Phenotypic and Genotypic Characterization of ESBL-Producing Escherichia coli and Klebsiella pneumonia isolates from Patient’s Urine specimens

Alfola, Mohammad Mohammad Hady Rizk; Kamel, Zeinat; Nada, Mona Gamal El Din; Rashed, Laila Ahmed; Elawady, Basma

doi:10.3823/798

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…In the present study, E. coli was the leading faecal carriage of ESBL producing Enterobacteriaceae with a prevalence of 19.9%, followed by K. pneumonia (5.5%). Our nding agrees with studies conducted in India (26,27), Central African (30), Central India (35) and Burkina Faso (33), where E. coli was the predominant ESBL producer than K. pneumonia. However, study conducted in Uganda (36), Gambia (37) and elsewhere (38) reported a higher prevalence of K. pneumonia than E. coli.…”

Section: Discussionsupporting

confidence: 92%

Faecal Carriage Rate of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Pneumonia Among Apparently Health Food Handlers in Dilla University Student Cafeteria

Diriba

Awulachew

Takele

et al. 2020

Preprint

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Background: The rapid spread of extended-spectrum β- lactamases (ESBL) producing enterobacteriaceae among food handlers, which can cause food borne outbreaks, is a public health concern and become a serious world threat. Klebsiella pneumoniae and Escherichia coli are the predominant ESBL-producing enterobacteriaceae. There is no sufficient data related to this in underdeveloped countries. Objective: This study was aimed assess the magnitude of ESBL producing Klebsiella pneumoniae and Escherichia coli isolated from stool of apparently health food handlers in the Dilla University Student Cafeteria. Methods: A cross-sectional study was conducted from November to September 2018/2019. A structured questionnaire was used for collection of data on socio- demographics. A total of 220 stool samples were cultured on MacConkey agar and a series of biochemical tests was done for the identification of bacterial species. Double-disk synergy (DDS) method was used for the detection of ESBL-producing strains. A disc of amoxicillin clavulanic acid was placed in the center of the Mueller–Hinton agar plate, and cefotaxime, aztreonam, and ceftazidime were placed at a distance of 20mm from the disk placed at center. Enhanced inhibition zone of any of the cephalosporin discs on the side facing amoxicillin clavulanic acid was considered as ESBL producer. Results: The rate of faecal carriage of E. coli and K. pneumonia among the food handlers of the current study was found to be 66.4%, of which 81.5% was E. coli, while 18.5% was K. pneumonia. From the total bacterial isolates, 25.3% were confirmed to be positive for ESBL production of which 19.9% was E. coli, while 5.5% was K. pneumonia. ESBL-producing faecal carriage showed high resistance to aztreonam, cefotaxime, ceftriaxone, cefuroxime, and ceftazidime with resistance rate ranged from 88-100%, while the least resistance rate was seen against imipenem accounted <26.3%. In this study, around 91.9% of ESBL-producing isolates were co-resistant to β -lactams antibiotics plus at least one of the non β -lactam antibiotics. Only food handlers who used antibiotics repeatedly in the last 3months were significantly associated with the ESBL carriage with P values of 0.001, 95% CI (1.12-3.18). Conclusion: The magnitude of ESBL-producing E. coli and K. pneumonia faecal carriage is alarmingly high and a threat to human health. The occurrence of multidrug resistance to third-generation cephalosporins and non-β lactam antibiotics is more common among ESBL producers. Detecting and reporting of ESBL-producing organisms have a remarkable importance in clinical decision-making. Hence, a coordinated effort should be implemented for the prevention and control the disease Enterobacteriaceae

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Section: Discussionsupporting

confidence: 92%

Faecal Carriage Rate of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Pneumonia Among Apparently Health Food Handlers in Dilla University Student Cafeteria

Diriba

Awulachew

Takele

et al. 2020

Preprint

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“…This was in agreement with studies conducted in Uganda [ 72 ] with prevalence of K. pneumoniae (72.7 %) and E. coli (58.1 %) and elsewhere [ 73 ] with prevalence of K. pneumoniae (69.8 %) and E. coli (58.2 %). However, E. coli was a predominant ESBL producer compared to K. pneumoniae according to studies in Burkina Faso [ 67 ] ( E. coli 67.5 %, K. pneumoniae 26 %), India [ 69 ] ( E. coli 61.4 %, K. pneumoniae 46.2 %) and Central India [ 74 ] ( E. coli 50.14 %, K. pneumoniae 48.27 %). Rapid adaptation to selective changes in environmental pressures, upregulation of the intrinsic resistance mechanisms, and acquisition and transfer of drug resistance genes through mobile genetic elements such as plasmids and transposons could be a possible explanation for an elevated overall drug resistance prevalence rate against different categories of drugs.…”

