The Mediterranean Region : A Reservoir for CTX - M - ESBL - Producing Enterobacteriacae

Abstract

The incidence of ESBL-producing bacteria is increasing worldwide, which represents a challenge for the healthcare systems. More recently, the emergence of the CTX-M group has been frequently reported as being associated with both nosocomial and community acquired infections. CTX-M-15 was identified as being the most prevalent in a large geographic area including Europe and the Middle East, suggesting the presence of a community reservoir of CTX-M enzymes disseminating in the Mediterranean area. Thus, this review will focus on the Mediterranean region to highlight the increasing prevalence of CTX-M-ESBL producing Enterobacteriacae.

Frequency and Antibiotics Resistance of Extended-Spectrum Beta-Lactamase (ESBLs) Producing Escherichia coli and Klebsiella pneumoniae Isolated from Patients in Gaza Strip, Palestine

“…In the present study, the overall prevalence rate of ESBL-producing E. coli isolates was 39.1%. Similar studies have shown 16.8% in Lebanon [14], 22.9% in Jordan [15], 42.3% in Egypt [16], and 52% in Syria [17]. We observed that 59.3% (n=16) of the K. pneumoniae isolates were ESBL producers in the present study.…”

“…In many parts of the middle east, the prevalence of ESBL-producing K. pneumoniae isolates has been reported, e.g., United Arab Emirates (36%) [11], Syria (67.5%) [12], and Jordan (70%) [13]. Data from some countries showed that the prevalence of ESBL-producing E. coli was 16.8% in Lebanon [14], 22.9% in Jordan [15], 42.3% in Egypt [16], and 52% in Syria [17].…”

First Report of Extended-Spectrum β-Lactamases Among Clinical Isolates ofKlebsiella pneumoniaein Gaza Strip, Palestine

“…20 Nonetheless, numerous reports are available from Middle East and North African countries. 9,10 In this report, 14 of the16 K. pneumoniae clinical isolates harbored ESBLs of the CTX-M-1 group, including isolates encoding bla CTX-M-15 (n = 13) and bla CTX-M-3 (n = 1) genes. This finding is in agreement with recent reports both in Middle East and other parts of the world, where CTX-M-15 remains the globally predominant ESBL enzyme.…”

“…8 In the Middle East, several reports highlighted to what extent the spread of ESBL producers has become of serious concern, and this region might indeed be one of the major epicenters of the global ESBL pandemic. 9,10 The clonal dissemination of CTX-M-15-producing K. pneumoniae isolates has been reported in Saudi Arabia, Egypt, Iran, Oman, Lebanon, Gulf Council, Iraq, Kuwait, and Turkey. 9,[11][12][13][14][15][16][17][18][19] No data are available, so far, on ESBL-producing K. pneumoniae in Gaza Strip, Palestine and very scarce data in West Bank, Palestine.…”

Molecular Characterisation of ESBL producer E. coli

“…The above frequencies varies with geographical areas of the performed studies, however, the global trends indicated an increase of CTX-M gene in ESBL E. coli isolates and became responsible for outbreak of community and hospital acquired UTI infection [15,22,[38][39][40][41][42][43]. The higher frequency rate of E. coli antibiotic resistance gene was demonstrated by bla -OXA gene (100%; 15/15), followed by bla CTX-M gene (86.7%, 13/15), and bla-TEM gene (66.7%, 10/15), while the lowest one was bla SHV gene which was detected in 60% (9/15) of the isolates.…”