Phenotypic and Genotypic Prevalence of Extended-Spectrum β-Lactamase-Producing <i>Escherichia coli</i>: A Systematic Review and Meta-Analysis in Iran

Jabalameli, Leila; Beigverdi, Reza; Ranjbar, Hamidreza Hagh; Pouriran, Ramin; Jabalameli, Fereshteh; Emaneini, Mohammad

doi:10.1089/mdr.2019.0396

Cited by 14 publications

(6 citation statements)

References 60 publications

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Section: Discussionmentioning

confidence: 97%

“…38 In Iran, CTX-M enzyme prevalence reached 31.2% followed by TEM with 27.6%. 69 It is worth to mention that the prevalence analyzed here only accounted for E. coli, thus it might be an underestimation if including other bacterial species such as K. pneumoniae, which usually harbor TEM or SHV enzymes. [70][71][72] Apart from the best-known enzymes (ie, TEM, SHV, and CTX-M), TOHO, reported for the first time in Japan in 1993, 73 was also found in South America among human clinical and environmental studies (Figures 4A and 8A).…”

Section: Dovepressmentioning

confidence: 96%

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Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective

Bastidas-Caldes¹,

Romero-Álvarez²,

Valdez-Vélez³

et al. 2022

IDR

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Purpose Extended-spectrum beta-lactamase-producing (ESBL) Enterobacteriaceae, which includes Escherichia coli , has emerged as a global health threat. ESBL enzymes including CTX-M, TEM, and SHV are the most detected. Here, a systematic review was developed to assess the status of ESBLs in E. coli considering studies performed in the human, animal, food, and environmental realms in South America. Methods Following PRISMA guidelines, a systematic review was performed using the PubMed database as a primary source to identify studies containing data on ESBL-producing E. coli in South America. To obtain a comprehensive sample, studies in English, Spanish, and Portuguese were included from 1990 to April 2021. Inclusion such as the reporting of sample origin and diagnostic method and exclusion criteria such as review/letter articles were established to complete data extraction steps. Results Amongst 506 articles retrieved, 130 met the inclusion criteria. Brazil reported 65 (50%) of publications, followed by Argentina, and Ecuador with 11.5% each. According to the category of studies, human studies represented the 56%, animals the 20%, environmental the 11%, and food studies the 6%. Interestingly, studies assessing more than one category (ie, interdisciplinary) represented the 7%. Prevalence of ESBL producing E. coli in animal, food, and environmental studies was widely superior compared to human sources. In clinical studies, Brazil presented the greatest diversity in terms of ESBLs, featuring CTX-M, TEM, SHV, TOHO, OXA, and AmpC. CTX-M enzymes were the most frequent variants with 89.4% detections. Conclusion The present One Health review of 130 studies conducted over the past 21 years found ESBLs producing E. coli distributed across human, animal, food, and environmental samples across South America. There is a need to increment studies in underrepresented countries and to strengthen multi-sectoral antimicrobial resistance research and surveillance. This information can be used as basis for subsequent implementation of monitoring programs, targeting potential critical points of transmission sources.

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Section: Discussionmentioning

confidence: 97%

Section: Dovepressmentioning

confidence: 96%

Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective

Bastidas-Caldes¹,

Romero-Álvarez²,

Valdez-Vélez³

et al. 2022

IDR

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“…In level of antimicrobial resistance genes (ARGs), β-lactamase ( bla ) genes were studied; the results showed that bla TEM and bla CTX-M genes were positive with a high prevalence rate, but bla SHV and bla CMY had low frequency. Meta-analytic studies showed that the prevalence of ESBL genes was significantly high in different regions of Iran with various rates [ 33 , 34 ]. Similar to our study, high frequencies of bla TEM and bla CTX-M- positive isolates were reported in other countries and regions, such as northern and eastern Europe [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

High prevalence of β-lactam and fluoroquinolone resistance in various phylotypes of Escherichia coli isolates from urinary tract infections in Jiroft city, Iran

