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Amare, Azanaw, Setegn Eshetie, Desie Kasew, and Feleke Moges. "High prevalence of fecal carriage of Extended-spectrum beta-lactamase and carbapenemase-producing Enterobacteriaceae among food handlers at the University of Gondar, Northwest Ethiopia." PLOS ONE 17, no. 3 (2022): e0264818. http://dx.doi.org/10.1371/journal.pone.0264818.
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Background Fecal carriage of extended-spectrum beta-lactamase and Carbapenemase-producing Enterobacteriaceae is a potential risk for the transmission of infection with resistant strains. Understanding the burden of these resistant strains in asymptomatic people is essential to reduce the chain of infection transmission. However, data on the fecal carriage of Extended-spectrum Beta-lactamase and Carbapenemase-producing Enterobacteriaceae among food handlers were limited in developing countries especially in Ethiopia. The aim of the present study is, therefore, to assess fecal carriage rate, associated factors, and antimicrobial resistance patterns of Extended-spectrum Beta-lactamase and Carbapenemase-producing Enterobacteriaceae among food handlers at the University of Gondar Cafeterias, Northwest Ethiopia. Materials and methods An institution-based cross-sectional study was conducted from February to June 2021 at the University of Gondar cafeterias. A total of 290 stool samples were collected, transported using Cary Blair transport medium, and processed. All isolates were cultured and identified by using MacConkey agar, and routine biochemical tests. Antimicrobial susceptibility testing was done to each isolate following the Kirby Bauer disk diffusion method. If the zone of inhibition was ≤ 22 mm for ceftazidime, ≤25 mm for ceftriaxone, and ≤27 for cefotaxime they were considered as potential ESBL strain and selected for a further phenotypic confirmatory. Moreover, the double-disc diffusion test and the modified carbapenem inactivation method were used for confirmations of Extended-spectrum β-lactamase and Carbapenemase-producing Enterobacteriaceae respectively. If a ≥5mm difference in zone diameter for either antimicrobial agent in combination with clavulanic acid versus the zone diameter of the agent when tested alone (without B-lactamase inhibitor), was confirmed as ESBL-PE and if the zone of inhibition diameter between 6-15mm and 16- 18mm with a pinpoint colony, it was considered as carbapenem resistance Enterobacteriaceae. Data were entered using Epi-data version 4.6 and then exported to SPSS version 26 for analysis. Potential risk factors were assessed using multivariable logistic regression and a p-value less than 0.05 was considered statistically significant. Results Out of 290 stool samples, 63 (21.7%) and 7 (2.4%) were confirmed as Extended-spectrum β-lactamase and Carbapenemase-producing Enterobacteriaceae. The most predominant ESBL-PE was E. coli 43 (14.8%) followed by K. pneumoniae 17 (5.9%). Most of the Extended-spectrum β-lactamase and Carbapenemase-producing isolates were resistant to tetracycline, cefotaxime, ceftazidime, and ceftriaxone (100% each). In contrast, a low resistance level was recorded for Meropenem and cefoxitin. The overall Multi-drug resistant Enterobacteriaceae (MDR) was 147 (42.3%). Antibiotics usage in the last 3 months and drinking unpasteurized milk were associated with the carriage of the Extended-spectrum beta-lactamase-Producing Enterobacteriaceae. Conclusions and recommendations The high fecal carriage rate of Multi-drug resistance isolate, Extended-spectrum β-lactamase, and Carbapenemase-producing Enterobacteriaceae were recorded among food handlers. Therefore, this study gives signals in the spread of drug-resistant bacteria easily to the community. Hence, the need for adjusting and promotion of infection prevention measures to prevent the spread of drug-resistant bacteria should not be underestimated.
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Cantón, Rafael, María Pérez-Vázquez, Antonio Oliver, et al. "Evaluation of the Wider System, a New Computer-Assisted Image-Processing Device for Bacterial Identification and Susceptibility Testing." Journal of Clinical Microbiology 38, no. 4 (2000): 1339–46. http://dx.doi.org/10.1128/jcm.38.4.1339-1346.2000.
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The Wider system is a newly developed computer-assisted image-processing device for both bacterial identification and antimicrobial susceptibility testing. It has been adapted to be able to read and interpret commercial MicroScan panels. Two hundred forty-four fresh consecutive clinical isolates (138 isolates of the familyEnterobacteriaceae, 25 nonfermentative gram-negative rods [NFGNRs], and 81 gram-positive cocci) were tested. In addition, 100 enterobacterial strains with known β-lactam resistance mechanisms (22 strains with chromosomal AmpC β-lactamase, 8 strains with chromosomal class A β-lactamase, 21 broad-spectrum and IRT β-lactamase-producing strains, 41 extended-spectrum β-lactamase-producing strains, and 8 permeability mutants) were tested. API galleries and National Committee for Clinical Laboratory Standards (NCCLS) microdilution methods were used as reference methods. The Wider system correctly identified 97.5% of the clinical isolates at the species level. Overall essential agreement (±1 log2dilution for 3,719 organism-antimicrobial drug combinations) was 95.6% (isolates of the family Enterobacteriaceae, 96.6%; NFGNRs, 88.0%; gram-positive cocci, 95.6%). The lowest essential agreement was observed with Enterobacteriaceae versus imipenem (84.0%), NFGNR versus piperacillin (88.0%) and cefepime (88.0%), and gram-positive isolates versus penicillin (80.4%). The category error rate (NCCLS criteria) was 4.2% (2.0% very major errors, 0.6% major errors, and 1.5% minor errors). Essential agreement and interpretive error rates for eight β-lactam antibiotics against isolates of the family Enterobacteriaceae with known β-lactam resistance mechanisms were 94.8 and 5.4%, respectively. Interestingly, the very major error rate was only 0.8%. Minor errors (3.6%) were mainly observed with amoxicillin-clavulanate and cefepime against extended-spectrum β-lactamase-producing isolates. The Wider system is a new reliable tool which applies the image-processing technology to the reading of commercial trays for both bacterial identification and susceptibility testing.
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Stewardson, Andrew J., Gesuele Renzi, Nathalie Maury та ін. "Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae in Hospital Food: A Risk Assessment". Infection Control & Hospital Epidemiology 35, № 4 (2014): 375–83. http://dx.doi.org/10.1086/675609.
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Objective.Determine the prevalence of extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae (ESBL-PE) contamination of food and colonization of food handlers in a hospital kitchen and compare retrieved ESBL-PE strains with patient isolates.Design.Cross-sectional study.Setting.A 2,200-bed tertiary care university hospital in Switzerland.Participants.Food handlers.Methods.Raw and prepared food samples were obtained from the hospital kitchen, with a comparator group from local supermarkets. Fecal samples collected from food handlers and selectively pre-enriched homogenized food samples were inoculated onto selective chromogenic media. Phenotypic confirmation of ESBL production was performed using the double disk method. Representative ESBL-PE were characterized using polymerase chain reaction (PCR) and sequencing for blaCTX-M, blaSHV, and blaTEM genes, and Escherichia coli strains were typed using phylotyping, repetitive element palindromic PCR, and multilocus sequence typing. Meat samples were screened for antibiotic residues using liquid chromatography time-of-flight mass spectrometry.Results.Sixty (92%) of the raw chicken samples were ESBL-PE positive, including 30 (86%) of the hospital samples and all supermarket samples. No egg, beef, rabbit, or cooked chicken samples were ESBL-PE positive. No antibiotic residues were detected. Six (6.5%) of 93 food handlers were ESBL-PE carriers. ESBL-PE strains from chicken meat more commonly possessed blaCTX-M-1 and blaCTX-M-2, whereas blaCTX-M-14and blaCTX-M-15 were predominant among strains of human origin. There was partial overlap in the sequence type of E. coli strains of chicken and human origin. No E. coli ST131 strains or blaCTX-M-15 genes were isolated from meat.Conclusions.Although there is significant ESBL-PE contamination of delivered chicken meat, current preventive strategies minimize risks to food handlers, hospital staff, and patients.
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Gekenidis, Maria-Theresia, Anita Kläui, Kornelia Smalla та David Drissner. "Transferable Extended-Spectrum β-Lactamase (ESBL) Plasmids in Enterobacteriaceae from Irrigation Water". Microorganisms 8, № 7 (2020): 978. http://dx.doi.org/10.3390/microorganisms8070978.
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Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are classified as serious threats to human health by the U.S. Centers for Disease Control and Prevention. Water used for irrigation of fresh produce can transmit such resistant bacteria directly to edible plant parts. We screened ESBL-producing Escherichia coli, Enterobacter cloacae, and Citrobacter freundii isolated from irrigation water for their potential to transmit resistance to antibiotic-susceptible E. coli. All strains were genome-sequenced and tested in vitro for transmission of resistance to third-generation cephalosporins on solid agar as well as in liquid culture. Of the 19 screened isolates, five ESBL-producing E. coli were able to transfer resistance with different efficiency to susceptible recipient E. coli. Transconjugant strains were sequenced for detection of transferred antibiotic resistance genes (ARGs) and compared to the known ARG pattern of their respective donors. Additionally, phenotypic resistance patterns were obtained for both transconjugant and corresponding donor strains, confirming ESBL-producing phenotypes of all obtained transconjugants.
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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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GESER, N., R. STEPHAN, P. KUHNERT та ін. "Fecal Carriage of Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae in Swine and Cattle at Slaughter in Switzerland". Journal of Food Protection 74, № 3 (2011): 446–49. http://dx.doi.org/10.4315/0362-028x.jfp-10-372.
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During the past decade, extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae have become a matter of great concern in human medicine. ESBL-producing strains are found in the community, not just in hospital-associated patients, which raises a question about possible reservoirs. Recent studies describe the occurrence of ESBL-producing Enterobacteriaceae in meat, fish, and raw milk; therefore, the impact of food animals as reservoirs for and disseminators of such strains into the food production chain must be assessed. In this pilot study, fecal samples of 59 pigs and 64 cattle were investigated to determine the occurrence of ESBL-producing Enterobacteriaceae in farm animals at slaughter in Switzerland. Presumptive-positive colonies on Brilliance ESBL agar were subjected to identification and antibiotic susceptibility testing including the disc diffusion method and E-test ESBL strips. As many as 15.2% of the porcine and 17.1% of the bovine samples, predominantly from calves, yielded ESBL producers. Of the 21 isolated strains, 20 were Escherichia coli, and one was Citrobacter youngae. PCR analysis revealed that 18 strains including C. youngae produced CTX-M group 1 ESBLs, and three strains carried genes encoding for CTX-M group 9 enzymes. In addition, eight isolates were PCR positive for TEM β-lactamase, but no blaSHV genes were detected. Pulsed-field gel electrophoresis showed a high genetic diversity within the strains. The relatively high rates of occurrence of ESBL-producing strains in food animals and the high genetic diversity among these strains indicate that there is an established reservoir of these organisms in farm animals. Further studies are necessary to assess future trends.
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Wang, Hui, Swathi Kelkar, Weiyuan Wu, Minjun Chen та John P. Quinn. "Clinical Isolates of Enterobacteriaceae Producing Extended-Spectrum β-Lactamases: Prevalence of CTX-M-3 at a Hospital in China". Antimicrobial Agents and Chemotherapy 47, № 2 (2003): 790–93. http://dx.doi.org/10.1128/aac.47.2.790-793.2003.
