Susceptibility profiles of bacteria causing urinary tract infections in Southern Tunisia

Guermazi-Toumi, Sonda; Boujlel, Sirine; Assoudi, Mouna; Issaoui, Riadh; Tlili, Sonia; Hlaiem, Mohamed Ennaceur

doi:10.1016/j.jgar.2017.09.004

Cited by 20 publications

(29 citation statements)

References 18 publications

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“…This result nearly similar to that previously documented one (20.7%) in a study conducted at Zawiya city, Libya [13] . However; the rate of prevalence in the current study was higher than in two studies previously documented by Mohammed et al at Messalata city, Libya and Toumi et al at Gafsa city, Tunisia (13.9% and 16.5% respectively) [14,15] , but it is lower compared to the result in an investigation previously conducted in Misurata city, Libya (25.2%) and much lower compared to another study conducted in Zliten city, Libya (37.3%) [16,17] . The low growth rate of UTI in this study could result from illogical use of antibiotics in this country which are given without beforehand culture and antibiotics susceptibility tests and other clinical conditions.…”

Section: Discussioncontrasting

confidence: 71%

“…In another study in Messalata, Libya, Mahammed et al have reported the predominance of Escherichia coli (55.6%) and Klebsiella pneumonia (16.3%) [14] . In Southern Tunisia, The authors have found Escherichia coli (67.1%) and Klebsiella pneumonia (12.8%) as predominance uropathogens among patients of UTIs [15] . A study in Poland have reported uropathogens with a predominance of Escherichia coli (73%) and Proteus spp.…”

Section: Discussionmentioning

confidence: 95%

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Bacterial Profile of Urinary Tract Infection and Antimicrobial Susceptibility Pattern Among Patients Attending at Bushra Medical Laboratory, Tripoli, Libya

Salem¹,

Ahmed²

2018

Journal of Gastroenterology and Hepatology Research

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BACKGROUND: Urinary tract infection (UTI) is a common infection that affects the urinary tract, particularly in women, children and elderly, and it doesn't always cause classic signs and symptoms. Excessive utilization of antibiotics led to increased incidence of antibiotic resistance among uropathogens worldwide. AIM: To identify the causative bacteria of UTI and antimicrobial susceptibility pattern among patients attended to Bushra Medical laboratory, Tripoli, Libya. METHODS: This prospective study was conducted in Tripoli city, on 1423 urine specimens from untreated patients with clinical symptoms of UTIs. Bacterial identification and antimicrobial susceptibility testing were done on 291 specimens which their colony count ≥ 10 5 colony forming units (cfu)/mL, using DL-96II (Auto microbial identification and antimicrobial susceptibility testing system). RESULTS: The prevalence of significant bacteriuria was 20.4% (291/1423), among them 81.4% (237/291) were females and 18.6% (54/291) were males. Just 0.7% (2/291) cases of isolated bacteria were gram positive cocci represented in Staphylococcus aureus, that exhibited hugely resistance to Penicillin (100%) and susceptible to many tested antimicrobial agents, while 99.3% (289/291) were gram negative bacilli represented in Klebsiella pneumonia 43.6% (127/291); Escherichia coli 33% (96/291); Klebsiella ozaenae 10.7% (31/291); Proteus mirabilis 9.3% (27/291); Pseudomonas mendocina 1.7% (5/291) and Pseudomonas alcaligenes 1% (3/291). Considering the results of this study, Klebsiella pneumonia isolates were the predominant pathogens in UTI. Except for Pseudomonas isolates, our data demonstrated that gram negative isolates were susceptible to Cefoperazone/Sulbactam followed by Ceftazidime then Levofloxacin (3.9%, 4.9% and 6% resistance, respectively), while Pseudomonas isolates were extremely sensitive to Amikacin, Piperacillin and Norfloxacin. CONCLUSION: Because of highly resistant bacteria to antibiotics, physicians must prescribe appropriate antibiotics depending on antibiotics susceptibility results. Otherwise, routine monitoring of antimicrobial resistance among uropathogens must be accomplished to guide the treatment of UTIs in the country.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 95%

Bacterial Profile of Urinary Tract Infection and Antimicrobial Susceptibility Pattern Among Patients Attending at Bushra Medical Laboratory, Tripoli, Libya

Salem¹,

Ahmed²

2018

Journal of Gastroenterology and Hepatology Research

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“…The presence of CTX-M ESBLs and of carbapenemases such as NDM-1 from human enterobacteria isolates has been increasingly reported worldwide, including Tunisia. (1, 11, 16). In this 2-month survey, the incidence rate of ESBL-producing Enterobacteriaceae from urine collected from patients hospitalized in three health care facilities from two geographical areas of Tunisia, ranged from 11.1% to 3.7%.…”

Section: Discussionmentioning

confidence: 99%

“…Regarding the important number of CTX-M-producing K. pneumoniae collected from Tunisian community, our results corroborate previous studies where ESBL positive K. pneumoniae are often isolated from this setting (14). NDM-positive K. pneumoniae ST147 lineage strains are also relatively common in multiple countries across several continents, almost all of which were isolated from humans (11). Recently, reports indicated the presence of ST147 NDM-1-producing K. pneumoniae in Tunisian Hospitals, but no data indicate its spread in community (8, 31).…”

Section: Discussionmentioning

confidence: 99%

“…The bla CTX-M genes have mainly been disseminated via multiple horizontal gene transfer events (9), and they are often located on conjugative plasmids, especially multireplicon IncFII plasmids additionally harboring FIA/FIB replicons, which also carry other resistance genes (10). The important dissemination of ESBLs has compromised the use of ESC and promoted the use of carbapenems and consequently favored the diffusion of carbapenemase-producing isolates such as the metallo-enzyme NDM-1 (11). In Tunisia, several studies reported the presence of ESBLs in Enterobacteriaceae (12, 13).…”

Section: Introductionmentioning

confidence: 99%

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Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

Mhaya

Trabelsi

Bégu

et al. 2019

Preprint

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25CTX-M ESBLs have been increasingly reported from human enterobacteria isolates in 26 Tunisia. NDM-1 carbapenemase was recently reported in isolates from Tunisian Hospitals. 27 During a 2-month period (December 2017 to January 2018), we have collected 23 ESBL- 28 producing Enterobacteriaceae (ESBL-E) from urines of patients hospitalized in three health 29 care facilities and from community, situated in two distinct Tunisian geographical regions. 30 They were divided into 15 Escherichia coli and eight Klebsiella pneumoniae. The aim of this 31 study was to characterize ESBL-E with regard to their β-lactamase content and their 32 epidemiological relationship. The results indicated a high rate (47%) of E. coli producing both 33 CTX-M group-1 and -9. For the first time, we demonstrated the presence of E. coli having 34 concomitantly CTX-M-15 and CTX-M-27 which belong to two sequences types (ST), ie. A-35 ST617 (2 isolates) and B2-ST131 subclade C2 (2 isolates). All four E. coli isolates carried a 36 multireplicon IncF with an identical allelic combination, F31:A4:B1. This study reports also 37 the first description of K. pneumoniae belonging to the clone ST147 carrying the 38 carbapenemase NDM-1 in the Tunisian community. In conclusion, our data confirms the need 39 for monitoring the resistance to extended-spectrum cephalosporins and to carbapenems 40 among enterobacteria in Tunisia. 41 42 43Resistance to extended-spectrum cephalosporins (ESC) is widespread among 44 Enterobacteriaceae species and is mainly due to the production of extended-spectrum ß-45 lactamases (ESBLs). The dissemination of ESBLs is become a growing concern since they 46 are considered as a major cause of morbidity and mortality. Up to the end of the 1990s, TEM-47 and SHV-type ESBLs were mainly produced by the Klebsiella pneumoniae and Enterobacter 48 spp. responsible for nosocomial infections (1, 2). Since 2000s, CTX-M ESBLs have gained 49 prominence mainly in Escherichia coli and K. pneumoniae strains and are now considered as 50 pandemic enzymes. Many bla CTX-M variants exist, but they can be divided into two main 51 clusters (groups -1 and -9); each cluster of CTX-M genotypes has a corresponding progenitor 52 gene sharing homology with different environmental Kluyvera spp. from which bla CTX-M 53 genes originated. Among CTX-M enzymes, CTX-M-15 belonging to group 1, has currently 54 been the most frequent all over the world (1, 3) 55 The majority of CTX-M type ESBL-associated E. coli infections is often concentrated within 56 specific extraintestinal pathogenic E. coli (ExPEC) lineages belonging to highly virulent 57 phylogenetic group B2, and recognizable by their sequence type (ST). The bla CTX-M-15 is the 58 dominant ESBL gene in the virulent E. coli ST131 clone, in particular in the subclade ST131-59 C2 (4). However other genetically divergent CTX-M genes also occur in this ST, such as 60 bla CTX-M-14/14-like variants in Canada, China, and Spain (5, 6). A subclade of E. coli ST131 61 producing the CTX-M-27 (group 9 enzyme, CTX-M-1...

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Antimicrobial susceptibility profiles of bacteria causing urinary tract infections in Mexico: Single-centre experience with 10 years of results

Lagunas‐Rangel

2018

Journal of Global Antimicrobial Resistance

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Susceptibility profiles of bacteria causing urinary tract infections in Southern Tunisia

Cited by 20 publications

References 18 publications

Bacterial Profile of Urinary Tract Infection and Antimicrobial Susceptibility Pattern Among Patients Attending at Bushra Medical Laboratory, Tripoli, Libya

Bacterial Profile of Urinary Tract Infection and Antimicrobial Susceptibility Pattern Among Patients Attending at Bushra Medical Laboratory, Tripoli, Libya

Emergence of B2-ST131-C2 and A-ST617 Escherichia coli clones producing both CTX-M-15- and CTX-M-27 and ST147 NDM-1 positive Klebsiella pneumoniae in the Tunisian community

Antimicrobial susceptibility profiles of bacteria causing urinary tract infections in Mexico: Single-centre experience with 10 years of results

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