Extended-spectrum β-lactamase Enterobacteriaceae from patients in Jeddah, Saudi Arabia: Antibiotic susceptibility and molecular approaches
DOI:
https://doi.org/10.22317/jcms.v7i1.920Keywords:
ESBLs, Antibiotics, Molecular, Virulence genes, EnterobacteriaceaeAbstract
Objectives: This study aimed to determine the Enterobacteriaceae strains among patients who suffering diarrhea, phenotypic and genotypic characterization of ESBL-producing isolates in Jeddah, Saudi Arabia.
Methods: Stool samples were collected and cultured to determine the different Enterobacteriaceae strains, PCR was done for the isolates to detect the different ESBLs genes and antibiotic susceptibility against different antibiotics was done.
Results: The total number of patients in this study was 200 (114 males [57%] and 86 females [43%]). The patients were categorized to teenagers (21, 10.5%), adults (92, 46%), middle age (25, 12.5%) and elderlies (25, 12.5%) according to age. Five Enterobacteriaceae strains was found: Enterobacter cloaca (7, 3.5%), Escherichia coli (111, 55.5%), Klebsiella pneumoniae (75, 37.5%), Proteus mirabilis (6, 3.0%) and Pseudomonas aeruginosa (1.0, 0.5%). P. aeruginosa was absent in all female patients under investigation. The response of the isolated (E. coli, K. pneumoniae and E. cloaca) strains to ampicillin, cefotaxime, cefotaxime-clavulanate, ceftriaxone, cephalothin and chloramphenicol, ciprofloxacin, nalidixic acid, streptomycin, tetracycline and trimethoprim-sulphamethoxazole was highly resistant, while the response was highly susceptible to ampicillin sulbactam, ceftazidime, ceftazidime-clavulanate, and imipenem. The most frequent gene was blaCTX-M (195) followed by blaTEM (149), blaSHV (73) and blaOXA (3), while the highest pair of genes in the same organism was blaTEM+blaCTX-M (134) followed by blaSHV+blaCTX-M (64), blaSHV+blaTEM (52) and the least pairs were blaTEM+blaOXA (3) and blaCTX-M+blaOXA (2). blaSHV+blaCTX-M+blaTEM was found in 44 organisms and blaCTX-M+blaTEM+blaOXA in two organisms only. The blaSHV+blaOXA, blaSHV+blaCTX-M+blaOXA, blaSHV+blaTEM+blaOXA and blaCTX-M+blaTEM+blaOXA+blaSHV were not present in any organism under investigation.
Conclusion: In teenager group, there were no organism contain blaOXA gene, while blaOXA present in E. cloaca and P. mirabilis only. blaSHV gene was absent in E. coli but present in E. cloaca and K. pneumoniae. The most susceptible group to infection with Enterobacteriaceae was adults' group, while teenage was more resist to infection.
References
2. Chantziaras I, Boyen F, Callens B, Dewulf J. Correlation between veterinary antimicrobial use and antimicrobial resistance in food-producing animals: a report on seven countries. Journal of Antimicrobial Chemotherapy. 2014;69(3):827–34.
3. Murphy D, Ricci A, Auce Z, Beechinor JG, Bergendahl H, Breathnach R, et al. EMA and EFSA Joint Scientific Opinion on measures to reduce the need to use antimicrobial agents in animal husbandry in the European Union, and the resulting impacts on food safety (RONAFA). EFSA Journal. 2017;15(1):e04666.
4. Lazarus B, Paterson DL, Mollinger JL, Rogers BA. Do human extraintestinal Escherichia coli infections resistant to expanded-spectrum cephalosporins originate from food-producing animals? A systematic review. Clinical Infectious Diseases. 2015;60(3):439–52.
5. Woerther P-L, Burdet C, Chachaty E, Andremont A. Trends in human fecal carriage of extended-spectrum β-lactamases in the community: toward the globalization of CTX-M. Clinical microbiology reviews. 2013;26(4):744–58.
6. Livermore DM, Paterson DL. Pocket guide to extended-spectrum β-lactamases in resistance. Current Medicine Group; 2006.
7. Pitout JDD, Nordmann P, Laupland KB, Poirel L. Emergence of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the community. Journal of Antimicrobial Chemotherapy. 2005;56(1):52–9.
8. Paterson DL, Bonomo RA. Extended-spectrum β-lactamases: a clinical update. Clinical microbiology reviews. 2005;18(4):657–86.
9. Boucher HW, Talbot GH, Bradley JS, Edwards JE, Gilbert D, Rice LB, et al. Bad bugs, no drugs: no ESKAPE! An update from the Infectious Diseases Society of America. Clinical infectious diseases. 2009;48(1):1–12.
