Spread of TEM, VIM, SHV, and CTX-M<i>β</i>-Lactamases in Imipenem-Resistant Gram-Negative Bacilli Isolated from Egyptian Hospitals

Mohammed, El sayed Hamdy; Fakhr, Ahmed Elsadek; sayed, Hanan Mohammed El; Johery, Said abd Elmohsen Al; Hassanein, Wesam A.

doi:10.1155/2016/8382605

Cited by 18 publications

(14 citation statements)

References 30 publications

(29 reference statements)

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“…The frequency of the bla SHV gene was reported 13.3% by Salimi et al The study of Farzeali Shirehjini et al indicated that P. aeruginosa strains had high levels of resistance and 21.6% and 34.2% of the strains had bla CTX-M and bla TEM genes, respectively (23). The prevalence of bla TEM gene in the study of Mohammad was 25% that is less than the corresponding prevalence in our study (24).…”

Section: Discussioncontrasting

confidence: 85%

Prevalence of SHV, TEM, CTX-M and OXA-48 β-Lactamase Genes in Clinical Isolates of Pseudomonas aeruginosa in Bandar-Abbas, Iran

Bahrami¹,

Mmohammadi-Sichani²,

Karbasizade³

2018

Avicenna J Clin Microbiol Infect

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Background Pseudomonas aeruginosa is an aerobic gram-negative bacillus that is the cause of a range of opportunistic infections in humans. P. aeruginosa is one of the most important pathogenic bacteria in the development of nosocomial infections such as pneumonia associated with intensive care unit (ICU) ventilator, bacteremia, urinary tract infections, and infection in people with severe and septic burns (1, 2). Infections caused by P. aeruginosa are often severe and lifethreatening. P. aeruginosa infection is difficult to control and eliminate because it has intrinsic resistance to many antimicrobial agents (3). The rapid increase of extendedspectrum beta-lactamase (ESBL)-producing isolates of P. aeruginosa is a health risk. Many isolates of P. aeruginosa are susceptible to cephalosporins and carbapenems; however, this bacterium has acquired resistance to these antibiotics. P. aeruginosa resistance mechanisms include ß-lactamase production, efflux pumps and changes in outer membrane proteins. Multi-drug resistant (MDR) strain of P. aeruginosa is able to produce a wide range of beta-lactamase enzymes. According to Ambler classification, beta-lactamases are divided into four groups based on their structures (A-D). P. aeruginosa resistance to cephalosporins, monobactam and carbapenems may be acquired by ESBL enzymes (4,5). The prevalence of resistance to carbapenems among P. aeruginosa isolates is a common challenge facing the successful treatment of the life-threatening and permanent infections due to this bacterium (6,7). Proper and up-to-date information about the antibiotic resistance of clinical isolates of P. aeruginosa is essential for the treatment of the infections caused by these strains. The aim of this study was to investigate the presence of bla SHV , bla TEM , bla CTX-M and bla OXA-48 beta-lactamase genes in the clinical isolates of P. aeruginosa in Bandar Abbas, Iran. Materials and Methods In this descriptive study, 96 P. aeruginosa strains isolated from wound patients hospitalized in Bandar Abbas Hospital from May to December 2017 were studied. Identification of these isolates was confirmed using Gram staining and biochemical tests including catalase and oxidase tests, fermentation in oxidation-fermentation

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Section: Discussioncontrasting

confidence: 85%

Prevalence of SHV, TEM, CTX-M and OXA-48 β-Lactamase Genes in Clinical Isolates of Pseudomonas aeruginosa in Bandar-Abbas, Iran

Bahrami¹,

Mmohammadi-Sichani²,

Karbasizade³

2018

Avicenna J Clin Microbiol Infect

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“… 38 However, by contrast, Hamdy Mohammed el et al found that 72.7% of the isolates carried tem , 36 % harbored ctx-m , and 15% showed shv . 39 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of multidrug-resistant Gram-negative pathogens isolated from febrile neutropenic cancer patients with bloodstream infections in Egypt and new synergistic antibiotic combinations

