Antimicrobial susceptibility patterns and CTX-M β-lactamase producing clinical isolates from burn patients in Islamabad, Pakistan

Hussain, Mubbashir; Munir, Shahzad; Fatima, Madiha; Rahim, Kashif; Ahmed, Izrar; Basit, Abdul; Talpur, Mir Zulqarnain; Bashir, Nawaz Haider; Jamil, Arslan; Jamal, Muhammad Ameen

doi:10.12980/apjtd.7.2017d7-75

Cited by 4 publications

(5 citation statements)

References 28 publications

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“…These isolates were observed with more than 70% resistance against meropenem and 69% resistance against imipenem. ESBLs positive P. aeruginosa isolates have been observed in burn patients in Pakistan with 61% resistance against imipenem [13]. E. coli strains with 47% and K. pneumoniae with 44% resistance against meropenem have been detected in burn patients in Nigeria [18].…”

Section: Discussionmentioning

confidence: 99%

“…blaSHV5 and blaSHV12 from Korea and Japan, blaTEM12 and blaTEM52 from United Kingdom, blaOXA10 and blaOXA13 have been reported from Iran and France respectively [12]. Recent study from Pakistan reveals 40% of ESBLs producing bacteria are detected in burn patients [13]. Horizontal transfer by plasmids and transposons during conjugation is a principal genetic factor for worldwide dissemination of ESBLs encoding genes [14].…”

Section: Introductionmentioning

confidence: 99%

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blaOXA, blaSHV-, and blaTEM- extended-spectrum β-lactamases in Gram-negative strains from burn patients in Lahore, Pakistan

Haider

Ain

Abrar

et al. 2020

J Infect Dev Ctries

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Introduction: Gram-negative bacterial pathogens are associated with complications of post-burn infections that showed significant association with different genotypic variants of extended-spectrum β-lactamases. In this study, we aimed to determine the distribution of ESBL gene variants among bacterial pathogens from post-burn infections. Methodology: Cephalosporin-resistant isolates were collected from Jinnah Burn and Reconstructive Surgery Centre, Lahore. Phenotypic testing: double-disk synergy test, combination disk test, multiplex PCR for blaOXA, blaTEM, and blaSHV genes were performed. Results: Of the 53.5% cephalosporin-resistant isolates, 50.7% were community-acquired and 49.3% were nosocomial pathogens. Seventy-two percent of post-burn infections were found in males (p-value = 0.92, OR = 1.04). The age of burn victims ranged from 4 to 85 years (mean = 28.9, SD = 15.6). Pseudomonas aeruginosa was most predominant at a rate of 49%. There were 83.3% multidrug-resistant isolates, which showed susceptibility to meropenem, imipenem, and amikacin in 28.7%, 25.3%, and 26% respectively. In phenotypic tests 16% ESBLs detected by the DDST and 14% confirmed by the CDT. Molecular detection proved effective for the detection of 79.7% blaTEM, 37.7% blaOXA, and 18.8% blaSHV isolates. blaTEM genes were confirmed in 18.1% CDT-positive isolates, with 62.6% diagnostic accuracy (95% CI = 54.7-70) and 88% specificity (95% CI = 80.4-93.4). Conclusions: The antimicrobial resistance associated with the ESBL-producing Pseudomonas spp. and Enterobacteriaceae is becoming a challenge for the treatment and survival of burn patients. The high rate blaTEM, blaOXA, and blaSHV genes confirm the need to improve the management of burn patients in order to prevent post-burn infections.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

blaOXA, blaSHV-, and blaTEM- extended-spectrum β-lactamases in Gram-negative strains from burn patients in Lahore, Pakistan

Haider

Ain

Abrar

et al. 2020

J Infect Dev Ctries

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“…We have our own institutional antibiogram [16][17][18] , we strive for scientifically judicious usage of appropriate antibiotics as per our community/hospital bug prevalence. The 13.43% improvement in overall survival rate as compared to last year is a testament to all the policies and procedures that we are strictly adhering to, in the light of CDC guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Combination therapy with Minocycline, Tigecycline, Chloramphenicol and Fosfomycin are being suggested by extended range sensitivity screening 24,25 . Novel drugs like Cefiderocol, Eravacycline, Plazomicin are under trials but not freely available for clinical use 18 .…”

