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Biutifasari, Verna. "Extended Spectrum Beta-Lactamase ( ESBL )." Oceana Biomedicina Journal 1, no. 1 (2018): 1. http://dx.doi.org/10.30649/obj.v1i1.3.
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<p>Antibiotika telah banyak digunakan sekarang ini. Pemakaian antibiotika yang berlebihan dan tidak sesuai dengan klinis dapat menyebabkan terjadinya resistensi terhadap antibiotika tersebut</p><p>Salah satu antibiotika yang dipakai adalah antibiotika golongan <em>beta-lactam</em> yang bekerja menghambat dinding sel. Pemakaian antibiotika <em>beta-lactam</em> yang tidak sesuai dapat menyebabkan terjadi resistensi terhadap antibiotika tersebut. Resistensi terhadap <em>beta-lactam</em> dapar terjadi di berbagai tingkatan. Salah satu resistensi dapat terjadi adalah resistensi terhadap <em>extendedspectrum broad lactamase (ESBL)</em></p><p><em>Extended spectrum beta-lactamase</em> adalah enzim yang mempunyai kemampuan dalam menghidrolisis antibiotika golongan <em>penicillin, cephalosporin</em> generasi satu, dua, dan tiga serta golongan <em>monobactam </em>dan menyebabkan resistensi ke seluruh antibiotika tersebut.</p><p>ESBL banyak dihasilkan oleh <em>Enterobactericeae </em>(terutama <em>Escherichia coli</em>) dan <em>Klebsiella pneumoniae. </em><em>Enterobacteriacea</em><em>e</em> mempunyai 3 pola resistensi yang disebabkan b<em>road spectrum beta-lactamase,inhibitor </em>resistant beta-lactamase (derivat TEM) , <em>Cephalosporinase </em>yang berlebihan. ESBL dapat sulit terdeteksi karena ESBL mempunyai perbedaan tingkatan aktifitas terhadap bermacam-macam <em>cephalosporin</em></p><p>ESBL dapat dideteksi secara <em>clinical microbiology (phenotypic</em><em>)</em> dan <em>molecular detection (genotypic).</em></p><p><em> </em></p><p><strong>Keyword</strong><strong>s</strong><strong>:</strong> Antiobiotika, resistensi, ESBL</p>
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Anjelina, Liya, and Armen Ahmad. "Diagnosis and Treatment-Spectrum Beta-Lactamase and Multidrug Resistance Bacterial." Bioscientia Medicina : Journal of Biomedicine and Translational Research 6, no. 10 (2022): 221–2230. http://dx.doi.org/10.37275/bsm.v6i10.581.
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Multidrug-resistant (MDR) is a condition resistant to at least one type of antibiotic from 3 classes of antibiotics. Extended-Spectrum Beta Lactamases are globular proteins that consist of alpha-helices and beta-pleated sheets. β-lactamase hydrolyze broad-spectrum cephalosporin with oxyimino side chain. ESBL hydrolyze antibiotics group penicillin, cephalosporin first, second, third, fourth generation, and monobactam aztreonam. Multidrug resistance occurs through two mechanisms, bacteria accumulate multiple genes encoding resistance to one antibiotic, and due to increased expression of genes encoding multidrug effluent pump, enzymatic inactivation and target structure change. Multidrug-resistant (MDR) caused by extended-spectrum resistance beta-lactamase (ESBL) can be detected by phenotyping and genotyping methods. Treatment for MDR ESBLs other than carbapenems can be β-lactam/β-lactamase inhibitor combinations (BLBLIs), namely piperacillin/tazobactam (PZT).
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Lestari, Ida, Pestariati Pestariati, and Sri Sulami Endah Astuti. "Deteksi Gen Tem (Temoneira) dari Isolat Klinis Escherichia Coli Penghasil Extended Spectrum Beta Lactamases (ESBL) Pasien Penderita Infeksi Saluran Kemih." Malahayati Nursing Journal 5, no. 1 (2023): 173–83. http://dx.doi.org/10.33024/mnj.v5i1.7832.
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ABSTRACT Urinary tract infection (UTI) is a most common infectious disease. The prevalence of UTIs in Indonesia is estimated at 180.000 per year and can affect people of all ages. In East Java, the number of cases of Urinary Tract Infection reaches 3-4 cases per 100,000 population per year. The most dominant urinary tract infection is caused by Escherichia coli bacteria from the multidrug-resistant Gram-negative group, such as producing of Extended Spectrum Beta Lactamases (ESBL). Extended Spectrum Beta-Lactamases (ESBLs) are Beta- Lactamase enzymes which ability can cause bacteria resistant to penicillin, cephalosporin generation 1, 2 and 3, and aztreonam (but not cefamycin and carbapenem). The causes of bacteria producing ESBL enzymes is the presence of ESBL gene. The one of ESBL gene groups which responsibility to producing ESBLs to hydrolyzing beta-lactamase antibiotics is temoneira enzyme (TEM). This study aim to determine the presence of TEM gene in Escherichia coli clinical isolates producing Extended Spectrum Beta-Lactamases (ESBL) from UTI patients urine in RSPAL Dr. Ramelan Surabaya. This type of research is descriptive observational with cross sectional approach. The sample used in this study was the clinical isolate Escherichia coli ESBL, as many as thirty isolates from UTIs patient urine in RSPAL Dr. Ramelan Surabaya. The detection of TEM gene used the PCR (Polymerase Chain Reaction) method. The result of the detection of TEM gene found were 3% (1/30) in RSPAL. Dr Ramelan Surabaya. The analysis of distribution of Escherichia coli ESBL bacteria in patient care room was obtained 54% (16/30) in ICU rooms, 43% (1/30) Non ICU, 3% (1/30) PICU rooms, and not found 0% in the NICU rooms, and outpatient clinic. Keywords: Urinary Tract Infection (UTI), Antimicrobial Resistance, Escherichia Coli Clinical Isolate, ESBL, and TEM (Temoneira) Gen ABSTRAK Infeksi saluran kemih (ISK) merupakan penyakit infeksi yang sangat umum terjadi. Angka kejadian kasus ISK di Indonesia diperkirakan sebesar 180.000 kasus pertahun dan dapat menjangkit semua orang dari segala usia. Sedangkan untuk wilayah Jawa Timur jumlah kasus Infeksi Saluran Kemih mencapai 3-4 kasus per 100.000 penduduk per tahun. Bakteri Escherichia coli dari golongan gram negatif multidrugresiten, seperti penghasil Extended Spectrum Beta Lactamases (ESBL) yang paling dominan menyebabkan infeksi saluran kemih. Extended Spectrum Beta- Lactamases (ESBL) adalah enzim Beta- Lactamase yang kemampuanya dapat menyebabkan bakteri resisten terhadap penisilin, sefalosporin generasi 1, 2, dan 3, serta aztreonam (tetapi tidak terhadap sefamisin dan karbapenem). Penyebab bakteri menghasilkan enzim ESBL karena adanya gen yang mengkode ESBL. Kelompok gen ESBL yang bertanggungjawab menghasilkan ESBL dalam menghidrolisis antibiotik beta-lactamase salah satunya adalah enzim temoneira (TEM). Tujuan penelitian ini yaitu untuk mengetahui keberadaan gen TEM pada isolat klinis Escherichia coli penghasil Extended Spectrum Beta-Lactamases (ESBL) dari urin pasien ISK di RSPAL Dr. Ramelan Surabaya. Jenis penelitian ini yaitu obervasional deskriptif dengan pendekatan cross sectional. Total sampel penelitian ini yaitu sebanyak tiga puluh isolat klinis Escherichia coli ESBL. Deteksi gen TEM menggunakan metode PCR (Polymerase Chain Reaction). Hasil deteksi gen TEM yang berhasil ditemukan sebesar 3% (1/30) di RSPAL. Dr. Ramelan Surabaya. Analisis penyebaran bakteri Escherichia coli ESBL di ruang perawatan didapatkan 54% (16/30) di ruang ICU, 43% (13/30) Non ICU, 3% (1/30) PICU serta tidak ditemukan 0% di ruang NICU, dan klinik rawat jalan. Kesimpulan pada penelitian ini adalah itemukan Gen TEM pada isolat Klinis E.coli dari urine pasien ISK sebnyak satu isolat (3%) di ruang perawatan Non ICU. Kata Kunci: Infeksi Saluran Kemih (ISK), Resistensi Antimikroba, Isolat Klinis Escherichia coli, ESBL, dan gen TEM (temoneira)
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Poonam Loomba, Ashna Bhasin, Abha Sharma Bibhabati Mishra та Ashish Bajaj. "Coproduction of Extended Spectrum, AmpC and Metallo β- Lactamases in Pseudomonas aeruginosa Isolates from a Super Speciality Center". International Journal of Current Microbiology and Applied Sciences 10, № 10 (2021): 176–84. http://dx.doi.org/10.20546/ijcmas.2021.1010.020.
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Pseudomonas aeruginosa (P. aeruginosa) is one of the leading causes of hospital as well as community acquired infections. They’re strenuous to treat as most of isolates exhibit various degrees of beta- lactamase mediated resistance to majority of the beta-lactam antibiotics. Single isolate can express multiple β- lactamase enzymes, further limiting the treatment options. Therefore, this study was outlined to research the coexistence of various beta-lactamase enzymes in clinical isolates of P. aeruginosa. The aim of the study was to detect the co-prevalence of Extended Spectrum Beta lactmases (ESBL), AmpC and Metallo β-Lactamases (MBL) in Pseudomonas aeruginosa isolates from a superspeciality center. Fifty clinical isolates of P. aeruginosa were tested for the presence of AmpC beta-lactamase, extended spectrum beta- lactamase (ESBL) and metallo beta-lactamase (MBL) enzyme. Discernment of AmpC beta-lactamase was performed by disk antagonism while ESBL detection was done by the combined disk diffusion method as per Clinical and Laboratory Standards Institute (CLSI) guidelines and MBL were detected by the Imipenem EDTA disk potentiation test. Eleven of 50 (22%) isolates were confirmed to be positive for AmpC and Extended spectrum beta lactamases. Co-production of AmpC along side ESBL and MBL was reported in 12 % isolates. The study shows the high prevalence of multidrug resistant P. aeruginosa producing beta-lactamase enzymes of diverse mechanisms. Consequently, formulation of a correct antibiotic policy and taking measures to restrict the indiscriminative use of cephalosporins and carbapenems should be taken to mitigate the emergence of this multiple beta-lactamase producing pathogens.
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EM, Eze. "Prevalence of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae Isolated From Clinical Samples in Illorin Metropolis, Kwara State Nigeria." Open Access Journal of Microbiology & Biotechnology 6, no. 2 (2021): 1–7. http://dx.doi.org/10.23880/oajmb-16000195.
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Background: This study investigated the prevalence of extended spectrum beta-lactamase producing enterobacteriaceae in Illorin metropolis using standard methods. The prevalence of ESBLs is increasingly being reported worldwide, and it varies according to geographic location and is directly linked to the use and misuse of antibiotics extended spectrum lactamases (ESBLs) are a major challenge in hospitalized patients worldwide and cause epidemic outbreaks in health care facilities, spreading in the community leading to various infections. Objectives: Screen for the extended spectrum β-lactamase producing Enterobacteriaceae and also determine the prevalence of ESBL producing Enterobacteriaceae in relation to gender, age and sample source. Methods: One hundred and sixty eight samples collected from routine clinical specimen such as high vagina swabs, urine, urethra swabs and wound swabs and sputum from October to December 2018 were studied. Fifty two enterobacteriaceae were isolated using spread plate method on macConkey and Cystein lactose electrolyte deficient media. The organisms were Klebsiella pneumoniae, Escherichia coli, Salmonella sp, Shigella sp, and Proteus sp. The isolates were subjected to antibiotic susceptibility testing using modified Kirby-Bauer standardized disc diffusion method. The antibiotics used were ceftazidine (30ug), cefuroxime (30ug), gentamicin (10ug), ciprofloxacin (5ug), ofloxacin 5ug, amoxicillin/clavulanate 30ug, nitrofurantoin 30ug and ampicillin 10ug. Ceftazidime showed a susceptibility percentage of 84.6%,, cefuroxime 61.5%, gentamicin 71.2% ciprofloxacin 46.2%, ofloxacin 51.9%, augmentin 61.5%, nitrofurantoin 71.2% and ampicillin, 44.2% with a significant difference (P< 0.05).Extended spectrum beta-lactamase ESBL, production by clinical and laboratory standards institute (CLSI) methods showed that 15(28.9%) of isolates belonging to the genera Escherichia, Klebsiella and Proteus expressed ESBL production. The order of ESBL production by the isolates were Escherichia coli 9 (17.3%), Klebsiella pneumonia 5(9.3%) and Proteus 1(1.9%). Thus, attention needs to be given by health care personnel’s to ESBL producing organisms in order to reduce the spread.