Tohamy¹,

Aboshanab²,

El-Mahallawy³

et al. 2018

IDR

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IntroductionBloodstream infections with multidrug-resistant (MDR) Gram-negative bacteria (GNB) are among the most frequent complications in immunocompromised cancer patients because of their considerable morbidity and mortality. Several guidelines on antimicrobial therapy have addressed empirical treatment for such serious infections; however, the emergence of microbial resistance has become a significant problem worldwide.Materials and methodsIn this study, starting from November 2015 to October 2016, a total of 529 blood specimens were collected from febrile neutropenic cancer patients at a tertiary care cancer hospital in Egypt.ResultsOn examination for positive bacterial growth, it was found that 334 specimens showed no growth, while 195 were positive. Out of the 195 positive culture specimens, 102 (102/195, 52.3%) were Gram-negative and 93 (93/195, 47.7%) were Gram-positive. Out of the 102 GNB, 70 (70/102, 68.6%) were MDR, including Escherichia coli (27/70, 38.6%), Klebsiella pneumoniae (24/70, 34.3%), Acinetobacter baumannii (9/70, 12.8%), Enterobacter cloacae (4/70, 5.7%), Pseudomonas aeruginosa (2/70, 2.8%), Klebsiella oxytoca (2/70, 2.8%), and Klebsiella ornithinolytica (2/70, 2.8%). All MDR GNB showed high resistance to ampicillin, cefepime, ceftriaxone, and cephradine (minimum inhibitory concentration at which 50% of the isolates were inhibited [MIC50] >512 μg/mL for each). However, they showed good susceptibility to colistin (MIC50 <1 μg/mL). The most common extended-spectrum β-lactamases (ESBLs) genes detected were ctx-m (39/70, 55.7%), shv (31/70, 44.3%), and tem (22/70, 31.4%). The most common aminoglycoside-resistant gene detected was aac(6′)-Ib (42/70, 60%) followed by the plasmid-mediated quinolone resistance determinants; qnrA (2/70, 2.8%), qnrB (9/70, 12.8%), and qnrS (19/70, 27.1%). ESBL determinants were significantly associated with resistance to ciprofloxacin, levofloxacin, amikacin, and carbapenems (P-value <0.005). The fractional inhibitory concentration index for ampicillin/sulbactam plus ceftriaxone, ampicillin/sulbactam plus amikacin, and amikacin plus levofloxacin showed synergism against 29 (29/70, 41.4%), 19 (19/70, 27.1%), and 11 (11/70, 15.7%) isolates of the tested MDR GNB isolates, respectively.ConclusionAccordingly, new empirical antibiotics should be administered including the use of colistin or meropenem alone or both against the MDR GNB in neutropenic cancer patients.

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“…Other studies in Egypt reported higher prevalence of bla VIM in P. aeruginosa clinical isolates. 32 , 33 …”

Section: Discussionmentioning

confidence: 99%

Different phenotypic and molecular mechanisms associated with multidrug resistance in Gram-negative clinical isolates from Egypt

Helmy

Kashef

2017

IDR

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ObjectivesWe set out to investigate the prevalence, different mechanisms, and clonal relatedness of multidrug resistance (MDR) among third-generation cephalosporin-resistant Gram-negative clinical isolates from Egypt.Materials and methodsA total of 118 third-generation cephalosporin-resistant Gram-negative clinical isolates were included in this study. Their antimicrobial susceptibility pattern was determined using Kirby–Bauer disk diffusion method. Efflux pump-mediated resistance was tested by the efflux-pump inhibitor-based microplate assay using chlorpromazine. Detection of different aminoglycoside-, β-lactam-, and quinolone-resistance genes was done using polymerase chain reaction. The genetic diversity of MDR isolates was investigated using random amplification of polymorphic DNA.ResultsMost of the tested isolates exhibited MDR phenotypes (84.75%). The occurrence of efflux pump-mediated resistance in the different MDR species tested was 40%–66%. Acinetobacter baumannii isolates showed resistance to most of the tested antibiotics, including imipenem. The blaOXA-23-like gene was detected in 69% of the MDR A. baumannii isolates. The MDR phenotype was detected in 65% of Pseudomonas aeruginosa isolates, of which only 23% exhibited efflux pump-mediated resistance. On the contrary, efflux-mediated resistance to piperacillin and gentamicin was recorded in 47.5% of piperacillin-resistant and 25% of gentamicin-resistant MDR Enterobacteriaceae. Moreover, the plasmid-mediated quinolone-resistance genes (aac(6′)-Ib-cr, qnrB, and qnrS) were detected in 57.6% and 83.33% of quinolone-resistant MDR Escherichia coli and Klebsiella pneumoniae isolates, respectively. The β-lactamase-resistance gene blaSHV-31 was detected for the first time in one MDR K. pneumoniae isolate from an endotracheal tube specimen in Egypt, accompanied by blaTEM-1, blaCTX-M-15, blaCTX-M-14, aac(6′)-Ib-cr, qnrS, and multidrug efflux-mediated resistance.ConclusionMDR phenotypes are predominant among third-generation cephalosporin-resistant Gram-negative bacteria in Egypt and mediated by different mechanisms, with an increased role of efflux pumps in Enterobacteriaceae.

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Spread of TEM, VIM, SHV, and CTX-Mβ-Lactamases in Imipenem-Resistant Gram-Negative Bacilli Isolated from Egyptian Hospitals

Cited by 18 publications

References 30 publications

Prevalence of SHV, TEM, CTX-M and OXA-48 β-Lactamase Genes in Clinical Isolates of Pseudomonas aeruginosa in Bandar-Abbas, Iran

Prevalence of SHV, TEM, CTX-M and OXA-48 β-Lactamase Genes in Clinical Isolates of Pseudomonas aeruginosa in Bandar-Abbas, Iran

Prevalence of multidrug-resistant Gram-negative pathogens isolated from febrile neutropenic cancer patients with bloodstream infections in Egypt and new synergistic antibiotic combinations

Different phenotypic and molecular mechanisms associated with multidrug resistance in Gram-negative clinical isolates from Egypt

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