Emergence of carbapenem-resistant Enterobacteriaceae isolates in the Moroccan community

Barguigua, Abouddihaj; Otmani, Fatima El; Talmi, Mustapha; Zerouali, Khalid; Timinouni, Mohammed

doi:10.1016/j.diagmicrobio.2012.03.011

Cited by 27 publications

(32 citation statements)

References 10 publications

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“…Hammerum et al reported that patients transferred from Libya to Denmark carried OXA-48-producing K. pneumoniae [42].These studies underscore the importance of an early warning system at the European level and screening upon admission of patients transferred across countries. These findings may also confirm that North Africa, including Tunisia and Libya, are considered to be reservoirs of oxacillinase producers, particularly OXA-48; to date, this enzyme represents the most common carbapenemase type circulating in this region [43][44][45][46] (Table 5). Recently, in 2014, Agabou et al reported the first description of OXA-48-producing E. coli and the pandemic clone ST131 from patients hospitalized at the Regional Military Hospital of Constantine [33].…”

Section: Indeed Mamlouk Et Al Detected the Blactx-m-15 Gene Insupporting

confidence: 67%

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Mathlouthi

Al-Bayssari

Salabi

et al. 2016

J Infect Dev Ctries

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Introduction: The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase production among clinical isolates of Enterobacteriaceae recovered from Tunisian and Libyan hospitals. Methodology: Bacterial isolates were recovered from patients in intensive care units and identified by biochemical tests and MALDI-TOF. Antibiotic susceptibility testing was performed by disk diffusion and the E-test method. ESBL and carbapenemase activities were detected using standard microbiological tests. Antibiotic resistance-encoding genes were screened by PCR and sequencing. Clonal relationships between Klebsiella pneumoniae strains were carried out using multi-locus sequence typing (MLST). Results: A total of 87 isolates were characterized, with 51 and 36, respectively, identified as E. coli and K. pneumoniae. Overall the resistance prevalence was high for aminoglycosides (> 60%), fluoroquinolones (> 80%), and extended-spectrum cephalosporins (> 94%), and was low for imipenem (11.4%). Among this collection, 58 strains (66.6%) were ESBL producers and 10 K. pneumoniae strains (11.4%) were carbapenemase producers. The antibiotic resistance-encoding genes detected were blaCTX-M-15 (51.7%), blaTEM-1 (35.6%), several variants of blaSHV (21.8%), and blaOXA-48 (11.4%). The MLST typing of K. pneumoniae isolates revealed the presence of multiple clones and three novel sequence types. Also, close relationships between the OXA-48-producing strains from Tunisia and Libya were demonstrated. Conclusions: This study is the first paper describing the emergence of carbapenemase-and ESBL-producing Enterobacteriaceae, sensitive to colistin, isolated in Tunisia and Libya. Active surveillance and testing for susceptibility to colistin should be implementing because resistance to colistin, mainly in Klebsiella, has been recently reported worldwide.

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Section: Indeed Mamlouk Et Al Detected the Blactx-m-15 Gene Insupporting

confidence: 67%

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Mathlouthi

Al-Bayssari

Salabi

et al. 2016

J Infect Dev Ctries

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“…Genes K. pneumoniae isolates were screened by PCR for the following β-lactamase-encoding genes: bla CTX-M group 1, bla CTX-M group 9, bla CTX-M group 2, bla TEM , bla SHV , bla OXA-48 , bla NDM , bla KPC and bla VIM as described previously [12]. The known β-lactamase-producing strains E. coli U2A1790 (CTX-M-1), Salmonella spp.…”