Section: Discussionmentioning

confidence: 99%

The magnitude of extended-spectrum beta-lactamase- producing Enterobacteriaceae from clinical samples in Ethiopia: a systematic review and meta-analysis

Diriba

Awulachew

Gemede

et al. 2021

Access Microbiology

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Background. The rapid spread of resistance among extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae is a serious problem around the world. It results in serious clinical complications in humans and has become a global threat. Therefore, this systematic review and meta-analysis was aimed to estimate the pooled prevalence of ESBL-producing Enterobacteriaceae in different clinical samples in Ethiopia. Methods. A systematic search was conducted on PubMed, Web of Science, Embase, Google Scholar and the Cochrane Library. All identified observational studies reporting the prevalence of ESBL-producing Enterobacteriaceae from clinical samples in Ethiopia were included. Four authors independently extracted data and analysed using R software version 3.6.1 and STATA statistical software version 13. A random-effects model was computed to estimate the pooled prevalence of ESBL-producing Enterobacteriaceae in Ethiopia. Results. Of 142 articles reviewed, 14 studies that fulfilled the inclusion criteria were included in the meta-analysis. The pooled prevalence of ESBL-producing Enterobacteriaceae in the different clinical specimens in Ethiopia was 49 % (95 % CI: 39, 60). Klebsiella pneumoniae was the leading ESBL-producing Enterobacteriaceae followed by Escherichia coli and Acinetobacter baumannii with a prevalence of 74, 67 and 60 %, respectively. ESBL-producing isolates showed a high rate of resistance to cefotaxime, ceftriaxone, ceftazidime, Amoxicillin clavulanic acid (AMC), ampicillin and aztreonam. The better options for the treatment of ESBL-producing Enterobacteriaceae are amikacin and Imipenem. Conclusion. The magnitude of ESBL-producing Enterobacteriaceae in different clinical samples in Ethiopia is alarmingly high and represents a threat to human health. Hence, a coordinated effort needs to be implemented for the prevention and control of these Enterobacteriaceae .

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Molecular characterization of Extended-spectrum β lactamase- producing E. coli recovered from community-acquired urinary tract infections in Upper Egypt

Hassuna

Khairalla

Farahat

et al. 2020

Sci Rep

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Treatment of community urinary tract infections (UTIs) caused by extended-spectrum β lactamase (ESBL)- producing Escherichia coli (E. coli) is more expensive than treating ESBL-negative opposites. Evaluation of the prevalence of ESBL-production among urinary E. coli isolates is crucial due to its great impact on the choice of proper antimicrobials. Accordingly, the aim of this work was to detect and characterize ESBL-producing E. coli isolated from outpatients with signs of UTIs in Upper Egypt. Urinary E. coli isolates were identified by 16S rRNA and their ESBL-production was confirmed by Modified Double Disc Synergy Test (MDDST) and ESBL- CHROMagar media. Isolates were then subjected to Polymerase Chain Reaction (PCR) for new Clermont phylogrouping, ESBL genes detection and CTX-M typing. The study enrolled 583 patients with clinically diagnosed UTIs. Uropathogens were found in 400 urine samples (68.6%) out of which 134 E. coli isolates were identified. Among the examined uropathogenic E. coli (UPEC), 80 (59.7%) were recognized as ESBL-producers. Greater than half of the ESBL-producers were multi-drug resistant (MDR) (62%). All of them were susceptible to meropenem. Most of the E. coli isolates were distributed in 4 phylogenetic groups: B2 = 42 (52.5%), F = 17 (21.25%) and Clade I or II = 10 (12.5%). The predominant gene types were TEM 60 (75%) and CTX-M gene 45 (56.25%). The CTX-M-1 group was the most prevalent (62.2%), including the CTX-M-15 enzyme, followed by the CTX-M-2 group, CTX-M-8 group and CTX-M-9 group. In conclusion, the results present alarming evidence of a serious spread of ESBL genes in Egypt, especially the epidemiological CTX-M 15, with the potential for the dissemination of MDR UPEC strains in the community.

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Phenotypic and Genotypic Characterization of ESBL-Producing Escherichia coli and Klebsiella pneumonia isolates from Patient’s Urine specimens

Cited by 4 publications

References 11 publications

Faecal Carriage Rate of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Pneumonia Among Apparently Health Food Handlers in Dilla University Student Cafeteria

Faecal Carriage Rate of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella Pneumonia Among Apparently Health Food Handlers in Dilla University Student Cafeteria

The magnitude of extended-spectrum beta-lactamase- producing Enterobacteriaceae from clinical samples in Ethiopia: a systematic review and meta-analysis

Molecular characterization of Extended-spectrum β lactamase- producing E. coli recovered from community-acquired urinary tract infections in Upper Egypt

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