Phenotypic screening and molecular characterization of carbapenemase-producing Gram-negative bacilli recovered from febrile neutropenic pediatric cancer patients in Egypt

Kamel, Noha A.; Eltayeb, Wafaa N; El-Ansary, Mona R; Mansour, Mohamed; Aboshanab, Khaled M.

doi:10.1371/journal.pone.0202119

Cited by 46 publications

(53 citation statements)

References 32 publications

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“…In the same study, CTX-M type was the most common β-lactamase-encoding gene represent about 90% of the ESBL-producing E. coli [21] and this was higher than that in our study (20.41%). In contrast to this study, In a study conducted by Abdallah et al, the genetic analysis showed that CTX-M was present in 96% of ESBL E. coli in adult infections, also in a recent study the most common ESBLs genes detected were again CTX-M in multi-drug resistant gram negative bacilli in infected febrile neutropenic cancer patients [42]. These discrepancies can be attributed to the differences in age categories in the first study and the different patients' clinical criteria in the second one.…”

Section: Discussioncontrasting

confidence: 90%

Genetic Study of Extended Spectrum Beta-Lactamase and Carbapenemase Producing Escherichia Coli Causing Sepsis among Egyptian Children

Zaki¹,

El-Halaby²,

Elmansoury³

et al. 2019

TOMICROJ

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Background: Treatment failure of sepsis caused by Escherichia coli (E. Coli) is a leading cause of death of infants and children in intensive care units. Objective: To detect the prevalence of Extended-Spectrum Beta-Lactamase (ESBL) and carbapenemase-genes between E. coli isolates from infants and children with septicemia and to identify their antibiotic sensitivity pattern. Methods: This is a cross-sectional study performed on 88 patients with sepsis. The isolated E. coli were identified by Gram stain and biochemically by the Microscan automated system. ESBL and carbapenemase producing E. coli were isolated on double disk diffusion and EDTA double disk, respectively. Polymerase chain reaction for ESBL and carbapenemase producing E. coli genes were performed. Bacterial susceptibility to antibiotics was tested. The initial results were measured through the 30-days of hospital admission. IRB approved the study. Results: Of 88 patients with sepsis, 49 and 30 strains were ESBL producing and carbapenemase producing E. coli; respectively. Neither risk factors for infection nor clinical picture can differentiate between ESBL and carbapenemase producing E. coli. The most frequently detected gene of ESBL producing E. coli was SHV, it was more sensitive to Piperacillin/Tazobactam (90%) and cefepime (86.7%) while for carbapenemase-producing E. coli; IMP was the most frequent, its sensitivity was high to Piperacillin/Tazobactam and Ciprofloxacin (52.6% each). Conclusion: The commonest gene of ESBL producing E. coli is SHV whereas for carbapenemase-producing E. coli is IMP. Piperacillin/Tazobactam is the candidate drug to start in children with septicemia and suspected ESBL or carbapenemase-producing E. coli infection.

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Section: Discussioncontrasting

confidence: 90%

Genetic Study of Extended Spectrum Beta-Lactamase and Carbapenemase Producing Escherichia Coli Causing Sepsis among Egyptian Children

Zaki¹,

El-Halaby²,

Elmansoury³

et al. 2019

TOMICROJ

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“…The results shown in Table 1 indicate that in Egypt from 2000 through 2020, resistance to various cephalosporins, such as cefuroxime, cefotaxime, ceftazidime, and cefepime, was higher than that to b-lactam/b-lactamase inhibitor combinations, e.g., amoxicillin-clavulanic acid and piperacillin-tazobactam. A rise in resistance was reported against aminoglycosides; gentamcin/amikacin, ciprofloxacin (a quinolone drug) and carbapenems, i.e., imipenem and meropenem [ 84 , 85 , 86 , 87 , 88 , 89 ]. The increase in antibiotic resistance in these isolates has also been demonstrated by β-lactamase detection.…”

Section: Resultsmentioning

confidence: 99%

“…An increasing trend was also observed for bla PER and bla GES ESBL traits. On the other hand, bla VIM and bla IMP were the most prevalent metallo-β-lactamases resistance encoding genes which showed a remarkable increase, along with bla NDM [ 84 , 88 , 90 , 91 , 92 , 93 ].…”

