Extended-spectrum β-lactamases and plasmid-mediated quinolone resistance in enterobacterial clinical isolates from neonates in Tunisia

Charfi, Karama; Grami, Raoudha; Jeddou, Abir Ben; Messaoudi, Aziza; Mani, Yosra; Bouallègue, Olfa; Boujaafar, N.; Aouni, Mahjoub; Mammeri, Hedi; Mansour, Wejdène

doi:10.1016/j.micpath.2017.06.030

Cited by 11 publications

(11 citation statements)

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“…In this study, both E. coli and E. cloacae were highly sensitive to carbapenems, and no signi cant difference in resistance between ESBLs-producing and non-ESBLs-producing strains was observed, indicating that carbapenems could be used as an option in the treatment of ESBLs-resistant strains. In contrast to data collected from centers in east China, the reduced susceptibilities of E. coli and E. cloacae indicated a local carbapenem resistance [26]. Taken together, the carbapenem overuse might be an explanantion for the difference because of the developed areas with the higher incomes [27].…”

Section: Discussionmentioning

confidence: 64%

Antimicrobial resistance and epidemiology of ESBLs-producing Escherichia coli and Enterobacter cloacae isolates from the intensive care unit in an affiliated hospital of University, China

Chen¹,

Yang²,

Li³

2020

Preprint

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Background：Concerns are increasing over the importance of the hospital intensive care units (ICU) for the transmission of extended spectrum-β-lactamase (ESBLs) -producing Enterobacteriaceae. We reported the clinical characteristics and epidemiology of ESBLs isolates collected from a tertiary care hospital in China. Methods：Escherichia coli（E. coli）and Enterobacter cloacae （E. cloacae）isolates from ICU infection samples were isolated and identified. Antimicrobial susceptibility profiles and production of ESBLs were determined by using the disk diffusion method and the broth microdilution method. Clonality of isolates was determined by ERIC-PCR techniques. Results：From the included the 223 strains isolated from hospitalized patients with nosocomial infections in ICU during 2016 to 2018, the majority of isolates belonged to Gram-negative Enerobacteriaceae including E. coli (46.6% of all strains), and E. cloacae (46.2% of all strains). 63.25% of samples were separated from sputum or tracheal secretions. All of 207 isolates, ESBL-screen positive E. coli was 45.2% (47/104), and 44.7% (46/103) for E. cloacae. Resistance rates of ESBLs-producing E. coli and E. cloacae isolates were 95.5%-91.3% for ampicillin, 80.6%-76.1% for ampicillin/azobactam, 88.1%-28.3% for ciprofloxacin, 89.6%-15.2% for levofloxacin, 34.3%-45.7% for netilmicin, 82.1%-41.3% for compound sulfamethoxazole, 20.9%-43.5% for amikacin, 58.2%-37.0% for gentamicin, 20.9%-69.6% for piperacillin/tazobactam. All of ESBLs-producer isolates resistant to cefazolin, cefuroxime, ceftazidime, ceftriaxone, cefepime in additon to aztreonam were 100%, whereas the susceptibilities of isolates to imipenem and meropenem were 100%. Results of ERIC-PCR in all of ESBLs-producing E. coli isolates exhibited 11 distinct patterns using a similarity coefficient of 0.8. And one distinct ERIC profiles were observed amongst 46 strains of ESBLs-producing E. cloacae. ERIC profiles demonstrated an outbreak of nosocomial infection and ESBLs-producing E. coli and E. cloacae prevalent in the ICU of this hospital.Conclusions：Our data indicate that the ESBLs-producing E. coli and E. cloacae clones are circulating in the ICU and constitute a major source for further disseminating in this hospital. It is necessary to increase surveillance and development of adequate prevention strategies.

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Section: Discussionmentioning

confidence: 64%

Antimicrobial resistance and epidemiology of ESBLs-producing Escherichia coli and Enterobacter cloacae isolates from the intensive care unit in an affiliated hospital of University, China

Chen¹,

Yang²,

Li³

2020

Preprint

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“…The presence of CTX-M ESBLs and of carbapenemases such as NDM-1 from human enterobacteria isolates has been increasingly reported worldwide, including Tunisia. (1, 11, 16). In this 2-month survey, the incidence rate of ESBL-producing Enterobacteriaceae from urine collected from patients hospitalized in three health care facilities from two geographical areas of Tunisia, ranged from 11.1% to 3.7%.…”

Section: Discussionmentioning

confidence: 99%

“…Data are consistent with those described in literature which showed variable incidence rates depending of risk factors of ESBL-E acquisition (17, 18). Few studies including molecular analysis ESBL-E from community-acquired infections were reported in Tunisia (16). However, several reports from outpatients and from enterobacteria fecal carriage performed at Hospital admission have also underlined the presence of CTX-M-producing enterobacteria in the Tunisian community setting (14).…”