Section: Detection Of β-Lactamase-encodingmentioning

confidence: 99%

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Natoubi¹,

Barguigua²,

Zriouil³

et al. 2016

AiM

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Aim: The aim of the current study is to determine: (1) the prevalence of extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-Kp) isolated from clinical samples and a hospital environment in Hassan II Hospital (Settat, Morocco); (2) the associated risk factors of ESBL-Kp infections; (3) the link between clinical and environmental isolates. Methods: During the study period (April 2010 to March 2011), all patients infected and hospital environment sites contaminated by K. pneumoniae were considered as the potential study population and environmental site. The clinical data were collected to identify risk factors for ESBL carriage of K. pneumoniae infection. Screening of ESBL-and carbapenemase-producing isolates was performed by using a double-disk synergy test and the modified Hodge test, respectively. ESBL-Kp isolates were tested for the presence of genes encoding β-lactamases and were investigated by PCR. The clonal relationship between * Corresponding author. S. Natoubi et al. 153 ESBL-producing isolates was analysed by ERIC-and REP-PCR method. Results:The overall prevalence of ESBL-Kp among clinical and environmental K. pneumoniae isolates was 35.13% (13/37) and 4.04% (4/99), respectively. The main risk factors for carrying ESBL-Kp were renal disease (46.15%), recent surgery (53.84%), previous hospitalisation (76.92%), and the presence of many invasive devices (53.84%). All ESBL isolates were multidrug resistant. The blaCTX-M group1and blaSHV (70.58% for each) were the most prevalent followed by blaTEM (52.94%). Thirteen strains expressed at least two bla genes. One isolate was positive in the modified Hodge test and was a blaOXA-48 producer. ERIC and Rep-PCR methods revealed an epidemic clonal dissemination of these isolates. Conclusion: The emergence of OXA-48 carbapenemase, endemic clonal dissemination and multi-drug resistance of ESBL-Kp isolates in our institution is highly alarming.

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“…Carbapenem-resistant Enterobacteriaceae were tested by using specific primers for carabapenem-hydrolysing enzymes encoding the genes bla GES , bla KPC , bla VIM , bla IMP , bla ,and bla NDM as described previously [6].…”

Section: Detection Of β-Lactamase-encoding Genesmentioning

confidence: 99%

“…Enterobacteriaceae isolates were screened by PCR for the following β-lactamase-encoding genes: bla CTX-M of phylogenetic lineage groups 1, 2 and 9, bla TEM , bla SHV , bla PER , and bla VEB genes as described previously [6].…”

Section: Detection Of β-Lactamase-encoding Genesmentioning

confidence: 99%

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Occurrence of Carbapenemases and Extended-Spectrum Βeta-Lactamases in Uropathogenic Enterobacteriaceae Isolated From a Community Setting, Settat, Morocco

Natoubi

Barguigua²,

Baghdad³

et al. 2016

Asian J Pharm Clin Res

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Objective: Urinary tract infections (UTIs) are still commonly diagnosed in outpatients as well as in hospitalized patients. In this study, we investigated the prevalence and performed molecular characterization of extended-spectrum-β-lactamases (ESBL) and carbapenemases produced by Enterobacteriaceae isolates that cause community UTIs in Settat city, Morocco. Methods:From January 2012 to December 2013, all uropathogenic community Enterobacteriaceae isolates were collected from the microbiology laboratory of Hassan II Hospital, Settat, Morocco. Antibiotic susceptibility testing was performed as recommended by Clinical and Laboratory Standard Institute. Phenotypic identification of ESBL and carbapenemase producer isolates was confirmed by the double-disk synergy test and the modified Hodge test, respectively. Molecular characterization of β-lactamase genes was performed using polymerase chain reaction (PCR), followed by sequencing of the obtained products.Results: Among 153 isolates, 31 (20.26%) were multi-drug resistant (MDR). Nine strains (5.88%) were ESBL producers, of which Klebsiella pneumoniae (n=5; 20.83%), Escherichia coli (n=3; 3.15%), and Enterobacter cloacae (n=1; 9.09%) species were identified. The results of ESBLencoding gene detection by sequencing revealed the presence of CTX-M-15 (n=9) in association with other β-lactamase genes such as temoneira 1 (n=8) and sulfhydryl variable 1 (n=5). According to the modified Hodge test and PCR, three isolates (1.96%) were positive carry the bla OXA-48 gene. Conclusion:The emergence of MDR uropathogenic Enterobacteriaceae isolates in our community is highly alarming. Strict measures will be required to control the further spread of these uropathogenic isolates.

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Emergence of carbapenem-resistant Enterobacteriaceae isolates in the Moroccan community

Cited by 27 publications

References 10 publications

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Occurrence of Carbapenemases and Extended-Spectrum Βeta-Lactamases in Uropathogenic Enterobacteriaceae Isolated From a Community Setting, Settat, Morocco

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Emergence of carbapenem-resistant Enterobacteriaceae isolates in the Moroccan community

Cited by 27 publications

References 10 publications

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Occurrence of Carbapenemases and Extended-Spectrum Βeta-Lactamases in Uropathogenic Enterobacteriaceae Isolated From a Community Setting, Settat, Morocco

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Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco