Prevalence and characterization of extended spectrum beta-lactamase-producing Enterobacter cloacae strains in Algeria

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

doi:10.3855/jidc.3127

Cited by 13 publications

(10 citation statements)

References 26 publications

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“…In the present study, β -lactamase-producing bacteria were commonly found in ICU and surgical departments. This finding is similar to that reported in the eastern region of Saudi Arabia [20] and many parts of the world, such as in Algeria [21] and Nigeria [22]. It has been suggested that the higher use of invasive devices and the selective pressure of newer β -lactams for patients at ICU and surgery unit result in the emergence of such pathogens [20].…”

Section: Discussionsupporting

confidence: 86%

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Ibrahim

Abbas

Al-Shahrai

et al. 2019

Canadian Journal of Infectious Diseases and Medical Microbiolog

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Background. Emergence of pathogenic bacteria carrying β-lactamase-resistant determinants has become a major health problem in the hospital setting. The study aimed to determine antibiotic-resistant patterns and frequency of extended-spectrum β-lactamase- (ESBL-) producing Gram-negative bacteria (GNB) and AmpC β-lactamase-producing GNB. Methodology. A prospective cross-sectional study was conducted during a period from September 2017 to August 2018 at King Abdullah Hospital, Bisha Province, Saudi Arabia. GNB (n = 311) were recovered from patients’ clinical specimens including sputum, urine, wound pus, blood, tracheal aspirates and high vaginal swabs, umbilical discharge, eye discharge, and cerebrospinal fluids. Isolates were identified by the Phoenix identification system. Antimicrobial susceptibility was tested by the Kirby–Bauer disk procedure. Phenotypic characterization of ESBLs and AmpC β-lactamases was performed utilizing the double-disk synergy test and inhibitor-based method, respectively. Associations with outcome measures were determined by simple descriptive statistics and a chi-square test. Results. Out of 311 GNB isolates, the frequency of ESBL and AmpC β-lactamase producers was 84 (27%) and 101 (32.5%), respectively. Klebsiella pneumoniae and Escherichia coli were common ESBL producers. AmpC β-lactamases predominate among Acinetobacter spp. and Pseudomonas aeruginosa. Coproduction of ESBLs and AmpC β-lactamases was found in 36 (11.6%) isolates, with very close relative frequencies among K. pneumoniae, Acinetobacter spp., and P. aeruginosa. β-Lactamase producers were predominantly found in the surgical department (56.5%) and ICUs (44.2%). ESBL producers revealed high resistance for cefuroxime (96.4%), cefotaxime (92.9%), and trimethoprim/sulfamethoxazole (90.5%). The resistance rates were significantly higher among ESBL producers than nonproducers for cephalosporins (p<0.001), amoxicillin/clavulanate (p<0.001), piperacillin/tazobactam (p=0.010), nitrofurantoin (p=0.027), aztreonam (p<0.001), ciprofloxacin (p=0.002), and trimethoprim/sulfamethoxazole (p<0.001). Significantly higher (p<0.05) resistance rates were observed among AmpC β-lactamase producers than nonproducers for all tested antibiotics. Conclusions. This finding showed a high prevalence of ESBL- and AmpC β-lactamase-producing GNB in our hospital. Quality control practice and routine detection of β-lactamase producers before deciding on antibiotic therapy are advocated.

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Section: Discussionsupporting

confidence: 86%

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Ibrahim

Abbas

Al-Shahrai

et al. 2019

Canadian Journal of Infectious Diseases and Medical Microbiolog

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“…However, the current result was higher than of the study findings reported from Jima Ethiopia (51%) [17] and of study conducted in Algeria (47.6%) [18] and lower than reported from a tertiary care hospital in Riyadh capital Saudi Arabia (72%) [19]. These indicate that the distribution of ESBL producing organisms vary from region to region and may be higher in certain geographic areas [20].…”