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Rao, Sridhar PN, Prasad Subba Rama, Vishwanath Gurushanthappa, Radhakrishna Manipura, and Krishna Srinivasan. "Extended-spectrum beta-lactamases producing Escherichia coli and Klebsiella pneumoniaei: A Multi-centric Study Across Karnataka." Journal of Laboratory Physicians 6, no. 01 (2014): 007–13. http://dx.doi.org/10.4103/0974-2727.129083.
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ABSTRACT Background: There are sporadic reports on detection of extended-spectrum beta-lactamases (ESBL) producers from Karnataka; hence, this is a first multicentric study across Karnataka state to determine the prevalence of ESBL production among clinical isolates of Escherichia coli and Klebsiella pneumoniaei. Aims and objectives: To determine the prevalence of ESBL producing clinical isolates of E. coli and K. pneumoniae from five geographically distributed centers across Karnataka, to study the susceptibility of ESBL producing isolates to other beta-lactam and beta-lactam-beta-lactamase inhibitors and to demonstrate transferability of plasmids coding for ESBL phenotype. Materials and Methods: Two hundred isolates of E. coli and K. pneumoniae each were collected from each of the five centers (Bellary, Dharwad, Davangere, Kolar and Mangalore). They were screened for resistance to screening agents (ceftazidime, cefotaxime, ceftriaxone, aztreonam) and positive isolates were confirmed for ESBL production by test described by Clinical and Laboratory Standards Institute . Co-production of ESBL and AmpC beta-lactamase was identified by using amino-phenylboronic acid disk method. Susceptibility of ESBL producers to beta-lactam antibiotics and beta-lactamase inhibitors was performed. Transferability of plasmids was performed by conjugation experiment. Results: Overall prevalence of ESBL production among E. coli and K. pneumoniae across five centers of the state was 57.5%. ESBL production was found to be 61.4% among E. coli and 46.2% among K. pneumoniae. ESBL production was significantly more among E. coli than K. pneumoniae. Significant variations in distribution of ESBL across the state was observed among E. coli isolates, but not among K. pneumoniae isolates. All ESBL producers demonstrated minimum inhibitory concentration levels ≥2 μg/ml towards cefotaxime, ceftazidime and ceftriaxone. Conclusion: Overall prevalence of ESBL production among clinical isolates of E. coli and K. pneumoniae across Karnataka state was high. The prevalence of ESBL production was significantly higher with E. coli than K. pneumoniae isolates. Higher rates of resistance to ceftriaxone and cefotaxime than to ceftazidime suggests the possibility of presence of CTX-M type ESBLs. Of all the beta-lactam/beta-lactamase inhibitor combinations tested, cefepime-tazobactam demonstrated highest in-vitro activity against ESBL producers. There was no statistical difference in the transferability of plasmids among E. coli and K. pneumoniae.
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Dikoumba, Anicet-Clotaire, Pierre Philippe Mbehang Nguema, Leresche Even Doneilly Oyaba Yinda, et al. "Characterization of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Diarrhoeal Faeces from 0 to 5-Year-Old Children Attending Public Hospitals in Franceville, Gabon." Antibiotics 13, no. 11 (2024): 1059. http://dx.doi.org/10.3390/antibiotics13111059.
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Background: In Gabon, studies on the characterization of extended-spectrum beta-lactamase-producing Escherichia coli in young children with diarrhoea are almost nonexistent. The objective was to evaluate the prevalence of antibiotic resistance to extended-spectrum beta-lactamase-producing Escherichia coli in children at public hospitals in Franceville, Gabon. Methods: Seventy diarrhoea faecal samples were collected from children aged 0–5 years. The culture and isolation of colonies were carried out on MacConkey agar. The colonies were identified using VITEK 2. The determination of the extended-spectrum beta-lactamase’s profiles was accomplished using the double disk method. The identification of phylogroups and pathotypes was performed by PCR. Identification of the ESBL genes was performed by sequencing. Results: A total of 26 strains of Escherichia coli (33.0%) were identified from 78 bacterial isolates. Twenty (77.0%) Escherichia coli strains carried extended-spectrum beta-lactamases blaCTX-M-15 and 5.0% carried blaSHV-12 subtypes. Phylogroup D (62.0%) was predominant, followed by B1 (12.0%), B2 (8.0%) and E (4.0%). The bacterial pathogens causing diarrhoea were enterohemorrhagic E. coli (12.0%), typical enteropathogenic Escherichia coli (8.0%), atypical enteropathogenic Escherichia coli (4.0%), Enteroaggregative Escherichia coli (4.0%) and enteroinvasive E. coli (4.0%). Conclusions: This study showed a high prevalence of extended-spectrum beta-lactamase, Escherichia coli of phylogroup D and pathotype enterohemorrhagic Escherichia coli in children under 5 years old in public hospitals in Franceville, most probably due to the misuse or inappropriate consumption of beta-lactams.
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Leena, Muppa, Velmani Vaishnavi, N. Nandhani, Santhana Sophia B. Vincy, Radhakrishnan Sriram та Abirami M. Bala. "Extended Spectrum β-Lactamase: Tackling Antibiotic Resistance and Overcoming Treatment Challenges". International Journal of Current Science Research and Review 07, № 10 (2024): 8038–47. https://doi.org/10.5281/zenodo.14001474.
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Abstract : Antibiotics, also known as antibacterials, kill or inhibit bacterial growth but are ineffective against viruses, fungi, or parasites, often leading to misuse. They are categorized by molecular structure, mode of action, and spectrum of activity. Antimicrobial Resistance (AMR) occurs when pathogens no longer respond to antimicrobial drugs, arising naturally or through acquisition. Resistance mechanisms include enzymatic (most common), genetic and physical. Bacteria produce various β-lactamases, such as Extended Spectrum β-lactamases (ESBLs), AmpC enzymes, and carbapenemase to exert resistance to Beta-Lactam (βL) class of antibiotics. ESBL families include TEM, SHV, and CTX-M, with E. coli being the most prevalent host. Any Gram-Negative Bacteria (GNB) can be an ESBL producer, but most common ones are the Enterobacteriaceae including Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. ESBL-producing Enterobacteriaceae (ESBL-E) resist penicillin, aztreonam, and cephalosporins except cephamycins and carbapenems, posing a significant public health risk. Genetic resistance mechanisms involve random mutations and horizontal gene transfer through either of the following processes namely conjugation, transformation, transduction. Physical mechanisms include efflux pump production and decreased porin channels. In some microbiological laboratories, ESBL production are often not determined, rather resistance based on MIC values to third generation Cephalosporins are considered as resistance due to ESBL production. Antibiotic use in agriculture and medicine has increased Multi-drug resistant (MDR) ESBL-producing E. coli and evidenced in retail meat and among meat shop employees. Community-acquired ESBL-E infections are a growing concern, with hospital transmission primarily occurring among patients sharing rooms with ESBL carriers. Empirical and definitive therapies for ESBL-E infections must be adjusted based on Antibiotic Susceptibility Testing (AST). The MERINO trial identified urinary tract infections as the most common source of ESBL-E bacteremia, with E. coli being predominant. For critically ill patients with non-urinary tract infections, Meropenem or Imipenem-cilastatin are recommended. For uncomplicated UTIs, Nitrofurantoin, Cotrimoxazole, and Piperacillin-Tazobactam (Pip-Taz) are effective, while Cotrimoxazole, Fluoroquinolones, and Ceftolozane-tazobactam are suitable for complicated UTIs. New β-lactamase inhibitors like avibactam, vaborbactam, and relebactam are promising for treatment. Misuse of antibiotics, such as inappropriate dosing and duration, contributes to AMR, a growing global challenge. Deaths from AMR, estimated at 1.27 million in 2019, could reach 10 million by 2050. ESBLs drive the use of broad-spectrum antibiotics, accelerating resistance development. Inadequate therapy exacerbates infections, leading to prolonged hospital stays, complications, and increased mortality. Balancing new drug development with resistance emergence is crucial to combat AMR.
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Le, Kien Chi, Cuong Quoc Vo, Xuan Thanh Tran, et al. "Carriage of ESBL and Amp-C -b -lactamase among Escherichia coli strains isolated from dogs in kennels Dak Lak province." Science and Technology Development Journal - Natural Sciences 5, no. 2 (2021): 1198–207. http://dx.doi.org/10.32508/stdjns.v5i2.996.
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The global prevalence of antimicrobial resistance and Extended-Spectrum and AmpC Beta- Lactamases is continuously widespread among Escherichia coli during recent years, especially in Viet Nam. In Viet Nam, there have been researches on ESBL and AmpC-carrying E. coli inhabiting animal and human. However, studies of antimicrobial resistance in E. coli residing in pets, especially dogs are unavailable. The aim of the study was to investigate the antimicrobial sensitivity testing (AST), the resistance to 3rd cephalosporin and penicillin, also to assess the molecular detection of ESBL and Amp-C-beta -lactamase in E. coli isolates inhabiting the digestive tract of dogs at kennels Dak Lak. By using double disk synergy test (DDST), and ceftazidime-imipenem antagonism test (CIAT) to detect phenotypic characteristic of E. coli strains producing extended-spectrum beta- lactamases (ESBLs) and plasmid-mediated Amp-C-beta -lactamase, and by using multiplex polymerase chain reaction (multiplex PCR) to confirm the presence of ESBL genes (class A): blaCTX-M(1;2;8;9;25), bla TEM, bla SHV , bla OXA and genes encoding AmpC-type beta lactamase (class C): bla MOX-1;2 , bla CMY- (1;2-7;8-11) , blaLAT-(1;4) ,bla DHA-(1;2), bla ACC, bla FOX-(1-5B) ,bla MIR-1 ,bla ACT-1. From of three hundred twelve bacteial strains isolated from sixty-four rectal swabs two hundred sixty-nine E. Coli, isolates accounting for 86%, were identified and isolated, forty-four (16%) and twelve (4%) E. coli isolates encoding with ESBL and Amp-C-beta -lactamases. From molecular diagnosis with regard to phenotype, production of ESBL was shown in thirty-nine (15%) E. coli isolates and Amp-C enzymes in eight (3%) E. coli isolates. The high percentage of E. coli exhibiting antibiotic resistance revealed the accelerated overuse of antibiotics. Result of this study will contribute to the monitoring of epidemiologic resistance.
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Hassan, Manal I., Khaled R. Alkharsah, Alhusain J. Alzahrani, Obeid E. Obeid, Amar H. Khamis, and Asim Diab. "Detection of extended spectrum beta-lactamases-producing isolates and effect of AmpC overlapping." Journal of Infection in Developing Countries 7, no. 08 (2013): 618–29. http://dx.doi.org/10.3855/jidc.2919.
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Introduction: Few reports about the prevalence and genetic basis of extended spectrum beta-lactamases (ESBLs) are available from Saudi Arabia. We sought to determine the prevalence of ESBL-producing Enterobacteriaceae in a university hospital in eastern Saudi Arabia and to characterize the ESBLs produced by these isolates at the molecular level. Methodology: All clinical isolates of Escherichia coli, Klebsiella spp., and Proteus spp. collected over two years were evaluated for susceptibility to a panel of antimicrobials and were analyzed for the ESBL phenotype using screening and confirmatory tests. ESBL-positive isolates were then screened for the presence of genes encoding CTX-M, SHV, and TEM beta-lactamases by PCR. Results and conclusions: The overall prevalence of ESBL-producing isolates was 4.8% (253/5256). Most isolates (80%) were from the inpatient department. The ESBL phenotype was more frequently detected in K. pneumonia. CTX-M genes were the most prevalent ESBL genes, detected in 82% of the studied isolates. The ESBL producers demonstrated a high multidrug resistance rate (96.6%). In transconjugation assay, the same ESBL gene pattern was transmitted from 29.7% of K. pneumoniae donors to the recipient strain, and the latter exhibited concomitant decreased aminoglycosides and co-trimoxazole susceptibility. We observed the presence of ESBL screen-positive but confirmatory-negative isolates (8.9%). Phenotypic tests for the production of AmpC β-lactamase tested positive in 52% of these isolates. Further studies are needed for appropriate detection of concomitant ESBL and AmpC enzyme production among such isolates. Continued surveillance and judicious antibiotic usage together with the implementation of efficient infection control measures are absolutely required.
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Sütterlin, Susanne, Anna Heydecke, and Eva Tano. "Coresistance to quaternary ammonium compounds in extended-spectrum beta-lactamase-producing Escherichia coli." July-December 6, no. 2 (2020): 134–42. http://dx.doi.org/10.14202/ijoh.2020.134-142.
