Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women

Abstract

Introduction. Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. The aim of the study was to screen pregnant women for ESBL producing bacteria in Beirut, Lebanon, to examine their phenotypic and genotypic characterization and to study the association between ESBL colonization with adverse neonatal outcomes. Method. In this cross-sectional study, vaginal samples from 308 pregnant women at 35–37 weeks of gestation were studied during a one-year period. The samples were plated on MacConkey agar and selective MacConkey agar supplemented with ceftazidime. Phenotypic confirmation of ESBL production was performed by double-disc synergy test and all isolates were screened by PCR for the resistance genes blaSHV, blaTEM, and blaCTX-M. Clonal relatedness of Escherichia coli isolates was investigated by pulsed-field gel electrophoresis. Results. In total, 59 women out of 308 (19.1%) were colonized by ESBL producing gram negative bacteria. Two babies born to mothers colonized with ESBL were diagnosed with sepsis. The susceptibility rates of isolates to other antibiotics were 39% to co-trimoxazole, 49.2% to ciprofloxacin, 91.5% to gentamicin, 18.6% to aztreonam and 35.6% to cefepime. Most of isolates were highly sensitive to meropenem and imipenem, with a susceptibility of 93.2%. PCR was performed on all E. coli isolates to detect the most common ESBL producing genes; blaCTX-M was the predominant gene (90.7%), followed by blaTEM (88.4%) and finally blaSHV (44.2%). PFGE analysis of 34 E. coli isolates revealed 22 distinct clusters showing more than 85% similarity. Conclusion. In conclusion, this study showed that Lebanon has a high prevalence of ESBL carriage in pregnant women. Further studies that include a continuous screening of pregnant women and follow up of their newborn clinical status should be conducted to foresee the risk of transmission.

Molecular Characterization of Extended Spectrum Beta – Lactamase Producing Escherichia Coli Isolated from Pregnant Women with Urinary Tract Infections Attending Ante–Natal Clinics in Ilorin Metropolis

“…High resistance rates was observed among ESBLs -EC to aztreonam (75.47%), cefotaxime 37(69.81%) and the least was cefpodoxime (35.84%). This coincides with several with several reports (Al-Muhanna et al, 2016;Alyamani et al, 2017;Mahato et al, 2019;Ghaddar et al, 2020). This observed resistance to cephalosporins and monobactam is most likely due to selective pressure as a result of inappropriate use, misuse and hence the paradigm shift from firstline antibiotics to third generation cephalosporin antibiotics within Ilorin metropolis posing serious challenge to successful UTI empirical treatment.…”

“…This vary from disagrees with of 56.51% and 88.37% cohabitation reported among ESBL -EC from pregnant women in Beirut and Bhubaneswa respectively (Jena et al, 2017 andGhaddar et al, 2020). Furthermore, ten (10) different genotypes combinations were observed and the most dominant was blaTEM/OXA (20%).…”

Occurrence and distribution of extended-spectrum β-lactamase in clinical Escherichia coli isolates at Ho Teaching Hospital in Ghana.

“…This is an Open Access article under the CC BY license. 36,42 . This observation, however, is a threat to public health and will negatively affect treatment outcomes in our healthcare settings.…”

Phenotypic and Molecular Detection of Extended Spectrum Beta-Lactamases Producing-Bacteria Isolated From Pregnant Women With Genital Tract Infection in Duhok Governorate

“…Our results document that among 19 ESBL isolates seven genotypes pattern of ESBL were observed, and the predominant genotype was CTX-M type (21.1%), followed by the combination of the CTX-M gene with TEM and SHV types separately (15.8%). TEM+CTX-M combinations has been observed to be the prevalent genotype in Saudi Arabia, Japan and Lebanon, (Bindayna et al, 2010;Harada et al, 2013;Gaddar et al, 2020). On the other hand, another study in Macedonia (Kaftandzieva et al, 2011) showed the predominance of the genotype TEM+SHV combination.…”

“…Other studies from Sudan and Lebanon have reported that the percentage of isolates producing ESBL among symptomatic females with genital tract infection was 24.3% and 19.1% respectively (Gorish, 2019;Gaddar et al, 2020). The member of Enterobacteriaceae use several resistance mechanisms for avoiding the effects of antimicrobial agents, however, βlactamases production is the most important and clinically significant resistance mechanism against β-lactam antibiotics (Wax et al, 2008).…”