High frequency of simultaneous presence of ESBL and carbapenemase producers among nosocomial  coliform isolates in Faisalabad, Pakistan

Irfan, Sofia; Azhar, Aysha; Bashir, Anam; Ahmed, Salman; Haque, Abdul

doi:10.12669/pjms.37.1.3192

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…The most prevalent gene found in 15 ESBL E. coli isolates from water samples during the current study was bla TEM (40%, n ¼ 6), followed by bla CTX-M (33.33%, n ¼ 5) which concurs previous report from Pakistan (Irfan et al 2021). However, bla SHV gene could not be detected in the tested ESBL E. coli isolates in this study.…”

supporting

confidence: 86%

Antibiotic resistance pattern and molecular detection of ESBL-associated genes in E. coli from surface and wastewater of Islamabad capital territory, Pakistan

Ahsan¹,

Rehman

Irshad³

et al. 2022

Journal of Water and Health

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The goal of this study was to determine how surface and wastewater contribute to the contamination of the environment with an extended-spectrum β-lactamase-producing Escherichia coli (ESBL E. coli). Water samples (n = 32) were collected from eight different locations of Islamabad and processed for microbiological and molecular analyses of E. coli and ESBL E. coli. Antimicrobial susceptibility testing was carried out to determine the resistance pattern of the isolates. A total of 21 water samples were contaminated with E. coli and 15 isolates were identified as ESBL producers harboring blaTEM (40%) and blaCTX-M (33.33%) genes. Interestingly, all the ESBL E. coli isolates showed the least resistance against second-generation Cephalosporins compared to other generations. Moreover, the study showed that the aquatic environment is harboring multidrug-resistant E. coli; therefore, it may act as a source of transmission to humans. The recovery of ESBL E. coli isolates resistant to higher generation Cephalosporins, Monobactam, and Carbapenems from water samples indicated an alarming situation. Thus, there is an urgent need to treat water efficiently for microbial decontamination to minimize the transmission of antimicrobial-resistant (AMR) bacteria.

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supporting

confidence: 86%

Antibiotic resistance pattern and molecular detection of ESBL-associated genes in E. coli from surface and wastewater of Islamabad capital territory, Pakistan

Ahsan¹,

Rehman

Irshad³

et al. 2022

Journal of Water and Health

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“…The production of carbapenemase is usually associated with an extensively drug-resistant phenotype, leaving very few therapeutic options. A recent study from Pakistan showed significant presence of both ESBL and carbapenemase producers, as well as co-existence of ESBL and carbapenemases in the same isolate [ 59 ]. In that study, 50% of isolates were resistant to both imipenem and meropenem, with some isolates expressing the bla NDM-1 gene [ 59 ], which indicates a worrying trend.…”

Section: Escherichia Colimentioning

confidence: 99%

Mechanisms of Resistance in Gram-Negative Urinary Pathogens: From Country-Specific Molecular Insights to Global Clinical Relevance

Bedenić

Meštrović

2021

Diagnostics

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Urinary tract infections (UTIs) are the most frequent hospital infections and among the most commonly observed community acquired infections. Alongside their clinical importance, they are notorious because the pathogens that cause them are prone to acquiring various resistance determinants, including extended-spectrum beta-lactamases (ESBL); plasmid-encoded AmpC β-lactamases (p-AmpC); carbapenemases belonging to class A, B, and D; qnr genes encoding reduced susceptibility to fluoroquinolones; as well as genes encoding enzymes that hydrolyse aminoglycosides. In Escherichia coli and Klebsiella pneumoniae, the dominant resistance mechanisms are ESBLs belonging to the CTX-M, TEM, and SHV families; p-AmpC; and (more recently) carbapenemases belonging to classes A, B, and D. Urinary Pseudomonas aeruginosa isolates harbour metallo-beta-lactamases (MBLs) and ESBLs belonging to PER and GES families, while carbapenemases of class D are found in urinary Acinetobacter baumannii isolates. The identification of resistance mechanisms in routine diagnostic practice is primarily based on phenotypic tests for the detection of beta-lactamases, such as the double-disk synergy test or Hodge test, while polymerase chain reaction (PCR) for the detection of resistance genes is mostly pursued in reference laboratories for research purposes. As the emergence of drug-resistant bacterial strains poses serious challenges in the management of UTIs, this review aimed to appraise mechanisms of resistance in relevant Gram-negative urinary pathogens, to provide a detailed map of resistance determinants in Croatia and the world, and to discuss the implications of these resistance traits on diagnostic approaches. We summarized a sundry of different resistance mechanisms among urinary isolates and showed how their prevalence highly depends on the local epidemiological context, highlighting the need for tailored interventions in the field of antimicrobial stewardship.

