Antimicrobial susceptibility and molecular epidemiology of extended-spectrum beta-lactamase-producing Enterobacteriaceae from intensive care units at Hamad Medical Corporation, Qatar

Abstract

BackgroundThe emergence of extended-spectrum beta-lactamase (ESBL)-producing isolates has important clinical and therapeutic implications. High prevalence of ESBL-producing Enterobacteriaceae has been reported in the literature for clinical samples from a variety of infection sites. The present study was undertaken to evaluate the prevalence of ESBL-producing Enterobacteriaceae, and to perform molecular characterization and antimicrobial susceptibility testing of clinical isolates from patients admitted to the intensive care units at Hamad Medical Corporation, Doha, Qatar, from November 2012 to October 2013.MethodsA total of 629 Enterobacteriaceae isolates were included in the study. Identification and susceptibility testing was performed using Phoenix (Becton Dickinson) and the ESBL producers were confirmed by double-disk potentiation as recommended by the Clinical and Laboratory Standards Institute. Molecular analysis of the ESBL producers was performed by polymerase chain reaction.ResultsIn total, 109 isolates (17.3 %) were confirmed as ESBL producers and all were sensitive to meropenem in routine susceptibility assays. Most of the ESBL producers (99.1 %) were resistant to amoxicillin/clavulanic acid and ceftriaxone and 93.6 % were resistant to cefepime. Among the ESBL-producing genes, blaCTX-M (66.1 %) was the most prevalent, followed by blaSHV (53.2 %) and blaTEM (40.4 %).ConclusionsThese findings show the high prevalence of ESBL-producing Enterobacteriaceae within the intensive care units at Hamad Medical Corporation, Qatar, and emphasize the need for judicious use of antibiotics and the implementation of strict infection control measures.

Multi-Drug Resistant (MDR) Bacterial Isolates on Close Contact Surfaces and Health Care Workers in Intensive Care Units of a Tertiary Hospital in Bulawayo, Zimbabwe

“…Out of the 13 Klebsiella isolates, 9 (69.23%) were phenotypically positive for ESBL production, and out of the 11 E. coli isolates, 6 (54.55%) were phenotypically positive for ESBL production ( Table 3). Similar findings were obtained by Tajeddin et al [11] from Iran who reported 51.5% of Klebsiella and 77.8% of E.coli isolates to be ESBL positive, as well as Ahmed et al [47] from Qatar who ascertained 51.4% of Klebsiella isolates to be ESBL positive. In accordance with our findings, literature from Uganda and the United Kingdom also established Klebsiella species as the most frequent ESBL producers [9,39].…”

“…Imipenem was the most effective antimicrobial against E.coli, with a resistance rate of 9.09%. Resistance rates between the ranges 0% to 10% by E.coli to imipenem are globally comparable with several studies [9,[46][47][48]. Gentamicin proved to be the second most effective antimicrobial against both Klebsiella and E. coli isolates; including ESBL producers.…”

CTX-M-15 Type β-lactamases From Clinical Isolates of Escherichia coli by Polymerase Chain Reaction and DNA Sequencing

“…The prevalence of CTX-M-1 had little difference among isolates from the two studied cities. Recent reports have shown a rapid and alarming dissemination of Enterobacteriaceae producing ESBLs of the CTX-M type in certain countries such as India [20], Cambodia [21], France [22], UK [23], Qatar [9] and Canada [24] that has become the most prevalent ESBL-type world-wide. A high prevalence and broad geographic distribution of CTX-M-producing E. coli and K. pneumonia nosocomial strains have been shown in Russia.…”

“…CTX-M-15 belongs to the CTX-M-1 cluster [7]. Phylogenetic studies suggest that bla CTX -M genes have evolved from chromosomal bla genes of Kluyvera sps [8,9]. bla CTX -M gene encodes a 291 amino acid enzyme although insertions and deletions in a few variants have sequences ranging from 282 to 292 amino acids.…”

Single center study of ESBL-related strains of Enterobacteriaceae collected from clinical specimens of infants with the congenital heart disease using multiplex PCR amplification

“…Modern data indicate a growing prevalence of ESBL's isolated from different patient groups globally [5][6][7][8][9][10]. However, neither single-nor multicenter studies have been conducted on ESBL-related hospital infections in Ukraine.…”