Multi-drug resistant and extended-spectrum β-lactamases producing bacterial uropathogens among pregnant women in Northwest Ethiopia

Biset, Sirak; Moges, Feleke; Endalamaw, Demeke; Eshetie, Setegn

doi:10.1186/s12941-020-00365-z

Cited by 19 publications

(25 citation statements)

References 32 publications

(41 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The dominant carbapenemase-producing gram-negative bacilli were Klebsiella Pneumoniae 8.3%[9/109] followed by Acinetobacter species 6.8% [5/74], the study results marginally coincides with the findings of the following researchers which demonstrated the dominant prevalence of carbapenemase-producing Klebsiella pneumoniae: Beyene et al Klebsiella pneumoniae 5.6% [19], Melese et al Klebsiella pneumoniae 10.5%[24], Moges et al Klebsiella pneumoniae 5.8%[25], Moges et al Klebsiella pneumoniae 10.1%[26], Lopez-Hernandez Klebsiella pneumoniae 45% [29].The present study disagrees with finding by Okoche et al, which showed E. coli as the highest carbapenemase-producing organisms[28], The discrepancy could be explained by the fact that they utilized Boronic acid-based inhibition, a modified Hodge and EDTA double combination disk test, the number of samples analyzed, and a different geographical location. , etc.The highest number of carbapenemase producing isolates were recovered from urine samples 13/23(56.5%), which strongly disagrees with the results of study conducted by Moges et al in which the highest number of carbapenemase producing isolates was recovered from blood samples 22/24(91.6%)[25],The prevalence of MDR was 45.2% which is much lower than the study conducted at Ethiopian Public Health Institute, Ethiopia by Beyene et al 94.5%[19], three referral hospitals, Ethiopia by Moges et al 85.8%[25], Felegehiwot Hospital, Ethiopia by Moges et al 80% and by Alebel et al 81.1%[26,30], Addis Ababa, Ethiopia by Teklu et al 68.3%[31], North Iran by Hemmati 62.8%[32], and Jimma medical center, Ethiopia by Biset et al 56.67%[33]. The variation might be due to the study population, the number of isolates assessed, the technique utilized, etc.…”

mentioning

confidence: 72%

“…Out of four hundred twenty-nine (429) gram-negative bacilli, clinical isolates analyzed, (N=33,7.7%) were extremely drug-resistant. Out of 33 2. Ten out of twenty-three Carbapenemase-positive organisms were Metallo-beta-lactamase (MBL) producers.…”

Section: Resultsmentioning

confidence: 99%

“…Acinetobacter species(100%), P. aeruginosa(100%), Citrobacter species(100%), and Enterobacter cloacae(100%) were the dominant MDR isolates [30], the variation could be attributable to the fact that there were fewer samples evaluated, that samples were taken from intensive care unit patients, or that the study was conducted in a different geographic location and Biset et al [33] pneumoniae accounts for 100%, 40%, 50%,36%, and 75% of the gram-negative bacilli isolates respectively, the observed difference could be attributed to the types of gram-negative bacteria analyzed, as most of them only included Enterobacteriaceae, the techniques used, geographical location, and so on.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Abdeta

Bitew

Fentaw

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Multi-drug resistant, extremely drug-resistant, pan-drug resistant, carbapenem-resistant, and carbapenemase-producing gram-negative bacteria are becoming more common in health care settings and are posing a growing threat to public health. Objective The study was aimed to determine the magnitude of multi-drug resistant, extremely drug-resistant, carbapenem non-susceptible, and carbapenemase-producing gram-negative bacilli at Ethiopian Public Health Institute. Materials and methods Prospective cross-sectional study was conducted from June 30, 2019, to May 30, 2020, at the national reference laboratory of the Ethiopian Public Health Institute. Clinical samples were collected, inoculated, and incubated in accordance to standard protocol for each sample. Antimicrobial susceptibility testing was done using Kirby Bauer disk diffusion. Identification was done using the traditional biochemical method. Multidrug-resistant and extensively drug-resistant were classified using a standardized definition established by European Centers for Disease prevention and control and the United States Centers for Disease prevention and control experts. Carbapenemase production was confirmed by modified carbapenem inactivation and a simplified carbapenem inactivation method. Meropenem with EDTA was used to differentiate serine carbapenemase and Metallo β-lactamase. Results A total of 1337 clinical specimens were analyzed, of which 429-gram negative bacilli isolates were recovered. Out of 429 isolates 319, 74, and 36 were Enterobacterales, Acinetobacter species, and P. aeruginosa respectively. In our study, the prevalence of Multidrug-resistant, extensively drug-resistant, Carbapenemase-producing, and carbapenem non-susceptible Gram-negative bacilli were, 45.2%, 7.7%, 5.4%, and 15.4% respectively. Out of 66 isolates screened for Carbapenemase, 34.8% (23/66) were Carbapenemase enzyme producers. Ten out of twenty-three Carbapenemase-positive organisms were Metallo-beta-lactamase producers. Thirteen out of twenty-three isolates were serine carbapenemase producers. Three out of 13 serine Carbapenemase positive organisms were Klebsiella pneumoniae Carbapenemase. Conclusion The finding from this study revealed a high prevalence of Multidrug-resistant, extremely drug-resistant, carbapenemase-producing gram-negative bacteria, particularly among Intensive care unit patients at the health facility level, this necessitates a robust laboratory-based antimicrobial resistance monitoring and infection prevention and control program.