Section: Resultsmentioning

confidence: 99%

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

Nasser

Palwe²,

Bhargava

et al. 2020

Microorganisms

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The production of diverse and extended spectrum β-lactamases among Escherichia coli and ESKAPE pathogens is a growing threat to clinicians and public health. We aim to provide a comprehensive analysis of evolving trends of antimicrobial resistance and β-lactamases among E. coli and ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acine to bacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) in the Arabian region. A systematic review was conducted in Medline PubMed on papers published between January 2000 and February 2020 on countries in the Arab region showing different antibiotic resistance among E. coli and ESKAPE pathogens. A total of n = 119,144 clinical isolates were evaluated for antimicrobial resistance in 19 Arab countries. Among these clinical isolates, 74,039 belonged to E. coli and ESKAPE pathogen. Distribution of antibiotic resistance among E. coli and ESKAPE pathogens indicated that E. coli (n = 32,038) was the predominant pathogen followed by K. pneumoniae (n = 17,128), P. aeruginosa (n = 11,074), methicillin-resistant S. aureus (MRSA, n = 4370), A. baumannii (n = 3485) and Enterobacter spp. (n = 1574). There were no reports demonstrating Enterococcus faecium producing β-lactamase. Analyses revealed 19 out of 22 countries reported occurrence of ESBL (Extended-Spectrum β-Lactamase) producing E. coli and ESKAPE pathogens. The present study showed significantly increased resistance rates to various antimicrobial agents over the last 20 years; for instance, cephalosporin resistance increased from 37 to 89.5%, fluoroquinolones from 46.8 to 70.3%, aminoglycosides from 40.2 to 64.4%, mono-bactams from 30.6 to 73.6% and carbapenems from 30.5 to 64.4%. An average of 36.9% of the total isolates were reported to have ESBL phenotype during 2000 to 2020. Molecular analyses showed that among ESBLs and Class A and Class D β-lactamases, blaCTX-M and blaOXA have higher prevalence rates of 57% and 52.7%, respectively. Among Class B β-lactamases, few incidences of blaVIM 27.7% and blaNDM 26.3% were encountered in the Arab region. Conclusion: This review highlights a significant increase in resistance to various classes of antibiotics, including cephalosporins, β-lactam and β-lactamase inhibitor combinations, carbapenems, aminoglycosides and quinolones among E. coli and ESKAPE pathogens in the Arab region.

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“…Accordingly, out of the 342 GNB; 188 (54.9%) isolates were MDR which is in accordance with previous studies and imposes weak infection control strategies. 26 , 27 Despite the fact that the antibiogram analysis of recovered GNB is raising concerns, yet, the overall sensitivity patterns of amikacin, doxycycline and tigecycline ranging from 70% to 85% rise as a promising hope.…”

Section: Discussionmentioning

confidence: 99%

<p>Carbapenemase Producers Among Extensive Drug-Resistant Gram-Negative Pathogens Recovered from Febrile Neutrophilic Patients in Egypt</p>

Mabrouk

Abdellatif

El-Ansary

et al. 2020

IDR

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Purpose This study aimed to detect the prevalence of carbapenemase producers (CPs) among extensive drug-resistant (XDR)-carbapenemase producing Gram-negative bacteria (GNB) recovered from various clinical specimens of hospitalized neutrophilic febrile patients in two major tertiary care hospitals in Egypt. Methods Standard methods were used to evaluate the antimicrobial susceptibility of clinical isolates according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Phenotypic and genotypic analysis of CPs were carried out and statistically analyzed using standard methods. Results Three hundred and forty-two GNB were obtained from 342 clinical specimens during the period of the study, where 162 (47%) were enterobacterial isolates, including, 63 (18.4%) Escherichia coli , 87 (25.4%) Klebsiella spp., 5 (1.46%) Enterobacter cloacae , 5 (1.46%) Salmonella spp. and 2 (0.6%) Proteus and 180 (53%) were non-fermentative bacilli including, 129 (37.7%), Acinetobacter baumannii , and 51 (14.9%), Pseudomonas spp. Out of the 342 GNB, 188 (54.9%) isolates were multi-drug resistant (MDR). Of these, 52 (27.6%) were XDR as well as CPs as confirmed phenotypically. The MIC of imipenem against the XDR GNB against showed either low (11 isolates; 21.1%; MIC range =4–32 µg/mL) or high levels of resistance (41 isolates; 78.8%; MIC range = 64-≥1024). The most prevalent carbapenem resistance (CR) genes were blaKPC (63.5%) followed by blaOXA -48 (55.7%) and blaVIM (28.8%). No significant association could be observed between the MIC level and the presence of CR genes ( P value >0.05). Conclusion High prevalence of MDR (54.9%) and XDR (27.6%) GNB pathogens associated with high levels of resistance to carbapenems were observed. All XDR GNB were CPs and tested positive for at least one of the CR genes. However, most of them (78.8%) showed a high level of CR (MIC range = 64-≥1024) with no significant association with the CR genes.

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Phenotypic screening and molecular characterization of carbapenemase-producing Gram-negative bacilli recovered from febrile neutropenic pediatric cancer patients in Egypt

Cited by 46 publications

References 32 publications

Genetic Study of Extended Spectrum Beta-Lactamase and Carbapenemase Producing Escherichia Coli Causing Sepsis among Egyptian Children

Genetic Study of Extended Spectrum Beta-Lactamase and Carbapenemase Producing Escherichia Coli Causing Sepsis among Egyptian Children

Retrospective Analysis on Antimicrobial Resistance Trends and Prevalence of β-lactamases in Escherichia coli and ESKAPE Pathogens Isolated from Arabian Patients during 2000–2020

<p>Carbapenemase Producers Among Extensive Drug-Resistant Gram-Negative Pathogens Recovered from Febrile Neutrophilic Patients in Egypt</p>

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