Entérobactéries productrices de bêta-lactamases à spectre élargi : épidémiologie, facteurs de risque et mesures de prévention

Vodovar, Dominique; Marcadé, G.; Raskine, Laurent; Malissin, Isabelle; Mégarbane, Bruno

doi:10.1016/j.revmed.2012.10.365

Cited by 17 publications

(12 citation statements)

References 71 publications

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“…Cela peut être expliqué par le fait que les gènes des E-BLSE, portés généralement par des plasmides, seraient souvent associés à des gènes de résistance aux autres antibiotiques [4]. Ainsi, les E-BLSE sont aujourd’hui les Bactéries Multi-Résistantes (BMR) majoritaires dans de nombreux pays [12]. La fréquence significativement élevée des E-BLSE chez les sujets âgés pourrait être la conséquence de la pression des antibiotiques, de la fragilité de ces patients, de l’utilisation répétée des antibiotiques de la même famille et des infections à répétition [6, 13].…”

Section: Discussionunclassified

“…Leur émergence est aussi bien hospitalière que communautaire. De plus, les mesures « habituelles » d’hygiène ne permettent pas de répondre à la propagation des E-BLSE, leur prévalence étant en constante augmentation [12]. Par ailleurs, on a également observé une souche d’Entérobactérie Productrice de Carbapénèmase (EPC) dénommée actuellement Bactérie Hautement Résistante et Emergente (BHRe) [14].…”

Section: Discussionunclassified

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Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo

et al. 2017

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IntroductionI’infection urinaire à Escherichia coli est fréquente en milieu hospitalier. Cette étude se propose de décrire les différents phénotypes de résistance des souches d’Escherichia coli afin de surveiller leur émergence.MéthodesIl s’agit d’une étude rétrospective de type descriptif de 102 souches d’Escherchia coli responsables d’infection urinaire sur une période allant du mois de Janvier 2014 au mois d’Octobre 2016 au Laboratoire du Centre Hospitalo-Universitaire Befelatanana Antananarivo.RésultatsLa résistance aux béta-lactamines a identifié des pénicillinases de haut niveau 50% (n=51), des Escherichia coli sécrétrices de Béta-Lactamase à Spectre Etendu E-BLSE 22,5% (n=23), des céphalosporinases de haut niveau 14,7% (n=15), des pénicillinases de bas niveau 5,9% (n=6), des souches sauvages 5,9% (n=6) et une souche d’Escherichia coli hautement résistante émergente. La résistance aux aminosides a concerné 58 (56,9%) phénotypes sauvages, 29 (28,4%) souches sensibles à l’amikacine et 15 (14,7%) résistants à tous les aminosides. La résistance aux fluoroquinolones a identifiée 52 (51%) souches sauvages, 9 (8,8%) souches sensibles à la ciprofloxacine et 41 (40,2%) résistantes à tous les fluoroquinolones. Les femmes (25, 7%) (p= 0,25, NS), les sujets de plus de 60 ans (38,7%) (p=0,02), les sujets hospitalisés dans le service de néphrologie (53,8%) (p=0,04), ayant présenté des troubles urinaires et rénaux (29, 7%) (p= 0,2, NS), ont été les plus affectés par les E-BLSE.ConclusionLa multi-résistance élevée des souches d’Escherichia coli interpelle sur une révision du traitement empirique des infections urinaires.

