of ESBL-producing Escherichia coli strains. Most therapeutic response in patients was related to cefexime, ciprofloxacin and nitrofurantoin 27.4%, 26% 21.9%, respectively.Conclusion: This study showed that the history of antibiotic use, hospitalization, uti related to increase of ESBL-producing in E. coli isolates., the CTMX-M gene is the most common gene in ESBL-producing E. coli strains.
Background and Aim: Determination of antibiotic resistance pattern and awareness of current resistance in each region, it can help to take appropriate therapeutic measures. The purpose of this study to identification of bacterial agents causing infection, and was the determination of their antibiotic resistance in patients admitted to educational hospital of Shohada Qaen, through the years 2018-2019. Materials and Methods: In this descriptive-analytic study, in the period of one year, 1980 samples were collected from patients admitted to educational hospitals of Shohada Qaen. The specimens were cultured in blood agar and EMB, and were incubated at 37 ° C for 24 hours, then the infection-causing bacteria were identified by differential biochemical tests, depending on gram positive or gram negative bacteria. The Disk diffusion method was applied to determine antibiotic resistance pattern, and the combined disk phenotypic method was applied to determine the strains producing e extended-spectrum beta-lactamase enzymes (ESBLs). Results: of 1980 samples collected from patients admitted, 183 bacterial isolates were collected from which 151 gram negative and 32 gram-positive bacteria were identified. The most common isolated bacteria were Escherichia coli with a frequency of 60.1%, followed by Staphylococcus aureus and Klebsiella, with a frequency of 11.5% and 10.9% respectively. Generally, gram-positive bacteria had the least resistance to Ciprofloxacin and Imipenem and gram-negative bacteria had the least resistance to Amikacin. 44.7% of the gram-negative bacteria produced ESBL. Conclusion: Antibiotic administration based on the antibiotic resistance pattern can be more effective and useful. The high prevalence of ESBL producing strains indicates the necessity of rapid monitoring and identification of these strains.
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