Section: Discussionmentioning

confidence: 99%

Fight Against Superbugs in a Burn Centre: Are We Doing Enough

Aslam

Rizvi

Munawar

et al. 2021

PAFMJ

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Objective: To determine the superbug infection in a burn centre, its impact on mortality/morbidity and to review all preventive/therapeutic steps taken to fight this menace. Study Design: Retrospective cross sectional study. Place and Duration of Study: Department of Burns & Plastic Surgery, Army Burn Centre, Combined Military Hospital Kharian, from Oct 2018 to Sep 2019. Methodology: A detailed retrospective audit of departmental data was carried out. Parameters like direct admission vs transferred patient, percentage of burns (Total Burn Surface Area-TBSA%), records of all burns related deaths and all culture/sensitivity reports were analysed using SPSS-20. As a standard practice in our unit blood, tracheal secretions and pus culture specimens of all patients are collected at the time of admission and then periodically fresh samples are taken every week or earlier when-ever required. Results: Out of 515 patients, 283 (54.95%) were children under the age of 12 years. The overall survival rate improved by 13.43% as compared to last year. Out of 584 bacteriology reports 396 (67.81%) were positive and 188 (32.19%) were negative. On culture 508 organisms were isolated, majority of which were Carbapenem Resistant Pseudomonas, Acinetobacter, Enterobacteriaceae and Methicillin resistant staphylococcus aureus. Conclusion: Multi drug resistant superbug infection is a worldwide menace. The best clinical practices, strict contact isolation, enhanced environmental cleaning and judicious use of appropriate antibiotics are the main strategies in this war. Need for newer more effective antibiotics cannot be overemphasized.

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“…bla SHV5 and bla SHV12 from Korea and Japan, bla TEM12 and bla TEM52 from the United Kingdom, bla OXA10 and bla OXA13 have been reported from Iran and France respectively (18). A recent study from Pakistan revealed 40% of ESBLs producing bacteria in burn isolates (19). Horizontal transfer by plasmids and transposons during conjugation is a principal genetic factor for worldwide dissemination of ESBLs encoding genes (20).…”

Section: Introductionmentioning

confidence: 99%

Distribution of blaOXA, blaSHV, and blaTEM type extended-spectrum β-lactamase genes in multi-drug resistant Gram-negative isolates from burn patients of Lahore, Pakistan

Haider

Ain

Abrar

et al. 2019

Preprint

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Background Multidrug resistant Gram-negative bacterial pathogens are becoming a lethal source of infections and associated complications of sepsis and multiple organ failure following burn injuries. Genotypic variants of bla OXA , bla SHV and bla TEM type extended-spectrum-β-lactamases (ESBLs) have been detected in Pseudomonas aeruginosa , Enterobacteriaceae and other type of bacteria. These hydrolytic enzymes are responsible for the degradation of broad-spectrum antimicrobials including third generation cephalosporins. We aimed to determine the distribution of ESBLs gene variants among MDR pathogens from post burn infections.Methods A total of 358 specimens were collected during the period from 15 th August 2017 to 15 th August 2018 from burnt patients at Jinnah Burn and Reconstructive Surgery Centre (JB&RSC).Results 53.57% cephalosporins resistant isolates were found to be associated with a slightly higher frequency of 50.7% community-acquired and 49.30% nosocomial infections. 72% of these infections was found to be associated with males (p-value = 0.919, OR = 1.038). The age of burn victims ranged from 4 to 85 years (Mean=28.95, SD=±15.65). Pseudomonas spp., were the predominant as 49.33% followed by 22.67% Klebsiella spp., 20% Acinetobacter spp., and 8% Proteus spp., strains. There were 83.33% multidrug resistant isolates and meropenem, imipenem, and amikacin were found to be effective against 28.70%, 25.30%, and 26.00% of cephalosporins resistant strains respectively. Lowest sensitivity of phenotypic tests was observed as 16% ESBLs were detected by double disk synergism test (DDST) and 14% were confirmed by combination disk test (CDT). Molecular detection proved to be effective for the detection of 79.71% bla TEM , 37.68% bla OXA , and 18.84% bla SHV isolates. bla TEM genes were confirmed in 18.18% CDT positive isolates with 62.67% diagnostic accuracy (95% CI = 54.70, 70.00) and 88.42% specificity (95% CI = 80.45, 93.41). All of the bla TEM positive isolates were resistant to cefuroxime and 98.18% were resistant to cephradine, and piperacillin.Conclusion The antimicrobial resistance associated with the ESBLs producing Pseudomonas spp., and Enterobacteriaceae is becoming a challenge for the treatment and survival of burn patients. The higher frequency of MDR isolates and detection of bla TEM , bla OXA , and bla SHV genes confirms that management of burn patients should be improved to prevent the infections.

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Antimicrobial susceptibility patterns and CTX-M β-lactamase producing clinical isolates from burn patients in Islamabad, Pakistan

Cited by 4 publications

References 28 publications

blaOXA, blaSHV-, and blaTEM- extended-spectrum β-lactamases in Gram-negative strains from burn patients in Lahore, Pakistan

blaOXA, blaSHV-, and blaTEM- extended-spectrum β-lactamases in Gram-negative strains from burn patients in Lahore, Pakistan

Fight Against Superbugs in a Burn Centre: Are We Doing Enough

Distribution of blaOXA, blaSHV, and blaTEM type extended-spectrum β-lactamase genes in multi-drug resistant Gram-negative isolates from burn patients of Lahore, Pakistan

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