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Section: Discussionunclassified

Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo

et al. 2017

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“…Infections due to ESBL-producing K. pneumoniae (ESBL-Kp) increased mortality in hospitalised patients [1]. Risk factors for the acquisition of ESBL-Kp involve mechanical ventilation, the length of hospital stay especially in the intensive care units ICU, and previous use of antibiotics, identified to be the most prevalent risk factors for ESBL-producing bacteria [2]. Various class of β-lactamases have been described in ESBL-Kp, within the class A ESBL types, including the TEM, SHV and CTX-M, is the most extensive and clinically relevant [3].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, various epidemiological factors combined with ESBL-producing strains acquire to be described. Nosocomial infections caused by K. pneumoniae may lead to a potentially lifethreatening condition [2] [9]. Knowledge of local epidemiology is required to define the practical treatment for patients with a hospital infection.…”

Section: Introductionmentioning

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

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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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“…The majority of ESBLs are derived from TEM and SHV enzymes, but new ESBLs have been described such as cefotaximase (CTX-M), oxacillinase (OXA), Pseudomonas Extended Resistance (PER), Vietnam extended-spectrum β-lactamase (VEB), Guiana extended-spectrum β-lactamase (GES), TEM Like Activity (TLA), Brazilian Extended Spectrum βlactamases (BES), Serratia fonticola (SFO) and Fecal E. coli (FEC) (Cattoir, 2008). The rarer types such as SFO, TLA, PER, BES, GES, are found in Acinetobacter baumanii, Serratia fonticola, Pseudomonas aeruginosa, Klebsiella pneumoniae (Vodovar et al, 2013). ESBLs, because of their mode of distribution, constitute a major threat for West African countries where weak socioeconomic conditions result in poor hygiene conditions, favoring the spread of resistance.…”

Section: Introductionmentioning

confidence: 99%

Detection of multidrug-resistant enterobacteria simultaneously producing extended-spectrum -lactamases of the PER and GES types isolated at Saint Camille Hospital Center, Ouagadougou, Burkina Faso

Amana¹,

Wend-Kuni²,

Aminata³

et al. 2019

Afr. J. Microbiol. Res.

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Resistance to a wide variety of common antibiotics is observed among clinical strains designated as extended-spectrum β-lactamase (ESBL) producers. These produce enzymatic proteins that effectively inactivate cephalosporins and aztreonam and are a serious global health problem that complicates treatment strategies. Many studies report a high prevalence of ESBL producers among Gram-negative bacilli. The purpose of this work was to identify resistance genes in enterobacterial strains. Gramnegative bacilli resistant to at least one third-generation cephalosporin, aztreonam or showing a synergy image between amoxicillin + clavulanic acid and a third generation cephalosporin were isolated during an antibiogram. Antibiotic resistance was detected for the following antibiotics: Ceftriaxone, Cefotaxime, Ceftazidime and Aztreonam. Classical polymerase chain reaction (PCR) analyzes of Pseudomonas extended resistance (PER) and Guiana extended-spectrum (GES) β-lactamase genes were performed using specific primers in 60 ESBL-producing isolates. Among 250 strains of Gram negative bacilli collected, 60 strains (24%) showed resistance to antibiotics used. Stool samples are a major source of ESBL producers. The highest prevalence of resistant strains (35%) was observed in Escherichia coli. The GES and PER genes were simultaneously detected at a proportion of 13.33%. This study represents the first detection of PER and GES genes in multidrug-resistant enterobacteria in Burkina Faso.

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Entérobactéries productrices de bêta-lactamases à spectre élargi : épidémiologie, facteurs de risque et mesures de prévention

Cited by 17 publications

References 71 publications

Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo

Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo

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

Detection of multidrug-resistant enterobacteria simultaneously producing extended-spectrum -lactamases of the PER and GES types isolated at Saint Camille Hospital Center, Ouagadougou, Burkina Faso

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Entérobactéries productrices de bêta-lactamases à spectre élargi : épidémiologie, facteurs de risque et mesures de prévention

Cited by 17 publications

References 71 publications

Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo

Phénotypes de résistance des souches d’Escherichia coli responsables d’infection urinaire au laboratoire du Centre Hospitalo-Universitaire de Befelatanana Antananarivo

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

Detection of multidrug-resistant enterobacteria simultaneously producing extended-spectrum -lactamases of the PER and GES types isolated at Saint Camille Hospital Center, Ouagadougou, Burkina Faso

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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