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ABSTRACT The prevalence of extended-spectrum β-lactamase-producing strains was demonstrated in 5 of 44 (11.4%) Escherichia coli, 17 of 43 (39.5%) Klebsiella pneumoniae, 3 of 50 (6.0%) Enterobacter cloacae, and 2 of 25 (8.0%) Citrobacter freundii strains at a teaching hospital in China. Nineteen of these 27 strains expressed CTX-M-3 β-lactamase (pI 8.6). A subset of the clinical isolates expressing the CTX-M-3 enzyme, tested by pulsed-field gel electrophoresis, revealed multiple clones. Five isolates expressed a novel enzyme, SHV-43 (pI 8.0), which had two substitutions (Leu113Phe and Thr149Ser) compared with SHV-1.
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Arpin, Corinne, Véronique Dubois, Laure Coulange та ін. "Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Community and Private Health Care Centers". Antimicrobial Agents and Chemotherapy 47, № 11 (2003): 3506–14. http://dx.doi.org/10.1128/aac.47.11.3506-3514.2003.
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ABSTRACT In 1999, 39 of 2,599 isolates of the family Enterobacteriaceae (1.5%) collected by eight private laboratories in the Aquitaine region in France produced an extended-spectrum β-lactamase (ESBL). Among these were 19 Enterobacter aerogenes isolates; 8 Klebsiella pneumoniae isolates; 6 Escherichia coli isolates; 3 Proteus mirabilis isolates; and 1 isolate each of Serratia marcescens, Morganella morganii, and Providencia stuartii. ESBL producers were isolated from 38 patients, including 33 residents of 11 clinics or nursing homes and 5 ambulatory patients. Seven different ESBLs were characterized. These mainly consisted of TEM-24 (25 isolates) and TEM-21 (9 isolates), but TEM-15 (2 isolates) and TEM-3, TEM-19, SHV-4, and CTX-M-1 (1 isolate each) were also characterized. Seven strains showed the coexistence of different TEM- and/or SHV-encoding genes, including a new SHV-1 variant, SHV-44, defined by the substitution R205L previously reported for SHV-3 in association with S238G. The epidemiology of the ESBL producers was investigated by random amplification of polymorphic DNA, typing by enterobacterial repetitive intergenic consensus PCR, analysis of resistance cotransferred with the ESBL, and analysis of the restriction profiles of the ESBL-encoding plasmids. Of the TEM-24-expressing strains, 18 were E. aerogenes isolates, including 9 from the same clinic, that were representatives of the epidemic clone disseminating in France. Of the TEM-21-producing strains that belonged to different species of the family Enterobacteriaceae (E. coli, K. pneumoniae, and P. mirabilis), 8 were isolated in the same nursing home. Outbreaks due to strain and/or plasmid dissemination in these clinic and nursing home were demonstrated. The presence of ESBL producers in five ambulatory patients probably resulted from nosocomial acquisition. Our data highlight the serious need to monitor patients for ESBL-producing Enterobacteriaceae in general practice.
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Spanu, T., F. Luzzaro, M. Perilli та ін. "Occurrence of Extended-Spectrum β-Lactamases in Members of the Family Enterobacteriaceae in Italy: Implications for Resistance to β-Lactams and Other Antimicrobial Drugs". Antimicrobial Agents and Chemotherapy 46, № 1 (2002): 196–202. http://dx.doi.org/10.1128/aac.46.1.196-202.2002.
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ABSTRACT An Italian nationwide survey was carried out to assess the prevalences and the antimicrobial susceptibilities of members of the family Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs). Over a 6-month period, 8,015 isolates were obtained from hospitalized patients and screened for resistance to extended-spectrum cephalosporins and monobactams. On the basis of a synergistic effect between clavulanate and selected β-lactams (ceftazidime, aztreonam, cefotaxime, cefepime, and ceftriaxone), 509 isolates were found to be ESBL positive (6.3%). Colony blot hybridization with bla TEM and bla SHV DNA probes allowed one to distinguish four different genotypes: TEM-positive, SHV-positive, TEM- and SHV-positive, and non-TEM, non-SHV ESBL types. MICs for each isolate (E-test) were obtained for widely used β-lactams, combinations of β-lactams with β-lactamase inhibitors, aminoglycosides, and fluoroquinolones. Among ESBL-positive strains, Klebsiella pneumoniae, Proteus mirabilis, and Escherichia coli accounted for 73.6% of isolates. Overall, TEM-type ESBLs were more prevalent than SHV-type enzymes (234 versus 173), whereas the prevalence of strains producing both TEM- and SHV-type ESBLs was similar to that of isolates producing non-TEM, non-SHV enzymes (55 and 38, respectively). In vitro, all but one of the ESBL-producing isolates remained susceptible to imipenem. Susceptibility to other drugs varied: piperacillin-tazobactam, 91%; amoxicillin-clavulanic acid, 85%; cefoxitin, 78%; amikacin, 76%; ampicillin-sulbactam, 61%; ciprofloxacin, 58%; and gentamicin, 56%. Associated resistance to aminoglycosides and ciprofloxacin was observed most frequently among TEM-positive strains. Since therapeutic options for multiresistant Enterobacteriaceae are limited, combinations of β-lactams and β-lactamase inhibitors appear to represent an important alternative for treating infections caused by ESBL-producing Enterobacteriaceae.
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Arpin, Corinne, Laure Coulange, Véronique Dubois та ін. "Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae Strains in Various Types of Private Health Care Centers". Antimicrobial Agents and Chemotherapy 51, № 9 (2007): 3440–44. http://dx.doi.org/10.1128/aac.01431-06.
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ABSTRACT During a 2004 survey, 49 extended-spectrum-β-lactamase-producing enterobacteria were collected in 20 French private health care centers and one local hospital. They included 12 CTX-M-producing Escherichia coli strains (1.8% versus 0.3% in a 1999 survey). Most of them belonged to the same clone and contained a bla CTX-M-15 gene on similar conjugative plasmids.
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Ehrhardt, Anton F., Christine C. Sanders та Ellen S. Moland. "Use of an Isogenic Escherichia coliPanel To Design Tests for Discrimination of β-Lactamase Functional Groups of Enterobacteriaceae". Antimicrobial Agents and Chemotherapy 43, № 3 (1999): 630–33. http://dx.doi.org/10.1128/aac.43.3.630.
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ABSTRACT A study was designed to determine if an isogenic panel ofEscherichia coli strains containing many different β-lactamases could be used for the preliminary screening of a large number of β-lactam agents to identify which might be most useful in the development of a definitive test for specific β-lactamases found among the members of family Enterobacteriaceae. The susceptibilities of 46 strains, comprising the isogenic panel, to expanded-spectrum cephalosporins, cephamycins, and aztreonam were determined in the presence and absence of β-lactamase inhibitors in broth microdilution tests. The results indicated that strains producing extended-spectrum β-lactamases (ESBLs) could be distinguished from strains producing other Bush-Jacoby-Medeiros functional group 2 or group 1 β-lactamases. For strains producing group 1 β-lactamases, cefpodoxime and ceftazidime MICs were ≥4 μg/ml and addition of clavulanate did not reduce the MICs more than fourfold. For strains producing group 2 enzymes other than ESBLs, cefpodoxime and ceftazidime MICs were ≤2 μg/ml. With a single exception (ceftazidime for the strain producing SHV-3), among strains producing ESBLs, cefpodoxime and ceftazidime MICs were ≥4 μg/ml and addition of clavulanate reduced the MICs by more than eightfold. Cephamycins could also be used to discriminate between strains producing group 1 β-lactamases and ESBLs, since only the former required cefotetan concentrations as high as 8 μg/ml or cefoxitin concentrations of >16 μg/ml for inhibition. Other cephalosporins provided some discrimination between the various β-lactamase producers, although they were not as reliable as either cefpodoxime or ceftazidime. These results indicate the utility of an isogenic panel for identification of candidate drugs among many for further testing with clinical isolates of the familyEnterobacteriaceae to determine the best agents for detection of specific β-lactamases in this family.
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Mandal, Dipendra Kumar, Shiv Kumar Sah, Shyam Kumar Mishra та ін. "Carriage of Extended-Spectrum-β-Lactamase- and AmpC-β-Lactamase-Producing Enterobacteriaceae (ESBL-PE) in Healthy Community and Outpatient Department (OPD) Patients in Nepal". Canadian Journal of Infectious Diseases and Medical Microbiology 2020 (11 лютого 2020): 1–9. http://dx.doi.org/10.1155/2020/5154217.
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Background. Extended-spectrum β-lactamase (ESBL)- and AmpC-β-lactamase-producing Enterobacteriaceae have recently emerged as a public threat in the treatment of nosocomial as well as community-acquired infections. Very little information is currently available about its existence in Nepal. We, therefore, aim to determine the prevalence of ESBL and AmpC-β-lactamase-producing Enterobacteriaceae and also to determine their drug resistance pattern. Methods. During a 6-month period (November 2014–April 2015), a total of 190 stool specimens from 190 participants were obtained from different population. Of the total 260 fecal isolates, 152 from outpatient department (OPD) and 108 from healthy volunteer were collected. Stool specimens were cultured and enterobacterial isolates were subjected to antimicrobial susceptibility tests according to the standard microbiologic guidelines. ESBL was screened using ceftazidime (CAZ, 30 μg) and cefotaxime (CTX, 30 μg) disks and confirmed by double-disk synergy test. AmpC-β-lactamase enzyme production was detected by the aminophenylboronic acid inhibitor-based detection method. Antibiotic susceptibility test was performed for ESBL-positive isolates as per the Kirby-Bauer disk diffusion method, and interpretation was done according to CLSI (Clinical and Laboratory Standard Institute). Results. The prevalence of ESBL, AmpC-β-lactamases, and coproducer (ESBL + AmpC-β-lactamase) producing Enterobacteriaceae in OPD participants were 30.92%, 18.4%, and 13.81%, respectively, while 25%, 6.4%, and 1.8% in healthy population. ESBL-producing E. coli was 70.2% followed by K. pneumoniae (12.7%), and among AmpC-β-lactamase producer, E. coli were detected in half of the isolates (14/28, 50.0%) among OPD patients. Similarly, E. coli remained the most frequent ESBL producers 21/27 (77.8%) followed by K. pneumoniae 4/27 (14.21%) in healthy participants, and K. pneumoniae 5/7 (71.42%) and C. freundii 2/7 (28.57%) were detected highest among AmpC-β-lactamase-producing isolates. All isolates were highly sensitive (100%) to imipenem in both OPD and healthy participants. Conclusion. Our study revealed a high prevalence of ESBL- and AmpC-β-lactamase-producing enteric pathogen in Nepalese OPD and healthy population. The significant increase of these isolates and increased rate of drug resistance indicates a serious threat that stress the need to implement the surveillance system and a proper control measure so as to limit the spread of ESBL-producing Enterobacteriaceae (ESBL-PE) in both OPD as well as in community. Therefore, healthcare providers need to be aware that ESBL- and AmpC-β-lactamase-producing strains are not only circulating in hospital environments but also in the community and should be dealt with accordingly.
