Defining the Relationship Between Phenotypic and Genotypic Resistance Profiles of Multidrug-Resistant Enterobacterial Clinical Isolates

Galal, Lamis; Aziz, Neveen Abdel; Hassan, W. M.

doi:10.1007/5584_2018_208

Cited by 9 publications

(11 citation statements)

References 22 publications

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“…In Egypt, ESBL producers are widely spread in hospitals. One recent study showed a significant association between 3rd generation cephalosporins and resistance fluoroquinolones, gentamicin and tetracycline in hospital acquired infections (Galal et al, 2018). CTX-M-1, CTX-M-9, CTX-M-15, CTX-M-14, and SHV-12 were reported in E. coli strains isolated from different clinical origins (Hassan et al, 2012; Abdelaziz et al, 2013a; Abdallah et al, 2015b; Helmy and Kashef, 2017).…”

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

“…Other ESBL producers detected in Egyptian hospitals include CTX-M-14/CTX-M-15 Enterobacter spp. (Abdallah et al, 2015b; Galal et al, 2018), CTX-M-15/SHV P. mirabilis , CTX-M-15/SHV C. freundii , CTX-M-14 Serratia marcescens (Helmy and Kashef, 2017; Galal et al, 2018) and CTX-M Salmonella spp. (Abdallah et al, 2017).…”

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

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Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

et al. 2019

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In the last decade, extended-spectrum cephalosporin and carbapenem resistant Gram-negative bacilli (GNB) have been extensively reported in the literature as being disseminated in humans but also in animals and the environment. These resistant organisms often cause treatment challenges due to their wide spectrum of antibiotic resistance. With the emergence of colistin resistance in animals and its subsequent detection in humans, the situation has worsened. Several studies reported the transmission of resistant organisms from animals to humans. Studies from the middle east highlight the spread of resistant organisms in hospitals and to a lesser extent in livestock and the environment. In view of the recent socio-economical conflicts that these countries are facing in addition to the constant population mobilization; we attempt in this review to highlight the gaps of the prevalence of resistance, antibiotic consumption reports, infection control measures and other risk factors contributing in particular to the spread of resistance in these countries. In hospitals, carbapenemases producers appear to be dominant. In contrast, extended spectrum beta lactamases (ESBL) and colistin resistance are becoming a serious problem in animals. This is mainly due to the continuous use of colistin in veterinary medicine even though it is now abandoned in the human sphere. In the environment, despite the small number of reports, ESBL and carbapenemases producers were both detected. This highlights the importance of the latter as a bridge between humans and animals in the transmission chain. In this review, we note that in the majority of the Middle Eastern area, little is known about the level of antibiotic consumption especially in the community and animal farms. Furthermore, some countries are currently facing issues with immigrants, poverty and poor living conditions which has been imposed by the civil war crisis. This all greatly facilitates the dissemination of resistance in all environments. In the one health concept, this work re-emphasizes the need to have global intervention measures to avoid dissemination of antibiotic resistance in humans, animals and the environment in Middle Eastern countries.

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Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

Section: Distribution Of Multi-drug Resistant Organisms In Humansmentioning

confidence: 99%

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

et al. 2019

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“…Figure 3 Summary of the prevalence (%) of ESBL-producing/third-generation cephalosporin-resistant Enterobacteriaceae (ESBL-E).Notes: Data from references27,33,42,[64][65][66][67][68][69][70][71][72][73][74][75][76][77][78][79] . a Klebsiella spp.…”

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confidence: 99%

Landscape of Multidrug-Resistant Gram-Negative Infections in Egypt: Survey and Literature Review

