Prevalence of extended spectrum beta lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram negative bacilli isolates from pediatric patient population in Gaza strip

Abstract

Background Extended-spectrum β lactamases (ESBLs), have the ability to hydrolyze and cause resistance to various types of the β-lactam antibiotics, including the extended-spectrum (or third-generation) cephalosporins (e.g., cefotaxime, ceftriaxone, ceftazidime) and monobactams (e.g., aztreonam). ESBL-producing Gram negative bacteria is still posing significant therapeutic challenges. Objectives To assess the prevalence and molecular characteristics of ESBL producing Gram negative bacilli, isolated from a cohort of pediatric patients in Gaza hospitals. Methods A total of 322 isolates of Gram-negative bacilli were collected from four referral pediatric hospitals in Gaza, namely: Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals. These isolates were tested for ESBL production using the double disk synergy and CHROMagar phenotypic methods. Molecular characterization of the ESBL producing strains was performed using PCR targeting the CTX-M, TEM and SHV genes. Antibiotic profile was done using Kirby Bauer method according to Clinical and Laboratory Standard Institute. Results Out of 322 isolates tested by phenotypic methods, 166 (51.6%) were ESBL positive. The prevalence of ESBL production in Al-Nasr, Al-Rantisi, Al-Durra and Beit Hanoun hospitals was 54%, 52.5%, 45.5% and 52.8% respectively. The prevalence of ESBL production among Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Acinetobacter spp., Proteus mirabilis, Enterobacter spp., Citrobacter spp., and Serratia marcescens is 55.3%, 63.4%, 17.8%, 57.1%, 33.3%, 28.5%, 38.4%, and 4% respectively. ESBL production among urine, pus, blood, CSF and sputum was 53.3%, 55.2%, 47.4%, 33.3%, and 25% respectively. Out of the 322 isolates, 144 were screened for CTX-M, TEM and SHV production. Using PCR, 85 (59%) had at least one gene. The prevalence rate of CTX-M, TEM and SHV genes was 60%, 57.6%, and 38.3% respectively. Meropenem and amikacin were highest rates of susceptibility antibiotics against ESBLs producers (83.1% and 82.5% respectively), while the least effective antibiotics were amoxicillin (3.1%) and cephalexin (13.9%). Moreover, ESBLs producers showed high resistance rate to cefotaxime, ceftriaxone and ceftazidime (79.5%, 78.9% and 79.5% respectively). Conclusion Our results show high prevalence of ESBL production among Gram negative bacilli isolated from children in different pediatric hospitals in Gaza strip. A substantial level of resistance to first and second generation cephalosporins was also observed. This ascertains the need for a rational antibiotic prescription and consumption policy.

Genotypic characterization of bacterial isolates causing urinary tract infections among adults at Kiambu Level 5 Hospital, Kenya: selected extended-spectrum β-lactamase genes and biofilm formation

“…ESβLs are responsible for the increasing bacterial pathogens hydrolysing activity by enabling the breakdown of the β-lactam ring, thereby inactivating the antibiotic. Similar findings have been documented in recent related studies by [ 27 ] on how the ability to hydrolyse antibiotics by ESβL genes is causing significant resistance to various β-lactam antibiotics [ 28, 29 ].…”

Dissemination of Class A Cephalosporinases and Class D Carbapenemases in Escherichia coli Isolates From a Tertiary Hospital in Sudan

“…Similar studies reported that the ESBL producer frequency reached 82.5% and 41.1% in patients from India [ 17 , 18 ], 55.5% from Saudi Arabia [ 19 ], 66.56% from Nepal [ 20 ], 58% from Vietnam [ 21 ], 42% from Southwestern Iran [ 22 ], 48% from Pakistan [ 23 ], and 55.3% from Palestine [ 24 ].…”

Frequency and Antimicrobial Resistance Patterns of Foodborne Pathogens in Ready-to-Eat Foods: An Evolving Public Health Challenge

“…Studies have shown that E. coli is the major cause of diarrhea [99][100][101][102]. Despite the presence of various bacterial species in the human gut, E. coli is more resistant to antibiotics than other Enterobacteriaceae [103,104]. Therefore, antibiotic-resistant strains of E. coli present a significant challenge in the global fight against infectious diseases.…”