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Poirel, Laurent, Javier Fernández та Patrice Nordmann. "Comparison of Three Biochemical Tests for Rapid Detection of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae". Journal of Clinical Microbiology 54, № 2 (2015): 423–27. http://dx.doi.org/10.1128/jcm.01840-15.
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Enterobacterial isolates producing clavulanic-inhibited extended-spectrum β-lactamases (ESBLs) are increasingly spreading in the community and are often responsible for nosocomial infections. Rapid biochemical tests have been developed recently for their detection. Three tests, namely, the Rapid ESBL NDP test, the β-Lacta test, and the Rapid ESBL Screen, have been evaluated with a collection of 108 well-characterized strains, including wild-type strains, strains producing ESBLs, overexpressed cephalosporinases, and carbapenemases. The ESBL NDP test and the Rapid ESBL Screen (a copy of the ESBL NDP test) are aimed at detecting ESBL producers, while the β-Lacta test is aimed at detecting not only ESBL producers but also cephalosporinase and carbapenemase producers. The sensitivity and specificity for detecting ESBL producers (n= 60) were 95% and 100% for the Rapid ESBL NDP test, 80% and 87% (after 30 min) and 92% and 83% (after 2 h) for the Rapid ESBL Screen, and 88% and 71% for the β-Lacta test, respectively. Varied and time-consuming detection (up to 2 h) of ESBLs by the Rapid ESBL Screen and concomitant and varied detection of producers of AmpC and several types of carbapenemases correspond to significant shortcomings of using the Rapid Screen ESBL and β-Lacta tests, respectively.
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Baguy, Ouattara Mohamed, Affou Séraphin Wognin, Toty Abalé Anatole, et al. "Role of Healthy Human Gut Microbiota in the Emergence and Dissemination of Extended-Spectrum \(\beta\)-lactamase-Producing Enterobacteriaceae and Genes Associated with \(\beta\)-lactam Resistance in Community Settings in Abidjan, Côte d'Ivoire." Microbiology Research Journal International 33, no. 7 (2023): 27–37. http://dx.doi.org/10.9734/mrji/2023/v33i71393.
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Overuse of β-lactam antibiotics in communities in developing countries has transformed healthy human intestinal flora into a reservoir of antibiotic-resistant organisms. The prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae in community settings remains undetermined. In order to obtain data on ESBL enterobacteria, 265 stool samples were collected from August 2019 to February 2020 from individuals residing in the urban districts of Abidjan and attending medical consultations at the Institut Pasteur de Côte d'Ivoire. Isolates belonging to family Enterobacteriaceae were isolated on MacConkey and identified using the API 20E galerie and antibiotic susceptibility was determined using Clinical Laboratory Standard Institute disc diffusion method. Detection of extended spectrum β-lactamases (TEM, SHV, GES, PER, VEB, CTXM 1, CTXM 2, CTXM 8 and CTXM 9) was done by simplex and multiplex PCR. The human stools strains consisted of 513 species of Enterobacteria multidrug resistants. Among the 513 strains, 75 (14.6%) of the enterobacterial strains produced ESBLs, while 438 (85.4%) produced high-level cephalosporinases. Enterobacteria producing extended-spectrum β-lactamase we dominated by the species Escherichia coli (46.7%), Klebsiella pneumoniae (17.3%), Enterobacter cloacae (13.3%), Enterobacter aerogenes (6.7%), Proteus mirabilis (6.7%), Klebsiella oxytoca (4%), Proteus vulgaris (2.7%), Citrobacter koseri (1.3%), and Citrobacter freundii (1.3%). Strains were resistant (100%) to antibiotics from beta-lactam family (penicillin with inhibitor, monobactam, cephalosporin) but low level resistant (1,3%) was observed to carbapenem (imipénème, méropénème, Ertapenem). The rate of resistance to quinolones and aminoglycosides were respectively between 22.9% - 43.3% and 7.9-35.1%. The resistance genes TEM, SHV, CTXM 1, CTXM 2, CTXM 8 and CTXM 9 were detected. No GES and PER genes were not detected. The high fecal carriage rate of ESBL-PE associated with genes in community settings of Ivory Coast highlights the risk for transmission and dissemination because healthy people are potential patients on borrowed time.
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Tayh, Ghassan, Nahed Al Laham, Houssem Ben Yahia, Rym Ben Sallem, Abed Elkader Elottol та Karim Ben Slama. "Extended-Spectrum β-Lactamases among Enterobacteriaceae Isolated from Urinary Tract Infections in Gaza Strip, Palestine". BioMed Research International 2019 (13 жовтня 2019): 1–11. http://dx.doi.org/10.1155/2019/4041801.
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Background. Extended-spectrum β-lactamase-producing organisms causing urinary tract infections are increasing in incidence and pose a major impendence to health-care facility, having limited therapeutic options. This study aimed to assess the prevalence of ESBLs in Enterobacteriaceae isolates causing urinary tract infections in Gaza strip, Palestine, and to characterize β-lactamase types and associated resistance genes. Methods. Eighty-five Enterobacteriaceae isolates were recovered from urinary tract infections within three months in Gaza Strip hospitals. The characterization of β-lactamase genes and the genetic environments of CTX-M, the identification of associated resistance genes, and the presence and characterization of integrons were tested by PCR and sequencing. Results. The occurrence rate of ESBL among tested isolates was 30 (35.3%), and among ESBL-positive isolates, blaCTX-M was the highest followed by blaTEM. ESBL-CTX-M-1 group was confirmed in 93.3%, and the remaining carried CTX-M-9 group. CTX-M-15, CTX-M-3, CTX-M-1, CTX-M-14, CTX-M-27, and CTX-M-37 enzymes were demonstrated among the isolates with the majority (73%) being CTX-M-15. ISEcp-1 was demonstrated in 27 (90%, high incidence) of ESBL isolates. Class 1 integrons have been detected in higher rates (53.3%) in ESBL-positive isolates in comparison with non-ESBL isolates (6, 33.3%). Cassettes of integron-1 contain (aadA1, aadA2, aadA5, dfrA5, dfrA7, dfrA12, and dfrA17) genes. The aac(6′)-Ib-cr gene was demonstrated in 36.7% of ESBL-positive isolates. Conclusions. This study indicates that blaCTX-M-15 was the most prevalent β-lactamase in this region. Our study demonstrates for the first time in Palestine the identification of blaCTX-M-15 in P. rettgeri and S. liquefaciens, also blaCTX-M-37 in E. cloacae. The coexpression of multiple β-lactamase genes with aac(6′)-Ib-cr and qnr in the presence of ISEcp-1 and integrons in individual strains will increase the dissemination of highly resistant strains. ESBL producers were more resistant than non-ESBLs producers for almost all tested antibiotics.
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PARKER, ELIZABETH, AMY ALBERS, DIXIE MOLLENKOPF та ін. "AmpC- and Extended-Spectrum β-Lactamase–Producing Enterobacteriaceae Detected in Fresh Produce in Central Ohio". Journal of Food Protection 84, № 5 (2021): 920–25. http://dx.doi.org/10.4315/jfp-20-347.
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ABSTRACT Salad vegetables purchased from farmer's markets and grocery stores in central Ohio during the summers of 2015 and 2016 were tested for the presence of Enterobacteriaceae resistant to extended-spectrum cephalosporins and carbapenems, Salmonella contamination, and coliform bacterial counts. A total of 364 samples were collected from 36 farmers' markets and 33 grocery stores. Using selective media, we found 23 (6.3%) samples that produced Enterobacteriaceae expressing an AmpC β-lactamase phenotype, with 11 (3.0%) confirmed to contain blaCMY and 6 (1.6%) that produced Enterobacteriaceae with an extended-spectrum β-lactamase (ESBL) phenotype, 1 (0.3%) of which was confirmed to contain blaCTX-M. All blaCMY and blaCTX-M strains were isolated from leafy greens. No Salmonella spp. or carbapenem-resistant Enterobacteriaceae were recovered from fresh produce samples. Adjusting for year, the geometric mean coliform count differed (P < 0.05) between produce types, with the count in tomatoes (15 CFU/mL) being lower than those in cucumbers (77.4 CFU/mL) and leafy greens (75.0 CFU/mL). The coliform counts also differed (P < 0.05) between years, with 19.6 CFU/mL in 2015 and 96.0 CFU/mL in 2016. There was no difference in coliform counts or the prevalences of Enterobacteriaceae expressing AmpC or ESBL phenotypes in produce purchased from farmers' markets and grocery stores. HIGHLIGHTS
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Thomson, Kenneth S., та Ellen Smith Moland. "Cefepime, Piperacillin-Tazobactam, and the Inoculum Effect in Tests with Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae". Antimicrobial Agents and Chemotherapy 45, № 12 (2001): 3548–54. http://dx.doi.org/10.1128/aac.45.12.3548-3554.2001.
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ABSTRACT There is little information about the clinical effectiveness of cefepime and piperacillin-tazobactam in the treatment of infections caused by extended-spectrum β-lactamase (ESBL)-producing pathogens. Some inferences have been drawn from laboratory studies, which have usually involved only one or a few strains of ESBL-producingKlebsiella pneumoniae or Escherichia colithat produced only a limited range of ESBLs. Such studies are indirect, sometimes conflicting, indicators of efficacy. To extend previous laboratory findings, a study was designed to investigate organism-drug interactions by determining the in vitro activities of eight parenteral β-lactam agents against 82 clinical and laboratory strains ofKlebsiella, Escherichia,Enterobacter, Citrobacter,Serratia, Morganella, andProteus species that produced 22 different ESBLs, alone or in combination with other β-lactamases. Activities were determined in broth microdilution MIC tests using standard and 100-fold-higher inocula. An inoculum effect, defined as an eightfold or greater MIC increase on testing with the higher inoculum, was most consistently detected with cefepime, cefotaxime, and ceftriaxone and least frequently detected with meropenem and cefoteten. Piperacillin-tazobactam was intermediate between these two groups of agents. Although the inoculum effect is an in vitro laboratory phenomenon, if it has any predictive value in identifying increased risk of therapeutic failure in serious infections, these results support suggestions that cefepime may be a less-than-reliable agent for therapy of infections caused by ESBL-producing strains.
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Lu, Su-Ying, Ya-Li Zhang, Sui-Na Geng, et al. "High Diversity of Extended-Spectrum Beta-Lactamase-Producing Bacteria in an Urban River Sediment Habitat." Applied and Environmental Microbiology 76, no. 17 (2010): 5972–76. http://dx.doi.org/10.1128/aem.00711-10.