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Background and Aim: Extended-spectrum β-lactamases (ESBL) in Escherichia coli constitutes one of the major threats to modern medicine, and the increasing pollution with quaternary ammonium compounds (QACs) has been suspected to contribute to the spread of ESBL-producing bacteria. The aim of the study was to investigate ESBLA and ESBLM-C-producing E. coli isolates for their coresistance to QACs and their phylogeny isolated from a Swedish University Hospital. Materials and Methods: Coresistance in E. coli with production of ESBL enzymes of the type blaCTX-M (n=23) was compared to E. coli producing AmpC type ESBL enzymes blaCMY and blaDHA (n=27). All isolates were tested for susceptibility to antibiotics and QACs, and high-quality whole-genome sequences were analyzed for resistance determinants. Results: The plasmid-borne small multidrug resistance (SMR) efflux pump sugE(p) was solely present in blaCMY-producing E. coli (n=9), within the same genetic environment blaCMY–blc–sugE(p). Other small multidrug efflux pumps were found without association for ESBL-types: emrE (n=5) and the truncated qacEΔ1 (n=18). Conclusion: Coresistance of ESBL enzymes and SMR efflux pumps in E. coli was common and might indicate that other substances than antibiotics contribute to the spread and emergence of antibiotic resistance.
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Stone, Tyler J., James Beardsley, James Johnson, et al. "838. Drivers of empiric carbapenem use: How important is history of extended-spectrum beta-lactamase (ESBL) infection?" Open Forum Infectious Diseases 7, Supplement_1 (2020): S460. http://dx.doi.org/10.1093/ofid/ofaa439.1027.
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Abstract Background CARs are first line agents for serious infections caused by ESBL producers. Likelihood of developing subsequent ESBL infection is unknown. In patients (pts) with a history (hx) of ESBL positive (ESBLP) culture, empiric therapy with a CAR has become common in hospitals. The purpose of this study was to evaluate the microbiology of subsequent infections (SI) among pts with hx of ESBLP culture and determine risk factors associated with ESBLP SI that may justify an empiric CAR. Methods This retrospective observational study was conducted at a multicenter health system. The electronic medical record (EMR) was used to generate a report of all E. coli (EC) or K. pneumoniae (KP) ESBLP cultures during 2017, an analogous report was generated for ESBL-negative (ESBLN) EC or KP. These were termed index cultures (IC). Pts were randomly selected from each report until 200 total pts were enrolled. Inpatients, outpatients, and all culture specimens were included. Pts with an ESBLP culture prior to 2017 were excluded. The EMR was reviewed up to 1 year after the IC. Pt and culture characteristics were recorded. The primary outcome was proportion of pts who developed an ESBLP SI. Risk factors associated with ESBLP SI were determined. Relapsed infection (same site, same bacteria) that occurred within 2 weeks of the IC was excluded. Results 200 pts were included, 100 with ESBLP IC and 100 with ESBLN IC. The mean age was 58 years, 84% were female, and 69% were outpatients. 86% of IC were EC and 86% were urine specimens. Within 1 year of IC, 100 pts (50%) developed a SI. 22 of these were ESBLP, 43 were ESBLN, and 35 had no or negative culture. The mean time since IC for ESBLP SI and ESBLN SI was 85 (26-226) days and 140 (15-363) days, respectively (p=0.014). When comparing time to SI, 21 (96%) ESBLP and 26 (61%) ESBLN occurred &lt; 6 months after IC (p=0.003). Among SI with culture data (n= 65), the number of ESBLP SI was higher if the IC was ESBLP (22 vs 0, p&lt; 0.001). Incidence of ESBLP or ESBLN SI in all pts with an ESBLP IC was similar (22 vs 18, p=0.428). Factors associated with ESBLP SI were hx of ESBLP IC, male gender, and time between IC and SI. Table 1. Index Culture Characteristics of Culture Positive Subsequent Infections Figure 1. Cumulative rate of ESBL-positive SI in 180 days (6 months) following IC Table 2. Univariate Analysis of Patient Characteristics Comparing ESBL-positive and ESBL-negative Culture Positive Subsequent Infections Conclusion Hx of positive culture for ESBL-producing EC or KP is associated with SI caused by ESBLP EC or KP. Pts presenting &lt; 6 months after ESBLP IC are at increased risk for ESBLP SI, justifying empiric CAR therapy. Disclosures Tyler J. Stone, PharmD, Paratek (Research Grant or Support) Elizabeth Palavecino, MD, Paratek (Grant/Research Support)Paratek (Grant/Research Support) John Williamson, PharmD, Paratek (Research Grant or Support)
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Jain, Vikas, and Swati Jain. "Phenotypic characterization and antibiotic suceptibility patterns of extended spectrum beta-lactamase producing enterobacteriaceae." Panacea Journal of Medical Sciences 13, no. 1 (2023): 93–97. http://dx.doi.org/10.18231/j.pjms.2023.020.
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The rise of Enterobacteriaceae strains that produce an extended spectrum b-lactamase (ESBL) has become a global concern for epidemiological surveillance and the prevention of nosocomial acquired infections in the modern era. The choice of appropriate antibiotics to be employed in the treatment of infections brought on by ESBL-producing bacteria relies greatly on the detection and identification of these ESBLs in the laboratory. Limitations in ESBL detection have aided in the unbridled emergence of bacterial resistance and constitute a major health concern. Isolation and identification of ESBL among Enterobacteriaceae by phenotypic methodswith their Antibiogram.Phenotypic techniques were used to identify ESBL-producing Enterobacteriaceae (ESBLs-E) isolates from diverse clinical samples. Kirby Baur disc diffusion technique was performed to determine antimicrobial's susceptibility.Among 212 Enterobacteriaceae isolates 124(58.3%) were positive for ESBL production. E.coli(74.5%) & K.pneumoniae (52.2%) two main isolates that produce ESBLs. Maximum ESBL producing Enterobacteriaceae isolates were obtained from blood samples 82% (41/50) followed by urine 59 % (62/105). Meropenem (96.7%), Amikacin (82.1%), and Cefoxitin were most susceptible antibiotics for ESBL-producing isolates while high resistance was observed in ceftazidime (62%), followed by Ciprofloxacin (60%). The majority of ESBLs-E was mostly found in urine and blood samples.It was observed that E.coli produced the most ESBLs. There was a high prevalence of ESBLs-E in tertiary care hospital of central India. Therefore, strong infection control strategies must be implemented in hospital settings
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Alanazi, Badriah, Ghulam Muhiuddin, Yazeed Albalawi, et al. "Antibiotic Resistance & Extended-Spectrum ß-Lactamase Production in Clinical and Non-Clinical Isolates in Tabuk." Medical Sciences 12, no. 3 (2024): 42. http://dx.doi.org/10.3390/medsci12030042.
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The increasing prevalence of antibiotic resistance, driven by the production of extended-spectrum beta-lactamases (ESBLs), presents a critical challenge to current medical treatments, particularly in clinical settings. Understanding the distribution and frequency of ESBL-producing bacteria is essential for developing effective control strategies. This study investigated the antibiotic resistance and extended-spectrum beta-lactamase (ESBL) production in bacterial isolates in clinical and non-clinical (food) specimens in Tabuk, KSA. A total of 57 bacterial isolates were analysed, with E. coli and Pseudomonas sp. being the most prevalent. High resistance rates were observed, particularly against third-generation cephalosporins in clinical isolates. ESBL screening revealed a significant prevalence in clinical samples (58.3%), with E. coli showing the highest positivity. Conversely, only a low percentage of food isolates were ESBL positive. Molecular analysis confirmed the presence of various ESBL genes, with blaCTX-M being the most frequent, predominantly found in clinical isolates. This study highlights the concerning levels of antibiotic resistance and ESBL production in the region, emphasising the need for effective infection control measures and prudent antibiotic use.
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Vijayvergia, V., AK Sahni, M. Lall, K. Vijay, and ID Khan. "Phenotypic detection of Extended Spectrum Beta-Lactamases and Amp C Beta- Lactamases among nosocomial isolates in a tertiary care hospital." Bangladesh Journal of Medical Science 12, no. 4 (2013): 378–84. http://dx.doi.org/10.3329/bjms.v12i4.13309.
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Background & objectives: Extended-Spectrum Beta-Lactamases (ESBLs) is an important resistance mechanism in Enterobacteriaceae infections. Lack of standard guidelines from Clinical Laboratory Standards Institute (CLSI) for Amp C beta-lactamase detection poses a problem. This study was undertaken to detect ESBLs by phenotypic tests and Amp C beta-lactamase by inhibitor based method. Material and Methods: 200 consecutive non-repetitive isolates of E.coli, Klebsiella and Proteus from clinical samples were screened for ESBLs as per CLSI guidelines and confirmed by PCDT, DDST and E-tests (AB Biodisk, Biomerieux). Amp C beta lactamases were screened by cefoxitin resistance and confirmed by inhibitor (Cloxacillin) based method. Simultaneous occurrence of Amp C and ESBLs was detected by combined disk test (Neo-Sensitabs and Diatabs). Descriptive and Kappa statistics were used. Results: Out of 200 isolates studied, 131 were initially screened as ESBL producers and later 114 (57%) were confirmed by phenotypic methods. E-Test was found most sensitive phenotypic test as compared to PCDT and DDST. 13 strains resistant to cefoxitin (30?g) were found to be pure Amp C producers. Combined disk test detected 36 to be ESBL and Amp C co-producers. Surprisingly, six isolates found sensitive to cefoxitin disk were confirmed as Amp C producers by cloxacillin disk inhibition test. Conclusion: 57% ESBLs and 27.5% Amp C producers were isolated from nosocomial pathogens showing significant resistance to 3rd generation cephalosporins. Phenotypic confirmation by E-test, PCDT & DDST were useful for ESBL identification and for detection of Amp C, cloxacillin was found to be an effective inhibitor. DOI: http://dx.doi.org/10.3329/bjms.v12i4.13309 Bangladesh Journal of Medical Science Vol. 12 No. 04 October 13 Page 378-384
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Degnan, Lisa A., Aaron M. Milstone, Marie Diener-West, and Carlton K. K. Lee. "Extended-Spectrum Beta-Lactamase Bacteria From Urine Isolates in Children." Journal of Pediatric Pharmacology and Therapeutics 20, no. 5 (2015): 373–77. http://dx.doi.org/10.5863/1551-6776-20.5.373.
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OBJECTIVES: Multidrug-resistant Gram-negative bacteria, including extended-spectrum beta-lactamase (ESBL)–producing organisms, are a growing problem. The primary objective of this study was to describe the proportion of children with ESBL-producing urinary isolates at a tertiary medical center as well as these organisms' susceptibility patterns. The secondary objective was to identify the risk factors for acquiring ESBL urinary pathogens. METHODS: This retrospective study evaluated a cohort of children with ESBL urinary isolates, admitted to a tertiary children's hospital during a 6-year period. The proportion of patients with an ESBL-producing urinary isolate among all patients who grew a Gram-negative isolate is described together with the organism's susceptibility pattern. Patients with non-ESBL Gram-negative urinary organisms were used as a control group for identifying patient risk factors for ESBL. RESULTS: A total of 7.8% (29 of 370) of patients in our cohort grew Gram-negative urinary isolates with an ESBL strain. Most of the ESBL organisms isolated were sensitive to carbapenems (100% of ESBL organisms susceptible to ertapenem and 93.8% susceptible to meropenem) and amikacin (92.3% of ESBL organisms susceptible). Patients with longer hospitalization, recent antibiotic use, and recent intensive care unit admission were found to be at increased risk for ESBL organisms in the urine. CONCLUSIONS: When selecting empiric antibiotic therapy for suspected urinary tract infection in children, it may be prudent to consider the risk factors identified for acquiring an ESBL urinary pathogen.
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Thakur, Rameshwari, Kumar Atul, Chaudhary Varsha, Singh Paramjit, Sharma Vk, and Nidhi Agarwal. "PREVALENCE OF VARIOUS BETA LACTAMASES AMONG GRAM NEGATIVE BACILLI IN URINARY ISOLATES FROM PATIENTS IN A TERTIARY CARE HOSPITAL OF NORTHERN INDIA." Asian Journal of Pharmaceutical and Clinical Research 10, no. 4 (2017): 129. http://dx.doi.org/10.22159/ajpcr.2017.v10i4.16291.
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Objective: Urinary tract infections are considered among the most common infections, occurring either in the community or health-care setting. We are left with very few options for the treatment due to rapid development of antibiotic resistance among the organisms. To find out the prevalence of various types of β-lactamases among urinary isolates.Methods: Seven antibiotic discs (HiMedia) were placed in combinations and approximation in a particular sequence on a 90 mm diameter MuellerHintonagar plate.Results: Out of a total 165 urinary isolates, 66 (40%) isolates were positive for extended spectrum β-lactamase (ESBL) production, AmpC β-lactamases(AmpC) activity was present in 31 (18.78%) isolates, co-production of both ESBL and AmpC was seen in 16 (9.69%) isolates, 3 (1.81%) isolatesproduced metallo β-lactamase (MBL), 2 (1.21%) isolates produced both MBL, and ESBL and 1 (0.60%) isolates were positive for inducible third generation cephalosporin resistance.Conclusion: With the presence of such high prevalence of various β-lactamases in clinical isolates of gram-negative bacilli and also other types ofantibiotic resistance, antibiotic policy should be made, and strict adherence should be followed.Keywords: Extended spectrum β-lactamase, AmpC β-lactamase, Metallo β-lactamase.
