Incidence of metallo-beta-lactamase producing clinical isolates of Escherichia coli and Klebsiella pneumoniae in central Nepal

Bora, Arijit; Rajkumari, Sanjana; Jha, Brajesh Kumar; Mahaseth, Surya Narayan; Pokharel, Khilasa

doi:10.1186/1756-0500-7-557

Cited by 54 publications

(53 citation statements)

References 25 publications

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“…Majority of MBL isolates were isolated from ICUs (82.1%). Our findings are in accordance with several studies, which found that the majority of clinical isolates were yielded from blood cultures and from patients in the ICU (Bora et al, 2014;Sultan et al, 2013;Shibl et al, 2013).…”

Section: Discussionsupporting

confidence: 93%

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Phenotypic and genotypic methods for detection of metallo beta lactamases among carbapenem resistant Enterobacteriaceae clinical isolates in Alexandria Main University Hospital

El-Ghazzawy¹,

Meheissen²,

Younis³

2016

Afr. J. Microbiol. Res.

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Dissemination of carbapenem resistant Enterobacteriaceae (CRE) poses a considerable threat to public health. The aim of the present work was to estimate the prevalence of metallo beta lactamases (MBL) among CRE isolated from Alexandria Main University Hospital, Egypt, to evaluate the performance of different phenotypic methods for the detection of MBL, and to investigate the local antimicrobial sensitivity profile of these isolates. Eighty CRE were tested for MBL production by Etest® MBL MP/MPI, EDTA double disc synergy test, and EDTA combined disc test. All isolates were confirmed as MBL producers by polymerase chain reaction (PCR). Antibiotic sensitivity testing was performed using disc diffusion method. Among the 80 CRE, 56 isolates (70%) were MBL by PCR. Fifty-four isolates were positive for NDM (96.4%). Meropenem EDTA CDT was the most sensitive test (94.6%). Blood was the most frequent sample from which MBL were isolated (51.7%). Majority of the isolates were isolated from intensive care units (82.1%). All MBL were multidrug resistant; Colistin and polymyxin B showed the lowest resistance rate (26.8 and 19.6%, respectively). The EDTA-CDT will provide a reliable, convenient, and cost-effective approach for detection of MBL in laboratories, which cannot afford to perform molecular tests.

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Section: Discussionsupporting

confidence: 93%

“…Previous studies also found that the combined disc test was a highly sensitive (100%) method among the analyzed procedures (Picao et al, 2008;Galani et al, 2008b;Bora et al, 2014). This could be attributed to the subjective interpretation of DDST results.…”

Section: Discussionmentioning

confidence: 88%

Phenotypic and genotypic methods for detection of metallo beta lactamases among carbapenem resistant Enterobacteriaceae clinical isolates in Alexandria Main University Hospital

El-Ghazzawy¹,

Meheissen²,

Younis³

2016

Afr. J. Microbiol. Res.

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“…Table 5 OB (200) 1 (20) 4 (80) OFX (10) 4 (80) 1 (20) AK (10) 5 (100) 0 (0) from both community and hospital samples [1,[3][4][5]. Our result on the prevalence of MBL-and AmpC-producing bacteria does not correspond to previous study in which E. coli and Klebsiella species that produced MBL and AmpC enzymes was reported at a higher rate [1,15,23,26,27]. The MBL-producing E. coli isolate and AmpC-producing Klebsiella species were multiply resistant to 7 antibiotics.…”

Section: Discussioncontrasting

confidence: 65%

Phenotypic detection of metallo-?-lactamase (MBL) and AmpC enzymes among abattoir isolates of Escherichia coli and Klebsiella species in Abakaliki, Nigeria