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ABSTRACT Antibiotic-resistant bacteria (ARB) have been surveyed widely in water bodies, but few studies have determined the diversity of ARB in sediment, which is the most taxon-abundant habitat in aquatic environments. We isolated 56 extended-spectrum β-lactamase (ESBL)-producing bacteria from a single sediment sample taken from an urban river in China. All strains were confirmed for ESBL-producing capability by both the clavulanic acid combination disc method and MIC determination. Of the isolated strains, 39 were classified as Enterobacteriaceae (consisting of the genera Escherichia, Klebsiella, Serratia, and Aeromonas) by 16S rRNA gene sequencing and biochemical analysis. The present study identifies, for the first time, ESBL-producing strains from the families Brucellaceae and Moraxellaceae. The bla CTX-M gene was the most dominant of the ESBL genes (45 strains), while the bla TEM gene was the second-most dominant (22 strains). A total of five types of bla CTX-M fragments were identified, with both known and novel sequences. A library of bla CTX-M cloned from the sediment DNA showed an even higher diversity of bla CTX-M sequences. The discovery of highly diverse ESBL-producing bacteria and ESBL genes, particularly bla CTX, in urban river sediment raises alarms for potential dissemination of ARB in communities through river environments.
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Zurfluh, Katrin, Herbert Hächler, Magdalena Nüesch-Inderbinen та Roger Stephan. "Characteristics of Extended-Spectrum β-Lactamase- and Carbapenemase-Producing Enterobacteriaceae Isolates from Rivers and Lakes in Switzerland". Applied and Environmental Microbiology 79, № 9 (2013): 3021–26. http://dx.doi.org/10.1128/aem.00054-13.
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ABSTRACTOne of the currently most relevant resistance mechanisms inEnterobacteriaceaeis the production of enzymes that lead to modern expanded-spectrum cephalosporin and even carbapenem resistance, mainly extended-spectrum β-lactamases (ESBLs) and carbapenemases. A worrisome aspect is the spread of ESBL and carbapenemase producers into the environment. The aim of the present study was to assess the occurrence of ESBL- and carbapenemase-producingEnterobacteriaceaeand to further characterize ESBL- and carbapenemase-producingEnterobacteriaceaein rivers and lakes in Switzerland. ESBL-producingEnterobacteriaceaewere detected in 21 (36.2%) of the 58 bodies of water sampled. One river sample tested positive for a carbapenemase-producingKlebsiella pneumoniaesubsp.pneumoniaestrain. Seventy-four individual strains expressing an ESBL phenotype were isolated. Species identification revealed 60Escherichia colistrains, sevenKlebsiella pneumoniaesubsp.pneumoniaestrains, fiveRaoultella planticolastrains, oneEnterobacter cloacaestrain, and oneEnterobacter amnigenusstrain. Three strains were identified as SHV-12 ESBL producers, and 71 strains carried genes encoding CTX-M ESBLs. Of the 71 strains with CTX-M ESBL genes, 8 isolates expressed CTX-M-1, three produced CTX-M-3, 46 produced CTX-M-15, three produced CTX-M-55, one produced CTX-M-79, six produced CTX-M-14, and four produced CTX-M-27. Three of the four CTX-M-27 producers belonged to the multiresistant pandemic sequence typeE. coliB2:ST131 that is strongly associated with potentially severe infections in humans and animals.
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Willemsen, Ina, Jolande Nelson, Yvonne Hendriks та ін. "Extensive Dissemination of Extended Spectrum β-Lactamase–Producing Enterobacteriaceae in a Dutch Nursing Home". Infection Control & Hospital Epidemiology 36, № 4 (2015): 394–400. http://dx.doi.org/10.1017/ice.2014.76.
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OBJECTIVERisk factors for rectal carriage of ESBL-E and transmission were investigated in an outbreak of extended-spectrum β-lactamase–producing Enterobacteriaceae (ESBL-E).DESIGNRectal carriage of ESBL-E was determined in a cross-sectional survey by culture of perianal swabs or fecal samples. Both phenotypical and genotypical methods were used to detect the production of ESBL. Nosocomial transmission was defined as the presence of genotypically related strains in ≥2 residents within the NH. Patient characteristics and variables in infection control practices were registered to investigate risk factors for transmission.SETTINGA nursing home (NH) in the southern Netherlands.PARTICIPANTSOf 189 residents, 160 residents (84.7%) were screened for ESBL-E carriage. Of these 160 residents, 33 (20.6%) were ESBL-E positive. ESBL carriage rates varied substantially between wards (range, 0–47%). Four different ESBL-E clusters were observed. AblaCTX-M1-15positiveE. coliST131 constituted the largest cluster (n=21) and was found in multiple wards (n=7).RESULTSOur investigation revealed extensive clonal dissemination ofblaCTX-M1-15-positiveE. coliST131 in a nursing home. Unexplained differences in ESBL prevalence were detected among the wards.CONCLUSIONSAs NHs constitute potential sources of multidrug-resistant bacteria, it is important to gain a better understanding of the risks factors and routes of transmission of ESBL-E.Infect Control Hosp Epidemiol 2014;00(0): 1–7
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Pitout, J. D. D., K. S. Thomson, N. D. Hanson, A. F. Ehrhardt, E. S. Moland та C. C. Sanders. "β-Lactamases Responsible for Resistance to Expanded-Spectrum Cephalosporins in Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis Isolates Recovered in South Africa". Antimicrobial Agents and Chemotherapy 42, № 6 (1998): 1350–54. http://dx.doi.org/10.1128/aac.42.6.1350.
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ABSTRACT Although resistance to the expanded-spectrum cephalosporins among members of the family Enterobacteriaceae lacking inducible β-lactamases occurs virtually worldwide, little is known about this problem among isolates recovered in South Africa. Isolates of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis resistant to expanded-spectrum cephalosporins recovered from patients in various parts of South Africa over a 3-month period were investigated for extended-spectrum β-lactamase production. Antibiotic susceptibility was determined by standard disk diffusion and agar dilution procedures. Production of extended-spectrum β-lactamases was evaluated by using the double-disk test, and the β-lactamases were characterized by spectrophotometric hydrolysis assays and an isoelectric focusing overlay technique which simultaneously determined isoelectric points and general substrate or inhibitor characteristics. DNA amplification and sequencing were performed to confirm the identities of these enzymes. The P. mirabilis and E. coliisolates were found to produce TEM-26-type, SHV-2, and SHV-5 extended-spectrum β-lactamases. An AmpC-related enzyme which had a pI of 8.0 and which conferred resistance to cefoxitin as well as the expanded-spectrum cephalosporins was found in a strain of K. pneumoniae. This is the first study which has identified organisms producing different extended-spectrum β-lactamases from South Africa and the first report describing strains of P. mirabilis producing a TEM-26-type enzyme. The variety of extended-spectrum β-lactamases found among members of the familyEnterobacteriaceae isolated from major medical centers in South Africa is troubling and adds to the growing list of countries where these enzymes pose a serious problem for antimicrobial therapy.
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Gharout-Sait, Alima, Samer-Ahmed Alsharapy, Lucien Brasme та ін. "Enterobacteriaceae isolates carrying the New Delhi metallo-β-lactamase gene in Yemen". Journal of Medical Microbiology 63, № 10 (2014): 1316–23. http://dx.doi.org/10.1099/jmm.0.073767-0.
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Ten carbapenem-resistant Enterobacteriaceae (eight Klebsiella pneumoniae isolates and two Enterobacter cloacae) isolates from Yemen were investigated using in vitro antimicrobial susceptibility testing, phenotypic carbapenemase detection, multilocus sequence typing (MLST) and replicon typing. Carbapenemase, extended-spectrum β-lactamase (ESBL) and plasmid-mediated quinolone resistance determinant genes were identified using PCR and sequencing. All of the 10 carbapenem-resistant Enterobacteriaceae were resistant to β-lactams, tobramycin, ciprofloxacin and cotrimoxazole. Imipenem, doripenem and meropenem MICs ranged from 2 to >32 mg l−1 and ertapenem MICs ranged from 6 to >32 mg l−1. All of the K. pneumoniae isolates showed ESBL activity in phenotypic tests. Genes encoding bla NDM were detected in all strains. All K. pneumoniae strains produced CTX-M-15 ESBL and SHV β-lactamases. TEM-1 β-lactamase was detected in seven isolates. Nine isolates were qnr positive including QnrB1, QnrA1 and QnrS1, and six isolates produced AAC-6′-Ib-cr. MLST identified five different sequence types (STs): ST1399, ST147, ST29, ST405 and ST340. Replicon typing showed the presence of IncFII1K plasmids in four transformants. To the best of our knowledge, this is the first report of NDM-1-producing Enterobacteriaceae isolates in Yemen.
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Sader, Helio S., Paul R. Rhomberg, David J. Farrell, and Ronald N. Jones. "Antimicrobial Activity of CXA-101, a Novel Cephalosporin Tested in Combination with Tazobactam against Enterobacteriaceae, Pseudomonas aeruginosa, and Bacteroides fragilis Strains Having Various Resistance Phenotypes." Antimicrobial Agents and Chemotherapy 55, no. 5 (2011): 2390–94. http://dx.doi.org/10.1128/aac.01737-10.
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ABSTRACTCXA-101, a novel oxyimino-aminothiazolyl cephalosporin, CXA-201 (CXA-101 combined with tazobactam), and various comparators were susceptibility tested by broth microdilution methods against 1,301 well-characterized clinical strains collected worldwide, including ceftazidime-resistant members of the familyEnterobacteriaceaeandKlebsiella pneumoniaecarbapenemase (KPC)- and extended-spectrum β-lactamase (ESBL)-producing strains ofPseudomonas aeruginosaandBacteroides fragilis. CXA-201 was 2- to 32-fold more active than ceftazidime and piperacillin-tazobactam against ceftazidime-resistantEnterobacteriaceaespecies but less active than cefepime for some species. CXA-101 and CXA-201 were very active againstP. aeruginosa(MIC50, 1 μg/ml for both compounds), including imipenem-resistant strains.
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Jena, Jayanti, Nagen Kumar Debata, Rajesh Kumar Sahoo, Mahendra Gaur та Enketeswara Subudhi. "Molecular characterization of extended spectrum β-lactamase-producing Enterobacteriaceae strains isolated from a tertiary care hospital". Microbial Pathogenesis 115 (лютий 2018): 112–16. http://dx.doi.org/10.1016/j.micpath.2017.12.056.
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Hyun, Jonghoon, Yongseop Lee, Hye Seong та ін. "1452. Is Carbapenem-Sparing Therapy as Effective as Carbapenems Against Extended-Spectrum β-Lactamase Producing Enterobacteriaceae in UTI?" Open Forum Infectious Diseases 6, Supplement_2 (2019): S530. http://dx.doi.org/10.1093/ofid/ofz360.1316.
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Abstract Background With the emergence of carbapenem-resistant strains of Enterobacteriaceae, non-carbapenem antibiotics are suggested as the alternative treatment of extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae infection. In this study, efficacy of non-carbapenem antibiotics on acute pyelonephritis (APN) with ESBL-producing Enterobacteriaceae was compared with that of carbapenems. Methods The medical records of patients who had diagnosed to have acute pyelonephritis with ESBL-producing Enterobacteriaceae on their urine culture, from January 2011 to December 2018, were reviewed retrospectively. Patients were classified as carbapenem and non-carbapenem group according to the definitive antibiotics they had treated with. Results Total number of patients was 141, including 112 (79.4%) who had received carbapenem, and 29 (20.6%) received non-carbapenem as definitive therapy against to APN with ESBL-producing Enterobacteriaceae. The duration of hospitalization was shorter for non-carbapenem group (median 9.93 days) than for carbapenem group (median 14.39 days) (P < 0.001). The duration of negative conversion of culture was shorter for carbapenem group (median 40.73 hours) than for non-carbapenem group (median 56.79 hours). There was no significant difference in time to febrile period and duration of definitive therapy between two groups. Conclusion Non-carbapenem therapy against APN with ESBL-producing Enterobacteriaceae has no significant difference in clinical outcome compared with carbapenem therapy. Disclosures All authors: No reported disclosures.