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“…coli and Klebsiella pneumoniae are the most frequent carriers of bla NDM , with specific sequence types (ST) such as ST11, 14, 15, 147 for K. pneumoniae and ST167, 410, 617 for E. coli. Diverse variants of carbapenemases such as VIM, IMP, NDM, KPC, and GIM have also been reported in Enterobacterales across Pakistan [17][18][19]. Limited data are available regarding the epidemiology of CPE carriage in the community [20][21][22], but suggesting a marked dissemination of CPE in Pakistan, Our study aimed to fill these gaps in assessing the CPE carriage prevalence in a Pakistani urban community and the underlying genetic determinants responsible for emergence of carbapenem resistance.…”

Section: Introductionmentioning

confidence: 99%

Dissemination of carbapenemase-producing Enterobacterales in the community of Rawalpindi, Pakistan

Habib

Villageois-Tran

et al. 2022

PLoS ONE

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Carbapenems are considered last-line beta-lactams for the treatment of infections caused by multidrug-resistant Gram-negative bacteria. However, their activity is compromised by the rising prevalence of carbapenemase-producing Enterobacterales (CPE), which are especially marked in the Indian subcontinent. In Pakistan, previous reports have warned about the possible spread of CPE in the community, but data are still partial. This study was carried out to analyse the prevalence of CPE, the genetic characterisation, and phylogenetic links among the spreading CPE in the community. In this cohort study, we collected 306 rectal swabs from patients visiting Benazir Bhutto hospital, Rawalpindi. CPEs were screened by using ertapenem-supplemented MacConkey agar. Identification was performed by using conventional biochemical tests, and genomes were sequenced using Illumina chemistry. Antibiotic resistance genes, plasmid incompatibility groups, and Escherichia coli phylogroups were determined in silico. Sequence types were determined by using MLST tool. The prevalence of CPE carriage observed was 14.4% (44/306 samples). The most common carbapenemase-encoding gene was bla-NDM-5 (n = 58) followed by blaNDM-1 (n = 7), blaNDM (non-assigned variant, n = 4), blaOXA-181 (n = 3), blaOXA-232 (n = 3) and blaNDM-7 (n = 1). Most of the CPE were E. coli (55/64, 86%), and the genomic analysis revealed a pauciclonal diffusion of E. coli with ST167 (n = 14), 405 (n = 10), 940 (n = 8), 648 (n = 6) and 617 (n = 5). We obtained a second sample from 94 patients during their hospital stay in whom carriage was negative at admission and found that 7 (7.4%) acquired a CPE. Our results indicate that the prevalence of CPE carriage in the Pakistani urban community was high and driven by the dissemination of some E. coli clones, with ST167 being the most frequent. The high CPE carriage in the community poses a serious public health threat and calls for implementation of adequate preventive measures.

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High frequency of simultaneous presence of ESBL and carbapenemase producers among nosocomial coliform isolates in Faisalabad, Pakistan

Cited by 3 publications

References 22 publications

Antibiotic resistance pattern and molecular detection of ESBL-associated genes in E. coli from surface and wastewater of Islamabad capital territory, Pakistan

Antibiotic resistance pattern and molecular detection of ESBL-associated genes in E. coli from surface and wastewater of Islamabad capital territory, Pakistan

Mechanisms of Resistance in Gram-Negative Urinary Pathogens: From Country-Specific Molecular Insights to Global Clinical Relevance

Dissemination of carbapenemase-producing Enterobacterales in the community of Rawalpindi, Pakistan

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