Diversity of Extended Spectrum Beta-lactamase (ESBL) genes in Escherichia coli isolated from wastewater generated by a Sick Bay located in a University Health Care Facility

Adekanmbi, Abimbola Olumide; Akinpelu, Miracle Opeyemi; Olaposi, Adedolapo Victoria; Oyelade, Abolade A.

doi:10.1016/j.genrep.2020.100738

Cited by 21 publications

(15 citation statements)

References 42 publications

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“…In contrast to the reports of Adekanmbi et al [46], where the resistance to ertapenem, (a carbapenem) was high in ESBL-producing E. coli obtained in their study, there was no resistance to imipenem, another carbapenem, by any of the ESBL producers in this present study. The observation in this study is also in concordance with the work of Alqasim et al [38] and Pandit et al [39], where imipenem was the most sensitive drug to the ESBL producers in their respective studies.…”

Section: Discussioncontrasting

confidence: 99%

Molecular characterization of ESBL- producing uropathogenic Escherichia coli recovered from urine samples of patients attending a University Teaching hospital in Nigeria

Adekanmbi

Usidamen

Onilude

2021

AMicr

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Infection of the urinary tract ranks as one of the most common infections affecting people worldwide and its treatment is made complicated by the rising incidence of antibiotic resistance. This study aimed to detect extended spectrum beta-lactamase (ESBL) genes and antibiotic resistance profile of uropathogenic Escherichia coli (E. coli) recovered from patients attending a University Teaching hospital in Nigeria. Uropathogenic E. coli isolates were obtained from the culture collection of Department of Microbiology and Parasitology of the University Teaching hospital for a period of four months (October 2019–January, 2020). Antibiotic susceptibility testing was done using the disc diffusion method while phenotypic ESBL production was detected using double disc synergy test (DDST). Detection of β-lactamase genes was done using Real-Time PCR. Forty-nine E. coli isolates were recovered from 120 urine samples, with 24 (49%) being ESBL positive. The resistance to antibiotics in the ESBL producers was: ciprofloxacin (100%), cefotaxime (100%), cefpodoxime (100%), tetracycline (95.7%), ceftazidime (56.7%), amoxicillin-clavulanate (50%), gentamicin (33.3%), and imipenem (0%). All the ESBL producers carried blaTEM, blaCTX-M-1 and blaCTX-M-9, 75% (18/24) carried blaSHV, while blaCTX-M-2, blaCTX-M-8 and blaCTX-M-25 groups were detected in 20.8% (5/24) of the isolates. There was co-occurrence of CTX-M, SHV and TEM β-lactamases in 79.2% (19/24) isolates, while five isolates (20.8%) co-harbored blaCTX-M and blaTEM. This study showed a high level of multidrug resistance and ESBL gene carriage in uropathogenic E. coli obtained in this study, suggesting a likely review of therapeutic options in the treatment of UTI to clamp down on the rising cases of antibiotic resistance.

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Section: Discussioncontrasting

confidence: 99%

Molecular characterization of ESBL- producing uropathogenic Escherichia coli recovered from urine samples of patients attending a University Teaching hospital in Nigeria

Adekanmbi

Usidamen

Onilude

2021

AMicr

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“…The high level of resistance to the commonly used antibiotics has been reported also by other research groups in West Africa (34,35). In Nigeria, full resistance to cefotaxime, cefpodoxime, sulfonamide and ertapenem was reported among ESBL producing E. coli isolated from wastewater originating from a healthcare facility (35). Likewise, in Côte d'Ivoire, ESBL producing E. coli and K. pneumoniae isolated from hospital wastewaters were reported to be fully resistant to amoxicilline + clavulanic acid, cefotaxime, ceftriaxone and ceftazidime, E. coli were also fully resistant and K. pneumoniae 62.5% resistant to cipro oxacin, 87% resistant to nalidixic acid and cefepime, and furthermore, 76.5% of E. coli and 50% of K. pneumonia were resistant to gentamycin (34).…”

Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 63%

Title: Healthcare center wastewaters in Burkina Faso: sources of ESBL, AmpC-β-lactamase and carbapenemase producing Escherichia coli and Klebsiella pneumoniae

Garba¹,

Bonkoungou²,

Millogo

et al. 2023

Preprint

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Background Extended-spectrum β-lactamase (ESBL), plasmid-mediated AmpC-β-lactamase and carbapenemase producing Escherichia coli and Klebsiella pneumoniae have spread into environment worldwide posing a possible public health threat. However, the prevalence data in low- and middle-income countries are still scarce. The aim of this study was to assess the occurrence of ESBL, AmpC-β-lactamase and carbapenemase producing and multidrug-resistant E. coli and K. pneumoniae in wastewater collected from healthcare centers in Burkina Faso. Methodology Eighty-four (84) wastewater samples were collected from 5 healthcare centers and bacterial counts on ESBL ChromAgar were performed. E. coli and K. pneumoniae isolates were identified using API20E. ESBL production was confirmed using the double disc synergy test (DDST). AmpC-β-lactamase detection was performed on Muller Hinton (MH) agar supplemented with cloxacillin (4µg/l). Carbapenemase testing was carried out using O.K.N.V.I. RESIST-5 immunochromatography test. Result E. coli and/ or K. pneumoniae strains were isolated from 82 wastewater samples (97.6%). In total, 170 strains were isolated, E. coli more commonly (64%). Average concentrations of ESBL producing bacteria per hospital varied from 1.10x105 to 5.23x106 CFU/ml. Out of 170 presumptive ESBL producing isolates and 51 presumptive AmpC-β-lactamase producing isolates, 95% and 45% were confirmed, respectively. Carbapenemase production was detected in 10 isolates, 6 were NDM producers, 3 were OXA-48 producers and 1 was NDM and OXA-48 producer. All isolates were multidrug resistant and, furthermore, all of them were resistant to all β-lactams tested. Also, resistance to ESBL inhibitors was common, up to 66% E. coli and 62% in K. pneumoniae. Amikacin, fosfomycin and nitrofurantoin were the antibiotics for which least resistance was detected. Conclusion This study showed that wastewater from healthcare centers constitutes a reservoir of multidrug-resistant bacteria in Burkina Faso, including those capable of producing carbapenemases, which may disseminate into environment and further back to humans. Therefore, following the microbiological quality of the wastewaters released from healthcare centers is important to include in the future national AMR surveillance program.

