The characterization of ESBL genes in Escherichia coli and Klebsiella pneumoniae causing nosocomial infections in Vietnam

Abstract

Background: Extended-spectrum β-lactamases (ESBLs) are enzymes capable of hydrolyzing oxyimino-β-lactams and inducing resistance to third generation cephalosporins. The genes encoding ESBLs are widespread and generally located on highly transmissible resistance plasmids. We aimed to investigate the complement of ESBL genes in E. coli and Klebsiella pneumoniae causing nosocomial infections in hospitals in Ho Chi Minh City, Vietnam. Methodology: Thirty-two non-duplicate isolates of E. coli and Klebsiella pneumoniae causing nosocomial infections, isolated between March and June 2010, were subjected to antimicrobial susceptibility testing. All isolates were PCR-amplified to detect the bla SHV , bla TEM and bla CTX-M ESBL genes and subjected to plasmid analysis. Results: We found that co-resistance to multiple antimicrobials was highly prevalent, and we report the predominance of the bla CTX-M-15 and bla CTX-M-27 genes, located on highly transmissible plasmids ranging from 50 to 170 kb in size. Conclusions: Our study represents a snap shot of ESBL-producing enteric bacteria causing nosocomial infections in this setting. We suggest that antimicrobial resistance in nosocomial E. coli and Klebsiella pneumoniae is rampant in Vietnam and ESBL organisms are widespread. In view of these data and the dramatic levels of antimicrobial resistance reported in Vietnam we advocate an urgent review of antimicrobial use in the Vietnamese healthcare system.

Molecular epidemiology and antimicrobial resistance phenotypes of Acinetobacter baumannii isolated from patients in three hospitals in southern Vietnam

“…Specifically, we found that, in comparison to XDR strains, non-XDR organisms exhibited a low rate of resistance against aminoglycosides but a high degree of resistance against third-and fourthgeneration cephalosporins. The resistance rates associated with the antimicrobials profiled in this study support previous data from Vietnamese hospitals, which have shown a substantial increase in the rate of isolation of MDR Gramnegative organisms [26].…”

Occurrence and molecular characteristics of antimicrobial resistance of Escherichia coli from broilers, pigs and meat products in Thailand and Cambodia provinces

“…This plasmid‐mediated ampC ‐like gene was previously found to spread among E. coli and Salmonella in food animals, retail meat and humans . The different type and frequency of ESBL genes present is likely as a result of different geographical areas, different types of cephalosporins used, and different antimicrobial selective pressure . The latter is supported by the observation that all the ESBL producers were multi‐resistant, suggesting the possible co‐selection of resistance genes.…”

Antibiotic Resistance Pattern of Bacterial Pathogens in Elderly Patients Admitted in the Intensive Care Unit

“…Antimicrobial resistance (AMR) is a serious threat to public health and patient safety in Europe, leading to mounting healthcare costs, patient treatment failure, and deaths [15]. Several classes of bacteria have already exhibited multidrug resistance to antibiotics, such as Klebsiella pneumoniae and E. coli strains producing extended-spectrum beta-lactamase (ESBL), which hydrolyses the beta-lactam ring of penicillin, cephalosporins, and other related antibiotics, contributing to treatment failure [16][17][18].…”