Drug Resistance Pattern of Bacterial Pathogens of Enterobacteriaceae Family

Sah, Bhola Shankar; Aryal, Manita; Bhargava, Dipak; Siddique, Amrullah

doi:10.3126/tujm.v4i0.21672

Cited by 4 publications

(5 citation statements)

References 10 publications

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“…In the present study, a total of 204 bacterial isolates were obtained from 667 various clinical specimens. Among total isolates, Gram negative bacteria were predominant constituting 75.5% and Gram positive bacteria constituted 24.5%, which was in accordance with results of previous studies (Bhandari et al, 2016;Sah et al, 2017) suggesting predominance of Gram negative bacteria over Gram positive bacteria. Of all isolates, E. coli (31.4%) was the most prevalent bacteria followed by K. pneumoniae (27.5%).…”

Section: Discussionsupporting

confidence: 91%

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Antibacterial Activity of Lemon Juice on Multi-Drug Resistant Klebsiella species Harboring blaOXA-48 Gene

Malla

Khanal

Sudeep

et al. 2022

J. Inst. Sci. Tech.

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Klebsiella species cause a wide range of infections, and infections caused by multi-drug resistant species have significantly higher rates of morbidity and mortality. Extended spectrum β-lactamase ESBL prodan emergingd carbapenem resistant K. pneumoniae is emerging problem in hospital settings worldwise. However, the distribution of blaOXA-48 in Klebsiella pneumoniae has rarely been described from Nepal. This study was carried out to evaluate in vitro antibacterial activity of lemon juice against clinical isolates of Klebsiella having blaOXA-48 gene. A total of 667 clinical specimens were processed for the identification of Klebsiella species by morphological, cultural and biochemical tests. Methods of antimicrobial susceptibility testing and confirmation of extended spectrum beta lactamase (ESBL) were adopted from the guidelines of the Clinical Laboratory Standard Institute (2018), and blaOXA-48 gene was detected by polymerase chain reaction. The antibacterial activity of lemon juice was assayed using agar well diffusion, and the bactericidal effect of lemon juice was determined by the broth dilution method. Out of 204 culture positive isolates, 29.5% were Klebsiella species of which 16.7% were ESBL producers. Among 19 isolates positive to Modified Hodge test, 68.4% were detected with the plasmid mediated blaOXA-48 gene. The MIC of lemon juice ranged from 12.5-50% (v/v), and the bacteriostatic activity was observed after 6-8 hours of exposure. The tested varieties of lemon juice showed potential inhibitory activity against Klebsiella species indicating that lemon juice has the potential to be used as an antibacterial agent.

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Section: Discussionsupporting

confidence: 91%

“…Of all isolates, E. coli (31.4%) was the most prevalent bacteria followed by K. pneumoniae (27.5%). Corroborating with the present study, several other studies have reported similar pattern of pathogens recovery from clinical specimens in Nepal and elsewhere (Akanbi et al, 2013;Ghimire et al, 2017;Sah et al, 2017).…”

Section: Discussionsupporting

confidence: 91%

Antibacterial Activity of Lemon Juice on Multi-Drug Resistant Klebsiella species Harboring blaOXA-48 Gene

Malla

Khanal

Sudeep

et al. 2022

J. Inst. Sci. Tech.

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“…One disc each of ceftazidime (30μg) and cefotaxime (30μg) alone and one in combination ceftazidime and clavulanic acid (30/10μg) were placed at a distance of 20mm on a Muller Hinton agar plate inoculated with a bacterial suspension of 0.5 McFarland turbidity standards, and incubated overnight at 37°C. The ESBL-producing strains showed ≥5mm increase in zone diameter for either antimicrobial agent tested in combination with clavulanic acid versus its zone when tested alone [9,10,22] .…”

Section: Confirmatory Testmentioning

confidence: 97%

“…AmpC over production along with porin mutations of the outer membrane, can reduce susceptibility to carbapenems, in particular in plasmid mediated AmpC producers. [8,11,22] Porins are chemically selective and transport only one group of molecules and are specific for one molecule so the β-lactam and fluoroquinolone antibiotics they pass through porins to reach their targets in gram negative bacteria. Bacteria can develop resistance to these antibiotics by mutation of the gene that encodes the porin the antibiotics are then excluded from passing through the outer membrane resulting in multidrug resistance [8] .…”

Section: Detection Of Extended-spectrum Beta Lactamases and Ampc Betamentioning

confidence: 99%

Detection of Extended-Spectrum Beta Lactamases and AmpC Beta Lactamases Producing Uropathogenic Escherichia coli in a Tertiary Care Hospital