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Nossair, Mohamed A., Fatma A. Abd El Baqy, Mohammad S. Y. Rizk та ін. "Prevalence and Molecular Characterization of Extended-Spectrum β-lactamases and AmpC β-lactamase-Producing Enterobacteriaceae among Human, Cattle, and Poultry". Pathogens 11, № 8 (2022): 852. http://dx.doi.org/10.3390/pathogens11080852.
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Extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are a universal public health alarm frequently identified among humans, animals, and poultry. Livestock and poultry production are a possible source of multidrug-resistant microorganisms, including ESBL-producing Enterobacteriaceae, which confer antimicrobial resistance to different β-lactam antimicrobial agents. From January to May 2020, a cross-sectional study was carried out in three dairy cattle farms and four poultry farms in different districts of northern Egypt to assess the prevalence of ESBLs, AmpC beta-lactamase-producing E. coli and Klebsiella in livestock, poultry, and human contacts, and to investigate the genetic relatedness of the recovered isolates. In total, 140 samples were collected, including human fecal samples (n = 20) of workers with intimate livestock contact, cattle rectal swabs (n = 34), milk (n = 14), milking machine swabs (n = 8), rations (n = 2), and water (n = 2) from different cattle farms, as well as cloacal swabs (n = 45), rations (n = 5), water (n = 5) and litter (n = 5) from poultry farms. The specimens were investigated for ESBL-producing E. coli and Klebsiella using HiCrome ESBL media agar. The agar disk diffusion method characterized the isolated strains for their phenotypic antimicrobial susceptibility. The prevalence of ESBL-producing Enterobacteriaceae was 30.0%, 20.0%, and 25.0% in humans, cattle, and poultry, respectively. Further genotypic characterization was performed using conventional and multiplex PCR assays for the molecular identification of ESBL and AmpC genes. The majority of the ESBL-producing Enterobacteriaceae showed a multi-drug resistant phenotype. Additionally, blaSHV was the predominant ESBL genotype (n = 31; 93.94%), and was mainly identified in humans (n = 6), cattle (n = 11), and poultry (14); its existence in various reservoirs is a concern, and highlights the necessity of the development of definite control strategies to limit the abuse of antimicrobial agents.
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Oliver, Antonio, Teresa M. Coque, Diana Alonso, Aránzazu Valverde, Fernando Baquero, and Rafael Cantón. "CTX-M-10 Linked to a Phage-Related Element Is Widely Disseminated among Enterobacteriaceae in a Spanish Hospital." Antimicrobial Agents and Chemotherapy 49, no. 4 (2005): 1567–71. http://dx.doi.org/10.1128/aac.49.4.1567-1571.2005.
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ABSTRACT CTX-M-10 has been widely disseminated among multiple clones of several species of Enterobacteriaceae, harboring seemingly different plasmids, for over a decade in Ramón y Cajal University Hospital, Madrid, Spain. Cloning and sequencing of a 12.2-kb DNA fragment from plasmid pRYCE21 from Klebsiella pneumoniae strain KP4aC revealed a novel phage-related element immediately upstream of bla CTX-M-10 conserved among different CTX-M-10-producing strains. This is the first report showing an extended-spectrum-β-lactamase gene linked to a phage-related element.
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Castanheira, Mariana, Sarah E. Farrell, Kevin M. Krause, Ronald N. Jones та Helio S. Sader. "Contemporary Diversity of β-Lactamases among Enterobacteriaceae in the Nine U.S. Census Regions and Ceftazidime-Avibactam Activity Tested against Isolates Producing the Most Prevalent β-Lactamase Groups". Antimicrobial Agents and Chemotherapy 58, № 2 (2013): 833–38. http://dx.doi.org/10.1128/aac.01896-13.
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ABSTRACTEscherichia coli(328 isolates),Klebsiella pneumoniae(296),Klebsiella oxytoca(44), andProteus mirabilis(33) isolates collected during 2012 from the nine U.S. census regions and displaying extended-spectrum-β-lactamase (ESBL) phenotypes were evaluated for the presence of β-lactamase genes, and antimicrobial susceptibility profiles were analyzed. The highest ESBL rates were noted forK. pneumoniae(16.0%, versus 4.8 to 11.9% for the other species) and in the Mid-Atlantic and West South Central census regions. CTX-M group 1 (including CTX-M-15) was detected in 303 strains and was widespread throughout the United States but was more prevalent in the West South Central, Mid-Atlantic, and East North Central regions. KPC producers (118 strains [112K. pneumoniaestrains]) were detected in all regions and were most frequent in the Mid-Atlantic region (58 strains). Thirteen KPC producers also carriedblaCTX-M. SHV genes encoding ESBL activity were detected among 176 isolates. Other β-lactamase genes observed were CTX-M group 9 (72 isolates), FOX (10), TEM ESBL (9), DHA (7), CTX-M group 2 (3), NDM-1 (2 [Colorado]), and CTX-M groups 8 and 25 (1). Additionally, 62.9% of isolates carried ≥2 β-lactamase genes. KPC producers were highly resistant to multiple agents, but ceftazidime-avibactam (MIC50/90, 0.5/2 μg/ml) and tigecycline (MIC50/90, 0.5/1 μg/ml) were the most active agents tested. Overall, meropenem (MIC50, ≤0.06 μg/ml), ceftazidime-avibactam (MIC50, 0.12 to 0.5 μg/ml), and tigecycline (MIC50, 0.12 to 2 μg/ml) were the most active antimicrobials when tested against this collection. NDM-1 producers were resistant to all β-lactams tested. The diversity and increasing prevalence of β-lactamase-producingEnterobacteriaceaehave been documented, and ceftazidime-avibactam was very active against the vast majority of β-lactamase-producing strains isolated from U.S. hospitals.
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Mathlouthi, Najla, Charbel Al-Bayssari, Allaaeddin El Salabi та ін. "Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals". Journal of Infection in Developing Countries 10, № 07 (2016): 718–27. http://dx.doi.org/10.3855/jidc.7426.
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Introduction: The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase production among clinical isolates of Enterobacteriaceae recovered from Tunisian and Libyan hospitals. Methodology: Bacterial isolates were recovered from patients in intensive care units and identified by biochemical tests and MALDI-TOF. Antibiotic susceptibility testing was performed by disk diffusion and the E-test method. ESBL and carbapenemase activities were detected using standard microbiological tests. Antibiotic resistance-encoding genes were screened by PCR and sequencing. Clonal relationships between Klebsiella pneumoniae strains were carried out using multi-locus sequence typing (MLST). Results: A total of 87 isolates were characterized, with 51 and 36, respectively, identified as E. coli and K. pneumoniae. Overall the resistance prevalence was high for aminoglycosides (> 60%), fluoroquinolones (> 80%), and extended-spectrum cephalosporins (> 94%), and was low for imipenem (11.4%). Among this collection, 58 strains (66.6%) were ESBL producers and 10 K. pneumoniae strains (11.4%) were carbapenemase producers. The antibiotic resistance-encoding genes detected were blaCTX-M-15 (51.7%), blaTEM-1 (35.6%), several variants of blaSHV (21.8%), and blaOXA-48 (11.4%). The MLST typing of K. pneumoniae isolates revealed the presence of multiple clones and three novel sequence types. Also, close relationships between the OXA-48-producing strains from Tunisia and Libya were demonstrated. Conclusions: This study is the first paper describing the emergence of carbapenemase- and ESBL-producing Enterobacteriaceae, sensitive to colistin, isolated in Tunisia and Libya. Active surveillance and testing for susceptibility to colistin should be implementing because resistance to colistin, mainly in Klebsiella, has been recently reported worldwide.
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Fares, R., M. Debabza та A. Mechai. "Detection and prevalence of extended spectrum β-lactamases production among Enterobacteriaceae isolated from urinary tract infections". Biosystems Diversity 31, № 2 (2023): 163–69. http://dx.doi.org/10.15421/012317.
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Urinary tract infections (UTIs) by extended-spectrum β-lactamase producing Enterobacteriaceae (ESBL-E) have become an important public health problem with a substantial economic burden, as they lead to more complicated infections, longer duration of treatment, and increases in patient mortality. A total of 1267 urine samples were collected from patients during the period of 2018 to 2020. The isolates were identified based on colony morphology and biochemical tests. Antimicrobial susceptibility testing was done by modified Kirby Bauer disc diffusion method. Resistant isolates to third generation cephalosporins were tested for ESBL production by double-disk synergy test (DDST), DDST methods on MH agar plates supplemented with cloxacillin and by confirmatory double disk test (DDT). 400 strains causing UTIs were identified and classified as members of Enterobacteriaceae. The results of antimicrobial susceptibility tests showed that 68.5% (274/400) of the Enterobacteriaceae isolates were multi-drug resistant (MDR) strains. The overall prevalence of ESBL-E was 59.5% (238/400). The highest frequencies of ESBL-E were observed in internal medicine devices (68/400) and the highest ESBL production was observed in E. coli (85/238). The ESBL producing isolates were significantly resistant to penicillins and cephalosporins compared to non-ESBL producers. However, those ESBL-E strains were sensitive to imipenem (80.2%) and nitrofurantoin (87.8%). High levels of MDR strains and ESBL-E in our study highlights the need for applying specific infection control measures, and accordingly we urge physicians to opt for specific strategies for regular surveillance of uropathogenic bacteria.
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Onishi, Reo, Katsumi Shigemura, Kayo Osawa, et al. "The Antimicrobial Resistance Characteristics of Imipenem-Non-Susceptible, Imipenemase-6-Producing Escherichia coli." Antibiotics 11, no. 1 (2021): 32. http://dx.doi.org/10.3390/antibiotics11010032.
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Imipenemase-6 (IMP-6) type carbapenemase-producing Enterobacteriaceae is regarded as dangerous due to its unique lack of antimicrobial susceptibility. It is resistant to meropenem (MEPM) but susceptible to imipenem (IPM). In addition to carbapenemase, outer membrane porins and efflux pumps also play roles in carbapenem resistance by reducing the antimicrobial concentration inside cells. Extended-spectrum β-lactamase (ESBL) is transmitted with IMP-6 by the plasmid and broadens the spectrum of antimicrobial resistance. We collected 42 strains of IMP-6-producing Escherichia coli and conducted a molecular analysis of carbapenemase, ESBL, porin, efflux, and epidemiological characteristics using plasmid replicon typing. Among the 42 isolates, 21 strains were susceptible to IPM (50.0%) and 1 (2.4%) to MEPM. Seventeen strains (40.5%) co-produced CTX-M-2 type ESBL. We found that the relative expression of ompC and ompF significantly correlated with the MIC of IPM (p = 0.01 and p = 0.03, respectively). Sixty-eight% of CTX-M-2-non-producing strains had IncI1, which was significantly different from CTX-M-2-producing strains (p < 0.001). In conclusion, 50.0% of our IMP-6-producing strains were non-susceptible to IPM, which is different from the typical pattern and can be attributed to decreased porin expression. Further studies investigating other types of carbapenemase are warranted.
