Multidrug-Resistant Escherichia coli, Klebsiella pneumoniae and Staphylococcus spp. in Houseflies and Blowflies from Farms and Their Environmental Settings

Antimicrob Resist Infect Control

et al. 2020

Background Local data from the Asella Teaching and Referral Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum β-lactamase- (ESBL) producing Gram-negative bacteria (GNB) in clinical isolates. To investigate a possible route of transmission, we determined the proportions ESBL-producing GNB in isolates from flies caught in the hospital and in the town of Asella. Methods Flies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital’s waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek®-MS and VITEK® 2. Results In total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 12 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The proportions of ESBL-producing bacteria among isolates obtained from flies collected in the hospital compound were significantly higher (82%, 90%, and 57% in NICU, orthopedic ward and waste disposal area, respectively) compared to flies collected outside of the hospital compound (2% (@1/45) in the butchery) (p ≤ 0.001). The proportion of ESBL was 67% (6/9) among Raoultella spp. 67% (4/6) among Kluyvera spp., 56% (5/9) among Enterobacter spp., 50% (5/10) among E. coli, and 44% (8/18) among Klebsiella spp.. Of the 40 ESBL-genes detected, 85% were CTX-M-like, 83% TEM-like, 23% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria. Conclusion A high proportion of ESBL was identified in isolates from flies caught in the hospital compound compared with isolates of flies collected at a distance of 1.5 km from the hospital. Flies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in flies and possible impact of MDR for nosocomial infections.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Carriage of ESBL-producing Gram-negative bacteria by flies captured in a hospital and its suburban surroundings in Ethiopia

Tufa

Antimicrob Resist Infect Control

et al. 2020

“…This nding is an indicator for the limited options of appropriate antibiotic therapy regimen for ESBL-producing bacterial infection management. Poudel A, et al (2019) also reported high rates of resistance of E. coli and K. pneumoniae isolated from ies against tetracycline and ampicillin due to emergence of ESBL-producing strains (21). This might probably be caused by plasmidmediated mobile resistance genes such as quinolone-resistance (qnr) genes, aminoglycoside acetyltransferase (aac), dfr (trimethoprim resistance) and sul (sulfamethoxazole resistance) genes, being more frequent in ESBL-producing bacteria compared to ESBL-negative bacteria (22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

“…In order to inhibit further expansions of ESBL-carrying bacteria from hospitals to residential areas, environmental and health professionals and municipality administration should work together and strengthen a one health approach. Future AMR prevention and control protocols may consider screening of house ies for AMR and eradication-measures to control the population density of house ies at health care facilities in tropical regions (21). As distribution of ESBL genes in clinical samples and house ies caught in the hospital show comparable results, house ies might be used as an indicator organism for ESBL-prevalence in hospital facilities.…”

Section: Discussionmentioning

confidence: 99%

Carriage of ESBL-producing Gram-negative bacteria by houseflies captured in a hospital and its suburban surroundings in Ethiopia

Tufa¹,

et al. 2020

Preprint

Background: Local data from the Asella Referral and Teaching Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum β-lactamase- (ESBL) producing Gram-negative bacteria in clinical isolates. To investigate a possible route of transmission, we determined the colonization rate of houseflies with ESBL-producing Gram-negative bacteria in the hospital compound and in the town of Asella. Methods: Houseflies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital’s waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek®-MS and VITEK® 2. Results: In total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 20 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The prevalence of ESBL-producing bacteria in collected flies was 82%, 90%, and 57% in NICU, orthopedic ward and the waste disposal area, respectively and 2% (1/45) in the butchery. The difference between flies trapped inside and outside the hospital compound was statistically significant (p≤0.001). The frequency of ESBL was 67% (6/9) in Raoultella spp. 67% (4/6) in Kluyvera spp., 56% (5/9) in Enterobacter spp., 50% (5/10) in E. coli and Citrobacter spp., and 44% (8/18) in Klebsiella spp.. Of the 40 ESBL-genes detected, 85% were CTX-M-like, 83% TEM-like, 23% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of antimicrobial resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria. Conclusion: A high proportion of the hospital’s housefly population were colonized with pathogenic ESBL-producing bacteria, but not houseflies collected at a distance of 1.5 km from the hospital. Houseflies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in houseflies and possible impact of the high rate of MDR for nosocomial infections.

“…This nding is an indicator for the limited options of appropriate antibiotic therapy regimen for ESBL-producing bacterial infection management. Poudel et al (2019) also reported high rates of resistance of E. coli and K. pneumoniae isolated from ies against tetracycline and ampicillin due to emergence of ESBL-producing strains (21). This might probably be caused by plasmidmediated mobile resistance genes such as quinolone-resistance (qnr) genes, aminoglycoside acetyltransferase (aac), dfr (trimethoprim resistance) and sul (sulfamethoxazole resistance) genes, being more frequent in ESBL-producing bacteria compared to ESBL-negative bacteria (22)(23)(24)(25).…”

Section: Discussionmentioning

confidence: 99%

Carriage of ESBL-producing Gram-negative bacteria by flies captured in a hospital and its suburban surroundings in Ethiopia

Tufa¹,

et al. 2020

Preprint

Background: Local data from the Asella Teaching and Referral Hospital in the town of Asella, Ethiopia reveal a high prevalence of extended-spectrum β-lactamase- (ESBL) producing Gram-negative bacteria (GNB) in clinical isolates. To investigate a possible route of transmission, we determined the proportions ESBL-producing GNB in isolates from flies caught in the hospital and in the town of Asella. Methods: Flies were collected in August 2019 from the neonatal intensive care unit (NICU), the orthopedic ward, the hospital’s waste disposal area, and from a butchery situated 1.5 km from the hospital. After trapping, the flies were macerated and suspended in sterile normal saline. The suspensions were inoculated on MacConkey agar and incubated overnight. Species identification and antimicrobial susceptibility testing were performed using Vitek®-MS and VITEK® 2. Results: In total, 103 bacterial isolates were obtained from 85 flies (NICU: 11 isolates from 20 flies, orthopedic ward: 10 isolates from 12 flies, waste disposal area: 37 isolates from 26 flies, butchery: 45 isolates from 27 flies). The proportions of ESBL-producing bacteria among isolates obtained from flies collected in the hospital compound were significantly higher (82%, 90%, and 57% in NICU, orthopedic ward and waste disposal area, respectively) compared to flies collected outside of the hospital compound (2% (1/45) in the butchery) (p≤0.001). The proportion of ESBL was 67% (6/9) among Raoultella spp. 67% (4/6) among Kluyvera spp., 56% (5/9) among Enterobacter spp., 50% (5/10) among E. coli, and 44% (8/18) among Klebsiella spp.. Of the 40 ESBL-genes detected, 85% were CTX-M-like, 83% TEM-like, 23% SHV-like, and 2% CTX-M-2-like. ESBL-producing bacteria showed higher rates of resistance against ciprofloxacin (66% vs. 5%), gentamicin (68% vs. 3%), piperacillin-tazobactam (78% vs. 5%), and trimethoprim-sulfamethoxazole (88% vs. 16%), compared to non-ESBL-producing bacteria. Conclusion: A high proportion of ESBL was identified in isolates from flies caught in the hospital compound compared with isolates of flies collected at a distance of 1.5 km from the hospital. Flies can be potential vectors for transmission of multidrug-resistant (MDR) bacteria within hospitals. Further studies are needed to determine the source of MDR colonization in flies and possible impact of MDR for nosocomial infections.