Section: Discussionmentioning

confidence: 99%

Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

Mhaya

Trabelsi

Bégu

et al. 2019

Preprint

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25CTX-M ESBLs have been increasingly reported from human enterobacteria isolates in 26 Tunisia. NDM-1 carbapenemase was recently reported in isolates from Tunisian Hospitals. 27 During a 2-month period (December 2017 to January 2018), we have collected 23 ESBL- 28 producing Enterobacteriaceae (ESBL-E) from urines of patients hospitalized in three health 29 care facilities and from community, situated in two distinct Tunisian geographical regions. 30 They were divided into 15 Escherichia coli and eight Klebsiella pneumoniae. The aim of this 31 study was to characterize ESBL-E with regard to their β-lactamase content and their 32 epidemiological relationship. The results indicated a high rate (47%) of E. coli producing both 33 CTX-M group-1 and -9. For the first time, we demonstrated the presence of E. coli having 34 concomitantly CTX-M-15 and CTX-M-27 which belong to two sequences types (ST), ie. A-35 ST617 (2 isolates) and B2-ST131 subclade C2 (2 isolates). All four E. coli isolates carried a 36 multireplicon IncF with an identical allelic combination, F31:A4:B1. This study reports also 37 the first description of K. pneumoniae belonging to the clone ST147 carrying the 38 carbapenemase NDM-1 in the Tunisian community. In conclusion, our data confirms the need 39 for monitoring the resistance to extended-spectrum cephalosporins and to carbapenems 40 among enterobacteria in Tunisia. 41 42 43Resistance to extended-spectrum cephalosporins (ESC) is widespread among 44 Enterobacteriaceae species and is mainly due to the production of extended-spectrum ß-45 lactamases (ESBLs). The dissemination of ESBLs is become a growing concern since they 46 are considered as a major cause of morbidity and mortality. Up to the end of the 1990s, TEM-47 and SHV-type ESBLs were mainly produced by the Klebsiella pneumoniae and Enterobacter 48 spp. responsible for nosocomial infections (1, 2). Since 2000s, CTX-M ESBLs have gained 49 prominence mainly in Escherichia coli and K. pneumoniae strains and are now considered as 50 pandemic enzymes. Many bla CTX-M variants exist, but they can be divided into two main 51 clusters (groups -1 and -9); each cluster of CTX-M genotypes has a corresponding progenitor 52 gene sharing homology with different environmental Kluyvera spp. from which bla CTX-M 53 genes originated. Among CTX-M enzymes, CTX-M-15 belonging to group 1, has currently 54 been the most frequent all over the world (1, 3) 55 The majority of CTX-M type ESBL-associated E. coli infections is often concentrated within 56 specific extraintestinal pathogenic E. coli (ExPEC) lineages belonging to highly virulent 57 phylogenetic group B2, and recognizable by their sequence type (ST). The bla CTX-M-15 is the 58 dominant ESBL gene in the virulent E. coli ST131 clone, in particular in the subclade ST131-59 C2 (4). However other genetically divergent CTX-M genes also occur in this ST, such as 60 bla CTX-M-14/14-like variants in Canada, China, and Spain (5, 6). A subclade of E. coli ST131 61 producing the CTX-M-27 (group 9 enzyme, CTX-M-1...

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“…ESBL genes are often located on plasmids, and this phenomenon can cause the rapid spread of these genes among strains and even different species of bacteria, in particular inside hospital sewage (4). Due to the rapid spread, the plasmid-mediated quinolone resistance has played an important role in the quinolone resistance of enterobacteriaceae in recent years (9,10). The most common genes of this group are qnrA, qnrB and qnrS.…”

Section: Introductionmentioning

confidence: 99%

The Antibiotic Resistance Profiles of Escherichia Coli Isolated from Pre and Post Treated Hospital Sewage

Akya

Shavise-Zadeh

Bozorgomid

et al. 2020

Preprint

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Background: The dissemination of resistant strains of bacteria into the environment through hospital sewage has been recognized as a public health concern. We investigated the antibiotic resistance profile of E. coli isolated from hospital sewage.Methods: E. coli strains were isolated from the hospital sewage system from both pre and post treatment phases in a general hospital of Kermanshah city (west of Iran). Resistance to antibiotics (clindamycin, ceftriaxone, Co-trimoxazole, penicillin, ciprofloxacin, amikacin, gentamicin, imipenem, and piperacillin) was determined by disc diffusion. Isolates were screened phenotypically for extended-spectrum beta-lactamases (ESBL) production. The frequency of common antibiotic resistance genes (bla CTX-M, bla TEM, bla SHV, and qnr) were detected by PCR and data was statistically analyzed.Results: Sixty E. coli strains (30 for pre treatment and 30 for post treatment sewage) were randomly selected from isolates. All ESBL-producing isolates showed resistance to three antibiotic classes and were MDR. For non-ESBL isolates, 70 and 90 percent were MDR for pre and post treatment sewage, respectively. Of isolates tested, 100% had at least one of resistance genes. The frequency of bla CTX-M-1 gene was significantly higher in isolates of post treatment sewage. The bla TEM gene was more common than other genes in ESBL-producing isolates.Conclusion: The high rate of antibiotic resistance and resistance genes in E. coli isolates of hospital sewage, especially in post treatment is alarming. These data suggest that despite the widespread use of active sludge system to treat hospital sewage, they may not capable to adequately eliminate or reduce the antibiotic resistance strains of E.coli.

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Extended-spectrum β-lactamases and plasmid-mediated quinolone resistance in enterobacterial clinical isolates from neonates in Tunisia

Cited by 11 publications

References 42 publications

Antimicrobial resistance and epidemiology of ESBLs-producing Escherichia coli and Enterobacter cloacae isolates from the intensive care unit in an affiliated hospital of University, China

Antimicrobial resistance and epidemiology of ESBLs-producing Escherichia coli and Enterobacter cloacae isolates from the intensive care unit in an affiliated hospital of University, China

Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

The Antibiotic Resistance Profiles of Escherichia Coli Isolated from Pre and Post Treated Hospital Sewage

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