High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran

Mehrgan, Hadi; Rahbar, Mohammad; Arab-Halvaii, Zohreh

doi:10.3855/jidc.488

Cited by 45 publications

(41 citation statements)

References 15 publications

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“…Similar findings have been reported in other studies in Iran and Tanzania [9,10]. In these two studies imipenem was shown to be the most active antibiotic against the ESBL producing isolates and nitrofurantoin showed moderate activity.…”

Section: Discussionsupporting

confidence: 90%

Antimicrobial resistance patterns in extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates in a private tertiary hospital, Kenya

Maina¹,

Makau²,

Nyerere³

et al. 2013

Microbiol Discov

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Background: Extended-Spectrum β-Lactamase (ESBL) producing Enterobacteriaceae have become widespread in hospitals and are increasing in community settings where they cause a variety of infections. In addition to hydrolyzing most beta-lactam agents, bacteria harboring these enzymes display resistance to other unrelated antimicrobial agents and thus often pose a therapeutic dilemma. Though these resistance patterns have been studied elsewhere within Africa, such data from hospitals in Kenya are scanty. We therefore undertook to determine these patterns at the Aga Khan University hospital by studying multidrug resistant Escherichia coli and Klebsiella pneumoniae isolates from patients' samples. Findings: A total of 159 isolates (109 E. coli and 50 K. pneumoniae) were confirmed as ESBL producers and tested against eighteen antimicrobials. The proportion of resistant isolates was high (>80%) for the antimicrobials tested with the exception of the carbapenems (<1%), nitrofurantoin (23%) and gentamicin (63%). Klebsiella pneumoniae had a higher proportion of isolates resistant to ceftazidime, gentamicin and nitrofurantoin (P < 0.05) than E. coli which had a higher proportion of isolates resistant to ciprofloxacin, levofloxacin and tetracycline (P < 0.05). Conclusions: In our study, antimicrobial coresistance is common in ESBL producers; however resistance to carbapenems is low and these drugs would be the appropriate empiric therapy for serious or life threatening systemic infections. Nitrofurantoin retains good activity among the multidrug resistant isolates and can be the drug of choice for non-complicated urinary tract infections due to ESBL producing E. coli.

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Section: Discussionsupporting

confidence: 90%

Antimicrobial resistance patterns in extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates in a private tertiary hospital, Kenya

Maina¹,

Makau²,

Nyerere³

et al. 2013

Microbiol Discov

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“…In the present study, high resistance of K. pneumonia to numerous antibiotics was observed (Table 1). These results are similar to the reported results from Colombia and Iran (25,27), showing more than 97% resistance to ampicillin in K. pneumonia isolates. The situation indicates a threat to the community and a possibility that the K. pneumonia could have become resistance to many more antibiotics to which it showed susceptibility earlier.…”

Section: Discussionsupporting

confidence: 82%

“…The occurrence of ESBL among clinical isolates varies greatly in different geographic parts of Iran and is rapidly changing over time. A study in 2010 shows a prevalence of 32% in Kashan (24), 77% in Tehran (25), and 19.02% in Sanandaj (26). In the present study, high resistance of K. pneumonia to numerous antibiotics was observed (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Extended Spectrum β-Lactamase inKlebsiella pneumoniaIsolates in a Teaching Hospital of Zahedan City, Iran

Mahbobeh¹,

Bahman²,

Rashki

et al. 2014

Avicenna J Clin Microbiol Infect

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Background: Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumonia has become widespread in hospitals and is increasing in community settings. Most of K. pneumonia that harbor these enzymes, display resistance to other unrelated antimicrobial agents and thus, often pose a therapeutic dilemma. Objectives: This study was conducted to determine the prevalence of ESBL-producing K. pneumonia in a major university hospital in Zahedan, Iran. Materials and Methods:The susceptibility of 83 K. pneumonia isolates to 12 antibiotics was assessed using Kirby-Bauer disc diffusion method. For the ESBL phenotypic test, double-disk diffusion (DD) method was used. Results: The highest resistance rates of the isolates were seen against cefixime (82%), cefotaxime (81%), ceftriaxone (73%), ceftazidime (72%), and azithromycin (60%), consecutively. The lowest resistance rates were observed against gentamicin (58%), tetracycline (59%), nalidixic acid (59%), and amikacin (63%), consecutively. ESBLs were found in 65% of K. pneumonia isolates. Conclusions: We found that 65% of K. pneumonia isolates produced ESBL. Therapeutic strategies to control infections should be carefully formulated in teaching hospitals. The high percentage of drug resistance in ESBL-producing K. pneumonia suggests that routine detection of ESBL by reliable laboratory methods is required.