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“…Besides, plasmids carrying the bla OXA gene harbour other non-ESBL genes like the bla CYM , bla NDM , and bla VIM, which confer enhanced Metallo- β -lactamase activity, alteration of porin synthesis, and the acquisition of other drug-degrading enzymes [ 88 ]. Notably, ESBL-associated genes are diverse and present varied characteristics [ 89 , 90 ]. The various genetic combinations in E. coli and K. pneumoniae observed in the present study probably contributed to high resistance rates toward single antibiotics and modified the activity of multiple antibiotics leading to MDR.…”

Section: Discussionmentioning

confidence: 99%

Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital

Maveke,

Aboge,

Kanja

et al. 2024

International Journal of Microbiology

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Background. The emergence of antimicrobial resistance (AMR) and multidrug resistance (MDR) among Escherichia coli and Klebsiella pneumoniae, especially through the production of extended spectrum β-lactamases (ESBLs), limits therapeutic options and poses a significant public health threat. Objective. The aim of this study was to assess the phenotypic and genetic determinants of antimicrobial resistance of ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates from patient samples in two Kenyan Hospitals. Methods. We collected 138 E. coli and 127 K. pneumoniae isolates from various clinical specimens at the two health facilities from January 2020 to February 2021. The isolates’ ESBL production and antibiotic susceptibility were phenotypically confirmed using a standard procedure. Molecular analysis was done through conventional polymerase chain reaction (PCR) with appropriate primers for gadA, rpoB, blaTEM, blaSHV, blaOXA, blaCTX-M-group-1, blaCTX-M-group-2, blaCTX-M-group-9, and blaCTX-M-group-8/25 genes, sequencing and BLASTn analysis. Results. Most E. coli (82.6%) and K. pneumoniae (92.9%) isolates were ESBL producers, with the highest resistance was against ceftriaxone (69.6% among E. coli and 91.3% among K. pneumoniae) and amoxicillin/clavulanic acid (70.9% among K. pneumoniae). The frequency of MDR was 39.9% among E. coli and 13.4% among K. pneumoniae isolates. The commonest MDR phenotypes among the E. coli isolates were CRO-FEP-AZM-LVX and CRO-AZM-LVX, while the FOX-CRO-AMC-MI-TGC-FM, FOX-CRO-FEP-AMC-TZP-AZM-LVX-MI and CRO-AMC-TZP-AZM-MI were the most frequent among K. pneumoniae isolates. Notably, the FOX-CRO-FEP-AMC-TZP-AZM-LVX-MI phenotype was observed in ESBL-positive and ESBL-negative K. pneumoniae isolates. The most frequent ESBL genes were blaTEM (42%), blaSHV (40.6%), and blaOXA (36.2%) among E. coli, and blaTEM (89%), blaSHV (82.7%), blaOXA (76.4%), and blaCTX-M-group-1 (72.5%) were most frequent ESBL genes among K. pneumoniae isolates. The blaSHV and blaOXA and blaTEM genotypes were predominantly associated with FOX-CRO-FEP-MEM and CRO-FEP multidrug resistance (MDR) and CRO antimicrobial resistance (AMR) phenotypes, among E. coli isolates from Embu Level V (16.7%) and Kenyatta National Hospital (7.0%), respectively. Conclusions. The high proportion of ESBL-producing E. coli and K. pneumoniae isolates increases the utilization of last-resort antibiotics, jeopardizing antimicrobial chemotherapy. Furthermore, the antimicrobial resistance patterns exhibited towards extended-spectrum cephalosporins, beta-lactam/beta-lactamase inhibitor combinations, fluoroquinolones, and macrolides show the risk of co-resistance associated with ESBL-producing isolates responsible for MDR. Hence, there is a need for regular surveillance and implementation of infection prevention and control strategies and antimicrobial stewardship programs.

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Diversity of Extended Spectrum Beta-lactamase (ESBL) genes in Escherichia coli isolated from wastewater generated by a Sick Bay located in a University Health Care Facility

Cited by 21 publications

References 42 publications

Molecular characterization of ESBL- producing uropathogenic Escherichia coli recovered from urine samples of patients attending a University Teaching hospital in Nigeria

Molecular characterization of ESBL- producing uropathogenic Escherichia coli recovered from urine samples of patients attending a University Teaching hospital in Nigeria

Title: Healthcare center wastewaters in Burkina Faso: sources of ESBL, AmpC-β-lactamase and carbapenemase producing Escherichia coli and Klebsiella pneumoniae

Phenotypic and Genotypic Characterization of Extended Spectrum Beta-Lactamase-Producing Clinical Isolates of Escherichia coli and Klebsiella pneumoniae in Two Kenyan Facilities: A National Referral and a Level Five Hospital

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