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Rezai, Mohammad Sadegh, Ebrahim Salehifar, Alireza Rafiei, et al. "Characterization of Multidrug Resistant Extended-Spectrum Beta-Lactamase-ProducingEscherichia coliamong Uropathogens of Pediatrics in North of Iran." BioMed Research International 2015 (2015): 1–7. http://dx.doi.org/10.1155/2015/309478.
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Escherichia coliremains as one of the most important bacteria causing infections in pediatrics and producing extended-spectrum beta-lactamases (ESBLs) making them resistant to beta-lactam antibiotics. In this study we aimed to genotype ESBL-producingE. coliisolates from pediatric patients for ESBL genes and determine their association with antimicrobial resistance. One hundred of theE. coliisolates were initially considered ESBL producing based on their MIC results. These isolates were then tested by polymerase chain reaction (PCR) for the presence or absence ofCTX,TEM,SHV,GES, andVEBbeta-lactamase genes. About 30.5% of isolatedE. coliwas ESBL-producing strain. TheTEMgene was the most prevalent (49%) followed bySHV(44%),CTX(28%),VEB(8%), andGES(0%) genes. The ESBL-producingE. coliisolates were susceptible to carbapenems (66%) and amikacin (58%) and showed high resistance to cefixime (99%), colistin (82%), and ciprofloxacin (76%). In conclusion, carbapenems were the most effective antibiotics against ESBl-producingE. coliin urinary tract infection in North of Iran. The most prevalent gene is the TEM-type, but the other resistant genes and their antimicrobial resistance are on the rise.
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ur Rahman, Sadeeq, Tariq Ali, Ijaz Ali, Nazir Ahmad Khan, Bo Han, and Jian Gao. "The Growing Genetic and Functional Diversity of Extended Spectrum Beta-Lactamases." BioMed Research International 2018 (2018): 1–14. http://dx.doi.org/10.1155/2018/9519718.
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Theβ-lactams—a large class of diverse compounds—due to their excellent safety profile and broad antimicrobial spectrum are considered to be the most widely used therapeutic class of antibacterials prescribed in human and veterinary clinical practices. This, unfortunately, has also given rise to a continuous increased resistance globally in health care settings as well as in the community due to their permanent selective force driving diversification of the resistance mechanism. Resistance againstβ-lactams is increasing rapidly as novelβ-lactamases, enzymes that degradeβ-lactams, are being discovered each day such as recent emergence of extended spectrumβ-lactamases (ESBL) that have the ability to inactivate most of the cephalosporins. The complexity and diversity of ESBL are increasing so rapidly that more than 170 variants have thus far been described for only a single genotype, theblaCTX-M-encoding ESBL. This review is to organize all the current updated literature describing genomic features, organization, and mechanism of resistance and mode of dissemination of all known ESBLs.
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Rahma, Trabelsi, Yengui Mariem, Mhaya Amel, Rebai Ahmed, Arpin Corinne, and Gdoura Radhouane. "Detection of extended-spectrum beta-lactamase and scarbapenemase-producing Enterobacteriaceae in Tunisia." Archives of Biotechnology and Biomedicine 7, no. 1 (2023): 001–11. http://dx.doi.org/10.29328/journal.abb.1001034.
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The emergence of dramatic urinary tract infections (UTIs) caused by the members of the Enterobacteriales is an important public health problem in the community as well as in Tunisian hospitals. This study aims to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase-producing uropathogenic isolates of Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae). Based on decreased susceptibility to β-lactams antibiotics and analyzed for the presence of ESBL and carbapenemase genes by Real Time- polymerase chain reaction (RT-PCR), 56 uropathogenic isolates of E. coli (n = 36) and K. pneumoniae (n = 20) were confirmed positive for ESBLs. The CTX-M-type β-lactamases were mostly detected in E. coli isolates (21 strains, 58.33% [95% CI 38.09% - 72.06%]) followed by blaSHV-like (18 strains, 50% [95% CI 32.92% - 67.07%]), blaTEM-like and blaCMY-2-like simultaneously (15 strains, 41.67% [95% CI 25.51% - 59.24%]). Furthermore, the RT-PCR system on the K. pneumoniae strains demonstrated that blaSHV-12-like was the most predominant (16 strains, 80% [95% CI 56.33% - 94.26%]) followed by blaTEM-like (14 strains, 70% [95% CI 45.72% - 88.10%]), blaCTX-M belonging to groups 9 and 1 (11 strains, 55% [95% CI 31.52% - 76.94%]) and finally blaCMY-2-like (10 strains, 50% [95% CI 27.19% - 72.80%]). In addition, E. coli and K. pneumoniae strains harbored a carbapenemase gene blaOXA-48-like with 22.2% [95% CI 10.11% - 39.15%]; 20% [95% CI 12.83% - 43.66%], respectively. Our results confirm the need to monitor the resistance to extended-spectrum β-lactams and to carbapenems among enterobacteria in Tunisia.
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Peretyatko, O. G., Yu. A. Yagnyuk, N. I. Sklyar, G. M. Bolshakova, and T. V. Kholodna. "Beta-lactamases of enterobacteria: general characteristics, mechanisms and regional features of distribution." Annals of Mechnikov Institute, no. 3 (September 12, 2022): 7–12. https://doi.org/10.5281/zenodo.7070850.
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The problem of the formation and spread of resistance to β-lactam antibiotics in clinically significant types of microorganisms is extremely important, since β-lactams traditionally form the basis of the treatment of bacterial infections. Special attention of antibiotic resistance researchers is directed to the microorganisms of the Enterobacteriaceae family, namely, to pathogens such as <em>Enterobacter spp., Citrobacter spp., Proteus spp., K. pneumoniae, E. coli,</em> which are capable of producing a wide range of β-lactamases. Since the discovery of the first beta-lactamase in the 1960s, these enzymes have evolved, and today several hundred types of beta-lactamases have been discovered, but new varieties of them are constantly emerging and the dominant groups of these enzymes are changing. It has been discovered that some members of the Enterobacteriaceae family (<em>Enterobacter spp., Citrobacter freundii, Morganella morganii, Serratia marcescens, Providencia spp.)</em> have the ability to produce chromosomal cephalosporinases characterized by high affinity to 3rd generation cephalosporins. However, enterobacteria (<em>Escherichia coli, Salmonella spp., Shigella spp., Klebsiella spp., Enterobacter spp.,</em> etc.) most often contain beta-lactamases of the TEM and SHV genetic groups, which are associated with plasmids and are responsible for the formation of resistance to penicillins and early cephalosporins, as well as the STX-M group responsible for resistance to broad-spectrum cephalosporins and monobactams. According to a number of researchers, the main groups of the β-lactamase family, represented by plasmid-mediated narrow-spectrum (NSBL) and extended-spectrum (ESBL) beta-lactamases, as well as AmpC cephalosporinases and carbapenemases, are spread throughout the world, however, predominance of specific beta-lactamases in certain geographical regions is observed. For example, while CTX-M enzymes are spread in all regions, serine carbapenemases are most often found in China, in the countries of North and South America and the Mediterranean, and metallo-betalactamases - in the Indonesian region and in the countries of Eastern Europe. In the countries of the Baltic region, the leading mechanism of resistance of enterobacteria to cephalosporins is the prevalence of extended-spectrum beta-lactamases (ESBLs) of the CTX-M class. Similar patterns of beta-lactamase genes distribution among clinical strains of enterobacteria were found in Spain, where the share of strains carrying the blaCTX-M gene was 93,3%. Significant spread of clinical strains of enterobacteria with resistance to beta-lactam antibiotics, especially ESBL-producing strains, necessitates constant monitoring of beta-lactam resistance and investigation of regional features of its distribution.
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Mohanty, Srujana, Rajni Gaind, Rajeev Ranjan, and Monorama Deb. "Use of the cefepime-clavulanate ESBL Etest for detection of extended-spectrum beta-lactamases in AmpC co-producing bacteria." Journal of Infection in Developing Countries 4, no. 01 (2009): 024–29. http://dx.doi.org/10.3855/jidc.493.
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Background: Extended-spectrum beta-lactamases (ESBLs) may not always be detected in routine susceptibility tests. This study reports the performance of the cefepime-clavulanate ESBL Etest for the detection of ESBLs in Enterobacteriaceae, including those producing AmpC enzyme. Methodology: Consecutive non-duplicate isolates of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolated from bloodstream infections from January to June 2008 were tested for ESBL by both the standard CLSI double-disk diffusion method using ceftazidime and cefotaxime disks and Etests using ceftazidime/ceftazidime-clavulanate, cefotaxime/cefotaxime-clavulanate and cefepime/cefepime-clavulanate gradients. Isolates were also tested for the presence of transferable AmpC beta-lactamase by AmpC disk test and the efficacies of the different Etests in detecting ESBL production were compared. Results: A total of 113 bacterial isolates (61 K. pneumoniae, 50 E. coli, and 2 P. mirabilis) were recovered. Respectively, 42 (37.2%) and 55 (48.7%) isolates were positive for ESBL by the ceftazidime-clavulanate and cefotaxime-clavulanate combined disk tests. The cefepime/cefepime-clavulanate Etest strip detected the maximum number of isolates (70/113, 61.9 %) as ESBL-positive compared to the ceftazidime/ceftazidime-clavulanate and cefotaxime/cefotaxime-clavulanate strips, which detected 57 (50.4%) isolates each as ESBL-positive. All three ESBL Etest strips were equally effective in detecting ESBL in the isolates that were AmpC negative. In the 66 (58.4%) isolates that co-produced AmpC in addition to the ESBL enzymes, cefepime/cefepime-clavulanate Etest strip detected ESBL in an additional 13 (11.4%) isolates as compared to the other ESBL Etest strips. Conclusions: Cefepime-clavulanate ESBL Etest is a suitable substitute to test for ESBL production, especially in organisms producing AmpC beta-lactamases.
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Chub, Olga I., Aleksandr V. Bilchenko, and Igor Khalin. "Extended Spectrum Beta-Lactamase Production in Uropathogens Isolated from Hospitalized Patients with Chronic Pyelonephritis." Open Urology & Nephrology Journal 8, no. 1 (2015): 71–75. http://dx.doi.org/10.2174/1874303x01508010071.
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Background : Increased multidrug resistance of extended-spectrum beta-lactamases (ESBLs) compromises the efficacy of treatment of urinary tract infections. Objective : The objective of this study is to determine the prevalence of ESBL-producing uropathogens from hospitalized patients with chronic pyelonephritis and to identify the presence of genes involved in the resistance. Methods : A cross-sectional study of 105 patients with chronic pyelonephritis, treated in Kharkiv City Clinical Emergency Hospital, Ukraine was carried. Bacterial isolates were collected, antimicrobial susceptibility of isolates was determined by the Kirby Bauer disk diffusion method and screening for the presence of blaSHV, blaTEM, blaCTX-M ESBL genes was performed by polymerase chain reaction. Results : 84 (80%) patients had positive urine cultures. Eschеrichia coli wаs the most common microorganism isolated. Among them, 29 (25.2%) were found to be ESBL producers. Out of 53 E. coli isolates, 10 (18.9%), 4 (7.5%) and 6 (11.3%) were identified to carry bla(TEM), bla(SHV) and bla(CTX-M) beta-lactamase genes, respectively. The highest resistance was observed against ampicillin (75.9%), ciprofloxacin (48.3%), levofloxacin (41.4%) and gentamicin (41.4%). Beside this, only meropenem (96.6% susceptibility), nitroxolinum (86.2%) and fosfomycin (72.4%) exhibited a good enough activity against ESBLs-producing urinary strains. Conclusion : Isоlation and detеction of ESBL-prоducing strаins are еssential fоr the sеlection оf the mоst effеctive antibiоtic for the empiric trеatment.
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Raja Merlinda Veronica, Dani Rosdiana, Anwar Bet, and Agustiawan. "PENGARUH EXTENDED-SPECTRUM BETA-LACTAMASE (ESBL) TERHADAP MORTALITAS PASIEN PNEUMONIA." Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara 24, no. 1 (2025): 68–75. https://doi.org/10.30743/ibnusina.v24i1.703.
