Frequency and Antibiotics Resistance of Extended-Spectrum Beta-Lactamase (ESBLs) Producing Escherichia coli and Klebsiella pneumoniae Isolated from Patients in Gaza Strip, Palestine

Tayh, Ghassan; Laham, Nahed Al; Fhoula, Imène; Abedelateef, Nahed; El-Laham, Mohamed; Elottol, Abed Elkader; Slama, Karim Ben

doi:10.52547/jommid.9.3.133

Cited by 5 publications

(4 citation statements)

References 34 publications

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“…El Aila reported that ESBL production was found in 45 (27%) and 11 (26.8%) of 159 E. coli and 41 K. pneumoniae isolates from Al Shifa hospital, respectively [ 35 ]. Tayeh et al, found significant percentages of ESBL-producing K. pneumoniae (59.3%) and E. coli (39.1%) among clinical isolates in another recent investigation [ 36 ]. High prevalence of ESBL was reported in Asian countries which varied from 66.7% in India [ 37 ], 54.7–61% in Turkey [ 38 , 39 ], 41% in United Arab Emirates [ 40 ], and 72.1% in Iran [ 41 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip

2023

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Background Extended-spectrum β lactamases (ESBLs), have the ability to hydrolyze and cause resistance to various types of the β-lactam antibiotics, including the extended-spectrum (or third-generation) cephalosporins (e.g., cefotaxime, ceftriaxone, ceftazidime) and monobactams (e.g., aztreonam). ESBL-producing Gram negative bacteria is still posing significant therapeutic challenges. Objectives To assess the prevalence and molecular characteristics of ESBL producing Gram negative bacilli, isolated from a cohort of pediatric patients in Gaza hospitals. Methods A total of 322 isolates of Gram-negative bacilli were collected from four referral pediatric hospitals in Gaza, namely: Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals. These isolates were tested for ESBL production using the double disk synergy and CHROMagar phenotypic methods. Molecular characterization of the ESBL producing strains was performed using PCR targeting the CTX-M, TEM and SHV genes. Antibiotic profile was done using Kirby Bauer method according to Clinical and Laboratory Standard Institute. Results Out of 322 isolates tested by phenotypic methods, 166 (51.6%) were ESBL positive. The prevalence of ESBL production in Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals was 54%, 52.5%, 45.5% and 52.8% respectively. The prevalence of ESBL production among Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., Proteus mirabilis, Enterobacter spp., Citrobacter spp., and Serratia marcescens is 55.3%, 63.4%, 17.8%, 57.1%, 33.3%, 28.5%, 38.4%, and 4% respectively. ESBL production among urine, pus, blood, CSF and sputum was 53.3%, 55.2%, 47.4%, 33.3%, and 25% respectively. Out of the 322 isolates, 144 were screened for CTX-M, TEM and SHV production. Using PCR, 85 (59%) had at least one gene. The prevalence rate of CTX-M, TEM and SHV genes was 60%, 57.6%, and 38.3% respectively. Meropenem and amikacin were highest rates of susceptibility antibiotics against ESBLs producers (83.1% and 82.5% respectively), while the least effective antibiotics were amoxicillin (3.1%) and cephalexin (13.9%). Moreover, ESBLs producers showed high resistance rate to cefotaxime, ceftriaxone and ceftazidime (79.5%, 78.9% and 79.5% respectively). Conclusion Our results show high prevalence of ESBL production among Gram negative bacilli isolated from children in different pediatric hospitals in Gaza strip. A substantial level of resistance to first and second generation cephalosporins was also observed. This ascertains the need for a rational antibiotic prescription and consumption policy.

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Section: Discussionmentioning

confidence: 99%

Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip

2023

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“…In Syria, the frequency of ESBLs producers of K. pneumoniae were (67.5%) [14]. In Palestine, 59.3% of clinical K. pneumoniae strains were ESBLs [13]. In Arab Galf, the ESBL phenotypes among K. pneumoniae strains were 23.5% and 36% in Kuwait and United Arab Emirates respectively [18,19].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the high percentage of resistance (>75%) to the tested antibiotics in this study could be caused by overuse or inappropriate use of these drugs in our country, particularly because they are easily accessible and Libya does not have an antibiotic policy in place. In a related study, high resistance to K. pneumoniae was reported [13,14]. MDR-K. pneumoniae infections are highly lethal and frequently linked to a higher chance of receiving insufficient antibiotic treatment [15].…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Multidrug-Resistant Klebsiella pneumoniae Isolated from Some Hospitals in Benghazi, Libya