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Réglier-Poupet, Hélène, Thierry Naas, Amélie Carrer та ін. "Performance of chromID ESBL, a chromogenic medium for detection of Enterobacteriaceae producing extended-spectrum β-lactamases". Journal of Medical Microbiology 57, № 3 (2008): 310–15. http://dx.doi.org/10.1099/jmm.0.47625-0.
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The chromogenic agar medium chromID ESBL (bioMérieux) was compared with BLSE agar medium (AES) for selective isolation and presumptive identification of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae from clinical samples. A total of 765 samples (468 rectal swabs, 255 urine samples and 42 pulmonary aspirations) obtained from 547 patients was processed. All bacterial strains isolated on either medium were further characterized using biochemical tests, and ESBL producers were confirmed by synergy testing. Genetic characterization of ESBL genes was determined by PCR. A total of 33 ESBL-producing Enterobacteriaceae strains [Escherichia coli (n=16), Klebsiella pneumoniae (n=8), Enterobacter spp. (n=3), Citrobacter spp. (n=5) and Proteus mirabilis (n=1)] was recovered. The sensitivity after 24 h incubation was 88 % for chromID ESBL and 85 % for BLSE agar. At 48 h, the sensitivity of chromID ESBL increased to 94 % and was higher than that obtained with BLSE agar. The positive predictive value at 24 h for chromID ESBL was 38.7 % [95 % confidence interval (95 % CI) 28.3 –50.2 %)], which was significantly higher than that for BLSE agar [15.4 %, 95 % CI 10.1 –21.5 %]. On both media, false-positive results were mostly due to Pseudomonas aeruginosa and to Enterobacteriaceae overproducing chromosomal cephalosporinase (Enterobacter spp.) or a chromosomal penicillinase (Klebsiella oxytoca). This study showed that chromID ESBL, a ready-to-use chromogenic selective medium, is sensitive and specific for rapid, presumptive identification of ESBL-producing Enterobacteriaceae. Its chromogenic properties and its selectivity are particularly useful in specimens containing resident associated flora.
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Chandramohan, Lakshmi, та Paula A. Revell. "Prevalence and Molecular Characterization of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in a Pediatric Patient Population". Antimicrobial Agents and Chemotherapy 56, № 9 (2012): 4765–70. http://dx.doi.org/10.1128/aac.00666-12.
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ABSTRACTVery little is known about the prevalence and composition of various types of extended-spectrum β-lactamases (ESBL) in pediatric patients. The aims of this study were the following: (i) to determine the prevalence of ESBLs amongEnterobacteriaceaein a tertiary-care pediatric population; (ii) to characterize the genetic composition of the identified ESBL enzymes; and (iii) to determine the relative prevalence of CTX-M enzymes andEscherichia coliST131 strains among ESBL-producing isolates in the same pediatric patient population. Among the 1,430Enterobacteriaceaeisolates screened for elevated MICs to cefotaxime and/or ceftazidime from pediatric patients during a 1-year period, 94 isolates possessed at least one ESBL gene. CTX-M was the most commonly isolated ESBL type, consisting of 74% of all ESBLs versus 27% TEM and 24% SHV enzymes. Sequence analysis and probe-specific real-time PCR revealed that the majority (80%) of the CTX-M-type ESBLs were CTX-M-15 enzymes, followed by CTX-M-14 (17%) and CTX-M-27(2.8%). Multilocus sequence typing (MLST) and repetitive PCR analyses revealed that the relative prevalence of ST131 among ESBL-producingE. coliisolates is 10.2%. This study highlights the growing problem of ESBL resistance in pediatricEnterobacteriaceaeisolates and demonstrates a transition toward the predominance of CTX-M-type enzymes among ESBL-producingEnterobacteriaceaeorganisms causing pediatric infections.
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Baraniak, Anna, Janusz Fiett, Agnieszka Sulikowska, Waleria Hryniewicz та Marek Gniadkowski. "Countrywide Spread of CTX-M-3 Extended-Spectrum β-Lactamase-Producing Microorganisms of the Family Enterobacteriaceae in Poland". Antimicrobial Agents and Chemotherapy 46, № 1 (2002): 151–59. http://dx.doi.org/10.1128/aac.46.1.151-159.2002.
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ABSTRACT Eighty-four clinical isolates of the family Enterobacteriaceae, recovered from 1998 to 2000 in 15 hospitals in 10 Polish cities, were analyzed. All the isolates produced β-lactamases with pIs of 8.4 and 5.4, and the pI 8.4 enzymes were demonstrated to hydrolyze cefotaxime but not ceftazidime in the in vitro bioassay. PCR analysis and DNA sequencing have revealed that in all cases the pI 8.4 β-lactamase was probably the CTX-M-3 extended-spectrum β-lactamase (ESBL) variant, which was originally identified in 1996 in Praski Hospital in Warsaw. In the majority of isolates, bla CTX-M-3 genes resided within large conjugative plasmids with similar fingerprints, which, in the context of the high degree of diversity of the randomly amplified polymorphic DNA types of the isolates, suggested that horizontal transfer of plasmids was likely the main mechanism of CTX-M-3 spread. The dissemination of plasmids was probably preceded by the center-to-center transmission of several strains, as indicated by the identification by pulsed-field gel electrophoresis of closely related or possibly related Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii isolates in five different hospitals. CTX-M-3-producing organisms revealed a very high degree of diversity in β-lactam resistance levels and patterns. This was attributed to several factors, such as the production of other β-lactamases including additional ESBLs, possible quantitative variations in CTX-M-3 expression, segregation of AmpC derepressed mutants, and permeability alterations.
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Hassen, Bilel, Ahlem Jouini, Monia Elbour, Safa Hamrouni та Abderrazek Maaroufi. "Detection of Extended-Spectrum β-Lactamases (ESBL) Producing Enterobacteriaceae from Fish Trapped in the Lagoon Area of Bizerte, Tunisia". BioMed Research International 2020 (10 червня 2020): 1–9. http://dx.doi.org/10.1155/2020/7132812.
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Extended-spectrum β-lactamase and their molecular mechanism in Enterobacteriaceae were analyzed in 126 fish samples of 9 various wild species, living in the lagoon of Bizerte in Tunisia. Fifty-nine (59) Gram-negative strains were isolated and identified as Escherichia coli (n=24), Klebsiella pneumonia (n=21), Citrobacter freundii (n=8), and Shigella boydii (n=6). Forty-seven ESBL producers were identified using the synergic test. β-Lactamase genes detected were blaCTX-M-1 (E. coli/15; K. pneumonia/8; C. freundii/1; Sh. boydii/1), blaCTX-M-1+ blaOXA-1 (E. coli/4; K. pneumonia/3), blaCTX-M-1+ blaTEM-1-a (K. pneumonia/2), blaCTX-M-15+ blaTEM-1-a (K. pneumonia/1; Sh. boydii/1), blaCTX-M-15+ blaOXA-1 (K. pneumonia/1), blaCTX-M-15 (E. coli/3; K. pneumonia/1; Sh. boydii/3), and blaCTX-M-9 (C. freundii/3). Most strains (84.7%) showed a multiresistant phenotype. qnrA and qnrB genes were identified in six E. coli and in ten E. coli+one K. pneumonia isolates, respectively. The resistance to tetracycline and sulfonamide was conferred by the tet and sul genes. Characterization of phylogenic groups in E. coli isolates revealed phylogroups D (n=20 strains), B2 (n=2), and A (n=2). The studied virulence factor showed prevalence of fimA genes in 9 E. coli isolates (37.5%). Similarly, no strain revealed the three other virulence factors tested (eae, aer, and cnf1). Our findings confirmed that the lagoons of Bizerte may be a reservoir of multidrug resistance/ESBL-producing Enterobacteriaceae. This could lead to indisputable impacts on human and animal health, through the food chain.
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Castanheira, Mariana, Sarah E. Farrell, Lalitagauri M. Deshpande, Rodrigo E. Mendes та Ronald N. Jones. "Prevalence of β-Lactamase-Encoding Genes among Enterobacteriaceae Bacteremia Isolates Collected in 26 U.S. Hospitals: Report from the SENTRY Antimicrobial Surveillance Program (2010)". Antimicrobial Agents and Chemotherapy 57, № 7 (2013): 3012–20. http://dx.doi.org/10.1128/aac.02252-12.
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ABSTRACTEnterobacteriaceaebacteremia isolates (n= 195; 6.4% overall) collected from 26 U.S. hospitals located in 20 states were screened for various β-lactamase classes. A total of 175 isolates carried one to eight acquired β-lactamase genes of 44 types that were detected in 55 combinations. Eighty-five (43.6%) strains carriedblaCTX-M, andblaCTX-M-15was the most prevalent (33.8%). Genes encoding OXA-1/30 (often associated withblaCTX-M-15), CMY-2, SHV extended-spectrum β-lactamase (ESBLs), and TEM-1 were also prevalent. Among 33 carbapenem-resistant strains, 28 carriedblaKPC-2orblaKPC-3(17 and 11 strains, respectively), and those were recovered mostly in the New York City area (16 strains) and Houston, TX (9 strains). Fourteen new SHV variants were identified amongKlebsiella pneumoniaeisolates carrying one or multiple SHV alleles, three carrying G238S and/or E240K amino acid alterations that confer ESBL activity. Only two of eightK. oxytocaisolates carried acquired β-lactamases, but most had mutations on theblaOXYpromoter region, and three new OXY-encoding genes were characterized. Concordance between a commercial nucleic acid-based microarray (Check-MDR CT101) and reference methods was noted for 105/109 (97.2%) strains. Thirty-two strains having genes that are not targeted by the commercial system were detected (OXA ESBLs, PER, PSE, or intrinsic genes). Overall, a great variety of enzymes were observed, with numerous strains carrying multiple genes. Rates of CTX-M-producing strains appear to be increasing in U.S. hospitals (26.6% in 2007 to 43.8% for 2010) participating in the SENTRY Program. Furthermore, the Check-Points system seems to be a reliable, robust, and user-friendly assay for detection of enzyme-mediated resistance.
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Pitart, C., F. Marco, T. A. Keating, W. W. Nichols, and J. Vila. "Activity of Ceftazidime-Avibactam against Fluoroquinolone-Resistant Enterobacteriaceae and Pseudomonas aeruginosa." Antimicrobial Agents and Chemotherapy 59, no. 6 (2015): 3059–65. http://dx.doi.org/10.1128/aac.05136-14.