El-Kholy¹,

El-Mahallawy²,

Elsharnouby³

et al. 2021

IDR

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This article is the first to review published reports on the prevalence of multidrugresistant (MDR) gram-negative infections in Egypt and gain insights into antimicrobial resistance (AMR) surveillance and susceptibility testing capabilities of Egyptian medical centers. Materials and Methods: A literature review and online survey were conducted. Results: The online survey and literature review reported high prevalence of extendedspectrum β-lactamase (ESBL)-producing Enterobacteriaceae (19-85.24% of E. coli, and 10-87% of K. pneumoniae), carbapenem-resistant Enterobacteriaceae (35-100% of K. pneumoniae and 13.8-100% of E. coli), carbapenem-resistant Acinetobacter baumannii (10-100%), and carbapenem-resistant Pseudomonas aeruginosa (15-70%) in Egypt. Risk factors for MDR Gram-negative infections were ventilated patients (67.4%), prolonged hospitalization (53.5%) and chronic disease (34.9%). Although antimicrobial surveillance capabilities were deemed at least moderate in most centers, lack of access to rapid AMR diagnostics, lack of use of local epidemiological data in treatment decision-making, lack of antimicrobial stewardship (AMS) programs, and lack of risk prediction tools were commonly reported by respondents. Conclusion:This survey has highlighted the presence of knowledge gaps as well as limitations in the surveillance and monitoring capabilities of AMR in Egypt, with most laboratories lacking rapid diagnostics and molecular testing. Future efforts in Egypt should focus on tackling these issues via nationwide initiatives, including understanding the AMR trends in the country, capacity building of laboratories and their staff to correctly and timely identify AMR, and introducing newer antimicrobials for targeting emerging resistance mechanisms in Gram-negative species.

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“…Для лечения пациентов с клебсиельными инфекциями используют беталактамные антибиотики, фторхиноло ны и аминогликозиды (Galal et al, 2019). При этом основны ми в терапии являются беталактамы, которые блокируют синтез клеточной стенки бактерий и наименее токсичны для человека.…”

Section: Introductionunclassified

“…К БЛРС относятся ферменты се мейств TEM, SHV, CTXM, OXA и др. (Gharrah et al, 2017;Galal et al, 2019). На сегодняшний день для каждого семейства беталактамаз известно большое количество аллельных вариантов, обеспечивающих устойчивость к третьему поколению цефалоспоринов, монобактамам и карбапенемам (Liakopoulos et al, 2016).…”

Section: Introductionunclassified

Genetic characterization of clinical <I>Klebsiella</I> isolates circulating in Novosibirsk

et al. 2021

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72 clinical strains of Klebsiella spp. isolated from samples obtained from humans in Novosibirsk, Russia, were analyzed. Species identification of strains was performed using 16S rRNA and rpoB gene sequences. It was revealed that Klebsiella pneumoniae strains were dominant in the population (57 strains), while the remaining 15 strains were K. grimontii, K. aerogenes, K. oxytoca and K. quasipneumoniae. By molecular serotyping using the wzi gene sequence, K. pneumoniae strains were assigned to twenty-one K-serotypes with a high proportion of virulent K1- and K2-serotypes. It was found that K. pneumoniae strains isolated from the hospitalized patients had a higher resistance to antibiotics compared to the other Klebsiella species. Real-time PCR revealed that the population contained genes of the blaSHV, blaTEM, blaCTX families and the blaOXA-48 gene, which are the genetic determinants of beta-lactam resistance. It has been shown that the presence of the blaCTX sequence correlated with the production of extended-spectrum beta-lactamases, and phenotypic resistance to car-bapenems is due to the presence of the blaOXA-48 gene. At the same time, the carbapenemase genes vim, ndm, kpc, imp were not detected. Among the aminoglycoside resistance genes studied, the aph(6)-Id and aadA genes were found, but their presence did not always coincide with phenotypic resistance. Resistance to fluoroquinolones in the vast majority of strains was accompanied by the presence of the aac(6’)-IB-cr, oqxA, oqxB, qnrB, and qnrS genes in various combinations, while the presence of the oqxA and/or oqxB genes alone did not correlate with resistance to fluoroquinolones. Thus, the detection of blaCTX and blaOXA-48 can be used to quickly predict the production of extended-spectrum beta-lactamases and to determine the resistance of Klebsiella to carbapenems. The detection of the aac(6’)-Ib-cr and/or qnrB/qnrS genes can be used to quickly determine resistance to fluoroquinolones.

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Defining the Relationship Between Phenotypic and Genotypic Resistance Profiles of Multidrug-Resistant Enterobacterial Clinical Isolates

Cited by 9 publications

References 22 publications

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

Understanding the Epidemiology of Multi-Drug Resistant Gram-Negative Bacilli in the Middle East Using a One Health Approach

Landscape of Multidrug-Resistant Gram-Negative Infections in Egypt: Survey and Literature Review

Genetic characterization of clinical <I>Klebsiella</I> isolates circulating in Novosibirsk

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