Bakshi

Sehgal

Kansal

et al. 2019

International Journal of Medical and Dental Sciences

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Background: The multidrug resistant among uropathogenic E. coli has become a potential threat to global health. The aim of the current study to evaluate the antimicrobial activities of nitrofurantoin and fosfomycin along with other antimicrobials against Extended Spectrum β-Lactamases (ESBL) and AmpC producer isolates from the most common organism E. coli. Methods: A total of 6046 clean catch midstream urine samples were collected and processed in Microbiology department of tertiary care hospital. The antimicrobial susceptibility of E. coli isolates was initially screened by Kirby-Bauer disk diffusion method. The resistant isolates were confirmed to be ESBL and AmpC producers by their respective phenotypic confirmatory tests of combined disc method. Results: Out of 6046 patients there were 1855 E. coli positive patients. Maximum patients in the age group of 21-30 years were 51.5% followed by 31-40 years where patients were 26%. 64.4% E. coli were isolated from female patients and 35.6% from male patients. E. coli showed higher sensitivity towards, fosfomycin (100%), imipenem (100%), nitrofurantoin (84.1%), piperacillin and tazobactam (77.3%), amikacin (76.1%) and while they showed high degree resistance pattern against Penicillin, cotrimoxazole, ciprofloxacin, norfloxacin and 2 nd and 3 rd generation cephalosporin. Out of 1855 E. coli, multi drug resistance was seen in 520 E. coli isolates. ESBL production was observed among 50% of E. coli isolates by combined disk method. Out of 520 isolates, 150 isolates showed resistance to one or more extended-spectrum cephalosporins and cefoxitin by Kirby-Bauer disk diffusion method. These were selected and screened for ESBL and AmpC production. Among 150 cefoxitin-resistant isolates, AmpC phenotype was detected in 100 isolates (66.6%) by AmpC disc method. The overall occurrence of AmpC in the study was found to be 19.2%. Susceptibility of ESBL and AmpC producers to fosfomycin, imipenem, nitrofurantoin and amikacin were found to be 100%, 98.5%, 89% and 75% respectively. Conclusions: There is increased prevalence of ESBL and AmpC producing E. coli. Thus, early detection of ESBL and AmpC producer E. coli by simple phenotypic methods is necessary to avoid treatment failure, where molecular techniques are not available.

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“…Studies have reported that bacteremia caused by ESBL-producing Enterobacterales is associated with higher rates of treatment failure and patient mortality when compared to bacteremia caused by non ESBL-producing strains 1 , 25 . Various authors have emphasized that ESBL-producing Enterobacterales strains are not associated with resistance to ceftazidime-avibactam 6 , 7 , 10 , 15 , 25 , 26 , which was also demonstrated in our study.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of in-vitro susceptibility of ß-lactam-resistant Gram-negative bacilli to ceftazidime-avibactam and ceftolozane-tazobactam from clinical samples of a general hospital in southern Brazil

Carvalho

Kobs²,

Hille³

et al. 2023

Rev. Soc. Bras. Med. Trop.

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Background: The spread of carbapenemase- and extended-spectrum β-lactamase (ESBL)-producing gram-negative bacilli (GNB) represent a global public health threat that limits therapeutic options for hospitalized patients. This study aimed to evaluate the in-vitro susceptibility of β-lactam-resistant GNB to ceftazidime-avibactam (C/A) and ceftolozane-tazobactam (C/T), and investigate the molecular determinants of resistance. Methods: Overall, 101 clinical isolates of Enterobacterales and Pseudomonas aeruginosa collected from a general hospital in Brazil were analyzed. Susceptibility to the antimicrobial agents was evaluated using an automated method, and the minimum inhibitory concentrations (MIC50/90) of C/A and C/T were determined using Etest ® . The β-lactamase-encoding genes were investigated using polymerase chain reaction. Results: High susceptibility to C/A and C/T was observed among ESBL-producing Enterobacterales (100% and 97.3% for CLSI and 83.8% for BRCAST, respectively) and carbapenem-resistant P. aeruginosa (92.3% and 87.2%, respectively). Carbapenemase-producing Klebsiella pneumoniae exhibited high resistance to C/T (80%- CLSI or 100%- BRCAST) but high susceptibility to C/A (93.4%). All carbapenem-resistant K. pneumoniae isolates were susceptible to C/A, whereas only one isolate was susceptible to C/T. Both antimicrobials were inactive against metallo-β-lactamase-producing K. pneumoniae isolates. Resistance genes were concomitantly identified in 44 (44.9%) isolates, with bla CTX-M and bla SHV being the most common. Conclusions: C/A and C/T were active against microorganisms with β-lactam-resistant phenotypes, except when resistance was mediated by metallo-β-lactamases. Most C/A- and C/T-resistant isolates concomitantly carried two or more β-lactamase-encoding genes (62.5% and 77.4%, respectively).

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Drug Resistance Pattern of Bacterial Pathogens of Enterobacteriaceae Family

Cited by 4 publications

References 10 publications

Antibacterial Activity of Lemon Juice on Multi-Drug Resistant Klebsiella species Harboring blaOXA-48 Gene

Antibacterial Activity of Lemon Juice on Multi-Drug Resistant Klebsiella species Harboring blaOXA-48 Gene

Detection of Extended-Spectrum Beta Lactamases and AmpC Beta Lactamases Producing Uropathogenic Escherichia coli in a Tertiary Care Hospital

Evaluation of in-vitro susceptibility of ß-lactam-resistant Gram-negative bacilli to ceftazidime-avibactam and ceftolozane-tazobactam from clinical samples of a general hospital in southern Brazil

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