Molecular characterization of extended-spectrum β-lactamase-producing Shigella isolates from humans in South Africa, 2003–2009

Tau, Nomsa P.; Smith, Anthony M.; Sooka, Arvinda; Keddy, Karen H.

doi:10.1099/jmm.0.033142-0

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…In these groups of patients, empirical antimicrobial use is likely to be higher because of responsive medical attention and greater antibiotic pressure, especially in the elderly. Our finding of ESBL producers among Enterobactericeae in hospitals is higher compared with that documented in some ESBL-affected institutions in South Africa (36.1%),9 Tunisia (38.5%)12 Tanzania (15%),14 Nigeria (40%),15 and in many other reviews for Europe (5.4–25%)19 and the United States (1–25%) 20…”

Section: Discussioncontrasting

confidence: 54%

“…Despite these public health concerns, few studies have reported on the problem of ESBLs in Africa in general and Ghana in particular. In Africa, outbreaks of infection with ESBL-producing enterobacteria have been reported in South Africa,7–9 Egypt,10,11 Tunisia,12 Morocco,13 Tanzania,14 and Nigeria 15. In Ghana, routine ESBL detection is absent.…”

Section: Introductionmentioning

confidence: 99%

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High Levels of Extended-Spectrum Beta-Lactamases in a Major Teaching Hospital in Ghana: The Need for Regular Monitoring and Evaluation of Antibiotic Resistance

Obeng‐Nkrumah¹,

Twum-Danso²,

Krogfelt³

et al. 2013

The American Society of Tropical Medicine and Hygiene

111

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Infections with bacteria producing extended-spectrum beta-lactamases (ESBLs) are increasing across Africa. This study reports on ESBL-producing Enterobacteriaceae as significant causes of infections and antibiotic resistance at Korle-Bu Teaching Hospital in Accra, Ghana. Of 300 isolates examined, 49.3% produced ESBLs. The prevalence of ESBLs was significantly high among isolates from neonates (28 of 43, 65.1%; relative risk = 1.62, 95% confidence interval = 1.33–2.13, P = 0.002) and adult patients > 65 years of age (36 of 51, 70.5%; relative risk = 1.89, 95% confidence interval = 1.41–2.40, P = 0.001). A marked increase in minimum inhibitory concentrations of ESBL-positive species was noticed compared with those for the other strains. Using these concentrations, we found that 26 (17%) ESBL producers were resistant to two or more antibiotics (aminoglycosides, fluoroquinolones, sulfonamide, and carbapenems) whereas 5 (3.2%) non–ESBL producers were multidrug resistant. Regular ESBL detection and evaluation of antibiotic resistance may help reduce the spread of ESBLs and antibiotic resistance in Ghana.

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Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

High Levels of Extended-Spectrum Beta-Lactamases in a Major Teaching Hospital in Ghana: The Need for Regular Monitoring and Evaluation of Antibiotic Resistance

Obeng‐Nkrumah¹,

Twum-Danso²,

Krogfelt³

et al. 2013

The American Society of Tropical Medicine and Hygiene

111

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“…Genes expressing broad-spectrum b-lactamases, ESBLs, and/or AmpC b-lactamases were detected in 69.9% of our MDR isolates. Co-expression of ESBL and AmpC genes in environmental (van Hoek et al, 2015;Ye et al, 2017) and clinical (Tau et al, 2012;Kharat et al, 2017) Enterobacteriaceae isolates has also been reported. Globally the blaCTX-M-type ESBL genes are predominant in Enterobacteriaceae, which was similar in our study, the majority being detected in E. coli isolates.…”

Section: Discussionmentioning

confidence: 97%

Occurrence, Identification, and Antimicrobial Resistance Profiles of Extended-Spectrum and AmpC β-Lactamase-Producing Enterobacteriaceae from Fresh Vegetables Retailed in Gauteng Province, South Africa