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Pendahuluan: Resistensi antimikroba merupakan krisis kesehatan global dalam beberapa tahun terakhir. Extended-spectrum beta-lactamase (ESBL) merupakan enzim yang diproduksi oleh bakteri yang mampu memghidrolisis golongan antibiotik beta laktam spektrum luas dan merupakan salah satu kelompok multi drug resitance (MDR). Penelitian ini bertujuan untuk mengetahui pengaruh ESBL terhadap tingkat kematian pasien pasien pneumonia. Metode: Studi observasional dengan pendekatan kohort retrospektif menggunakan data rekam medis. Pengambilan sampel dilakukan dengan consecutive sampling. Analisis bivariat dilakukan menggunakan uji chi square, dimana perbedaan signifikan jika nilai p <0,05. Hasil: Pasien dalam penelitian didominasi oleh laki-laki (59,5%) dan mereka dengan kategori usia <60 tahun (94,0%). Penderita pneumonia infeksi ESBL yang meninggal dunia sebanyak 41 orang (48,8% dari 84 orang sampel dan 89,1% dari total ESBL positif). Patogen Gram negatif terbanyak adalah Acinetobacter sp (16,7%), Escherichia coli (15,5%), Pseudomonas aeruginosa (10,7%), Stenoptrophomonas maltophilia (4,8%), Burkhoideria (24%), sedangkan patogen Gram positif yang ditemukan adalah Staphilococcus aureus (2,4%) dan Staphilococcus haemoliticus (2,4%). Sebanyak 89,1% pasien ESBL mengalami kematian, sedangkan sisanya tidak. Odds ratio (OR) mortalitas selama perawatan pada pasien dengan ESBL adalah 22,9 dengan interval kepercayaan (IK) 95% (7,1-74,4). Kesimpulan: Paparan infeksi bakteri ESBL dikaitkan dengan tingkat kematian yang lebih tinggi. Hal ini menunjukkan perlunya strategi pencegahan dan manajemen pasien dengan baik.
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Mulvey, Michael R., Elizabeth Bryce, David Boyd, et al. "Ambler Class A Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella spp. in Canadian Hospitals." Antimicrobial Agents and Chemotherapy 48, no. 4 (2004): 1204–14. http://dx.doi.org/10.1128/aac.48.4.1204-1214.2004.
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ABSTRACT This report describes a study carried out to gain baseline information on the molecular characteristics of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in Canada. A total of 29,323 E. coli and 5,156 Klebsiella sp. isolates were screened at 12 participating sites. Of these, 505 clinically significant, nonrepeat isolates displaying reduced susceptibility to the NCCLS-recommended beta-lactams were submitted to a central laboratory over a 1-year period ending on 30 September 2000. A total of 116 isolates were confirmed to be ESBL producers. PCR and sequence analysis revealed the presence of TEM-11 (n = 1), TEM-12 (n = 1), TEM-29 (n = 1), TEM-52 (n = 4), CTX-M-13 (n = 1), CTX-M-14 (n = 15), CTX-M-15 (n = 11), SHV-2 (n = 2), SHV-2a (n = 12), SHV-5 (n = 6), SHV-12 (n = 45), and SHV-30 (n = 2). Five novel beta-lactamases were identified and designated TEM-115 (n = 2), TEM-120 (n = 1), SHV-40 (n = 2), SHV-41 (n = 4), and SHV-42 (n = 1). In addition, no molecular mechanism was identified for five isolates displaying an ESBL phenotype. Macrorestriction analysis of all ESBL isolates was conducted, as was restriction fragment length polymorphism analysis of plasmids harboring ESBLs. Although a “clonal” distribution of isolates was observed at some individual sites, there was very little evidence suggesting intrahospital spread. In addition, examples of identical or closely related plasmids that were identified at geographically distinct sites across Canada are given. However, there was considerable diversity with respect to plasmid types observed.
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E.E. Kougnimon, Fifame, Thierry C. M. Medehouenou, Marcos A.D.F. Migan, Casimir D. Akpovi, and Frederic Loko. "POTENT ANTIBACTERIAL EFFECTS OF TERMINALIA SUPERBA ENGL. AND DIELS (COMBRETACEAE) BARK EXTRACTS." International Journal of Advanced Research 11, no. 09 (2023): 529–36. http://dx.doi.org/10.21474/ijar01/17559.
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Antibiotic misuse has caused widespread multi-resistance in Enterobacteriaceae. Our study investigates Terminalia superba (T. superba) extracts against Extended-spectrum beta-lactamases (ESBL)-producing strains. The minimum inhibitory concentration (MIC) and the minimum bactericidal concentration (MBC) were determined using broth microdilution (Mueller-Hinton, 106 CFU/mL). The extract concentrations ranged from 0.078 to 80 mg/mL. We evaluated T. superba extracts β-lactamase inhibition of nitrocefin hydrolysis, estimated inhibition percentages, and IC50 values for each extract. The double-disk test confirmed the presence of ESBLs in the strains, as all of them exhibited hydrolytic activity. The results indicated that the T. superba extracts displayed dose-dependent inhibitory effects on beta-lactamase. Among them, the hydro-ethanolic extract displayed potent inhibitory activity against β-lactamases produced by ESBL-E. coli (IC50 = 0.065 mg/mL), ESBL-K. pneumoniae (IC50 = 0.076 mg/mL), and ESBL-P. mirabilis (IC50 = 0.082 mg/mL). However, following the removal of tannins, the hydro-ethanolic extracts anti-β-lactamase activity was reduced. Our findings highlight the remarkable in vitro activity of T. superba extracts against ESBL-producing Enterobacteriaceae, suggesting their potential clinical utility in addressing infections caused by these drug-resistant pathogens. The exploration of T. superba extracts as a possible source of effective anti-ESBL agents could contribute significantly to combating antibiotic resistance.
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Ravi, Shankar Choubey, та Kumar Akhilesh. "Identification of Several β -Lactamases and Their Simultaneous Presence in Gram-Negative Bacteria Isolated from Clinical Specimens at a Tertiary Care Centre". International Journal of Pharmaceutical and Clinical Research 16, № 1 (2024): 966–70. https://doi.org/10.5281/zenodo.11109075.
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<strong>Background: </strong>Globally, the number of infections caused by Gram-negative bacteria is rising. In Gram negative bacteria (GNB), the extended spectrum β-lactamases (ESBLs), AmpC β-lactamases, and metallo β-lactamases (MBLs) have been identified as a source of antibiotic resistance. GNB that produces β-lactamase poses a serious diagnostic and treatment problem in the treatment of infection. Thus, the goal of the current study is to identify the antibiogram of isolates of Gram-negative bacteria, identify distinct β-lactamases and their co-existence, and assist clinicians in initiating the right antibiotic therapy for illness management. <strong>Methods: </strong>Following the recommendations set forth by the Clinical and Laboratory Standards Institute (CLSI), a total of 150 Gram negative clinical isolates were identified, and tests for antibiotic susceptibility were conducted on them. In accordance with CLSI recommendations, the combined disk diffusion method was utilized to detect ESBL. The phenyl boronic acid test was used to identify AmpC β-lactamase. The EDTA disc potentiation test was used to identify MBL. <strong>Result: </strong>Of the 150 Gram-negative bacteria that were examined, 26 (17.34%) produced just ESBL, and 50 (33.34%) produced only AmpC. In 16 isolates (10.67%), both ESBL and AmpC coexisted, while in 16 isolates (10.67%), AmpC and MBL co-occurred. <strong>Conclusion: </strong>For the purpose of managing infections effectively, further testing should be conducted in addition to normal antibiotic sensitivity testing to identify “hidden” resistance mechanisms.
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Telling, Kaidi, Age Brauer, Mailis Laht, et al. "Characteristics of Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Contact to Animals in Estonia." Microorganisms 8, no. 8 (2020): 1130. http://dx.doi.org/10.3390/microorganisms8081130.
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We have attempted to define the prevalence and risk factors of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-Enterobacteriaceae) carriage, and to characterize antimicrobial susceptibility, beta-lactamase genes, and major types of isolated strains in volunteers, with a specific focus on humans in contact with animals. Samples were collected from 207 volunteers (veterinarians, pig farmers, dog owners, etc.) and cultured on selective agar. Clonal relationships of the isolated ESBL-Enterobacteriaceae were determined by whole genome sequencing and multi-locus sequence typing. Beta-lactamases were detected using a homology search. Subjects filled in questionnaires analyzed by univariate and multiple logistic regression. Colonization with ESBL-Enterobacteriaceae was found in fecal samples of 14 individuals (6.8%; 95%CI: 3.75–11.09%). In multiple regression analysis, working as a pig farmer was a significant risk factor for ESBL-Enterobacteriaceae carriage (OR 4.8; 95%CI 1.2–19.1). The only species isolated was Escherichia coli that distributed into 11 sequence types. All ESBL-Enterobacteriaceae isolates were of CTX-M genotype, with the blaCTX-M-1 being the most prevalent and more common in pig farmers than in other groups. Despite the generally low prevalence of ESBL-Enterobacteriaceae in Estonia, the pig farmers may still pose a threat to transfer resistant microorganisms. The clinical relevance of predominant blaCTX-M-1 carrying E. coli is still unclear and needs further studies.
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Baral, Soma Kanta, Abinash Dhakal, Rabindra Prasad Timilsina, Krishna Das Manandhar, and Pramod Poudel. "Phenotypic Insights Into Beta-Lactamase-Mediated Multidrug Resistance In Escherichia Coli Clinical Isolates." Journal of Manmohan Memorial Institute of Health Sciences 10, no. 1 (2025): 51–54. https://doi.org/10.3126/jmmihs.v10i1.77748.
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Introduction: The global rise of multidrug-resistant (MDR) bacteria is largely attributed to the production of β-lactamases, including extended-spectrum β-lactamases (ESBLs), metallo-β-lactamases (MBLs), and AmpC β-lactamases. This study aimed to evaluate the phenotypic characteristics of β-lactamase-producing MDR Escherichia coli isolates and assess their antibiotic resistance profiles. Method: A cross-sectional study was conducted over six months (November 2021–April 2022) at Manmohan Memorial Teaching Hospital, Kathmandu. Clinical samples were processed using standard microbiological techniques to isolate E. coli. The Kirby-Bauer disk diffusion method was used for antimicrobial susceptibility testing. Phenotypic detection of ESBL, MBL, and AmpC β-lactamases was performed using the combined disk method. Results: Out of 127 E. coli isolates, 55 (43.3%) were identified as MDR. Among these, 26 (47.3%) expressed β-lactamase activity: AmpC (34.54%), MBL (7.27%), and ESBL (5.45%). No co-existence of β-lactamases was observed. High resistance was noted against amoxicillin (100%), cefixime (90.9%), and cotrimoxazole (85.5%), whereas amikacin (90.9%) and meropenem (89.0%) showed strong effectiveness. Conclusion: AmpC β-lactamase was the predominant resistance mechanism among MDR E. coli isolates. Early detection of β-lactamase production is crucial for effective infection control and to curb the spread of MDR pathogens.
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Çeliksöz, Canan, Tekin Karslıgil, and İclal Balcı. "Extended Spectrum Beta Lactamase Frequency In Cefhtazidime Resistant Pseudomonas Aeruginosa Strains." European Journal of Therapeutics 15, no. 1 (2009): 20–23. http://dx.doi.org/10.58600/eurjther.2009-15-1-1246-arch.
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One of the resistance mechanisms of Pseudomonas aeruginosa, which is an increasing resistance problem to antibiotics, is beta lactamase production. Especially it becomes more and more difficult to apply a treatment to the infections developed by extended spectrum beta lactamase (ESBL) producing strains. It is of importance for the success of the treatment that ESBL is determined in P. aeruginosa and reported to the clinician. In recent years, some ESBL types such as PER-1 in class A and OXA group in class have been determined in P. aeruginosa. These enzymes hydrolyze third generation cefhalosporins and some of them hydrolyze especially cefhtazidimes. In the study, ESBL existence was researched in ceftazidime-resistant (n:50) and cefhtazidim-sensitive (n:20) 70 P. aeruginosa strains with double disc synergy test. ESBL existence was determined in 35 (50%) of the strains. ESBL positivity was reported in cefhtazidime-resistant strains, but not in cephtazidime-sensitive ones. ESBL should be remembered in P. aeruginosa infections not treated with other beta lactam antibiotics except for carbapenem and waste of costs and treatments should be avoided by researching ESBL existence with the help of routine antibiogram tests and double disc synergy method.
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Al-salamy, Adnan kreem. "Detection of extended spectrum-beta lactamase enzymes producing E. coli that isolated from urine." Kufa Journal For Veterinary Medical Sciences 3, no. 1 (2012): 55–66. http://dx.doi.org/10.36326/kjvs/2012/v3i14079.
