Prevalence and characterization of extended spectrum β-lactamases in Klebsiella-Enterobacter-Serratia group bacteria, in Algeria

Nedjai, Sabrina; Barguigua, Abouddihaj; Djahmi, Nassima; Jamali, Loubna; Zerouali, Khalid; Dekhil, Mazouz; Timinouni, Mohammed

doi:10.1016/j.medmal.2011.10.001

Cited by 31 publications

(28 citation statements)

References 37 publications

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“…The ESBL are commonly plasmid encoded. The Plasmid usually carry genes encoding resistance to other antimicrobial agents, it is frequently responsible for ESBL production [4]- [6]. In Moroccan hospitals, the existence of ESBL-producing organisms has been reported and their prevalence varies from 8% to 51% [7] [8].…”

Section: Introductionmentioning

confidence: 99%

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Natoubi¹,

Barguigua²,

Zriouil³

et al. 2016

AiM

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Aim: The aim of the current study is to determine: (1) the prevalence of extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-Kp) isolated from clinical samples and a hospital environment in Hassan II Hospital (Settat, Morocco); (2) the associated risk factors of ESBL-Kp infections; (3) the link between clinical and environmental isolates. Methods: During the study period (April 2010 to March 2011), all patients infected and hospital environment sites contaminated by K. pneumoniae were considered as the potential study population and environmental site. The clinical data were collected to identify risk factors for ESBL carriage of K. pneumoniae infection. Screening of ESBL-and carbapenemase-producing isolates was performed by using a double-disk synergy test and the modified Hodge test, respectively. ESBL-Kp isolates were tested for the presence of genes encoding β-lactamases and were investigated by PCR. The clonal relationship between * Corresponding author. S. Natoubi et al. 153 ESBL-producing isolates was analysed by ERIC-and REP-PCR method. Results:The overall prevalence of ESBL-Kp among clinical and environmental K. pneumoniae isolates was 35.13% (13/37) and 4.04% (4/99), respectively. The main risk factors for carrying ESBL-Kp were renal disease (46.15%), recent surgery (53.84%), previous hospitalisation (76.92%), and the presence of many invasive devices (53.84%). All ESBL isolates were multidrug resistant. The blaCTX-M group1and blaSHV (70.58% for each) were the most prevalent followed by blaTEM (52.94%). Thirteen strains expressed at least two bla genes. One isolate was positive in the modified Hodge test and was a blaOXA-48 producer. ERIC and Rep-PCR methods revealed an epidemic clonal dissemination of these isolates. Conclusion: The emergence of OXA-48 carbapenemase, endemic clonal dissemination and multi-drug resistance of ESBL-Kp isolates in our institution is highly alarming.

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Section: Introductionmentioning

confidence: 99%

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Natoubi¹,

Barguigua²,

Zriouil³

et al. 2016

AiM

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“…The value obtained is also higher than the rate of ESBL production by E. cloacae isolated in Marseille (30%). This can be explained by the overuse of antibiotics in Algerian hospitals (21). The observed resistance is due to the presence of worldwide-spread CTX-M15 and TEM-1 genes in these Algerian and Marseille isolates, which have been described in previous studies (18).…”

Section: Source Of Samples and Units Among Our 77 Clinical Isolates Ofmentioning

confidence: 60%

“…Indeed, this clade suggests the occurrence of an outbreak in this uro-nephrology unit within a period of 4 months, between November 2012 and February 2013, with an unknown common source of transmission. The transmission could be due to hand carriage by paramedical personnel (12,21) or a contaminated cytoscope, which is typically used to place double J catheters, especially in urology clinics (21).…”

Section: Source Of Samples and Units Among Our 77 Clinical Isolates Ofmentioning

confidence: 99%

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MALDI-TOF MS as a Tool To Detect a Nosocomial Outbreak of Extended-Spectrum-β-Lactamase- and ArmA Methyltransferase-Producing Enterobacter cloacae Clinical Isolates in Algeria