10. Mosqueda-Gómez JL, Montaño-Loza A, Rolón AL, Cervantes C, Bobadilla-del-Valle JM, Silva-Sánchez J, et al. Molecular epidemiology and risk factors of bloodstream infections caused by extended-spectrum β-lactamase-producing Klebsiella pneumoniae: a case–control study. International journal of infectious diseases. 2008;12(6):653–9.
11. CLSI. Performance Standards for Antimicrobial Susceptibility Testing. Twenty First informational Supplement, Clinical and Laboratory Standards Institute (CLSI) document. 2011;M 100-S21.
12. Jarlier V, Nicolas M-H, Fournier G, Philippon A. Extended broad-spectrum β-lactamases conferring transferable resistance to newer β-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility patterns. Clinical Infectious Diseases. 1988;10(4):867–78.
13. Deak D, Outterson K, Powers JH, Kesselheim AS. Progress in the fight against multidrug-resistant bacteria? A review of US Food and Drug Administration–approved antibiotics, 2010–2015. Annals of internal medicine. 2016;165(5):363–72.
14. Mehrad B, Clark NM, Zhanel GG, Lynch III JP. Antimicrobial resistance in hospital-acquired gram-negative bacterial infections. Chest. 2015;147(5):1413–21.
15. Abrar S, Ain NU, Liaqat H, Hussain S, Rasheed F, Riaz S. Distribution of bla (CTX - M) , bla (TEM) , bla (SHV) and bla (OXA) genes in Extended-spectrum-β-lactamase-producing Clinical isolates: A three-year multi-center study from Lahore, Pakistan. Antimicrobial resistance and infection control [Internet]. 2019 May 22;8:80. Available from: https://pubmed.ncbi.nlm.nih.gov/31139363
16. Garrity G. Bergey’s Manual® of Systematic Bacteriology: Volume 2: The Proteobacteria, Part B: The Gammaproteobacteria. Vol. 2. Springer Science & Business Media; 2007.
17. Ahmed SF, Ali MMM, Mohamed ZK, Moussa TA, Klena JD. Fecal carriage of extended-spectrum β-lactamases and AmpC-producing Escherichia coli in a Libyan community. Annals of Clinical Microbiology and Antimicrobials. 2014;13(1).
18. Castanheira M, Mendes RE, Jones RN, Sader HS. Changes in the frequencies of β-lactamase genes among Enterobacteriaceae isolates in US hospitals, 2012 to 2014: activity of ceftazidime-avibactam tested against β-lactamase-producing isolates. Antimicrobial agents and chemotherapy. 2016;60(8):4770–7.
19. Jacob JT, Klein E, Laxminarayan R, Beldavs Z, Lynfield R, Kallen AJ, et al. Vital signs: carbapenem-resistant Enterobacteriaceae. MMWR Morbidity and mortality weekly report. 2013;62(9):165.
20. Gupta N, Limbago BM, Patel JB, Kallen AJ. Carbapenem-resistant Enterobacteriaceae: epidemiology and prevention. Clinical infectious diseases. 2011;53(1):60–7.
21. Ali MMM, Ahmed SF, Klena JD, Mohamed ZK, Moussa TAA, Ghenghesh KS. Enteroaggregative Escherichia coli in diarrheic children in Egypt: Molecular characterization and antimicrobial susceptibility. Journal of Infection in Developing Countries. 2014;8(5):589–96.
22. Sader HS, Castanheira M, Shortridge D, Mendes RE, Flamm RK. Antimicrobial activity of ceftazidime-avibactam tested against multidrug-resistant Enterobacteriaceae and Pseudomonas aeruginosa isolates from US medical centers, 2013 to 2016. Antimicrobial agents and chemotherapy. 2017;61(11).
23. Sader HS, Castanheira M, Shortridge D, Mendes RE, Flamm RK. Antimicrobial Activity of Ceftazidime-Avibactam Tested against Multidrug-Resistant Enterobacteriaceae and Pseudomonas aeruginosa Isolates from U.S. Medical Centers, 2013 to 2016. Antimicrobial agents and chemotherapy [Internet]. 2017 Oct 24;61(11):e01045-17. Available from: https://pubmed.ncbi.nlm.nih.gov/28827415
24. Pishtiwan AH, Khadija KM. Prevalence of blaTEM, blaSHV, and blaCTX-M genes among ESBL-producing Klebsiella pneumoniae and Escherichia coli isolated from thalassemia patients in Erbil, Iraq. Mediterranean journal of hematology and infectious diseases. 2019;11(1).
25. Ali MMM, Mohamed ZK, Klena JD, Ahmed SF, Moussa TAA, Ghenghesh KS. Molecular characterization of diarrheagenic Escherichia coli from Libya. American Journal of Tropical Medicine and Hygiene. 2012;86(5):866–71.
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