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The production of extended-spectrum- β lactamases (ESBLs) is an important mechanism for resistance to the third-generation cephalosporins. ESBLs represent a major group of lactamases enzymes that mostly produced by gram-negative bacteria, so the detection of these enzymes are very important for optimal patients care. The present study was done to detect extended spectrum beta lactamase producing E. coli among urinary tract infected patients. A total of 223 urine samples were examined for presence of E. coli and those producing ESBL enzymes. Urine samples were cultured for aerobic bacteria and antimicrobial susceptibility testing carried out by using Kirby-Baur agar diffusion method. Coli were tested for ESBLs on Mueller-Hinton agar by both modified double disk ( MDDT ) and phenotypic confirmatory test. E. coli was the most common bacteria isolated from urine 104 ( 44.2 ).78 E. coli isolated from urine are tested for ESBL production and it was found that 30 ( 38.4 ) were MDDT positive and 27 phenotypic confirmatory test positive. Three strain E. coli were MDDT positive but negative by phenotypic confirmatory. Antibiotic susceptibility test showed that E. coli isolated were totally resist ( 100% ) to ampicillin, moxicillin,and trimethoprim but maximum susceptible to imipenem ( 100% ) and variable resistant to another antibiotics. The ESBLs producing E. coli are highly resist to different types of antibiotics , especially third generation cephalosporins.
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Al-salamy, Adnan kreem. "Detection of extended spectrum-beta lactamase enzymes producing E. coli that isolated from urine." Kufa Journal For Veterinary Medical Sciences 3, no. 1 (2012): 55–66. http://dx.doi.org/10.36326/kjvs/2012/v3i14079.
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The production of extended-spectrum- β lactamases (ESBLs) is an important mechanism for resistance to the third-generation cephalosporins. ESBLs represent a major group of lactamases enzymes that mostly produced by gram-negative bacteria, so the detection of these enzymes are very important for optimal patients care. The present study was done to detect extended spectrum beta lactamase producing E. coli among urinary tract infected patients. A total of 223 urine samples were examined for presence of E. coli and those producing ESBL enzymes. Urine samples were cultured for aerobic bacteria and antimicrobial susceptibility testing carried out by using Kirby-Baur agar diffusion method. Coli were tested for ESBLs on Mueller-Hinton agar by both modified double disk ( MDDT ) and phenotypic confirmatory test. E. coli was the most common bacteria isolated from urine 104 ( 44.2 ).78 E. coli isolated from urine are tested for ESBL production and it was found that 30 ( 38.4 ) were MDDT positive and 27 phenotypic confirmatory test positive. Three strain E. coli were MDDT positive but negative by phenotypic confirmatory. Antibiotic susceptibility test showed that E. coli isolated were totally resist ( 100% ) to ampicillin, moxicillin,and trimethoprim but maximum susceptible to imipenem ( 100% ) and variable resistant to another antibiotics. The ESBLs producing E. coli are highly resist to different types of antibiotics , especially third generation cephalosporins.
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Ha, Thi Thao Mai, Tin Nghia Tran, Thi Tam Trinh, et al. "ANTIBIOTIC RESISTANCE INDUCED BY EXTENDED-SPECTRUM BETA-LACTAMASES AND COVID-19." Tạp chí Y Dược học Cần Thơ, no. 6 (October 20, 2023): 61–72. http://dx.doi.org/10.58490/ctump.2023i6.2159.
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Antibacterial resistance, particularly that resulted from by extended-spectrum betalactamases (ESBLs), is increasing at an alarming pace as a direct consequence of extensive antibiotic usage, leading to an increase in the number of infections that are difficult to be eradicated.. Klebsiella pneumoniae and Staphylococcus epidermidis were the most common pathogens grown from 156 (18.5%) samples. Escherichia coli AmpC-producing ESBL due to worldwide Escherichia coli proliferation, researchers tested 10,780 clinical strains for decreased susceptibility. Nevertheless, genes and multilocus sequences varied widely among nations. CTX-M enzymes caused ESBL to rise 53% from 2012 to 2017. Levofloxacin, cefepime, piperacillintazobactam, and meropenem may detect ESBL-E bacteremia risk. During the COVID-19 pandemic, Acinetobacter baumannii had the most resistant strains, followed by Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. To combat the epidemic's spread, a statewide community lockdown was implemented, confining nursing home patients and prohibiting outside contact and movement. This study found that donor screening for fecal microbiota transplantation is likely to fail due to a high frequency of extended-spectrum beta-lactamase positive bacteria in feces, poor adherence to regular fecal donation, increased social isolation, travel restrictions, and decreased antibiotic use. Conventional lactamase antagonists may decrease ESBLs, which cause cephalosporin resistance in certain bacteria. Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strains are increasing, and the COVID-19 pandemic triggered a critical care unit pandemic. This study found that gram-negative antibiotic resistance was 1.11-fold higher among those without documented attempts to improve infection prevention, treatment, or prescription safety. More efforts need to be made to prevent infections, offer treatments, and monitor medication resistance. These activities are all vital.
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Gharrah, Mustafa Muhammad, Areej Mostafa El-Mahdy, and Rasha Fathy Barwa. "Association between Virulence Factors and Extended Spectrum Beta-Lactamase ProducingKlebsiella pneumoniaeCompared to Nonproducing Isolates." Interdisciplinary Perspectives on Infectious Diseases 2017 (2017): 1–14. http://dx.doi.org/10.1155/2017/7279830.
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Klebsiella pneumoniaeis considered an important opportunistic multidrug-resistant pathogen. Extended spectrumβ-lactamases (ESBLs) and expression of a multitude of virulence factors may work in a harmony resulting in treatment failure. This study was undertaken to compare the virulence characteristics and genetic relatedness between ESBL and non-ESBL producingK. pneumoniae. Methods. Antibiotic sensitivity test of all isolates was determined by disc diffusion assay. Phenotypic and genotypic detection of ESBL were done. Various virulence factors and some virulence factor-associated genes were screened. Random amplified polymorphic DNA (RAPD) was employed to investigate the genetic fingerprints of ESBL from non-ESBL producingK. pneumoniae.Results. 50% of isolates were ESBL producers. A significant association was observed between ESBL production and biofilm (strong and moderate), serum resistance, andissgene. Moreover, significant association between non-ESBL producers and hypermucoviscosity was identified. Dendogram analysis of RAPD profile classifiedK. pneumoniaeisolates into four clusters (a, b, c, and d). Seventy-six percent of ESBL producers belonged to cluster a. In conclusion, this study suggests a correlation between ESBL production and some virulence factors. Therefore, success of treatment depends mainly on increased clinicians awareness and enhanced testing by laboratories to reduce the spread of these isolates.
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Khan, Diwan Mahmood, I. Venkatakrishna Rao, and M. S. Moosabba. "COMPARATIVE STUDY OF GELATINASE ACTIVITY AND PELLICLE FORMATION AMONG EXTENDED-SPECTRUM BETA-LACTAMASE AND NON-EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ACINETOBACTER BAUMANNII FROM DIABETIC FOOT ULCER INFECTIONS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 9 (2018): 496. http://dx.doi.org/10.22159/ajpcr.2018.v11i9.28336.
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Objective: The aim of the study was to assess and compare the gelatinase activity and pellicle formation in extended-spectrum beta-lactamase (ESBL) and non-ESBL producing Acinetobacter baumannii isolates from diabetic foot ulcer infection (DFI).Methods: A total of 42 isolates of A. baumannii recovered from patients of DFI from September 2016 to February 2018. Isolates were identified by the standard microbiological method and confirmed by the BD Phoenix 100 system. The antimicrobial susceptibility test was performed by the Kirby–Bauer disk diffusion method and ESBL was detected by double disk diffusion synergy test method. Gelatinase production was determined by the Luria Bertani agar supplemented with 30 g/L gelatin, and pellicle formation was determined by the Mueller-Hinton broth which is incubated at two different temperatures.Results: A total of 42 A. baumannii isolates were multidrug resistant. Among 21 isolates, each was ESBL and non-ESBL producers. Pellicle formation at 25°C in ESBL and non-ESBL producer isolates was 47.61% (10/21) and 28.57% (06/21). Pellicle formation at 37°C in ESBL and non-ESBL producer isolates was 57.14% (12/21) and 42.85% (09/21), respectively. Gelatinase production was present in 38.09% ESBL and 28.57% in non-ESBL producers. ESBL strains were more virulent compared to non-ESBL producers among patients of DFIs.Conclusion: This study showed that pellicle formation at 37°C was highly virulent due to ESBL producers. Gelatinase production was elevated in ESBL compared to non-ESBL producer isolates. This attribute of the isolates could render ESBL positive more pathogenic. Colistin and polymyxin B are the only choices of treatment for multidrug-resistant Acinetobacter baumannii infections.
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Giriyapur, Ravi S., Namratha W. Nandihal, Krishna B. V. S., Asha B. Patil, and Chandrasekhar M. R. "Comparison of Disc Diffusion Methods for the Detection of Extended-Spectrum Beta Lactamase-Producing Enterobacteriaceae." Journal of Laboratory Physicians 3, no. 01 (2011): 033–36. http://dx.doi.org/10.4103/0974-2727.78561.
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ABSTRACTBackground: Resistance to broad-spectrum β lactams, mediated by extended-spectrum β lactamases (ESBLs), is an increasing problem world wide. This resistance poses problems for in vitro testing and reporting. Increased prevalence of ESBLs among Enterobacteriaceae creates a great need for laboratory testing methods that will accurately identify their presence.Materials and Methods: During the study, the Enterobacteriaceae isolated were tested for the presence of ESBL by the National Committee for Clinical Laboratory Standards (NCCLS) screening test, Jarlier double disc synergy (approximation) test (DDST) and NCCLS phenotypic confirmatory test (PCT), and compared their efficiency in detection.Results: A total of 313 Enterobacteriaceae were isolated and tested for the presence of ESBL. NCCLS PCT identified 200 (63.89%) as ESBL producers and DDST identified 176 (56.23%), with a P-value of <0.001. Among the screening agents, ceftazidime had a better sensitivity (89.49%) and specificity (95.74%).Conclusions: Close monitoring of the susceptibility pattern of isolates and careful spacing with specific discs can identify many ESBL producers. Ceftazidime has a better sensitivity and specificity as a screening agent. A combination of different tests can be useful for accurate identification.
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Amin, Aalia. "The Detection of ESBL-Producing Escherichia coli in Various Clinical Sample Using 3rd Generation Cephalosporin by Different Diffusion Methods." International Journal of Current Microbiology and Applied Sciences 13, no. 6 (2024): 59–68. http://dx.doi.org/10.20546/ijcmas.2024.1306.006.
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This study aimed to determine the prevalence of extended spectrum of beta lactamases (ESBLs), to compare two antibiotic i.e Cefotaxime & Ceftazidime by different phenotypic methods for ESBL con?rmation and to evaluate the antibiotic resistance patterns among ESBL-producing Escherichia coli. Total no. of E.coli isolates were obtained from various clinical samples. They were subjected for the antibiotic susceptibility pattern by Kirby bauer disc diffusion method. 3rd generation cephalosporin resistant isolates were detected for ESBL production. In our isolates we have found increased percentage (100%) isolates showed sensitivity to colistin followed by cefepime which showed sensitivity of (54%). (80 - 90 %) of E.coli isolates showed resistance to cephalosorin group of drugs. (51%) of E.coli isolates were found to be extended spectrum beta lactamase producers using cefotaxime (30µg). Cefotaxme/ Clavulanic acid (30/10 µg) & (55%) os isolates were shown to be positive ESBL using ceftazdime (30 µg), Ceftazidime /Clavulanic acid (30/10 µg). This study found a high rate of ESBL production among cefotaxime antibiotic. Clinical microbiology laboratories should routinely incorporate ESBLdetection methods in their laboratory producers for continous surveillance of drug resistance isolates & antibiogram to guide eprical theapy.
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Pestariati, Dr, and Dr Suhariyadi. "Detection of CTX-M Gene in Escherichia coli Producing Extended Spectrum Beta Lactamase (ESBL) Isolated from Patients with Urinary Tract Infection." International Journal of Medical Science and Clinical Invention 8, no. 09 (2021): 5610–14. http://dx.doi.org/10.18535/ijmsci/v8i09.05.
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Escherichia coli is a Gram-negative bacterium from Enterobacteriaceae family causes urinary tract infections (UTI). A major problem encountered in antibiotics therapy is Multiple Drug Resistant Organisms (MDROs). MDROs occur because of the presence of resistance coding genes such as CTX-M which causes bacteria to produce the Extended Spectrum Beta-Lactamase (ESBL) enzyme. This study aims to detect the presence of the CTX-M gene in Extended-Spectrum Beta Lactamase (ESBL) Escherichia coli isolated from UTI patients. The study was conducted at the Institute of Tropical Disease (ITD) Airlangga University, Jl. Mulyorejo Campus C Surabaya, Indonesia for polymerase chain reaction (PCR) examination. The isolation and identification of Escherichia coli bacteria were carried out at the Microbiology Laboratory Department in Poltekkes Kemenkes Surabaya, Jl. Karangmenjangan 18A, Surabaya, Indonesia. Conventional identification of Escherichia coli and the presence of the CTX-M gene were observed using the PCR method. The results showed that 18 of 30 samples (60%) were caused by Escherichia coli. Escherichia coli producing ESBL was found in 15 samples (83%), of which 12 samples (80%) showed the presence of the CTX-M gene.
