Detection of CTX-M-15 Among Uropathogenic Escherichia coli Isolated from Five Major Hospitals in Tripoli, Libya

Zorgani, Abdulaziz; Almagatef, Asma; Sufya, Najib; Bashein, Abdulla; Tubbal, Abdullatif

doi:10.5001/omj.2017.61

Cited by 32 publications

(26 citation statements)

References 46 publications

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“…56 Multidrug resistance was observed in 69% of ESBLproducing isolates, which was significantly higher compared with non-ESBL producers. Similar findings have been reported in previous studies, 57,58 particularly with CTX-M enzyme producers. 59,60 Plasmids coding for ESBL enzymes may carry coresistance genes for other non-b-lactam antibiotics, thus limiting the number of useful drugs against these bacteria.…”

Section: Discussionsupporting

confidence: 92%

Phenotypic and Genotypic Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Asymptomatic Bacteriuria in Pregnancy

Youssef

Rizk

Hassuna

2019

Microbial Drug Resistance

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Asymptomatic bacteriuria (ASB) has been consistently observed in pregnancy. However, there is a paucity of data on the prevalence and characteristics of extended-spectrum b-lactamase (ESBL)-producing Enterobacteriaceae in ASB in pregnant women. Therefore, we sought to investigate ESBL-producing and multidrug-resistant Enterobacteriaceae in antenatal women with ASB. Urine samples were collected from 310 asymptomatic pregnant women attending primary antenatal clinics and screened for significant bacteriuria. Isolates of Enterobacteriaceae were phenotypically tested for their ESBL production. ESBL genes (CTX-M, TEM, and SHV genes) were then amplified by polymerase chain reaction (PCR). Multiplex PCRs were used to perform phylogenetic typing of ESBLproducing Escherichia coli isolates and to examine the commonality of sequence type 131 (ST131)-O25b and ST131-O16. A total of 103 (33.2%) pregnant women were positive for significant bacteriuria (80 Enterobacteriaceae). Of these isolates, 32.5% (n = 26) were ESBL producers and had a higher rate of multidrug resistance than non-ESBL producers. Genotypic characterization of ESBL-producing isolates showed that 84.6% had the bla CTX-M gene (bla CTX-M-15 = 77.3%; bla CTX-M-9 = 18.2%). None of the isolates were of the TEM or SHV type. Half of the ESBLproducing E. coli isolates were of the phylogroup B2, and 4 (20%) isolates were of the ST131-O16 clonal subgroup. This study is the first in Egypt to provide evidence for the high prevalence of ESBL-producing Enterobacteriaceae in pregnant women with ASB. It also represents an important step toward genotypic characterization of this resistant form of bacteria, which may be useful for future antimicrobial studies.

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Section: Discussionsupporting

confidence: 92%

Phenotypic and Genotypic Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Asymptomatic Bacteriuria in Pregnancy

Youssef

Rizk

Hassuna

2019

Microbial Drug Resistance

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“…From these tables we can observe that studies conducted in non-con ict affected countries appeared to be slightly more focused in terms of site of infection under investigation compared to studies conducted in con ict affected countries, where in a substantial proportion of cases the site of infection was not speci ed, or the authors were analysing resistance pro les of bacteria isolated from a miscellanea of specimens. Publication bias was assessed for a sub-sample of ten studies which presented the proportion of ESBL producers among E. coli isolates on urinary samples, six of which were conducted in con ict-affected countries (45,54,59,75,114,159) and four in non-con ict settings (154,155,164,165). Figure 4 shows the funnel plots elaborated on the logarithm of the proportion of ESBL producers amongst E. coli isolates in urine samples in all studies, and in studies conducted in con ict and non-con ict settings separately.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…Not applicable in virtue of the study design (systematic literature review). (50,58,126,130,159) * Articles can report antibiotic resistance profile on more than one pathogen, and therefore the sum of the articles in this table can differ from the total per Country detailed Table 4. Number of studies included in this systematic review reporting on individual GLASS pathogens in non-conflict affected Countries Map of countries included in this systematic review on AMR and con ict in the Middle East (the identi cation as fragile and con ict affected and non-con ict affected is based on the World Bank classi cation, 2011-2018)…”

