Extended-Spectrum Beta-Lactamase-Producing <i>Salmonella</i> Enteritidis in Trinidad and Tobago

Cherian, Benny P; Singh, Neera; Charles, Walton N; Prabhakar, Parimi

doi:10.3201/eid0501.990128

Cited by 12 publications

(12 citation statements)

References 5 publications

(4 reference statements)

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“…Examination of 234 non-typhoid salmonella strains derived during 1994-1997 from both hospital-and community-acquired infections in a coastal district in Kenya, showed an ESC-resistance frequency of 15% [84]. A ceftriaxone-resistant, ESBL-producing S. Enteritidis strain has been isolated recently from a hospitalised patient in Trinidad (Caribbean) [85]. A prolonged outbreak of infections in a neonatal unit due to an ESC-resistant S. Infantis has recently been described in Brazil [86].…”

Section: Esc-resistant Salmonella With Unidentified Mechanisms Of Resmentioning

confidence: 98%

Expanded-spectrum cephalosporin resistance in non-typhoid Salmonella

Miriagou

Tassios

Legakis

et al. 2004

International Journal of Antimicrobial Agents

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Section: Esc-resistant Salmonella With Unidentified Mechanisms Of Resmentioning

confidence: 98%

Expanded-spectrum cephalosporin resistance in non-typhoid Salmonella

Miriagou

Tassios

Legakis

et al. 2004

International Journal of Antimicrobial Agents

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“…The presence and characterization of ESBL-producing genes in clinical isolates of K. pneumonia e and other Enterobacteriaceae have previously been described in Trinidad and Tobago [2, 3, 11]. However, this study sought to determine the evolving nature of these genes, specifically in the hospital setting, in order to provide data that could be useful in improving infection control measures and guide antimicrobial stewardship programmes.…”

Section: Introductionmentioning

confidence: 99%

Detection of a CTX-M group 2 beta-lactamase gene in a Klebsiella pneumoniae isolate from a tertiary care hospital, Trinidad and Tobago

Cheddie

Dziva

Akpaka

2017

Ann Clin Microbiol Antimicrob

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BackgroundIdentification of the prevalence and spread of ESBL-mediated antibiotic resistance is essential especially in the hospital setting. It is for this reason, more and more studies are highlighting the importance of complementing phenotypic ESBL-detection techniques with molecular techniques in order to understand the basis and extent of this form of resistance among clinically evolved bacterial populations, especially those belonging to the Enterobacteriaceae family. However, in Trinidad and Tobago and other Caribbean countries, very little is known regarding ESBL detection rates and/or the prevalence of genes conferring ESBL resistance.MethodologySixty-six Klebsiella pneumoniae isolates from clinical specimens phenotypically identified by the Microscan Walkaway-96 System as potential ESBL-producers were analysed in this study. Screening and confirmation of these isolates as ESBL producers was done by the Clinical and Laboratory Standards Institute (CLSI) approved methods. Polymerase chain reaction amplification of beta-lactamase genes bla TEM, bla SHV, bla CTX-M1, bla CTX-M2 and bla AmpC was performed to identify mechanisms of β-lactam resistance.ResultsESBL-producing K. pneumoniae was confirmed in 78.8% (41/52) from isolates collected from a variety of sources during the period, April–July 2015. bla SHV (84.8%) and bla CTX-M (46.9%) were the predominant β-lactamase genes identified. A single K. pneumoniae isolate possessed a bla CTX-M group 2 beta-lactamase gene. RAPD analysis identified a number of epidemiologically related isolates. However, current isolates were unrelated to isolates from previous years.ConclusionThis study revealed that among K. pneumoniae isolates exhibiting extended spectrum β-lactam resistance, there was a high prevalence of bla SHV and bla CTX-M genes. This result highlights the need for a reliable epidemiological apparatus that involves the molecular characterisation of ESBL resistance.Electronic supplementary materialThe online version of this article (doi:10.1186/s12941-017-0209-x) contains supplementary material, which is available to authorized users.

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“…Reports of ESBL-producing organisms also exist from Central America and the Caribbean Islands (84,114,146,370,371).…”

Section: Global Epidemiologymentioning

confidence: 99%

Extended-Spectrum β-Lactamases: a Clinical Update

2005

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SUMMARY Extended-spectrum β-lactamases (ESBLs) are a rapidly evolving group of β-lactamases which share the ability to hydrolyze third-generation cephalosporins and aztreonam yet are inhibited by clavulanic acid. Typically, they derive from genes for TEM-1, TEM-2, or SHV-1 by mutations that alter the amino acid configuration around the active site of these β-lactamases. This extends the spectrum of β-lactam antibiotics susceptible to hydrolysis by these enzymes. An increasing number of ESBLs not of TEM or SHV lineage have recently been described. The presence of ESBLs carries tremendous clinical significance. The ESBLs are frequently plasmid encoded. Plasmids responsible for ESBL production frequently carry genes encoding resistance to other drug classes (for example, aminoglycosides). Therefore, antibiotic options in the treatment of ESBL-producing organisms are extremely limited. Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet carbapenem-resistant isolates have recently been reported. ESBL-producing organisms may appear susceptible to some extended-spectrum cephalosporins. However, treatment with such antibiotics has been associated with high failure rates. There is substantial debate as to the optimal method to prevent this occurrence. It has been proposed that cephalosporin breakpoints for the Enterobacteriaceae should be altered so that the need for ESBL detection would be obviated. At present, however, organizations such as the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards) provide guidelines for the detection of ESBLs in klebsiellae and Escherichia coli. In common to all ESBL detection methods is the general principle that the activity of extended-spectrum cephalosporins against ESBL-producing organisms will be enhanced by the presence of clavulanic acid. ESBLs represent an impressive example of the ability of gram-negative bacteria to develop new antibiotic resistance mechanisms in the face of the introduction of new antimicrobial agents.

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Extended-Spectrum Beta-Lactamase-Producing Salmonella Enteritidis in Trinidad and Tobago

Cited by 12 publications

References 5 publications

Expanded-spectrum cephalosporin resistance in non-typhoid Salmonella

Expanded-spectrum cephalosporin resistance in non-typhoid Salmonella

Detection of a CTX-M group 2 beta-lactamase gene in a Klebsiella pneumoniae isolate from a tertiary care hospital, Trinidad and Tobago

Extended-Spectrum β-Lactamases: a Clinical Update

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