Molecular characterization of extended spectrum beta-lactamases produced by Klebsiella pneumoniae clinical strains from a Tunisian Hospital

Alibí, Sana; Ferjani, Asma; Boukadida, Jalel

doi:10.1016/j.medmal.2015.01.010

Cited by 22 publications

(10 citation statements)

References 26 publications

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“…Therefore, the high resistance to broad-spectrum β-lactams might be attributed to the indiscriminate use of these antimicrobials, which creates a selective pressure. Resistance to trimethoprim-sulfamethoxazole was 93.9%, which is comparable with different studies in Ethiopia; 86.4% in Addis Ababa [ 15 ] and 96.5% in Bahir Dar [ 16 ]; furthermore, there was a consistent report from Tunisia citing 94.06% [ 19 ]. Nevertheless, it was higher than those observed in studies conducted in Bangladesh (44%) [ 20 ] and Nepal (51.3%) [ 21 ].…”

Section: Discussionsupporting

confidence: 83%

High Prevalence of Multidrug-Resistant Klebsiella pneumoniae in a Tertiary Care Hospital in Ethiopia

et al. 2021

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Klebsiella pneumoniae poses an urgent public health threat, causing nosocomial outbreaks in different continents. It has been observed to develop resistance to antimicrobials more easily than most bacteria. These days, multidrug-resistant strains are being increasingly reported from different countries. However, studies on the surveillance of multidrug-resistant Klebsiella pneumoniae are very rare in Ethiopia. This study aimed to determine the antimicrobial resistance patterns and magnitude of MDR K. pneumoniae isolates from patients attending or admitted to Tikur Anbessa Specialized Hospital (TASH). A cross-sectional study was conducted from September 2018 to February 2019 at TASH, Addis Ababa, Ethiopia. Identification of K. pneumoniae was done by examining the Gram stain, colony characteristics on MacConkey agar and 5% sheep blood agar, as well as using a series of biochemical tests. Antimicrobial susceptibility testing of the isolates for 21 antimicrobials was done by the Kirby–Bauer disc diffusion technique. Data were double entered using Epidata 3.1 and exported to SPSS version 25 software for analysis. Among the total K. pneumoniae isolates (n = 132), almost all 130 (98.5%) were MDR. Two (1.5%) isolates showed complete non-susceptibility to all antimicrobial agents tested. Moreover, a high rate of resistance was observed to cefotaxime and ceftriaxone 128 (97%), trimethoprim-sulfamethoxazole 124 (93.9%), and cefepime 111 (84.1%). High susceptibility was recorded to amikacin 123 (93.2%), imipenem 107 (81.1%), meropenem 96 (72.7%), and ertapenem 93 (70.5%). K. pneumoniae isolates showed a high rate of resistance to most of the tested antimicrobials. The magnitude of MDR K. pneumoniae was very alarming. Therefore, strengthening antimicrobial stewardship programs and antimicrobial surveillance practices is strongly recommended in TASH.

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Section: Discussionsupporting

confidence: 83%

High Prevalence of Multidrug-Resistant Klebsiella pneumoniae in a Tertiary Care Hospital in Ethiopia

et al. 2021

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“…before but have been identified among different genera. B la SHV -11 have been found in many clinical and environmental K. pneumoniae strains (Alibi et al, 2015; Davies et al, 2016; Shahraki-Zahedani et al, 2016), bla CTX-M-27 in many Enterobacteriaceae strains (Matsumura et al, 2016; Rodrigues et al, 2016), bla CTX-M-98 in E. coli strains from China (Liu et al, 2015) and bla PER-4 in Proteus vulgaris clinical strain (NG_049963). The rest of the identified ESBL bla genes have been observed in Aeromonas spp.…”

Section: Discussionmentioning

confidence: 99%

Occurrence and Variety of β-Lactamase Genes among Aeromonas spp. Isolated from Urban Wastewater Treatment Plant

