Characterization of Multidrug Resistant Extended-Spectrum Beta-Lactamase-ProducingEscherichia coliamong Uropathogens of Pediatrics in North of Iran

Abstract

Escherichia coli remains as one of the most important bacteria causing infections in pediatrics and producing extended-spectrum beta-lactamases (ESBLs) making them resistant to beta-lactam antibiotics. In this study we aimed to genotype ESBL-producing E. coli isolates from pediatric patients for ESBL genes and determine their association with antimicrobial resistance. One hundred of the E. coli isolates were initially considered ESBL producing based on their MIC results. These isolates were then tested by polymerase chain reaction (PCR) for the presence or absence of CTX, TEM, SHV, GES, and VEB beta-lactamase genes. About 30.5% of isolated E. coli was ESBL-producing strain. The TEM gene was the most prevalent (49%) followed by SHV (44%), CTX (28%), VEB (8%), and GES (0%) genes. The ESBL-producing E. coli isolates were susceptible to carbapenems (66%) and amikacin (58%) and showed high resistance to cefixime (99%), colistin (82%), and ciprofloxacin (76%). In conclusion, carbapenems were the most effective antibiotics against ESBl-producing E. coli in urinary tract infection in North of Iran. The most prevalent gene is the TEM-type, but the other resistant genes and their antimicrobial resistance are on the rise.

Prevalence of co-existence genes and clonal spread of ESBL-producing isolates causing hospital and community-acquired infections in Zenica-Doboj Canton, Bosnia and Herzegovina

“…This is similar with the report from India, Germany, Malaysia, and Iran where the prevalence of coproduction of more than two types of beta-lactamases in inpatient was 70%, 77%, 50%, and 45% (5,8,11,13), respectively. These prevalences are lower in the report from China (11%), North Iran (30%), and Egypt (10%) (6,7,9).…”

“…In recent years, the production of more than one beta-lactamase has frequently been reported in some countries, such as in the study from India (4,5), China (6), Iran (7), and Germany (8), Egypt (9), USA (10), Malaysia (11), and Bosnia and Herzegovina (B and H) (12). The antimicrobial resistance of Gram-negative bacteria has risen progressively during the past decades, leading to an increasing number of outbreaks due to the existence of multi-resistant bacteria, especially those producing more than one beta-lactamase type (4).…”

Extended-Spectrum Beta-Lactamase Producing Gram Negative Bacteria in Iran: A Review

“…In a recent study, there was a significant correlation between ESBL production and resistance to all types of antibiotics except for piperacillin and ciprofloxacin, and out of eight ESBL positive isolates, seven (87.5%) carried class 1 integrons . In another study from pediatric patients for ESBL genes, about 30.5% of isolated E. coli were ESBL-positive and TEM gene was identified in 49% followed by CTX in 28%, SHV in 44%, VEB in 8%, and GES in 0% of isolates (Rezai et al, 2015).…”

Co-occurrence of Extended-Spectrum Beta-Lactamases in Isolated Enterobacter spp. From Patients Specimens

“…Some strains of these bacteria can be extremely resistant against treatment with antibiotics, because Enterobacter spp. can produce extended-spectrum beta-lactamase (ESBLs) enzymes (3). These enzymes make bacteria resistant to most betalactam antibiotics, such as penicillins, cephalosporins, monobactam and aztreonam (4).…”