 Keywords : CTX-M gene, Extended-Spectrum Beta Lactamase (ESBL), Escherichia coli
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Mohammed, A., A. M. Magashi, and M. Yushau. "Incidence of extended spectrum Beta-Lactamase producing Klebsiella pneumoniae among patients with urinary tract infections in Kano Metropolis Nigeria." Bayero Journal of Pure and Applied Sciences 12, no. 1 (2020): 139–44. http://dx.doi.org/10.4314/bajopas.v12i1.23s.
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Extended Spectrum Beta-Lactamase (ESBLs) production is one of the ways by which bacteria become resistant to antibiotics and pathogens of UTIs such as Klebsiella pneumoniae have been incriminated at global scale. This study was conducted to investigate the incidence of Extended Spectrum Beta lactamase producing Klebsiella pneumoniae from Urinary Tract Infections in Kano metropolis. The work involved One hundred and fourty seven K. Pneumoniae isolates obtained from patients with suspected urinary tract infections were studied from January to July 2017. The identity of the isolates was confirmed using MicrogenTMGnA + B-ID System. Antibiotic susceptibility testing was carried out using the Kirby-Bauer Disc Diffusion Technique. Screening for ESBLs production was done using Clinical Laboratory Standards Institute breakpoint. Suspected ESBLs producers were subjected to confirmation using Double Disc Synergy Test. Standard Discs of Augmentin (AMC 30µG Oxoid England), Ceftazidime (CAZ 30µG, Oxoid England) and Cefotaxime (CTX 30µG, Oxoid England) were used for the screening and confirmation. Accordingly, Multidrug Resistant K. pneumoniae were found to be 63.3% and all were ESBLs producers. The Double Disc Synergy Test however confirmed 6.8% ESBLs producing K. pneumoniae. Antimicrobial sensitivity of the ESBLs producing organisms showed 100% resistance to Augmentin, ceftriaxone, ceftazidime, cefotaxime while resistance to gentamicin was 91.5%, chloramphenicol 23.4%, Nitrofurantoin 61.7%, Ciprofloxacin 93.6% and cotrimoxazole 95.7%. However, Imipenem was the most pharmacologically active drug. ESBL producing K. pneumoniae are incident in Kano and are resistant to commonly prescribed antibiotics. We, therefore, suggest screening and confirmation for ESBL in any attempt to treat UTIs due to such pathogens
 Keywords: Extended Spectrum Beta Lactamases, K. pneumoniae, Urinary Tract Infection, Incidence, Kano
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Nedjai, Sabrina, Abouddihaj Barguigua, Nassima Djahmi, et al. "Prevalence and characterization of extended spectrum beta-lactamase-producing Enterobacter cloacae strains in Algeria." Journal of Infection in Developing Countries 7, no. 11 (2013): 804–11. http://dx.doi.org/10.3855/jidc.3127.
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Introduction: Expended spectrum β-lactamase (ESBL)-producing Enterobacter cloacae is an important nosocomial pathogen. In this study, the prevalence and the molecular epidemiology of ESBL producing E. cloacae strains isolated from various hospitals in Annaba, Algeria were investigated. Methodology: The study involved 63 isolates of E. cloacae obtained during 2009 at the four hospitals in Annaba. The detection of ESBL was performed using the double-disk synergy test and the combined disk test. Minimum inhibitory concentrations (MICs) were determined using the agar dilution method. The presence of blaCTX-M, blaSHV, blaTEM, and blaDHA β-lactamase genes was evaluated by PCR, and genomic typing was determined by pulsed-field gel electrophoresis (PFGE) analysis. The clinical and microbiological data were entered into the EpiI Info database. Results: Thirty isolates (47.6%) had an ESBL phenotype. BlaCTX-M group1 (76%); blaTEM (70%) were the most prevalent, followed by blaDHA (16.6%) and blaSHV (10%). Eighteen strains expressed at least two bla genes. MICs revealed a high level of resistance to cefotaxime, ceftazidime, and cefepime. PFGE revealed an epidemic clonal dissemination of these isolates. Various risk factors associated with the occurrence of ESBL-producing E. cloacae were detected. Conclusions: A higher frequency of ESBL-producing isolates and a diversity of β-lactamases were detected among ESBL-producing E. cloacae; these resulted from an epidemic clonal dissemination and high transference of ESBL genes between bacteria in hospital settings. Strict measures will be required to control the further spread of these pathogens in hospital settings.
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Priyadharsini, R. Indra, A. Kavitha, Reena Rajan, S. Mathavi, and K. R. Rajesh. "Prevalence of bla CTX M Extended Spectrum Beta Lactamase Gene in Enterobacteriaceae from Critical Care Patients." Journal of Laboratory Physicians 3, no. 02 (2011): 080–83. http://dx.doi.org/10.4103/0974-2727.86838.
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ABSTRACT Context: Critical care units provide a favourable environment for the antimicrobial resistant organisms to disseminate. There is recent increase in number of extended spectrum beta lactamase (ESBL) producers because of the emergence of CTX M Beta lactamases produced by Enterobacteriaceae. They colonize the intestinal flora and spread with greater intensity in the community and hospital. Usage of Carbapenems becomes mandatory as the ESBL inhibitor combination antibiotics (Amoxicillin/Clavulanate) are not effective especially against CTX M ESBLs. Aim: The aim of this study is to detect ESBL producing bla CTX M gene in Enterobacteriaceae from infections in Critical care patients and to stress on the intensity of the problem and to make interventions to curb the emergence and dissemination of CTX M ESBLs. Materials and Methods: A total of 118 Enterobacteriaceae isolates from Critical care unit patients were recovered from a variety of clinical specimens. Antimicrobial susceptibility test was done and isolates with resistance or with reduced susceptibility to any of the third generation Cephalosporins were selected for the study. Phenotypic confirmation of ESBL production was done by Double Disc Synergy Test and confirmed by minimum inhibitory concentration. Multiplex polymerase chain reaction was performed to screen the four groups of CTX-M ESBLs. Results: Among the 118 isolates of Enterobacteriaceae 54 isolates were positive for CTX-M group I ESBL which constitutes 45.7 %. Conclusions: Early detection of CTX M producing Enterobacteriaceae by continuous surveillance and thereby reducing their spread and restricted use of third generation Cephalosporins (3GC) antibiotics could be the possible routes to prevent the emergence and spread of CTX M ESBL producing organisms.
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Kumar, Diwakar, Ananya Choudhury, Mitul Nath, and Udaya Kumar Vandana. "SCREENING FOR EXTENDED-SPECTRUM BETA-LACTAMASES PRODUCING ESCHERICHIA COLI ISOLATES IN FISH SAMPLE AND PROFILING FOR ANTIBIOTICS SUSCEPTIBILITY." Bacterial Empire 4, no. 1 (2021): 25–29. http://dx.doi.org/10.36547/be.2021.4.1.25-29.
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At present, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and other species of Enterobacteriaceae have emerged as a matter of utmost concern. Indiscriminate utilization of antimicrobials in aquaculture generates selective pressure creating reservoirs of drug-resistance genes in fish pathogens and other bacteria, which may disseminate by horizontal gene transfer and reach human pathogens. The present study aims to detect extended-spectrum beta-lactamases (ESBL) production by enterobacteria isolated from locally harbored and imported fresh and dry fishes. Out of 235 fish samples investigated, the observed incidence of 9.78% (n=23) E. coli isolates. PCR detection of extended-spectrum β-lactamase (ESBL)-producing Escherichia coli using primers specific for Bla-TEM, Bla-SHV, Bla-CTX-M. As per molecular detection by Multiplex PCR, 11 isolates exhibited Bla-TEM+CTX-M+SHV genes, and two isolates exhibited the presence of TEM genes only. Antimicrobial susceptibility patterns against 12 antibiotics were studied, where it was observed that resistance to the selected drug ranges from 4.34 % to 73.9 % for 12 different antibiotics.
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Beshah, Daniel, Adey Feleke Desta, Gurja Belay Woldemichael, et al. "High burden of ESBL and carbapenemase-producing gram-negative bacteria in bloodstream infection patients at a tertiary care hospital in Addis Ababa, Ethiopia." PLOS ONE 18, no. 6 (2023): e0287453. http://dx.doi.org/10.1371/journal.pone.0287453.
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Background Bloodstream infection due to beta-lactamase and carbapenemase-producing gram-negative bacteria poses a substantial challenge to the effectiveness of antimicrobial treatments. Therefore, this study aimed to investigate the magnitude of beta-lactamase, carbapenemase-producing gram-negative bacteria, and associated risk factors of bloodstream infections in patients at a tertiary care hospital, in Addis Ababa, Ethiopia. Methods An institutional-based cross-sectional study was conducted with convenience sampling techniques from September 2018 to March 2019. Blood cultures were analyzed from 1486 bloodstream infection suspected patients across all age groups. The blood sample was collected using two BacT/ALERT blood culture bottles for each patient. Gram stain, colony characteristics, and conventional biochemical tests were used to classify the gram-negative bacteria at the species level. Antimicrobial susceptibility testing was carried out to screen beta-lactam and carbapenem drug-resistant bacteria. The E-test was conducted for extended-spectrum-beta-lactamase and AmpC-beta-lactamase-producers. A modified and EDTA-modified carbapenem inactivation method was conducted for carbapenemase and metallo-beta-lactamases producers. Data collected using structured questionnaires and medical records were reviewed, encoded, and cleaned using EpiData V3.1. software. The cleaned data were exported and analyzed using SPSS version 24 software. Descriptive statistics and multivariate logistic registration models were used to describe and assess factors associated with acquiring drug-resistant bacteria infection. A p-value <0.05 was considered statistically significant. Result Among 1486 samples, 231 gram-negative bacteria were identified; of these, 195(84.4%) produce drug-hydrolyzing enzymes, and 31(13.4%) produce more than one drug-hydrolyzing enzyme. We found 54.0% and 25.7% of the gram-negative bacteria to be extended-spectrum-beta-lactamase and carbapenemase-producing, respectively. The extended-spectrum-beta-lactamase plus AmpC-beta-lactamase-producing bacteria account for 6.9%. Among the different isolates Klebsiella pneumonia 83(36.7%) was the highest drug-hydrolyzing enzyme-producing bacteria. Acinetobacter spp 25(53.2%) was the most carbapenemase producer. Extended-spectrum-beta-lactamase and carbapenemase-producing bacteria were high in this study. A significant association between age groups and extended-spectrum-beta-lactamase producer bacterial infection was seen, with a high prevalence in neonates (p = <0.001). Carbapenemase showed a significant association with patients admitted to the intensive care unit (p = 0.008), general surgery (p = 0.001), and surgical intensive care unit (p = 0.007) departments. Delivery of neonates by caesarean section, and insertion of medical instruments into the body were exposing factors for carbapenem-resistant bacterial infection. Chronic illnesses were associated with an extended-spectrum-beta-lactamase-producing bacterial infection. Klebsiella pneumonia and Acinetobacter species showed the greatest rates of extensively drug-resistant (37.3%) and pan-drug-resistance (76.5%), respectively. According to the results of this study, the pan-drug-resistance prevalence was found to be alarming. Conclusion Gram-negative bacteria were the main pathogens responsible for drug-resistant bloodstream infections. A high percentage of extended-spectrum-beta-lactamase and carbapenemase-producer bacteria were found in this study. Neonates were more susceptible to extended-spectrum-beta-lactamase and AmpC-beta-lactamase-producer bacteria. Patients in general surgery, caesarean section delivery, and intensive care unit were more susceptible to carbapenemase-producer bacteria. The suction machines, intravenous lines, and drainage tubes play an important role in the transmission of carbapenemase and metallo-beta-lactamase-producing bacteria. The hospital management and other stakeholders should work on infection prevention protocol implementation. Moreover, special attention should be given to all types of Klebsiella pneumoniae and pan-drug resistance Acinetobacter spp transmission dynamics, drug resistance genes, and virulence factors.
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Bourjilat, Fatna, Brahim Bouchrif, Noureddine Dersi, Jean David Perrier Gros Claude, Hamid Amarouch, and Mohammed Timinouni. "Emergence of extended-spectrum beta-lactamases-producing Escherichia coli in community-acquired urinary infections in Casablanca, Morocco." Journal of Infection in Developing Countries 5, no. 12 (2011): 850–55. http://dx.doi.org/10.3855/jidc.1490.