Richter

Plessis

Duvenage

et al. 2019

Foodborne Pathogens and Disease

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Extended-spectrum b-lactamase (ESBL) and AmpC b-lactamase-producing Enterobacteriaceae are no longer restricted to the health care system, but represent increased risks related to environmental integrity and food safety. Fresh produce has been increasingly reported to constitute a reservoir of multidrug-resistant (MDR) potential human pathogenic Enterobacteriaceae. This study aimed to detect, identify, and characterize the antimicrobial resistance of ESBL/AmpC-producing Enterobacteriaceae isolates from fresh vegetables at point of sale. Vegetable samples (spinach, tomatoes, lettuce, cucumber, and green beans; n=545) were purchased from retailers in Gauteng, the most densely populated province in South Africa. These included street vendors, trolley vendors, farmers' market stalls, and supermarket chain stores. Selective enrichment, plating onto chromogenic media, and matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDITOF MS) confirmation of isolate identities showed that 17.4% (95/545) vegetable samples analyzed were contaminated with presumptive ESBL/AmpC-producing Enterobacteriaceae. Dominant species identified included Escherichia coli, Enterobacter cloacae, Enterobacter asburiae, and Klebsiella pneumoniae. Phenotypic antibiotic resistance analysis showed that 96.1% of 77 selected isolates were MDR, while resistance to aminoglycoside (94.8%), chloramphenicol (85.7%), and tetracycline (53.2%) antibiotic classes was most prevalent. Positive phenotypic analysis for ESBL production was shown in 61 (79.2%) of the 77 isolates, and AmpC production in 41.6% of the isolates. PCR and sequencing confirmed the presence of b-lactamase genes in 75.3% isolates from all vegetable types analyzed, mainly in E. coli, Enterobacter spp., and Serratia spp. isolates. CTXM group 9 (32.8%) was the dominant ESBL type, while EBC (24.1%) was the most prevalent plasmidic type AmpC b-lactamase. Our findings document for the first time the presence of MDR ESBL/AmpC-producing Enterobacteriaceae in raw vegetables sold at selected retailers in Gauteng Province, South Africa.

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“…There is a high proportion of class D ESBLs existent, mainly OXA-1, and it has been found in between 3.3 and 93.3% of the studied isolates (34, 38, 40, 53, 54, 58, 59, 67, 69, 78, 80). pAmpC genes exist in some isolates, mainly DHA-1 and CMY-2 (16, 18, 21, 28, 29, 32, 49, 50, 53, 65, 69, 79), but because of the different classifications of ESBLs, these are not always included in the analyses performed in the studies. Disturbing results are the existence of carbapenemase genes.…”

Section: Discussionmentioning

confidence: 99%

ESBL-producingEnterobacteriaceaein Africa – a non-systematic literature review of research published 2008–2012

Storberg

2014

Infection Ecology & Epidemiology

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Introduction Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBL) has been found all over the world, and risk factors for acquiring these bacteria involve hospital care and antibiotic treatment. Surveillance studies are present in Europe, North America, and Asia, but there is no summarizing research published on the situation in Africa.AimThis review aims to describe the prevalence of ESBL-producing Enterobacteriaceae in hospital and community settings in Africa and the ESBL genes involved.MethodA non-systematic literature search was performed in PubMed. All articles published between 2008 and 2012 were screened and read in full text. Relevant articles were assessed for quality of evidence and included in the review. Articles were divided into regional areas in Africa and tabulated.ResultsESBL-producing Enterobacteriaceae in hospitalized patients and in communities varies largely between countries and specimens but is common in Africa. ESBLs (class A and D) and plasmid-encoded AmpC (pAmpC) were regularly found, but carbapenemases were also present.ConclusionESBL-producing Enterobacteriaceae in hospital and community settings in Africa is common. Surveillance of antimicrobial resistance needs to be implemented in Africa to tailor interventions targeted at stopping the dissemination of ESBL-producing Enterobacteriaceae.

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Molecular characterization of extended-spectrum β-lactamase-producing Shigella isolates from humans in South Africa, 2003–2009

Cited by 14 publications

References 11 publications

High Levels of Extended-Spectrum Beta-Lactamases in a Major Teaching Hospital in Ghana: The Need for Regular Monitoring and Evaluation of Antibiotic Resistance

High Levels of Extended-Spectrum Beta-Lactamases in a Major Teaching Hospital in Ghana: The Need for Regular Monitoring and Evaluation of Antibiotic Resistance

Occurrence, Identification, and Antimicrobial Resistance Profiles of Extended-Spectrum and AmpC β-Lactamase-Producing Enterobacteriaceae from Fresh Vegetables Retailed in Gauteng Province, South Africa

ESBL-producingEnterobacteriaceaein Africa – a non-systematic literature review of research published 2008–2012

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