Extended-Spectrum Beta-Lactamase Producing Gram Negative Bacteria in Iran: A Review

Leylabadlo, Hamed Ebrahimzadeh; Pourlak, Tala; Bialvaei, Abed Zahedi; Aghazadeh, Mohammad; Asgharzadeh, Mohammad; Kafil, Hossein Samadi

doi:10.21010/ajid.v11i2.6

Cited by 44 publications

(23 citation statements)

References 44 publications

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“…[ 19 20 21 ] In recent years, the emergence of MDR strains is growing problem in Iranian health-care centers, especially extended-spectrum beta-lactamases and carbapenem producing strains of enterobacteriaceae. [ 22 23 ] The study findings showed the promising effect of carbapenem for MDR isolates and can be recommended for treatment of related infections in patients with cancer. Despite reports that are indicating to increasing trend of carbapenem resistance among enterobacteriaceae our findings emphasize the effectiveness of these agents.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer

2018

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Background:Nosocomial infections are one of the most leading causes of morbidity and mortality in patients with cancer. The emergence of multiple-drug-resistant (MDR) strains of Gram-negative bacteria causing nosocomial infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of Gram-negative bacteria related nosocomial infections among Iranian cancer patients.Materials and Methods:This descriptive cross-sectional study was conducted during the 6 months from December 2015 to May 2016 in two tertiary care centers located in Isfahan and Arak Province. Gram-negative bacteria obtained from different clinical specimens from hospitalized patients with cancer and were identified using standard microbiological methods. Antibiotic susceptibility pattern was determined by the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) recommendation.Results:Of totally 259 culture positive cases, Escherichia coli showed the highest isolation rate (60.6%) followed by Klebsiella pneumoniae (26.6%) and Proteus spp (11.2%). The rate of MDR isolates were 91.5% (237/259). Overall, the most frequent source of bacterial isolation was urinary tract infection (65.6%) followed by skin and soft-tissue infection (23.6%). The antibiotic susceptibility results showed meropenem (MEN) and ceftazidime as the most effective antibiotics for E. coli, K. pneumoniae, and Proteus spp. isolates. Moreover, MEN was the most effective antibiotic against MDR isolates.Conclusion:The study findings showed a significant distribution of MDR Gram-negative bacteria which may increase the burden of healthcare-associated infections in cancer patients. Although, carbapenem can be considered as effective agents toward MDR strains for empirical antibiotic therapy in our region.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer

2018

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“…3 Because of the severity and life-threatening features, doing multiple cultures from patients and prescription of broad-spectrum antibiotics are of great importance. 4 The obtained results from the disk diffusion method and blood cultures determine the type of the prescribed antibiotics. 3 In addition, in South Africa and Ethiopia, the mortality rate due to sepsis is nearly 53%, which is considered an important health concern in developing countries.…”

Section: Introductionmentioning

confidence: 99%

Determination of Antimicrobial Resistance Patterns in Bloodstream Infections-Isolated Bacteria From a University Tertiary Hospital Patients

Hasani

Faezi

Rezaee

et al. 2019

Int J Enteric Pathog

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Background: Bloodstream infections are considered a significant medical concern associated with high morbidity and mortality rates. Therefore, physicians should be guided to use antimicrobial susceptibility patterns in order to select appropriate empiric antimicrobial agents to treat the patients who suffer from bacteremia. Objective: The present study aimed to determine antimicrobial resistance and susceptibility patterns in isolates collected from bloodstream infections. Materials and Methods: To achieve this, a total of 710 bacterial blood culture isolates were collected from Sina hospital, and then susceptibility patterns to a number of antibiotics were analyzed according to Clinical and Laboratory Standards Institute guidelines. Results: The identified isolates included Staphylococcus aureus 14 (20.6%), Escherichia coli 14 (20.6%), Acinetobacter baumannii 12 (17.6%), Pseudomonas aeruginosa 11 (16.2%), Coagulasenegative Staphylococcus 8 (11.8%), Klebsiella pneumoniae 6 (8.8%), and Enterobacter spp. 3 (4.4%). The total resistance rate to co-trimoxazole, ceftriaxone, ceftazidime, cefotaxime, ofloxacin, gentamicin, ciprofloxacin, levofloxacin, amikacin, and imipenem was 44 (64.7%), 42 (61.8%), 39 (57.4%), 38 (55.9%), 35 (51.51%), 32 (47.1%), 31 (45.6%), 25 (36.8%), and 27 (39.7%), respectively. Finally, the susceptibility rate to amikacin and imipenem was 43 (63.2%) and 41 (60.3%), respectively. Conclusion: In general, A. baumannii strains isolated from blood cultures were resistant to most antibiotics and the greatest sensitivity was observed to gentamicin (58.3%) compared to other antibiotics. Therefore, gentamicin was found as the most effective antibiotic for treating bloodstream infections caused by A. baumannii.

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“…Previous results on prevalence of gram-negative bacteria, generators of broad-spectrum beta-lactamases, have shown that ESBLs are rising rapidly. 25,26 In view of our survey, it was indicated that spread of ESBLs and their expression was associated with failures in treatment and increased mortality.…”

Section: Discussionmentioning

confidence: 85%

Prevalence of blaCTX-M, blaSHV and blaTEM β-Lactamase Genes Among Escherichia coli Isolates in Foodborne Outbreak in Iran

Dallal¹,

Fani²,

Rajabi³

et al. 2018

Int J Enteric Pathog

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Background: FExtended spectrum beta-lactamases (ESBLs) are known as enzymes that are responsible for creating high level of antimicrobial resistance in gram negative microorganisms especially in Escherichia coli. Therefore, survey and identification of the genes generating these enzymes can be effective in controlling the resistance and helpful in using appropriate β-lactam drug against them. Objective: In this study we focused on evaluating the prevalence of ESBL enzyme genes, including CTX-M, SHV, and TEM β-lactamase, among E. coli isolates in foodborne disease outbreak. Materials and Methods: Four hundred stool samples from the individuals with diarrhea, nausea, vomiting, abdominal cramps, fever and headache were tested by IMVIC biochemical test for E. coli. ESBL genes were determined using antimicrobial susceptibility test based on the Clinical and Laboratory Standards Institute (CLSI), disk diffusion method, and confirmatory test (combined disk). Subsequently, polymerase chain reaction (PCR) was performed for following the relative genes. Results: The highest resistance in E. coli isolates was reported against ampicillin (56%), and 36% of samples were ESBL-positive. As determined by PCR, the prevalence of SHV, TEM, and CTX-M1 genes was 0%, 18%, and 38%, respectively. Conclusion: Due to the prevalence of β-lactamase genes, application of accurate and rapid identification methods such as PCR deems essential. Therefore, it can be considered as a routine method.

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Extended-Spectrum Beta-Lactamase Producing Gram Negative Bacteria in Iran: A Review

Cited by 44 publications

References 44 publications

Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer

Antimicrobial Resistance Pattern and Spectrum of Multiple-drug-resistant Enterobacteriaceae in Iranian Hospitalized Patients with Cancer

Determination of Antimicrobial Resistance Patterns in Bloodstream Infections-Isolated Bacteria From a University Tertiary Hospital Patients

Prevalence of blaCTX-M, blaSHV and blaTEM β-Lactamase Genes Among Escherichia coli Isolates in Foodborne Outbreak in Iran

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