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ABSTRACTCeftazidime-avibactam and comparator antibiotics were tested by the broth microdilution method against 200Enterobacteriaceaeand 25Pseudomonas aeruginosastrains resistant to fluoroquinolones (including strains with the extended-spectrum β-lactamase [ESBL] phenotype and ceftazidime-resistant strains) collected from our institution. The MICs and mechanisms of resistance to fluoroquinolone were also studied. Ninety-nine percent of fluoroquinolone-resistantEnterobacteriaceaestrains were inhibited at a ceftazidime-avibactam MIC of ≤4 mg/liter (using the susceptible CLSI breakpoint for ceftazidime alone as a reference). Ceftazidime-avibactam was very active against ESBLEscherichia coli(MIC90of 0.25 mg/liter), ESBLKlebsiella pneumoniae(MIC90of 0.5 mg/liter), ceftazidime-resistant AmpC-producing species (MIC90of 1 mg/liter), non-ESBLE. coli(MIC90of ≤0.125 mg/liter), non-ESBLK. pneumoniae(MIC90of 0.25 mg/liter), and ceftazidime-nonresistant AmpC-producing species (MIC90of ≤0.5 mg/liter). Ninety-six percent of fluoroquinolone-resistantP. aeruginosastrains were inhibited at a ceftazidime-avibactam MIC of ≤8 mg/liter (using the susceptible CLSI breakpoint for ceftazidime alone as a reference), with a MIC90of 8 mg/liter. Additionally, fluoroquinolone-resistant mutants from each species tested were obtainedin vitrofrom two strains, one susceptible to ceftazidime and the other a β-lactamase producer with a high MIC against ceftazidime but susceptible to ceftazidime-avibactam. Thereby, the impact of fluoroquinolone resistance on the activity of ceftazidime-avibactam could be assessed. The MIC90values of ceftazidime-avibactam for the fluoroquinolone-resistant mutant strains ofEnterobacteriaceaeandP. aeruginosawere ≤4 mg/liter and ≤8 mg/liter, respectively. We conclude that the presence of fluoroquinolone resistance does not affectEnterobacteriaceaeandP. aeruginosasusceptibility to ceftazidime-avibactam; that is, there is no cross-resistance.
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Maladkar, M. "The effect of inoculum size on the activity of different ratios of Ceftriaxone – Sulbactam [(1:1) vs. (2:1)] against ESBL producing organisms." Indian Journal of Applied Microbiology 7, no. 06 (2021): 01–15. http://dx.doi.org/10.46798/ijam.2021.v23i02.4.
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Background and Objective: Antibiotic resistance has become the most importunate health issue and remains a major public health concern worldwide. Production of extended spectrum β-lactamases (ESBL) is one of the major causes of resistance to β-lactam antibiotics. Several in-vitro studies have demonstrated the significant impact of inoculum size on the effectiveness of β-lactam-β-lactamase inhibitor combination. Higher concentration of β-lactamase inhibitor (Sulbactam) will be needed to combat the increased production of ESBLs in infections with high inoculum. The primary objective of the present study is to evaluate Minimum Inhibitory Concentration (MICs) of ESBL producing Enterobacteriaceae, against Ceftriaxone alone and Ceftriaxone with Sulbactam combination (1:1 and 2:1) in presence of normal and higher inoculum of these bacteria. The secondary objective of the study is to demonstrate the in-vitro efficacy of Ceftriaxone-Sulbactam (CS) in presence of higher inoculum of bacteria. Method: ESBL producing strains of Enterobacteriaceae (E. coli, K pneumoniae 30 each) were isolated from patient samples. MIC of Ceftriaxone and Sulbactam alone and in combination (1:1 and 2:1) was determined in presence of both normal (105CFU/ml) and higher inoculum (107CFU/ml) of these bacteria using micro broth dilution method of antimicrobial susceptibility testing. Resultsand Conclusion: The study finds an inoculum effect with Ceftriaxone. After addition of Sulbactam, MIC value for Ceftriaxone was reduced by 4-128 folds and 2-32 folds in ESBL producing strains of E. coli and K. pneumoniae respectively. The findings of the present study demonstrated that CS at 1:1 ratio has better in-vitro activity against ESBL producing strains of E. coli and K. pneumoniae than at a 2:1 ratio in both normal bacterial inoculum and higher bacterial inoculum. This is suggestive of the need for the 1:1 ratio combination of Ceftriaxone-Sulbactam in management of severe infections caused by ESBL producing organisms.
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Ojdana, Dominika, Paweł Sacha, Piotr Wieczorek та ін. "The Occurrence of blaCTX-M, blaSHV, and blaTEM Genes in Extended-Spectrum β-Lactamase-Positive Strains of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis in Poland". International Journal of Antibiotics 2014 (6 лютого 2014): 1–7. http://dx.doi.org/10.1155/2014/935842.
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Bacteria belonging to the Enterobacteriaceae family that produce extended-spectrum β-lactamase (ESBL) enzymes are important pathogens of infections. Increasing numbers of ESBL-producing bacterial strains exhibiting multidrug resistance have been observed. The aim of the study was to evaluate the prevalence of blaCTX-M, blaSHV, and blaTEM genes among ESBL-producing Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis strains and to examine susceptibility to antibiotics of tested strains. In our study, thirty-six of the tested strains exhibited blaCTX-M genes (blaCTX-M-15, blaCTX-M-3, blaCTX-M-91, and blaCTX-M-89). Moreover, twelve ESBL-positive strains harbored blaSHV genes (blaSHV-18, blaSHV-7, blaSHV-2, and blaSHV-5), and the presence of a blaTEM gene (blaTEM-1) in twenty-five ESBL-positive strains was revealed. Among K. pneumoniae the multiple ESBL genotype composed of blaCTX-M-15, blaCTX-M-3, blaSHV-18, blaSHV-7, blaSHV-2, and blaSHV-5 genes encoding particular ESBL variants was observed. Analysis of bacterial susceptibility to antibiotics revealed that, among β-lactam antibiotics, the most effective against E. coli strains was meropenem (100%), whereas K. pneumoniae were completely susceptible to ertapenem and meropenem (100%), and P. mirabilis strains were susceptible to ertapenem (91.7%). Moreover, among non-β-lactam antibiotics, gentamicin showed the highest activity to E. coli (91.7%) and ciprofloxacin the highest to K. pneumoniae (83.3%). P. mirabilis revealed the highest susceptibility to amikacin (66.7%).
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Aitken, Samuel L., Micah Bhatti, Pranoti Sahasrabhojane та ін. "1055. Epidemiology and Mechanisms of Carbapenem Resistance in Recurrent Extended-Spectrum β-Lactamase- Producing Enterobacteriaceae Bacteremia". Open Forum Infectious Diseases 5, suppl_1 (2018): S315. http://dx.doi.org/10.1093/ofid/ofy210.892.
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Abstract Background Carbapenems are the treatment of choice for bacteremia caused by extended spectrum β-lactamase producing Enterobacteriaceae (ESBL-E). The emergence carbapenem resistance (CR) in ESBL-E isolates has been described; however, the rate of such resistance in clinical settings is unknown. We describe the frequency and mechanisms of CR in recurrent ESBL-E bacteremia at an NCI-designated cancer center. Methods We performed a prospective whole genome sequencing (WGS) study and retrospective cohort review of adult (age ≥18 years) patients with ESBL-E bacteremia between January 2015 and July 2016. Recurrent bacteremia was defined as identification of the same organism in blood culture at any time following initial successful treatment. CR was defined as resistance to meropenem. Carbapenemase production was assessed in the microbiology laboratory using Carba-NP. Available paired isolates underwent WGS via Illumina HiSeq for assessment of clonality and identification of CR mechanisms. Results One hundred and sixteen patients with ESBL-E bacteremia were identified. E. coli was the most common organism (86%), followed by K. pneumoniae (12%), and K. oxytoca (2%). Recurrent bacteremia was identified in 17 (15%) patients (E. coli [n = 15], K. pneumoniae [n = 2]). Of these, 6 (35%) were CR and 5/6 (83%) were Carba-NP negative. All six recurrent CR isolates occurred in patients with leukemia. Five isolate pairs were available for WGS. In four of five pairs (three E. coli, one K. pneumoniae), CR emerged from the same strain causing the original infection; one recurrence was caused by a distinct E. coli with a OXA-48-like gene. Compared with parental strains, CR E. coli contained deletions in porin-encoding genes and had increased mapping depth for genes encoding CTX-M ESBLs. The K. pneumoniae was Carba-NP negative with no identifiable CR mechanism. Conclusion Emergence of CR following treatment for ESBL-E bacteremia was seen only in leukemia patients and was primarily due to porin loss and amplification of ESBL genes, rather than acquisition of exogenous carbapenemases. These are the first clinical data describing the molecular mechanism of ESBL-E transformation to CR. These data serve as the basis for future studies of antimicrobial stewardship interventions to limit the emergence of CR in ESBL-E. Disclosures S. L. Aitken, Shionogi: Scientific Advisor, Consulting fee. Medicines Company: Scientific Advisor, Consulting fee. Merck & Co.: Scientific Advisor, Consulting fee.
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Jamal, Wafaa, Vincent O. Rotimi, M. John Albert, Fatima Khodakhast, Patrice Nordmann та Laurent Poirel. "High prevalence of VIM-4 and NDM-1 metallo-β-lactamase among carbapenem-resistant Enterobacteriaceae". Journal of Medical Microbiology 62, № 8 (2013): 1239–44. http://dx.doi.org/10.1099/jmm.0.059915-0.
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The purpose of this study was to identify the mechanisms leading to carbapenem resistance among multidrug-resistant Enterobacteriaceae isolates recovered from hospitalized patients with nosocomial infections in Mubarak Al Kabeer Hospital, Kuwait. Fourteen carbapenem-resistant Enterobacteriaceae isolates were obtained from inpatients in different wards and intensive care units between April 2009 and February 2011. Antibiotic susceptibilities were determined using the E-test method. Genes encoding β-lactamases were characterized by specific PCR amplification, sequencing and conjugation assays. All isolates were identified as metallo-β-lactamase (MBL) producers using phenotypic and molecular methods. Eleven of the 14 isolates produced VIM-4 (six Klebsiella pneumoniae, three Escherichia coli, one Enterobacter cloacae and one Klebsiella oxytoca). Three K. pneumoniae isolates produced the MBL NDM-1 and co-produced the plasmid-encoded AmpC CMY-4. The VIM-4-producing isolates co-produced extended-spectrum β-lactamases including CTX-M-15 and some SHV derivatives. The VIM-4 gene was not transferable by conjugation studies of six selected strains. We demonstrated here the emergence of VIM-4- and NDM-1-producing isolates in the largest teaching hospital in Kuwait.
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Sarah, Diakité Sally Otolorin, Yapi Adompo Jaurès Cedric, Amon Aby Christiane та Coulibaly N’golo David. "Detection of Plasmid-mediated Extended Spectrum β-Lactamase Genes (bla CTX-M) in Enterobacteriaceae Isolated from the Oral Cavity of Patients in a Dental Clinic in Abidjan, Côte d’Ivoire". Journal of Advances in Microbiology 25, № 6 (2025): 46–55. https://doi.org/10.9734/jamb/2025/v25i6948.
