Prevalence of CTX-M, TEM and SHV Beta-lactamases in Clinical Isolates of Escherichia Coli and Klebsiella Pneumoniae Isolated From Aleppo University Hospitals, Aleppo, Syria

Abstract

Background: Extended spectrum β-lactamases (ESBLs) have emerged as a major threat worldwide, with limited treatment options available. Objectives: The present study aimed to estimate the prevalence, possible types of ESBL genes and antibiotic resistant patterns of ESBLproducing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). Materials and Methods: A total of 199 clinical isolates of E. coli and K. pneumoniae, collected between October 2010 to March 2012, at three University Hospitals in Aleppo city center, in north Syria, were examined phenotypically and genotypically for ESBL production. Results: The ESBLs were found in (62.89%) of E. coli and (67.5%) of K. pneumoniae isolates. The majority of the typeable isolates harbored two or more ESBL genes (73%). Overall, bla CTX-M-1 was the commonest genotype (81.74%). Resistances of ESBL isolates to other antibiotics were measured: tremithoprim/sulfamethoxazole (72%), nalidixic acid (72%), tetracycline (66%), gentamicin (54%) and ciprofloxacin (53%). Conclusions: Our study showed high ESBL incidence, with CTX-M genotype as the emerging strain in our hospitals. High co-resistance to other non-β-lactam antibiotics is a major challenge for the management of ESBL infections.

Molecular Epidemiology of Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Strains Isolated from Children with Urinary Tract Infections

“…In this study, bla CTX -M (64.5%) was found in the majority of ESBL-producing K. pneumoniae isolates, followed by bla SHV (54.8%) and bla TEM (41.9%). In agreement with the present study, AL-Subol and Youssef found that bla CTX -M was the most prevalent among E. coli and K. pneumoniae isolates in Syria, followed by bla SHV and bla TEM (38). The findings of the present study are consistent with an earlier study conducted in Morocco which found that CTX-M enzymes were the most common ESBL types (39).…”

High Frequency of Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli Isolates From Male Patients’ Urine

“…The dramatic shifts reported in the types of ESBLs from Europe, Asia, and South America, with strains producing CTX-M becoming dominant (19,21,24,25). The urinary ESBL E. coli and K. pneumoniae isolates in this study were carried high rate of bla CTX-M gene (46.7% and 22.8%, respectively) and bla TEM genes (30% and 27.5%, respectively).…”

“…Surveillance data reported various levels of ESBL-producing strains of K. pneumoniae and E. coli throughout the world. The ESBL rates in northern Europe, north America, and Australia is 5%-10%, in contrast, high level ESBL producer K. pneumoniae and E. coli were found in Syria (≥ 60%), India (≥ 80%), China (≥ 60%), and other areas in east and southeast Asia, southern Europe (≥ 30%) (21,22,24).…”

Molecular Detection and Sequencing of SHV Gene Encoding for Extended-Spectrum Β-Lactamases Produced by Multidrug Resistance Some of the Gram-Negative Bacteria

“…However, these contrast with Saha et al, [23] ESBL producers were observed among Klebsiella spp. (75%) and with AL-Subol and Youssef, [24] they were detected (67.5%) of K. pneumoniae, different rates for the prevalence of ESBL-producing K. pneumoniae are detecting in the variation difficult to explain but may be due to differences in antibiotic exhaustion and a variety of specimens handling time. Further, E. coli isolates was resistant to the antimicrobial agents meropenem, ceftazidime, cefoxitin, ceftriaxone, aztreonam, and cefoxitin with percentage of resistance 16.7%, 83.3, 83.3%, 100%, and 100, respectively.…”