Asma Elramli,

Ahmed Zaghdani,

Ameni Arfaoui

et al. 2024

Alq J Med App Sci

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Klebsiella pneumoniae is one of the leading causes of hospital outbreaks worldwide, mainly in hospitalized or immune-compromised individuals. Also, this could be due to the emergence of Multidrug resistance (MDR) Extended Spectrum Beta Lactamase (ESBL) and carbapenemase-producing strains. This study's main goals were to evaluate the prevalence of resistance demonstrated by K. pneumoniae strains found in clinical samples from Benghazi Medical Center and AL-jalaa Hospital and to find evidence of ESBL strains and their resistance to certain antibiotic. During the study period, K. pneumoniae was isolated from 320 clinical samples (urine, sputum, blood and wound). The procedure for processing of samples, identification, susceptibility toward antimicrobials and evidence of ESBL, MBL strains were carried out according to the recommended standards. PCR was used to detect β-Lactamase and carbapenemase resistance genes. From a total K. pneumoniae isolates, 120 (37.5%) were isolated from hospital patients. The isolates exhibited high resistance to all used antibiotics. Forty-eight (40%) of the isolates were ESBL producers. MDR and XDR were identified in 89% and 56% of isolates respectively. ESBL-CTX-M-15 gene and OXA-48 were detected in all isolates. Moreover, SHV and NDM were identified in four isolates. In this study shows the high rate of MDR in clinical K. pneumoniae isolates in hospitals. There is an urgent need to implement an antibiotic resistance surveillance system to regulate and continuously monitor the emergence of antimicrobial resistance.

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“…Extended-spectrum beta-lactamase (ESBL)producing strains of E. coli have been discovered as a significant cause of antibiotic resistance. 3,4 ESBLs are enzymes that render various beta-lactam antibiotics inactive including cephalosporins and monobactams. Due to the widespread usage of these antibiotics, resistance has emerged.…”

Section: Introductionmentioning

confidence: 99%

Genomic Determinants and Antimicrobial Resistance Pattern of Clinical Isolates of Extended Spectrum Beta Lactamase (ESBL) Producing Escherichia coli

Shah,

Syed,

Bhat

et al. 2023

J. Pure Appl. Microbiol.

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The growing prevalence of antibiotic-resistant bacteria is a worldwide public health apprehension, and Escherichia coli (E. coli) is one of the most commonly implicated bacterial species. Among E. coli isolates, extended-spectrum β-lactamase (ESBL)-producing strains have been identified as a key contributor to antibiotic resistance. Penicillin’s, cephalosporins, and monobactams are only a few of the β-lactam antibiotics that can be rendered inactive by ESBLs. This investigation’s goals were to determine the prevalence of ESBL-producing E. coli isolates found in clinical samples and to analyze the distribution of the blaTEM, blaSHV, and blaCTX-M genes among them. Additionally, we aimed to determine the antibiotic susceptibility patterns of these isolates to other antibiotics. Clinical isolates from urine, ear swab, and wound/pus swabs were collected from patients with suspected E. coli bacterial infections from different regions of north India viz., SKIMS-JVC medical college and NABL accredited Dr. Qadri’s Lab both from Srinagar Kashmir valley region and SMSR, SU from Greater Noida UP. Standard laboratory techniques were used to identify E. coli isolates, and the combined disc method and other phenotypic confirmation techniques were used to confirm ESBL formation. PCR amplification and sequencing were used to find the blaTEM, blaSHV, and blaCTX-M genes. The Kirby-Bauer disc diffusion method was used to test the antimicrobial susceptibility of various bacteria to different antibiotics. A total of 210 E. coli isolates were collected from different clinical samples and only 158 isolates showed positive results for ESBL by DDST and phenotypic confirmatory tests. Of these, 124 (78.48%) were ESBL-producing isolates. We found that blaTEM was the most prevalent gene (45.16%), followed by blaCTX-M (34.16%) and blaSHV (12.09%). Antimicrobial resistance profiles were assessed for each of the 120 isolates. Ampicillin and Cefepime were the most resistant drugs to ESBL-producing isolates, followed by Gentamicin, Ceftriaxone, and Cefixime.

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Frequency and Antibiotics Resistance of Extended-Spectrum Beta-Lactamase (ESBLs) Producing Escherichia coli and Klebsiella pneumoniae Isolated from Patients in Gaza Strip, Palestine

Cited by 5 publications

References 34 publications

Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip

Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip

Molecular Characterization of Multidrug-Resistant Klebsiella pneumoniae Isolated from Some Hospitals in Benghazi, Libya

Genomic Determinants and Antimicrobial Resistance Pattern of Clinical Isolates of Extended Spectrum Beta Lactamase (ESBL) Producing Escherichia coli

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