Occurrence, identification, and antibiogram signatures of selected Enterobacteriaceae from Tsomo and Tyhume rivers in the Eastern Cape Province, Republic of South Africa

Fadare, Folake Temitope; Adefisoye, Martins Ajibade; Okoh, Anthony I.

doi:10.1371/journal.pone.0238084

Cited by 13 publications

(14 citation statements)

References 86 publications

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“…Therefore, these carbapenems may still be efficient against infections arising from C. freundii. Only one of these isolates carried two of the ARGs assayed (bla CTX-M-1 and tetA), which contrasts the results of the various β-lactamases reported in previous clinical and environmental studies [10,[38][39][40].…”

Section: Discussioncontrasting

confidence: 97%

“…The bla CTX-M group has been reported as the most predominant enzymes among the β-lactamases, followed by the bla TEM [40,47]. The CTX-M variants are one of the most widespread in South Africa [10,19]. As per this study, the co-occurrence of the ESBLs and pAmpCs were mostly detected in Klebsiella spp., with a similar co-carriage detected in one E. coli strain.…”

Section: Discussionsupporting

confidence: 57%

“…The occurrences of these bacterial species, especially the antibiotic-resistant phenotypes in the environment and hospital, are an essential environmental and public health concern [9,10]. The development of multidrug-resistant (MDR) members of the Enterobacteriaceae family, most notably the Klebsiella pneumoniae and K. oxytoca, is quite concerning.…”

Section: Introductionmentioning

confidence: 99%

“…These include penicillins, carbapenems, and cephalosporins prescribed to treat infections arising from Enterobacteriaceae. Enterobacteriaceae' ability to produce the enzymes ESBLs and the pAmpC β-lactamases are a cause of worry to public health safety [10,12,15,16]. According to Bush and Jacoby [17], the ESBLs are the Ambler class A, including the TEM-, SHV-, OXA-and CTX-M enzymes.…”

Section: Introductionmentioning

confidence: 99%

“…The resistance of ESBL producers against multiple antibiotic classes makes them of significant concern in the clinical settings [18,22], making the treatment of patients infected by them difficult and quite often almost impossible. Additionally, the co-occurrence of β-lactamases, particularly the pAmpC β-lactamases, and the ESBLs has been commonly reported [10,21]. The genes encoding the ESBLs and pAmpC are frequently encoded on plasmids with large sizes.…”

Section: Introductionmentioning

confidence: 99%

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Distribution and molecular characterization of ESBL, pAmpC β-lactamases, and non-β-lactam encoding genes in Enterobacteriaceae isolated from hospital wastewater in Eastern Cape Province, South Africa

Fadare

Okoh

2021

PLoS ONE

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Globally, there is an increasing occurrence of multidrug-resistant (MDR) Enterobacteriaceae with extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases in clinical and environmental settings of significant concern. Therefore, we aimed to evaluate the occurrence of ESBL/pAmpC genetic determinants, and some essential non-β-lactam genetic determinants in the MDR phenotypic antimicrobial resistance in Enterobacteriaceae isolates recovered from hospital wastewater. We collected samples from two hospitals in Amathole and Chris Hani District Municipalities in the Eastern Cape Province, South Africa, within October and November 2017. Using the matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF), we identified a total of 44 presumptive Enterobacteriaceae isolates. From this, 31 were identified as the targeted Enterobacteriaceae members. Thirty-six percent of these belonged to Klebsiella oxytoca, while 29% were Klebsiella pneumoniae. The other identified isolates included Citrobacter freundii and Escherichia coli (10%), Enterobacter asburiae (6%), Enterobacter amnigenus, Enterobacter hormaechei, and Enterobacter kobei (3%). We established the antibiotic susceptibility profiles of these identified bacterial isolates against a panel of 18 selected antibiotics belonging to 11 classes were established following established guidelines by the Clinical and Laboratory Standard Institute. All the bacterial species exhibited resistance phenotypically against at least four antibiotic classes and were classified as MDR. Notably, all the bacterial species displayed resistance against cefotaxime, ampicillin, nalidixic acid, and trimethoprim-sulfamethoxazole. The generated multiple antibiotic resistance indices ranged between 0.5 to 1.0, with the highest value seen in one K. oxytoca isolated. Molecular characterization via the Polymerase Chain Reaction uncovered various ESBLs, pAmpCs, and other non-β-lactam encoding genes. Of the phenotypically resistant isolates screened for each class of antibiotics, the ESBLs detected were blaCTX-M group (including groups 1, 2, and 9) [51.6% (16/31)], blaTEM [32.3% (10/31)], blaOXA-1-like [19.4% (6/31)], blaSHV [12.9% (4/31)], blaPER [6.5% (2/31)], blaVEB [3.2% (1/31)], blaOXA-48-like and blaVIM [15.4% (2/13)], and blaIMP [7.7% (1/13)]. The pAmpC resistance determinants detected were blaCIT [12.9% (4/31)], blaFOX [9.7% (3/31)], blaEBC [6.5% (2/31)], and blaDHA [3.2% (1/31)]. The frequencies of the non-β-lactam genes detected were catII [79.2% (19/24)], tetA [46.7% (14/30)], sulI and sulII [35.5% (11/31)], tetB [23.3% (7/30)], aadA [12.9% (4/31)], tetC [10% (3/30)], and tetD [3.3% (1/30)]. These results indicate that hospital wastewater is laden with potentially pathogenic MDR Enterobacteriaceae with various antibiotic resistance genes that can be spread to humans throughout the food chain, provided the wastewaters are not properly treated before eventual discharge into the environment.

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Section: Discussioncontrasting

confidence: 97%