Section: Consent For Publicationmentioning

confidence: 99%

Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: A systematic review

Truppa

Abo‐Shehada

2020

Preprint

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Background: In spite of the evident general negative effects of armed conflict on countries’ health systems and populations’ health outcomes, little is known about similar impacts of conflicts on the spread of antimicrobial resistances (AMR). This review was to address this evidence gap and describe:1. Patterns of AMR in the Middle East (ME) and resistance profiles of pathogens included in the Global AMR Surveillance System (GLASS) supported by the World Health Organization;2. Differences in proportions of AMR isolates between conflict and non-conflict countries. Methods: A systematic literature review was conducted following PRISMA guidelines and searching five electronic databases. Subject heading and free text were searched for “antimicrobial resistances” and “Middle East”, to identify observational studies on AMR published from January 2011 to June 2018. Data were extracted from included articles on a predefined set of variables. Percentages of AMR were analysed as median and interquartile ranges. Risk of bias was assessed using the Newcastle-Ottawa Scale. Results: A total of 132 articles met the inclusion criteria. Included studies showed heterogeneity in study design, laboratory methods and standards for interpretation of results, and an overall high risk of bias. Main findings were the following:1. High proportions of carbapenem resistance in Acinetobacter spp. (median 74.2%: range), and both carbapenem resistance (median 8.1% and 15.4% for E. coli and K. pneumoniae respectively) and ESBL-production (median 32.3% and 27.9% for E. coli and K. pneumoniae respectively) amongst Enterobacteriaceae. S. aureus isolates showed a median methicillin resistance percentage of 45.1%, while vancomycin resistance was almost absent. A median of 50% of the strains of S. pneumoniae showed non-susceptibility to penicillin. 2. Similar trends were observed in conflict and non-conflict affected countries.Conclusions: There is a lack of standardization in the methodological approach to AMR research in the Middle East. The proportion of antibiotic resistances among specific GLASS pathogens is high, particularly among Acinetobacter spp.

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“…The spread of E . coli strains producing CTX‐M‐type β‐lactamases is mostly responsible for the increased incidence of ESBL, especially CTX‐M‐15 variant, both in animals and humans (Belas et al ., 2014; Ewers et al ., 2014; Kojima et al ., 2014; Rocha‐Gracia et al ., 2015; Zorgani et al ., 2017).…”

Section: Introductionmentioning

confidence: 99%

Molecular diversity of Extended‐spectrum β‐lactamase‐producing Escherichia coli from vultures in Canary Islands

Carvalho

Tejedor-Junco

González-Martín

et al. 2020

Environ Microbiol Rep

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Antimicrobial resistance among isolates from wild animals is increasingly reported. Extended‐spectrum beta‐lactamase (ESBL)‐producing Enterobacteriaceae, and particularly Escherichia coli, have spread worldwide as one of the most common multidrug‐resistant organisms. The aim of this study was to determine the carriage rate of ESBL‐producing E. coli isolates and their genetic characteristics in wild vultures from the Canary Islands. Faecal samples were collected from 22 apparently healthy free‐ranging (wild) vulture chicks from Lanzarote and Fuerteventura (Canary Islands) during July 2019. They were seeded in MacConkey agar supplemented with cefotaxime (2 μg ml−1). Colonies with typical morphology of E. coli were identified by MALDI‐TOF‐MS. Antimicrobial susceptibility was done by disk diffusion. Phenotypic detection of ESBL was performed by double‐disk tests. The presence of blaCTX‐M, blaSHV, blaTEM, blaKPC and blaOXA‐48 genes, as well as mcr‐1 (colistin resistance), tetA/tetB and int1 gene, was tested by PCR/sequencing. Phylogenetic groups and multilocus sequence typing (MLST) were determined by PCR/sequencing. ESBL‐producing E. coli isolates were detected in 5/22 tested animals (22.7%), and all isolates (one/animal) carried blaCTX‐M genes: blaCTX‐M‐15 (n = 3) and blaCTX‐M‐55 (n = 2). ESBL‐positive isolates were ascribed to phylogenetic group D (two isolates), B1 (two isolates) and A (one isolate), and five sequence types were detected (ST/phylogenetic‐group/ESBL): ST515/B1/CTX‐M‐15, ST1290/A/CTX‐M‐15, ST38/D/CTX‐M‐15, ST457/D/CTX‐M‐55 and ST6448/B1/CTX‐M‐55; this suggests a genetic diversity among these isolates. Three CTX‐M‐15‐producing isolates contained the blaTEM gene and one the tetA gene. To our knowledge, this appears to be the first report of ESBL‐producing E. coli in vulture chicks from the Canary Islands.

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Detection of CTX-M-15 Among Uropathogenic Escherichia coli Isolated from Five Major Hospitals in Tripoli, Libya

Abstract: The isolation of MDR ESBL-producing uropathogens expressing the CTX-M-15 gene will limit the choices clinicians have to treat their patients with UTIs. Continued surveillance and implementation of efficient infection control measures are required.

Cited by 32 publications

References 46 publications

Phenotypic and Genotypic Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Asymptomatic Bacteriuria in Pregnancy

Phenotypic and Genotypic Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Asymptomatic Bacteriuria in Pregnancy

Antimicrobial resistance among GLASS pathogens in conflict and non-conflict affected settings in the Middle East: A systematic review

Molecular diversity of Extended‐spectrum β‐lactamase‐producing Escherichia coli from vultures in Canary Islands

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