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Introduction: Extended-spectrum beta-lactamase- (ESBL)-producing Escherichia coli are an increasingly significant cause of community-acquired infection worldwide. The aim of this study was to assess the prevalence of ESBL-producing E. coli in a community, to analyze the relationship between strains studied, and to characterize the ESBL genes involved in this resistance. Methodology: ESBL production was detected by the double disk synergy test. Genes encoding ESBLs (blaTEM, blaCTM, blaSHV) were identified by PCR and DNA sequencing. Conjugation experiments were performed to check the transferability of antibiotic resistance genes. Strain inter-relationships were studied by pulsed field gel electrophoresis. Results: Seven ESBL-producing E. coli were identified among the 535 E. coli isolates. Most of them expressed a CTX-M enzyme (6/7) with a predominance of CTX-M-15 (6/6). Two strains possessed TEM in combination with CTX-M-15 or SHV-5. Plasmid content and gene transfer analysis showed that resistance genes were carried by high molecular weight conjugative plasmids. PFGE analysis showed that the strains were not clonal. Conclusions: ESBL-producing E. coli from urinary tract infections in Casablanca belong to different clones and carry mobile beta-lactamase genes. It is therefore essential to monitor the epidemiology of ESBLs in E. coli and related organisms locally to effectively combat resistance.
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Chaudhary, Mahesh Kumar, Indrani Jadhav, Indrani Jadhav, and Megha Raj Banjara. "Antibiotic Profile of Extended Spectrum Beta Lactamase Escherichia coli from Clinical Samples." Journal of Karnali Academy of Health Sciences 3, no. 2 (2020): 102–10. http://dx.doi.org/10.3126/jkahs.v3i2.31324.
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Background: Extended spectrum β-lactamases have addressed the serious challenges worldwide due to the emergence of ESBL producing genes which possess a serious threat for the treatment of infections both in community and hospitals since it is found to be increasing trends of multidrug resistance. This study was focused to find out the antibiotic profile of multidrug resistant Escherichia .coli and status of ESBLs producing E.coli.
 Methods: This was a cross-sectional study conducted over a period of 2 years (September 2017 to April 2019) at microbiology laboratory of Nepal Mediciti Hospital. A total of 16542 samples were processed. Various clinical samples were collected from both inpatients and outpatients aseptically and without contaminating skin commensals. Standard microbiological techniques were used for isolation and identification of pathogens. Extended spectrum beta-lactamases were phenotypically confirmed by combined disc method.
 Results: Out of 1449 E.coli isolates, 323(22.29%) were found to be MDR E.coli. Isolation rate of ESBL producing E.coli (66.56%) were found to be high among MDR E.coli isolates.
 Conclusion: There was increasing prevalence of ESBL producing E.coli and was essential to monitor antibiotic susceptibility pattern and formulate antibiotic policy to prevent the spread of MDR and ESBL producers.
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Shrestha, Pallavi, Saroj Sharma, and Roshani Maharjan. "Extended Spectrum Beta Lactamase and Metallo Beta Lactamase producing Pseudomonas aeruginosa at Tertiary care Hospital of Nepal." Tribhuvan University Journal of Microbiology 5 (September 26, 2018): 45–50. http://dx.doi.org/10.3126/tujm.v5i0.22301.
Full textAbstract:
Objective: To assess the prevalence of Extended spectrum beta lactamase (ESBL) and Metallo beta lactamase (MBL) producing Pseudomonas aeruginosa from pus samples.
 Methods: A cross-sectional study was conducted at Kanti Children’s Hospital, Kathmandu, Nepal during which 316 pus samples were collected and tested using standard microbiological procedures. Antibiotic Susceptibility Test (AST) was done by Kirby-Bauer disk diffusion method and the detection of ESBL and MBL production were done using Ceftazidime/clavulanic acid combined disk test and Imipenem- Ethylenenediaminetetraacetic acid combined disk test respectively as per CLSI guideline 2014.
 Results: The prevalence rate of P. aeruginosa was found to be 7.9% in pus samples. Out of 25 P. aeruginosa isolates 9(36%) were ESBL producers and 2(8%) were MBL producers. ESBL producers were predominant in the age group 2-3 years (33.3%) and in male patient (55.6%). Out of 2 MBL producing P. aeruginosa, 1(50%)was isolated from the age group below 2 years and male patient and 1(50%) from the age group 8-9 years and female patient. 96% of isolates showed sensitive to Polymyxin B.
 Conclusion: The study showed increasing trend of ESBL and MBL production in P. aeruginosa so constant survey of prevalence of ESBL and MBL producing isolates is essential to control and manage spread of these isolates in different units of health institutions.
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COZMA, Andreea Paula, Iulia Elena MACIUCA, Cristina Mihaela RIMBU, Serban MOROSAN, Lucia Carmen TRINCA, and Dorina TIMOFTE. "PREVALENCE AND CHARACTERISATION OF EXTENDED-SPECTRUM BETA-LACTAMASES AND PLASMID-MEDIATED QUINOLONES RESISTANCE IN Enterobacteriaceae ISOLATED FROM COMPANION ANIMALS." Journal of Applied Life Sciences and Environment 56, no. 4(196)/2023 (2024): 541–49. http://dx.doi.org/10.46909/alse-564115.
Full textAbstract:
Antimicrobial resistance is a major public health concern worldwide. This study aims to determine the prevalence of Enterobacterales producing beta-lactamase (TEM, SHV, OXA) or extended-spectrum beta-lactamases (ESBL), as well as plasmid-mediated resistance to quinolones (PMQR) (qnrA, qnrB, qnrS) in companion animals from the northeast region of Romania. A total of 124 faecal samples were collected aseptically from healthy dogs attending the veterinary practice for vaccination and cultivated on Brilliance ESBL medium (Oxoid, UK). The ESBL production testing was performed using the combination disc test. The identification of Enterobacterales strains was achieved using molecular identification and based on biochemical tests. Antimicrobial susceptibility testing was performed using the disk diffusion method. Identification of genes encoding for beta-lactamase enzymes and genes encoding plasmid-mediated resistance to quinolones was performed by PCR according to the protocols previously described. After ESBL screening, 31 (31/124; 25%) extended-spectrum cephalosporin (ESC)-resistant Enterobacterales were obtained, and 67.74% (21/31) of them were confirmed as ESBL-producers. Regarding the Enterobacterales species, 27 (27/31; 87.1%) were Escherichia coli and 4 (4/31; 12.9%) strains were Klebsiella pneumoniae. Among the ESBL-producing isolates, the blaCTX-M-1 gene group was predominant (58.82%), followed by the blaCTX-M-9 group (41.18%). The blaTEM, blaSHV and blaOXA gene groups were identified in 54.83%, 29.03% and 3.22% of the analysed strains, respectively. The prevalence of PMQR genes was 22.58% and consisted only of qnrS (19.35%) and qnrA (3.22%) genes. The prevalence of ESBL strains related to the total number of analysed samples was 16.93% (21/124). The findings show a significant prevalence of ESBLs and PMQR genes in Enterobacterales strains isolated from the faeces of healthy dogs, implying that pets may pose a risk of transmitting ESBL strains to other animals or owners.
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Nwosu, Uchenna Ogbu, Francis Amadi Ibiam, Christiana Onyemaechi Amadi-Ibiam, et al. "Fecal carriage of extended spectrum beta-lactamase and fluoroquinolone resistant gene in non-typhoidal Salmonella enterica isolates from food-producing animals and humans." Journal of Drug Delivery and Therapeutics 13, no. 9 (2023): 128–38. http://dx.doi.org/10.22270/jddt.v13i9.5964.
Full textAbstract:
This study seeks to determine the feacal carriage of extended spectrum beta-lactamase and fluoroquinolone resistant non-typhoidal Salmonella enterica isolates from food-producing animals and humans. A total of three hundred (300) fecal samples were collected using sterile universal containers from food-producing animals namely (Chicken [100], Pig [100] and humans (100) from Onicha Local Government Area of Ebonyi State and analyzed for the presence of non-typhoidal Salmonella enterica using standard microbiological techniques. Phenotypic detection of extended-spectrum beta-lactamase (ESBL) were done by disc diffusion and Double Disk Synergy Test. Molecular characterization for ESBL and fluoroquinolone-resistant genes were done by PCR with specific primers. The result shows that non-typhoidal Salmonella species (NTS) accounted for 25 % and 17 % in poultry and pig fecal sample respectively while 60 % and 40% were phenotypic ESBL producers respectively. When compared statistically there is significant difference among isolates confirmed ESBL-positive (P˂ 0.05). Also, none of the 16 (58 %) NTS isolated from humans harbored ESBL phenotype. PCR analysis with β-lactam specific primer detected the presence of blaOXA 50 % and 50 %, blaSHV 36 %, and 64 %, blaTEM 43 % and 57 %, blaCTX-M 36 % and 64 % in poultry and pig respectively. Fluoroquinolone resistant gene QnrA was present in 0 and 100 % of poultry and pig respectively. QnrB was 40 % and 60 % in poultry and pig isolates respectively. QnrS was present in 64 % isolates of poultry and 13 % isolates in pig. The high prevalence of genes encoding beta-lactamases and fluoroquinolone resistance (TEM, SHV, CTX-M and OXA, (qnrA, qnrB and qnrS) were present more in poultry and pig than in humans and demonstrate a significant public health threat from consumption of food-producing animal harboring such pathogenic resistant genotype if not properly controlled.
 Keywords: Extended spectrum beta-lactamase, Fluoroquinolone, non-typhoidal Salmonella enterica, feacal carriage
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Salihu, M. K., A. Yarima, and H. I. Atta. "Methods for the Phenotypic Detection of Extended Spectrum Beta Lactamase (ESBL)-Producing Bacteria." Nigerian Journal of Biotechnology 37, no. 2 (2021): 113–25. http://dx.doi.org/10.4314/njb.v37i2.11.
Full textAbstract:
1983. These enzymes possess the ability to inactivate susceptible β-lactam antibiotics i.e. penicillins, first, second and third generation cephalosporins and aztreonam, but not cephamycins and carbapenems . Their mode of action is by hydrolyzing the β-lactam ring. Even before the first β-lactam antibiotic (penicillin) was developed, resistance to β-lactam antibiotics was observed . ESBL genes are plasmids- and transposons- mediated, as such, can be spread easily to other species of bacteria. Resistance of ESBL- producing bacteria to the β-lactam antibiotics is a continuing cause of public health problems , it is increasingly being observed in community and nosocomial acquired infections. Detection and identification of these ESBLs in the laboratory is of prime importance for the selection of appropriate antibiotics to be used in the treatment of infections caused by ESBL- producing bacteria. The aim of this review is to explain in detail , several phenotypic methods used in the detection and confirmation of extended spectrum β lactamases.
 Keywords: Antibiotic resistance, ESBL, bacteria, phenotypic method
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Kannaiyan, Moorthy, Gedif Meseret Abebe, Chinnasamy Kanimozhi, et al. "PREVALENCE OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE MEMBERS ISOLATED FROM CLINICALLY SUSPECTED PATIENTS." Asian Journal of Pharmaceutical and Clinical Research 11, no. 5 (2018): 364. http://dx.doi.org/10.22159/ajpcr.2018.v11i5.19363.
Full textAbstract:
Objective: Emergence of extended-spectrum beta-lactamases (ESBLs) production poses another clinical problem with Gram-negative bacterial infections. The present study was aimed to evaluate the ESBL producers among various clinical samples of clinically suspected patients.Methods: A total of 1279 samples (urine [918], pus [207] and stool [154]) were collected and 465 isolates (Escherichia coli [320], Enterobacter aerogenes [119] and Klebsiella pneumoniae [26]) were isolated and screened for the presence of ESBL producers using combination disc method and double disc synergy test.Results: Of the 465 culture positive isolates, 130 (E. coli 93 [29.06%], E. aerogenes 35 [29.41%] and K. pneumoniae 2 [7.69%]) were identified as ESBL producers. Among the three Enterobacteriaceae members, E. coli 93 (29.06%) was found to be predominant ESBL producer next in order E. aerogenes 35 (29.41%) and K. pneumoniae 2 (7.69%). Maximum number of ESBL producers were recovered from urine (n=111) followed by pus (n=14) and stool (n=5). All the ESBL-producing isolates were subjected to antibiotic sensitivity test using 10 different antibiotics. ESBL producers were chiefly resistance to ceftriaxone followed by ceftazidime and cefotaxime. Of 130 ESBL producers, 15 (E. coli (8), E. aerogenes (6) and K. pneumoniae (1)] strains were selected for genotypic identification. Among, only two strains of E. aerogenes were positive isolates for CTX-M type ESBL in polymerase chain reaction.Conclusion: This study concluded that among Enterobacteriaceae members, E. coli was the predominant ESBL producers and urine was noted as the prime source for the ESBL positive isolates when compared to other source. Genotypic identification was the best method to differentiate ESBL types which were essential to provide proper treatment.