show abstract

mentioning

confidence: 72%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Abdeta

Bitew

Fentaw

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…TEM and SHV variants were dominant in the 1990s, whereas CTX-M have been increasing recently all over the world, with the CTX-M-15 variant being widespread around the globe with a resistance phenotype including a high level of resistance to extended-spectrum cephalosporins (ESCs) and ciprofloxacin [ 35 ]. There are many reports on this allelic variant in urinary isolates from South America [ 36 , 37 ], Africa [ 38 ], and Asia [ 34 ]. Other CTX-M allelic variants found among urinary isolates were CTX-M-1, CTX-M-3, CTX-M-14, and CTX-M-27 [ 39 ].…”

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

View full text Add to dashboard Cite

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.

show abstract

“…A similar observation was noted by Linares et al [ 16 ], who reported that the incidence of ESBL-producing gram-negative bacteria in renal transplantation was 11.8%. Previous antibiotic therapy is an important risk factor for the development of ESBL-producing bacteria[ 17 , 18 ]. ESBL-producing E. coli infection is commonly associated with a significantly longer hospital stay and greater hospital charges[ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence, serotyping and drug susceptibility patterns ofEscherichia coliisolates from kidney transplanted patients with urinary tract infections

Khah

Hakemi-Vala

Samavat

et al. 2020

WJBC

View full text Add to dashboard Cite

BACKGROUND Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli ( E. coli ) are among the main pathogens in urinary tract infections (UTIs) among kidney transplant patients (KTPs). AIM To estimate the prevalence of ESBL-producing E. coli in KTPs and to evaluate the most prevalent serotypes and antibacterial susceptibility patterns of isolated bacteria in Tehran, Iran. METHODS A total of 60 clinical isolates of uropathogenic E. coli were collected from 3 kidney transplant centers from April to May 2019. Antimicrobial susceptibility testing was performed by the disk diffusion method as recommended by the Clinical Laboratory and Standards Institute. The serotyping of E. coli isolates was performed by the slide agglutination method. The presence of bla TEM , bla SHV, and bla CTX-M genes was evaluated by polymerase chain reaction. RESULTS The frequency of ESBL-producing E. coli in KTPs was found to be 33.4%. All of the 60 E. coli isolates were found to be susceptible to doripenem (100%) and ertapenem (100%). High resistance rates to ampicillin (86%), cefotaxime (80%), and cefazolin (77%) were also documented. The most frequent serotypes were serotype I (50%), serotype II (15%), serotype III (25%), and serotype VI (10%). The gene most frequently found was bla TEM (55%), followed by bla CTX-M (51%) and bla SHV (41%). CONCLUSION Molecular analysis showed that bla TEM was the most common ESBL-encoding gene. The high resistance to β-lactams antibiotics ( i.e. , ampicillin, cefotaxime, and cefazolin) found in E. coli from KTPs with UTIs remains a serious clinical challenge. Further efforts to control ESBL-producing E. coli should include the careful use of all antibiotics as well as barrier precautions to reduce spread.

show abstract

Multi-drug resistant and extended-spectrum β-lactamases producing bacterial uropathogens among pregnant women in Northwest Ethiopia

Cited by 19 publications

References 32 publications

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

Detection and phenotypic characterization of carbapenem non susceptible gram-negative bacilli isolated from clinical specimens

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

Prevalence, serotyping and drug susceptibility patterns ofEscherichia coliisolates from kidney transplanted patients with urinary tract infections

Contact Info

Product

Resources

About