Evaluation of Fecal Colonization with Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Risk Factors among Cancer Patients in Eastern Iran

Abstract

Background: This research aimed to estimate the prevalence of extended-spectrum b-lactamase-producing Enterobacteriaceae (ESBL-PE) in stool samples of patients with different types of cancer. Materials and Methods: Stool samples or deep rectal swabs were collected from cancer cases from January 2017 to December 2018. After species identification, in order to detect ESBL-PE, double-disk synergy test (DD test) was used. Disk diffusion procedure was conducted to determine the susceptibility of bacteria to antimicrobials. Lastly, antibiotic resistance genes including bla genes were characterized via polymerase chain reaction (PCR). Findings: Among 100 patients enrolled in this study, 50 (50%) were ESBL carriers. Escherichia coli was the most prevalent bacterium isolated (85%). Genotyping of EBSL-PE encoding genes using PCR showed that the prevalence rates of bla CTX-M and bla CTX-M-15 genes were 94 (47 of 50) and 90% (45 of 50), respectively, which were higher than those of bla TEM (80%, 40 of 50) and bla SHV genes (34%, 17of 50). There was no significant association between ESBL-PE fecal carriage and age (p= .68), sex (p = .49), time of diagnosis (p= .21), antibiotic therapy for the past three months (p= .77), and history of chemotherapy (p= .49). Finally, it was determined that cancer type was an associated risk factor for ESBL-PE fecal carriage in cancer patients. Conclusion: This research emphasizes regular bacterial monitoring, and that antibiotic stewardship plans ought to be performed among cancer patients to prohibit further spread of ESBL-PE with confined therapeutic options.

Fecal Carriage of Extended-Spectrum β-Lactamase and Carbapenemase-Producing Enterobacteriaceae Among Oncology and Non-Oncology Patients at Jimma Medical Center in Ethiopia: A Comparative Cross-Sectional Study

“…This result was also higher than a study conducted among cancer patients in eastern Iran (50%). 37 This variation might be due to the difference in the study population, inappropriate use of antibiotics, variation in antibiotic resistance control and prevention measures, and variation in the method of ESBL detection.…”

High Incidence of MDR and XDR Pseudomonas aeruginosa Isolates Harboring blaGES, blaVEB, and blaPER Extended-Spectrum Beta-Lactamase Genes in Iran

“…ESBL-producing P. aeruginosa infections could lead to severe adverse clinical outcomes. Efforts to control the outbreak of these infections should emphasize prevention and management strategies and the judicious use of antimicrobial agents to reduce the spread of these resistant pathogens [10,33] . In the current study, 48.3% of P. aeruginosa isolates were identified as phenotypic ESBL producers.…”

“…The transmission of beta-lactamase genes between different bacterial strains could be accomplished by highly diverse mobile genetic elements, which play a significant role in their rapid dissemination in hospital settings. ES-BL-producing P. aeruginosa is one of the critical members of antibiotic-resistant bacteria whose spread in hospital environments could lead to the outbreak of infection and treatment failure [10,11] . In the last decade, several classes of beta-lactamases (A, B, and D) were identified in P. aeruginosa strains.…”