Section: Bacterial Strainscontrasting

confidence: 85%

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

Aseffa

Tigabu

Shiferaw

et al. 2020

Preprint

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Background Extended-spectrum beta-lactamases (ESBL) producing Enterobacteriaceae are prevalent worldwide and they are unique challenges for treatment and control of bacterial infectious diseases. ESBL genes not only confer resistance to oximino-cephalosporins and aztreonum but also, they are multidrug-resistant to other commonly available antimicrobial agents used in clinical practice.Objective To determine the prevalence and antimicrobial susceptibility profile of ESBL producing Enterobacteriaceae isolated from clinical samples referred to the national clinical bacteriology and mycology reference laboratory.Materials and Methods A cross-sectional study was conducted on Enterobacteriaceae culture- positive clinical samples that were referred to the national bacteriology and mycology reference laboratory from August 2018 to July 2019. Bacterial isolation was performed according to the inoculation and incubation conditions of each clinical specimen and identifications of the isolates were performed using standardized biochemical tests for gram-negative bacteria. Antimicrobial susceptibility profiles of these cultures were determined using the disk diffusion method on Muller Hinton agar according to the recommendation by Clinical and Laboratory Standard Institute (CLSI). ESBL production was detected using CLSI Screening and confirmation test. A double-disk synergy test was used for confirmation.Results Out of 371 culture positive for Enterobacteriaceae , 240 (64.7%) were positive for ESBL production, and the most prevalent species were Klebsiella sp 131(54.6%) followed by E. coli 79 (32.9%). Of 131 ESBL positive Klebsiella spp, 95 (72.5%) were obtained from blood samples and among 79 E. coli isolates, 51 (64.6%) of the strains were isolated from urine samples. All ESBL positive isolates were resistant to ampicillin and all generation of cephalosporins. In addition, 100% of them were multidrug resistant. There were also high proportions of resistant ESBL positive isolates to other classes of antimicrobial agents. Less resistance rates were documented for carbapenems drugs and amikacin from the class of aminoglycosides.Conclusion ESBL producing Enterobacteriaceae we reported in this study was not only highly prevalent but also they are multidrug resistant to most clinically available antimicrobial agents including carbapenems. Therefore, public awareness and regular monitoring

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“…For instance, in 2008 cefuroxime resistance was 87.3%, cefotaxime 59%, aztreonam 33.3%, and ceftazidime 12.8% [ 95 ]. Isolates expressing various ESBLs were tested using a dual-disk potentiation method, which showed increased ESBL rates from 17.7% to 47.6% during the study period [ 95 , 96 , 97 ]. Additionally, based on the molecular analysis, it was observed that in 2009, bla SHV was 10% [ 96 ], bla TEM 19.9% to 70% [ 95 , 96 , 98 ], bla CTX-M 19.9% to 100% [ 95 , 96 , 97 , 98 ], and in 2013 bla VIM was 82.3% [ 99 ].…”

Section: Resultsmentioning

confidence: 99%

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

Nasser

Palwe²,

Bhargava

et al. 2020

Microorganisms

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The production of diverse and extended spectrum β-lactamases among Escherichia coli and ESKAPE pathogens is a growing threat to clinicians and public health. We aim to provide a comprehensive analysis of evolving trends of antimicrobial resistance and β-lactamases among E. coli and ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acine to bacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) in the Arabian region. A systematic review was conducted in Medline PubMed on papers published between January 2000 and February 2020 on countries in the Arab region showing different antibiotic resistance among E. coli and ESKAPE pathogens. A total of n = 119,144 clinical isolates were evaluated for antimicrobial resistance in 19 Arab countries. Among these clinical isolates, 74,039 belonged to E. coli and ESKAPE pathogen. Distribution of antibiotic resistance among E. coli and ESKAPE pathogens indicated that E. coli (n = 32,038) was the predominant pathogen followed by K. pneumoniae (n = 17,128), P. aeruginosa (n = 11,074), methicillin-resistant S. aureus (MRSA, n = 4370), A. baumannii (n = 3485) and Enterobacter spp. (n = 1574). There were no reports demonstrating Enterococcus faecium producing β-lactamase. Analyses revealed 19 out of 22 countries reported occurrence of ESBL (Extended-Spectrum β-Lactamase) producing E. coli and ESKAPE pathogens. The present study showed significantly increased resistance rates to various antimicrobial agents over the last 20 years; for instance, cephalosporin resistance increased from 37 to 89.5%, fluoroquinolones from 46.8 to 70.3%, aminoglycosides from 40.2 to 64.4%, mono-bactams from 30.6 to 73.6% and carbapenems from 30.5 to 64.4%. An average of 36.9% of the total isolates were reported to have ESBL phenotype during 2000 to 2020. Molecular analyses showed that among ESBLs and Class A and Class D β-lactamases, blaCTX-M and blaOXA have higher prevalence rates of 57% and 52.7%, respectively. Among Class B β-lactamases, few incidences of blaVIM 27.7% and blaNDM 26.3% were encountered in the Arab region. Conclusion: This review highlights a significant increase in resistance to various classes of antibiotics, including cephalosporins, β-lactam and β-lactamase inhibitor combinations, carbapenems, aminoglycosides and quinolones among E. coli and ESKAPE pathogens in the Arab region.

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Prevalence and characterization of extended spectrum beta-lactamase-producing Enterobacter cloacae strains in Algeria

Cited by 13 publications

References 26 publications

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Phenotypic Characterization and Antibiotic Resistance Patterns of Extended-Spectrum β-Lactamase- and AmpC β-Lactamase-Producing Gram-Negative Bacteria in a Referral Hospital, Saudi Arabia

Antimicrobial Susceptibility Profile of Extended Spectrum Beta- lactamases Producing Enterobacteriaceae isolated from clinical samples refereed to the National Bacteriology and Mycology Reference Laboratory, Ethiopia

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

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