Antibiotic Resistance Patterns of Multidrug Resistant and Extended-Spectrum Β-Lactamase Producing Eshcherichia Coli Urinary Isolates at Queen Rania Al-Abdullah Hospitalfor Children, Jordan

Abstract

To determine the prevalence and the antibiotic resistant patterns of the multi-drug resistant Extended-Spectrum Β-Lactamase(ESBL) producing E. coli isolates from children urine samples, in Queen Rania Al-Abdullah Hospital for children.A total of 61 non-repetitive urine samples from various outpatient clinics and inpatient wards were collected retrospectively over a period of 5 months (May 2012 to September 2012). The resistant patterns, screening and confirmatory tests for phenotypic detection of ESBL-producers were studied using the VITEK 2 system against a set of antibiotics found on the antimicrobial susceptibility extend card AST-EXN8.Children were nearly equally infected by both types of E. coli isolates, ESBL-producers 31 (50.8%) and non ESBL-producers 30 (49.2%). ESBL-producing E. coli showed maximum rate resistance to Cefuroxime and Piperacillin (100%), Aztreonam, Cefixime, Ceftriaxone plus Levofloxacin (96.8%), Ampicillin/Sulbactam and Cefepime (93.5%), and Moxifloxacin (90.3%), while minimum resistance rate was seen with Tigecycline (12.9%), Colistin (3.2%) and meropenem (0%). ESBL-producing isolates were significantly more resistant than Non-ESBL-producers (p < 0.05) to the following antimicrobials (Ampicillin/Sulbactam, Aztreonam, Cefepime, Cefixime, Ceftriaxone, Levofloxacin, Moxifloxacin, Piperacillin and Tetracycline). Multi-drug resistance was found to be higher in ESBL-producing isolates, which were resistant to at least 9 antibiotics. To limit the spread of the multi-drug resistant ESBL-producers E. coli isolates, we should perform screening test for these isolates on daily basis, isolate the infected patients and choose the best therapeutic option.According to the resistant pattern and safety issue, Morepenem can be considered as first line treatment and colistin as last resort therapy.

Prevalence of CTX-M, TEM and SHV Beta-lactamases in Clinical Isolates of Escherichia Coli and Klebsiella Pneumoniae Isolated From Aleppo University Hospitals, Aleppo, Syria

“…In the present study, the carbapenems (imipenem and meropenem) and amikacin were very active antimicrobial agents against the ESBL and non-ESBL-producing E. coli and K. pneumoniae isolates. This is in agreement with other studies (3,9,10,13,18,23,31). During the past decade, ESBL producing Gramnegative bacilli, especially E. coli and K. pneumonia have emerged as serious pathogens, both in hospital and community acquired infections, worldwide.…”

“…Extendedspectrum β-lactamases (ESBLs) have emerged worldwide, as a significant cause of community and healthcareassociated infections (5)(6)(7)(8). The ESBLs consist of a heterogeneous group of plasmid-mediated bacterial enzymes that confer significant resistance to oxyimino-cephalosporin and monobactam antimicrobials (7,(9)(10)(11)(12). The emergence of ESBL-producing bacteria, particularly E. coli and K. pneumoniae, is now a critical concern for the development of therapies against bacterial infection (7,(12)(13)(14)(15).…”

Comparison of Antibiotic Sensitivity Pattern of Escherichia coli which Produce Extended Spectrum Beta-Lactamase Strains Isolated From Various Clinical Specimens In Intensive Care Unit

“…In our study, when we compared to resistance of PIP, E. coli isolates showed high antibiotic resistance with 98% PIP. Some researchers have reported resistance rate PIP from 100% to17.2% to E. coli in clinical samples (Kafilzadeh and Farsimadan., 2016;Batarseh et al, 2013). Our results were lower than Batarseh et al, (2013) who also reported that resistance rate of PIP with 100%.…”

Molecular detection of SHV-Type ESBL in E. coli and K.pneumoniae and their antimicrobial resistance profile

“…Testing was repeated wherever suggested by the AES. 16,17 Detection of ESBL by Phenotypic Method Each isolate was tested using the VITEK 2 system with the antimicrobial susceptibility test extend AST-EXN8 card. This system was designed to perform both screening and confirmatory tests for phenotypic detection of ESBL on the same plate.…”

“…This system was designed to perform both screening and confirmatory tests for phenotypic detection of ESBL on the same plate. 17 The test comprises a panel of six wells containing ceftazidime 0.5 mg⁄ L, cefotaxime 0.5 mg⁄ L and cefepime 1.0 mg⁄ L, the rest of three wells were filled with same three antibiotics in combination with clavulanic acid (4, 4 and 10 mg⁄ L, respectively). Growth in each well was quantitatively assessed by means of an optical reader.…”