Molecular characterization of multidrug-resistant Klebsiella pneumoniae and Escherichia coli harbouring extended spectrum beta-lactamases and carbapenemases genes at a tertiary hospital, Kenya

Abstract

SummaryBackground. Multidrug-resistant (MDR) Gram negative rods are increasingly being reported in sub-Saharan Africa. Molecular investigations play an important role, alongside other measures, in controlling nosocomial infections attributed to these organisms.This study aimed to determine the common extended spectrum beta-lactamases (ESBL) and carbapenemases genes, and clonal relationship in MDR Klebsiella pneumoniae and Escherichia coli.Methods. Fifty-four MDR isolates collected at the Aga Khan University hospital, Nairobi in the month of August 2012 formed the study. These were picked after an increase in the number of resistant strains during the said period was experienced.Results. blaCTXM was present in 41 (74%) of the isolates, while blaSHV was detected in 18 (33%) and blaTEM in 13 (24%) of the isolates.Nine (16.7%) of the isolates harboured all three ESBL genes and 8 (14.8%) harboured two. Eight of the isolates (all E. coli) had none of the ESBL genes tested. Two isolates harboured carbapenemases genotypes: one had blaNDM-1 and the other blaSPM.Sequencing matched CTXM-15 and TEM-1 genes in all the isolates harbouring blaCTXM and blaTEM respectively. However, there was diversity in blaSHV with SHV-11 and SHV-12 genes predominant. The isolates were non-clonal.Conclusions. The isolates mostly harboured blaCTX-M-15 while only a few had carbapenemases genes. Lack of clonality suggests these were the stable circulating strains at the time of the study.

Bacteriological and Molecular Study of Escherichia coli Isolated from Urinary Catheters in Baquba Teaching Hospital

“…The results showed that there were 8 isolates of E.coli and a ratio of 100% Picture (1) was contained in the gene bla TEM depending on the emergence of a 717-pair-base pack. These results were with the findings of [15], which indicated that E.coli isolates contained genes bla TEM (100%) (87.5 % respectively, but did not agree with the findings of [11] and study [21] which indicated that E.coli isolates contained bla TEM genes by (6.8 %) (48.7%) Respectively.…”

“…The prefixes of some anti-bla SHV, bla TEM and bla CTX-M resistant genes were used in these E.coli bacteria and they were confirmed through the use of the Ncbi-genbank site, which was processed by Bioneer company in Korea as a freeze-dried product (lyophilized). [11]…”

Molecular characterization and Antibiotic resistance profiles of Escherichia coli extended-spectrum β-lactamases producer strains isolated from urine samples in Benin

“…For example, in developed countries, it was reported that the economic and human damage caused by antibiotic-resistance is increasing at an alarming rate (Bush et al, 2011). Infections with multidrug-resistant organisms have linked with poorer clinical outcomes and prolonged hospitalization on average compared to infectionss with susceptible pathogens (Maina et al, 2017).…”

Epidemiology of Multidrug-resistant Organisms in Africa

“…In resource-constrained settings such as Africa, access to newer and often costly antibiotics such as plazomicin, colistin, and tigecycline (developed to treat MDR infections) is limited. Acquisition of MDROs has been linked to high morbidity and mortality rates, increased treatment costs, and prolonged hospitalization [7][8][9] . In both Africa and South-East Asia, for example, 45% of deaths have been attributed to MDR bacteria [9] .…”

“…In both Africa and South-East Asia, for example, 45% of deaths have been attributed to MDR bacteria [9] . In Africa, the problem of MDROs is influenced by factors such as indiscriminate use of antimicrobials, poor prescribing skills and training, lack of access to rapid and reliable diagnostics, poor hand hygiene practices, lack of infection prevention data, and inadequate surveillance [7,10] .…”