et al. 2023

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Background Urinary tract infection (UTI) is one of the most prevalent infectious diseases with worldwide health threatening. Antimicrobial resistant strains of Escherichia coli (E. coli) are a common cause of UTI which were identified as a treatment challenge. This study aimed to assay the prevalence of common β-lactam resistance genes including blaTEM, blaSHV, blaCTX-M and blaCMY and phenotypic resistance to commonly used β-lactam and fluoroquinolone antibiotics in UTIs. These factors were evaluated in various phylogenetic groups (phylotypes) of E. coli isolates. Real-time PCR was applied to detect β-lactam resistance genes and conventional PCR was used to determine the phylotypes. Phenotypic resistance against β-lactams (ceftazidime, cefotaxime, aztreonam and ceftriaxone) and fluoroquinolones (ciprofloxacin) were identified by the disc diffusion technique. The ability of extended spectrum β-lactamases (ESBLs) production in E. coli isolates was detected using the combined disc diffusion method. Results The prevalence of resistance genes were 89.6% for blaTEM, 44.3% for blaCTX-M, 6.6% for blaSHV and 0.9% for blaCMY. The two high prevalent phylotypes were B2 (29.2%) and D (17.9%) followed by E (14.1%), F (9.4%), C (6.6%) and 10.3% of isolates were unknown in phylotyping. Disc diffusion results showed high prevalence of antibiotic resistance to cefotaxime (88.6%), aztreonam (83%), ceftireaxon (77.3%), ceftazidime (76.4%) and ciprofloxacin (55.6%). Totally, 52.8% of isolates were found as phenotypical ESBL-producers. Conclusions This study’s results confirmed an explosion of antibiotic resistance amongst E. coli isolates from UTI against β-lactams and fluoroquinolones. Findings explain the necessity of deep changes in quantity and quality of drug resistance diagnosis and antibiotic therapy strategies. More studies are suggested to better and confident evaluations.

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“…Furthermore, eight (21.62%) isolates carried the bla CTX-M gene, which is lower than its prevalence reported in previous studies [ 47 , 50 ]. The distribution of ESBLs has evolved to a predominance of CTX-M enzymes, mainly with E. coli as one of the major carriers of ESBL encoding genes [ 51 ]. These higher rates of CTX-M among E. coli isolates may be associated with high mobilization of the encoding genes.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Urine Dipstick Test in Diagnosing Urinary Tract Infection and Detection of the blaCTX-M Gene among ESBL-Producing Escherichia coli

Gurung

Adhikari

et al. 2021

Diseases

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A urine dipstick test used for prompt diagnosis of urinary tract infection (UTI) is a rapid and cost-effective method. The main objective of this study was to compare the efficacy of the urine dipstick test with culture methods in screening for UTIs along with the detection of the blaCTX-M gene in extended spectrum β-lactamase (ESBL)-producing Escherichia coli. A total of 217 mid-stream urine samples were collected from UTI-suspected patients attending Bharatpur Hospital, Chitwan, and tested by dipstick test strip (COMBI-10SL, Germany) prior to the culture. E. coli isolates were identified by standard microbiological procedures and subjected to antimicrobial susceptibility testing by Kirby Bauer disc diffusion method following CLSI guideline. Primary screening of ESBL-producing E. coli isolates was conducted using ceftriaxone, cefotaxime and ceftazidime discs and phenotypically confirmed by combined disk diffusion test. Plasmid DNA of ESBL-producing strains was extracted by phenol-chloroform method and subjected to PCR for detection of the blaCTX-M gene. Out of 217 urine samples, 48 (22.12%) showed significant bacteriuria. Among 46 (21.20%) Gram negative bacteria recovered, the predominant one was E. coli 37 (77.08%) of which 33 (89.19%) were multidrug resistant (MDR). E. coli isolates showed a higher degree of resistance towards cefazolin (62.16%) while 81.08% of the isolates were sensitive towards amikacin followed by nitrofurantoin (70.27%). Among 14 (37.84%) phenotypically confirmed ESBL isolates, only eight (21.62%) isolates carried the blaCTX-M gene. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of urine dipstick test were 43.75%, 77.51%, 35.59% and 82.91%, respectively. Besides, the use of dipstick test strip for screening UTI was associated with many false positive and negative results as compared to the gold standard culture method. Hence, dipstick nitrite test alone should not be used as sole method for screening UTIs.

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Phenotypic and Genotypic Prevalence of Extended-Spectrum β-Lactamase-Producing Escherichia coli: A Systematic Review and Meta-Analysis in Iran

Cited by 14 publications

References 60 publications

Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective

Extended-Spectrum Beta-Lactamases Producing Escherichia coli in South America: A Systematic Review with a One Health Perspective

High prevalence of β-lactam and fluoroquinolone resistance in various phylotypes of Escherichia coli isolates from urinary tract infections in Jiroft city, Iran

Efficacy of Urine Dipstick Test in Diagnosing Urinary Tract Infection and Detection of the blaCTX-M Gene among ESBL-Producing Escherichia coli

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