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“…The percentage of E. coli isolates that was found to be resistant to ciprofloxacin in our study (89.7%) was lesser than that reported by [25] in Egypt -in which 40% of the tested E. coli isolates in their study was found to be resistant to ciprofloxacin. Members of the Enterobacteriaceae family including E. coli often contain resistance determinants for other classes of antibiotics such as This article is available in: http://www.imedpub.com/applied-microbiology-and-biochemistry ISSN 2576-1412 the aminoglycosides, sulfonamides, and fluoroquinolones which are readily transmissible from one strain of organism to another and between different species of Gram-negative bacteria [26,27]. The E. coli strains in this study were found to be highly resistant to the cephalosporins and carbapenems used in this study especially cefoxitin (93.1%), ceftazidime (69.0%), cefotaxime (55.2%), imipenem (31.0%), meropenem (58.6%) and ertapenem (75.9%).…”

Section: Discussionmentioning

confidence: 99%

Multiple Antibiotic Resistance, Antibiogram and Phenotypic Detection of Metallo-Beta-Lactamase (MBL) from Escherichia coli of Poultry Origin

Chika¹,

Ifeanyichukwu²,

O³

et al. 2017

J Appl Microbiol Biochem

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Background: Bacteria produce antibiotic-degrading enzymes such as carbapenemases. Carbapenemases are a consortium of carbapenem-hydrolyzing enzymes such as metallo-β-lactamase (MBL) that gives Gram-negative bacteria the exceptional ability to degrade and render the carbapenems inefficacious.Aim: This study evaluated the antibiogram, multiple antibiotic resistance and occurrence of MBL-producing E. coli from cloacal swabs of poultry birds in a local poultry farm in Abakaliki, Nigeria. Materials and methods:A total of 40 cloacal swab samples from the cloacal region of poultry birds were bacteriologically analyzed for the isolation of E. coli. E. coli isolates were identified using standard microbiology techniques and the antibiogram of the isolates was determined using the disk diffusion technique. The multidrug resistance nature of the E. coli isolates was determined using multiple antibiotics resistance index (MARI) protocol while MBL production was phenotypically confirmed using the inhibition based assay.Results: A total of 29 (72.5%) E. coli isolates was recovered from the 40 cloacal swab samples. The E. coli isolates were highly resistant to imipenem (31%), meropenem (58.6%), ertapenem (75.9%), cefotaxime (55.2%), ciprofloxacin (89.7%), cefoxitin (93.1%). and ceftazidime (69.0%). MBL production was phenotypically detected in 3 (10.3%) E. coli isolates out of the 29 isolates of E. coli recovered in this study. The resistant E. coli isolates were multiply resistant to antibiotics in the class of fluoroquinolones, cephalosporins, aminoglycosides and carbapenems; and they had a multiple antibiotic resistance of 0.4 on average. Conclusion:This presumptive study has shown that E. coli isolates of poultry origin produce MBL. The emergence and spread of drug resistant bacteria in the community can be contained if we use antibiotics rationally and find alternative measures for promoting animal growth without the use of antimicrobial agents. as metallo-β-lactamase (MBL)-producing bacteria has not yet been institutionalized in our healthcare system. And this could contribute to poor prognosis of the patient as well as lead to inappropriate use or application of antimicrobial therapy. The emergence of new beta-lactamases such as metallo-β-lactamases (MBLs), extended spectrum β-lactamases (ESBLs) and AmpC

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High prevalence of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a tertiary care hospital in Tehran, Iran

Cited by 45 publications

References 15 publications

Antimicrobial resistance patterns in extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates in a private tertiary hospital, Kenya

Antimicrobial resistance patterns in extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates in a private tertiary hospital, Kenya

Prevalence of Extended Spectrum β-Lactamase inKlebsiella pneumoniaIsolates in a Teaching Hospital of Zahedan City, Iran

Multiple Antibiotic Resistance, Antibiogram and Phenotypic Detection of Metallo-Beta-Lactamase (MBL) from Escherichia coli of Poultry Origin

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