Khennouchi

Loucif

Boutefnouchet

et al. 2015

Antimicrob Agents Chemother

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; Etablissement Hospitalier Spécialisé d'Uro-Nephrologie, Daksi, Constantine, Algeria d Enterobacter cloacae is among the most important pathogens responsible for nosocomial infections and outbreaks. In this study, 77 Enterobacter isolates were collected: 27 isolates from Algerian hospitals (in Constantine, Annaba, and Skikda) and 50 isolates from Marseille, France. All strains were identified by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). Antibiotic susceptibility testing was performed by the disk diffusion method. PCR was used to detect extended-spectrum-beta-lactamase (ESBL)-encoding, fluoroquinolone resistance-encoding, and aminoglycoside-modifying enzyme (AME) genes. Epidemiological typing was performed using MALDI-TOF MS with data mining approaches, along with multilocus sequence typing (MLST). Sixty-eight isolates (27 from Algeria, 41 from Marseille) were identified by MALDI-TOF MS as E. cloacae. Resistance to antibiotics in the Algerian isolates was significantly higher than that in the strains from Marseille, especially for beta-lactams and aminoglycosides. Eighteen of the 27 Algerian isolates and 11 of the 41 Marseille isolates possessed at least one ESBL-encoding gene: bla CTX-M and/or bla TEM . AME genes were detected in 20 of the 27 Algerian isolates and 8 of the 41 Marseille isolates [ant(2؆)-Ia, aac(6=)-Ib-cr, aadA1, aadA2, and armA]. Conjugation experiments showed that armA was carried on a transferable plasmid. MALDI-TOF typing showed three separate clusters according to the geographical distribution and species level. An MLST-based phylogenetic tree showed a clade of 14 E. cloacae isolates from a urology unit clustering together in the MALDI-TOF dendrogram, suggesting the occurrence of an outbreak in this unit. In conclusion, the ability of MALDI-TOF to biotype strains was confirmed, and surveillance measures should be implemented, especially for Algerian patients hospitalized in France. Enterobacter cloacae is an opportunistic pathogen that can cause several type of infections in the lower respiratory tract, surgical sites, urinary tract (1), and central nervous system (2); moreover, it is frequently associated with nosocomial infections in outbreaks, and thus there is a need for rapid detection and typing of such strains. Although multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) are good approaches to identify the spread of a given clone in an outbreak, these techniques remain time-consuming with a substantial cost. Recently, matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been introduced in clinical microbiology as a routine tool for rapid identification of bacteria at the species level (3), but it also could be used as a simple tool for typing in nosocomial outbreaks of infections with bacteria such as Acinetobacter baumannii (4). Antibiotic resistance in E. cloacae is being increasingly reported, with the acquisition of genes encoding extended-spectrum beta-lactamas...

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“…Currently, the ESBL CTX-M are the most frequently isolated in western and eastern Algeria (Ahmed et al, 2012;Nedjai et al, 2012), Tunisia (Elhani et al, 2011), Portugal (Mendonça et al, 2009), China (Liu et al, 2009), in Taiwan (Shu et al, 2010 and many countries worldwide. In our study, the phenotype of the DHA-1-producing strains was characterized in three cefoxitin-resistant strains, two strains (Kp18, Kp55.2) were isolated in the women medicine service, and one strain (kp73) was isolated in the intensive care unit (ICU).…”

Section: Discussionmentioning

confidence: 99%

First characterization of CTX-M-15 and DHA-1 -lactamases among clinical isolates of Klebsiella pneumoniae in Laghouat Hospital, Algeria

Lagha¹,

Abdelouahid²,

Hassaïne³

et al. 2014

Afr. J. Microbiol. Res.

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Extended-spectrum β-lactamases (ESBL) are a problem of great concern owing to the potential transmission of resistance to others bacterial species. Our study aims to investigate the ESBL and plasmid-mediated β-lactamases produced by Klebsiella pneumoniae strains isolated from 2010 to 2012, among patients hospitalized in "Ahemida Ben Adjila" hospital, Laghouat, Algeria, and to seek a possible clonal dissemination. Antimicrobial susceptibility testing was performed by the agar diffusion method, the characterization of resistance genes to β-lactam antibiotics was performed by PCR amplification and gene sequencing, and molecular typing was performed by ERIC-PCR. In total, of 112 clinical strains of K. pneumoniae isolated, nine isolates produced an ESBL. Antibiotics susceptibility testing showed a complete resistance to the majority of third-generation cephalosporins and a very frequent resistance to aminoglycosides and fluoroquinolones resistance. PCR analysis and sequencing showed that all isolates produced ESBL CTX-M-15; three strains of them also produced the cephalosporinase DHA-1. Molecular typing showed that most strains were not related; only three strains that produced CTX-M-15 and DHA-1 had identical profiles suggesting a clonality link. This study revealed the dissemination of ESBL CTX-M-15 and plasmid-mediated AmpC cephalosporinase DHA-1 in K. pneumoniae. This is a first report of these enzymes at the Laghouat hospital.

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Prevalence and characterization of extended spectrum β-lactamases in Klebsiella-Enterobacter-Serratia group bacteria, in Algeria

Cited by 31 publications

References 37 publications

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

MALDI-TOF MS as a Tool To Detect a Nosocomial Outbreak of Extended-Spectrum-β-Lactamase- and ArmA Methyltransferase-Producing Enterobacter cloacae Clinical Isolates in Algeria

First characterization of CTX-M-15 and DHA-1 -lactamases among clinical isolates of Klebsiella pneumoniae in Laghouat Hospital, Algeria

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Prevalence and characterization of extended spectrum β-lactamases in Klebsiella-Enterobacter-Serratia group bacteria, in Algeria

Cited by 31 publications

References 37 publications

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

MALDI-TOF MS as a Tool To Detect a Nosocomial Outbreak of Extended-Spectrum-β-Lactamase- and ArmA Methyltransferase-Producing Enterobacter cloacae Clinical Isolates in Algeria

First characterization of CTX-M-15 and DHA-1 -lactamases among clinical isolates of Klebsiella pneumoniae in Laghouat Hospital, Algeria

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Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco

Incidence of Extended-Spectrum Be-ta-Lactamase-Producing <i>Klebsiella pneumoniae</i> among Patients and in the Environment of Hassan II Hospital, Settat, Morocco