et al. 2017

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Members of the genus Aeromonas that commonly occur in various aquatic ecosystems are taken into account as vectors spreading antibiotic resistance genes (ARGs) in the environment. In our study strains of Aeromonas spp. (n = 104) not susceptible to ampicillin were isolated from municipal sewage of different levels of purification – raw sewage, activated sludge and treated wastewater. The crucial step of the study was the identification of β-lactamase resistance genes. The identified genes encode β-lactamases from 14 families – blaTEM, blaOXA, blaSHV, blaCTX-M, blaMOX, blaACC, blaFOX, blaGES, blaPER, blaV EB, blaKPC, cphA, imiH, and cepH. There were no significant differences in number of identified ARGs between isolation points. BlaOXA, blaFOX variants and, characteristic for Aeromonas genus, metallo-β-lactamase cphA-related genes were the most commonly identified types of β-lactam resistance determinants. Moreover, we found four extended-spectrum β-lactamases (blaSHV -11, blaCTX-M-27, blaCTX-M-98, and blaPER-4) – and seven AmpC (blaACC, blaFOX-2-like, blaFOX-3, blaFOX-4-like, blaFOX-9, blaFOX-10-like, and blaFOX-13-like) types and variants of genes that had never been found among Aeromonas spp. before. Five of the β-lactamases families (blaTEM, blaOXA, blaFOX, blaV EB, and cphA) were identified in all three isolation sites, which supports the hypothesis that wastewater treatment plants (WWTPs) are hot spots of ARGs dissemination. The obtained ARGs sequences share high identity with previously described β-lactamases, but new variants of those genes have to be considered as well. Characterization of antibiotic susceptibility was performed using disk the diffusion method with 12 different antibiotics according to CLSI guidelines. Over 60% of the strains are unsusceptible to cefepime and chloramphenicol and the majority of the strains have a multidrug resistance phenotype (68%). Finally, analysis of plasmid profiles among the resistant strains showed that 62% of the isolates from all three points of the WWTP carry plasmids of different sizes. Among some of the isolated plasmids blaFOX-4-like and blaGES genes have been found. To sum up, the results strongly suggest that Aeromonas spp. can be considered as agents of antibiotic resistance dissemination from wastewater to the natural environment.

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“…Coexistence between CTX-M and aminoglycoside and / or quinolone resistance genes has been described in Africa (Alibi et al, 2015;Breurec et al, 2013). In Senegal, Moquet et al (2011) observed a copresence of CTX-M15 / AAC'6 at 78.8% and CTX-M15 / QNR at 65%.…”

Section: Discussionmentioning

confidence: 99%

OXA-48 type carbapenemase in Klebsiella pneumoniae producing extended spectrum B-lactamases (ESBL) in Senegal

Seynabou¹,

FrÃ©dÃ©ric²,

Beyrouthy³

et al. 2018

Afr. J. Microbiol. Res.

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Enterobactericeae producing extended spectrum -lactamases (ESBL) are likely to express carbapenemases OXA-48 which have hydrolytic activity on carbapenems. The aim of this work was to evaluate prevalence of blaOXA-48 for Klebsiella pneumoniae isolates producing ESBL. This work was conducted at the French Reference Center for Antibiotic Resistance with strains from Senegalese Hospital. Standard antibiogram was performed in accordance to CA-SFM/EUCAST 2016 and presence of ESBL was confirmed by synergistic image. Polymerase chain reaction (PCR) was performed to detect systematically blaOXA-1, blaTEM-1, blaCTX-M-1, blaCTX-M-9 and blaOXA-48 gene in case of decrease sensitivity to carbapenem. PCR products were extracted, purified, sequenced and whole-genome sequence (WGS) were used for the analyses. Plasmids extraction was performed by Kado and Liu method. Five isolates harbored a decreased susceptibility to carbapenems. They were positive for blaOXA-48 gene and also expressed blaCTX-M-15. Analysis of the five plasmids by WGS identified a single IncL/M type plasmid of 63 kb and other genes for aminoglycosides and quinolones resistance. Carbapenemase-producing Enterobacteriaceae represent new threat to public health. Decrease in carbapenem susceptibility should be an alert for rapid detection of carbapenemases and to prevent their spread. Phenotypic or molecular methods should be available in many laboratories to take appropriate preventive and therapeutic measures.

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Molecular characterization of extended spectrum beta-lactamases produced by Klebsiella pneumoniae clinical strains from a Tunisian Hospital

Cited by 22 publications

References 26 publications

High Prevalence of Multidrug-Resistant Klebsiella pneumoniae in a Tertiary Care Hospital in Ethiopia

High Prevalence of Multidrug-Resistant Klebsiella pneumoniae in a Tertiary Care Hospital in Ethiopia

Occurrence and Variety of β-Lactamase Genes among Aeromonas spp. Isolated from Urban Wastewater Treatment Plant

OXA-48 type carbapenemase in Klebsiella pneumoniae producing extended spectrum B-lactamases (ESBL) in Senegal

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