Chika¹,

Ngozi²,

Agabus³

et al. 2018

Trends Med

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The surveillance of antibiotic resistance and antibiotic usage in livestock and other agricultural practices is still relatively poor in Nigeria; and this allow drug resistant bacteria to emerge and spread in the community almost undetected. Bacteria that produce metallo-β-lactamases (MBLs) and AmpC enzymes are notably resistant to the carbapenems and cephamycins respectively. And these antibiotics are important antimicrobial agents used clinically for the treatment of infectious diseases. In this study, the frequency of MBL-and AmpC-producing Klebsiella species and Escherichia coli isolates was phenotypically investigated. A total of 50 anal swab samples were bacteriologically analyzed for the selective isolation of Klebsiella species and E. coli isolates which were identified by standard microbiology techniques. Antimicrobial susceptibility testing was carried out using the modified Kirby-Bauer disk diffusion technique. The production of MBLs and AmpC enzymes was phenotypically detected using Hodges (Cloverleaf) test and ceftazidime-imipenem antagonism test (CIAT) respectively. The multidrug resistant nature of the MBLand AmpC-producing Klebsiella species and E. coli isolates was calculated using the multiple antibiotic resistance index (MARI) formular. A total of 5 E. coli isolates and 12 isolates of Klebsiella species were bacteriologically recovered from the anal swab samples. The Klebsiella species were resistant or intermediately resistant to cefoxitin (66.7%), ceftazidime (58.3%), cloxacillin (100%), ertapenem (83.3%), amikacin (16.7%) and ofloxacin (16.7%). E. coli isolates were also found to be resistant to cefoxitin (40%), ceftazidime (40%), cloxacillin (80%) and ofloxacin (20%). MBL was phenotypically detected in one (1) isolate of E. coli while AmpC enzyme production was detected in 9 isolates of Klebsiella species phenotypically. On average, the MBL-producing E. coli isolate and AmpC-producing Klebsiella species were multiply resistant to 7 antibiotics. This study has presumptively shown that bacteria from abattoir origin including Klebsiella species and E. coli isolates are notable MBL and AmpC enzyme producers, and they are multidrug resistant in nature. The use of antibiotics in agriculture and animal husbandry is a major driving force in the emergence and spread of resistant bacteria in the non-hospital environment. This should be discouraged at all levels to preserve the efficacy of available antibiotics especially in this environment where the detection of MBL-and AmpC-producing bacteria from clinical and non-clinical samples is still pitiable.

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“…CP-CRE prevalence rates are approximately 18% in two large hospitals in Nepal (99, 101). The most common carbapenemase in Enterobacteriaceae is NDM (101,102), with two new variants (NDM-8 and -12) described in Nepal recently (103,104). No mcr-positive Enterobacteriaceae have been found in Nepal to date.…”

Section: South Asiamentioning

confidence: 99%

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

et al. 2017

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SUMMARY Carbapenem-resistant Gram-negative bacteria, in particular the Acinetobacter baumannii-calcoaceticus complex and Enterobacteriaceae, are escalating global public health threats. We review the epidemiology and prevalence of these carbapenem-resistant Gram-negative bacteria among countries in South and Southeast Asia, where the rates of resistance are some of the highest in the world. These countries house more than a third of the world's population, and several are also major medical tourism destinations. There are significant data gaps, and the almost universal lack of comprehensive surveillance programs that include molecular epidemiologic testing has made it difficult to understand the origins and extent of the problem in depth. A complex combination of factors such as inappropriate prescription of antibiotics, overstretched health systems, and international travel (including the phenomenon of medical tourism) probably led to the rapid rise and spread of these bacteria in hospitals in South and Southeast Asia. In India, Pakistan, and Vietnam, carbapenem-resistant Enterobacteriaceae have also been found in the environment and community, likely as a consequence of poor environmental hygiene and sanitation. Considerable political will and effort, including from countries outside these regions, are vital in order to reduce the prevalence of such bacteria in South and Southeast Asia and prevent their global spread.

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Incidence of metallo-beta-lactamase producing clinical isolates of Escherichia coli and Klebsiella pneumoniae in central Nepal

Cited by 54 publications

References 25 publications

Phenotypic and genotypic methods for detection of metallo beta lactamases among carbapenem resistant Enterobacteriaceae clinical isolates in Alexandria Main University Hospital

Phenotypic and genotypic methods for detection of metallo beta lactamases among carbapenem resistant Enterobacteriaceae clinical isolates in Alexandria Main University Hospital

Phenotypic detection of metallo-?-lactamase (MBL) and AmpC enzymes among abattoir isolates of Escherichia coli and Klebsiella species in Abakaliki, Nigeria

Carbapenem-Resistant Acinetobacter baumannii and Enterobacteriaceae in South and Southeast Asia

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