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Background: The oral cavity represents one of the most complex and densely colonized environments of the human body, harboring a diverse microbiota including bacterial and fungal communities. Antimicrobial resistance has emerged as a pressing global health concern, with particularly severe implications for low-resource settings. Aims: This study aimed to assess the antibiotic resistance profiles of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae strains isolated from the oral cavity. Methodology: samples were collected from patients presenting with dental disorders for the isolation and characterisation of ESBL-producing Enterobacteriaceae from the oral cavity. Plasmid DNA was extracted using the phenol-chloroform method, and conventional PCR was employed to detect the presence of plasmid-borne resistance genes bla CTX-M-2, bla CTX-M-8, and bla CTX-M-9. Results: Four Enterobacteriaceae strains were successfully isolated and characterized, corresponding to an isolation rate of 5.40% (4/74). Among these, 60% harbored the bla CTX-M-2 and bla CTX-M-8 resistance genes. The bla CTX-M-9 gene was not detected in any of the isolates. Conclusion: Although uncommon in the oral cavity, the emergence of Enterobacteriaceae in this niche may represent a potential public health concern. The presence of ESBL-producing strains could contribute to therapeutic failures or limited treatment options, particularly if antibiotic prescribing guidelines are not adequately followed by healthcare professionals.
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Mugnaioli, Claudia, Francesco Luzzaro, Filomena De Luca та ін. "CTX-M-Type Extended-Spectrum β-Lactamases in Italy: Molecular Epidemiology of an Emerging Countrywide Problem". Antimicrobial Agents and Chemotherapy 50, № 8 (2006): 2700–2706. http://dx.doi.org/10.1128/aac.00068-06.
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ABSTRACT A nationwide survey of extended-spectrum β-lactamase (ESBL) production among Enterobacteriaceae, carried out in 2003, showed that CTX-M-type enzymes have achieved a sizeable prevalence among ESBL producers in Italy, mostly in Escherichia coli and, to a lesser extent, in Klebsiella pneumoniae. In this work, we report on the molecular epidemiology of the CTX-M-producing isolates from that survey and on the mechanisms of dissemination of these emerging resistance determinants. The CTX-M-producing isolates were detected in 10 of the 11 participating centers distributed across the Italian national territory, although at remarkably variable rates in different centers (1.2 to 49.5% of the ESBL producers). All CTX-M determinants were of group 1, with CTX-M-15 and CTX-M-1 being the most prevalent variants (60% and 35%, respectively) and CTX-M-32 carried by a minority (5%) of isolates. Each variant was detected both in E. coli and in K. pneumoniae. Genotyping of the CTX-M-producing isolates by random amplification of polymorphic DNA revealed a notable diversity, especially among those producing CTX-M-1, while clonal expansion was evident with some CTX-M-15-producing strains. Mating experiments revealed a higher overall transferability of bla CTX-M-1 and bla CTX-M-32 than of bla CTX-M-15. Coresistance to quinolones and aminoglycosides was overall higher with the CTX-M-15-producing isolates. The present results indicate that CTX-M-producing strains are now widespread across the Italian territory and underscore the emerging role of these ESBL determinants in the European setting. They also reveal notable differences in the dissemination mechanisms of genes encoding different CTX-M variants of the same lineage.
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Iseppi, Ramona, Alessandro Di Cerbo, Patrizia Messi та Carla Sabia. "Antibiotic Resistance and Virulence Traits in Vancomycin-Resistant Enterococci (VRE) and Extended-Spectrum β-Lactamase/AmpC-producing (ESBL/AmpC) Enterobacteriaceae from Humans and Pets". Antibiotics 9, № 4 (2020): 152. http://dx.doi.org/10.3390/antibiotics9040152.
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Background: We investigated the virulence factors, genes, antibiotic resistance patterns, and genotypes (VRE and ESBL/AmpC) production in Enterococci and Enterobacteriaceae strains isolated from fecal samples of humans, dogs, and cats. Methods: A total of 100 fecal samples from 50 humans, 25 dogs, and 25 cats were used in the study. MICs of nine antimicrobials were determined using the broth microdilution method. Polymerase chain reaction was used for the detection of genes responsible for antibiotic resistance (VRE and ESBL/AmpC) and virulence genes both in Enterococcus species, such as cytolysin (cylA, cylB, cylM), aggregation substance (agg), gelatinase (gelE), enterococcal surface protein (esp), cell wall adhesins (efaAfs and efaAfm), and in Enterobacteriaceae, such as cytolysin (hemolysin) and gelatinase production (afa, cdt, cnf1, hlyA, iutA, papC, sfa). Results: Enterococcus faecium was the most prevalent species in humans and cats, whereas Enterococcus faecalis was the species isolated in the remaining samples. A total of 200 Enterobacteriaceae strains were also detected, mainly from humans, and Escherichia coli was the most frequently isolated species in all types of samples. In the Enterococcus spp, the highest percentages of resistance for ampicillin, amoxicillin/clavulanate, erythromycin, tetracycline, ciprofloxacin, teicoplanin, and vancomycin were detected in cat isolates (41.6%, 52.8%, 38.9%, 23.6%, 62.5%, 20.8%, and 23.6% respectively), and in E. coli, a higher rate of resistance to cefotaxime and ceftazidime emerged in cat and dog samples, if compared with humans (75.4% and 66.0%, 80.0% and 71.4%, and 32.0% and 27.2%, respectively). Regarding the total number of enterococci, 5% and 3.4% of the strains were vancomycin and teicoplanin resistant, and the vancomycin resistance (van A) gene has been detected in all samples by PCR amplification. All the Enterobacteriaceae strains were confirmed as ESBL producers by PCR and sequencing, and the most frequent ESBL genes in E. coli strains from humans and pet samples were blaCTX-M-1 and blaCTX-M-15. Conclusions: Our results provide evidence that one or more virulence factors were present in both genera, underlining again the ability of pet strains to act as pathogens.
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Jouini, Ahlem, Amira Klibi, Souhir Kmiha, Safa Hamrouni, Abdeljelil Ghram та Abderrazak Maaroufi. "Lineages, Virulence Gene Associated and Integrons among Extended Spectrum β-Lactamase (ESBL) and CMY-2 Producing Enterobacteriaceae from Bovine Mastitis, in Tunisia". Pathogens 11, № 8 (2022): 948. http://dx.doi.org/10.3390/pathogens11080948.
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Extended Spectrum Beta-Lactamase (ESBL) Enterobacteriaceae are becoming widespread enzymes in food-producing animals worldwide. Escherichia coli and Klebseilla pneumoniae are two of the most significant pathogens causing mastitis. Our study focused on the characterization of the genetic support of ESBL/pAmpC and antibiotic resistance mechanisms in cefotaxime-resistant (CTXR) and susceptible (CTXS) Enterobacteriaceae isolates, recovered from bovine mastitis in Tunisia, as well as the analyses of their clonal lineage and virulence-associated genes. The study was carried out on 17 ESBL/pAmpC E. coli and K. pneumoniae and 50 CTXS E. coli. Detection of resistance genes and clonal diversity was performed by PCR amplification and sequencing. The following β-lactamase genes were detected: blaCTX-M-15 (n = 6), blaCTX-M-15 + blaOXA-1 (2), bla CTX-M-15 + blaOXA-1 + blaTEM-1b (2), blaCTX-M-15 + blaTEM-1b (4), blaCMY-2 (3). The MLST showed the following STs: ST405 (n = 4 strains); ST58 (n = 3); ST155 (n = 3); ST471 (n = 2); and ST101 (n = 2). ST399 (n = 1) and ST617 (n = 1) were identified in p(AmpC) E. coli producer strains. The phylogroups A and B1 were the most detected ones, followed by the pathogenic phylogroup B2 that harbored the shigatoxin genes stx1/stx2, associated with the cnf, fimA, and aer virulence factors. The qnrA/qnrB, aac(6′)-Ib-cr genes and integrons class 1 with different gene cassettes were detected amongst these CTXR/S isolated strains. The presence of different genetic lineages, associated with resistance and virulence genes in pathogenic bacteria in dairy farms, may complicate antibiotic therapies and pose a potential risk to public health.
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Freire, Samanta, Teresa Grilo, Laurent Poirel, and Marta Aires-de-Sousa. "Urban Pigeons (Columba livia) as a Source of Broad-Spectrum b-Lactamase-Producing Escherichia coli in Lisbon, Portugal." Antibiotics 11, no. 10 (2022): 1368. http://dx.doi.org/10.3390/antibiotics11101368.
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Wild birds may be healthy carriers, and therefore, may be involved in the dissemination of clinically relevant antimicrobial-resistant bacteria, such as extended-spectrum β-lactamases (ESBL) and carbapenemase-producing Enterobacteriaceae. This study evaluated whether urban pigeons living in five spots in Lisbon, Portugal, may be colonized and, therefore, constitute potential spreaders of multidrug-resistant bacteria. A total of 100 pigeon fecal samples were collected in different urban areas for the detection of ESBL- or carbapenemase-producing Enterobacteriaceae. All b-lactamase-producing isolates were tested for antimicrobial susceptibility and their genetic backgrounds were characterized by multilocus sequence typing. Of the 100 fecal samples collected, nine ESBL-producing Escherichia coli (9%) were identified. Three isolates carried the blaCTX-M-15 gene, three isolates harbored the blaCTX-M-27 and three isolates carried the blaSHV-12 gene. Genotyping of the nine ESBL-producing E. coli strains revealed seven different sequence types (STs) including ST10, ST131, ST154, ST206, ST1488 (SLV ST10), ST2858 and ST3576, most of which have been already described in humans, animals or in the environment. Urban pigeons constitute a potential source of ESBL genes and may be a transmission vehicle of multidrug-resistant bacteria in the environment.
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Sarowska, Jolanta, Irena Choroszy-Krol, Agnieszka Jama-Kmiecik, Beata Mączyńska, Sylwia Cholewa, and Magdalena Frej-Madrzak. "Occurrence and Characteristics of Carbapenem-Resistant Klebsiella pneumoniae Strains Isolated from Hospitalized Patients in Poland—A Single Centre Study." Pathogens 11, no. 8 (2022): 859. http://dx.doi.org/10.3390/pathogens11080859.
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The global emergence and spread of genes responsible for the production of ESBL (extended-spectrum beta-lactamases) and carbapenemases in Klebsiella pneumoniae isolates poses a serious threat to public health. The aim of this study was to retrospectively analyze the frequency of occurrence and drug resistance of selected alarm agents isolated from patients of the specialist hospital in Wrocław. A total of13,528 clinical materials collected from patients of a specialist hospital in Wrocław were analyzed in the period from 1 January 2020 to 31 December 2020. Overall, 3894 bacterial strains were isolated from clinical materials, including 416 K. pneumoniae isolates. K. pneumoniae that showed resistance to ETP (ertapenem) and/or MEM (meropenem) were tested using phenotypic tests for the detection of KPC (carbapenemase-producing Klebsiella), MBL (metallo-β-lactamase) and OXA-48 (oxacilinase-48) carbapenemases. In the case of a positive or doubtful result of the phenotypic test, immunochromatographic tests and the CarbaNP test were performed. In total, 58 K.pneumoniae isolates resistant to 1 or more carbapenem antibiotics were isolated. Of the 58 strains, 16 (27.6%) were isolated from rectal swabs conducted on CPE (carbapenemase-producing Enterobacteriaceae) carriers. In the case of CRE (carbapenem-resistant Enterobacteriaceae) K. pneumoniae, carbapenemases were detected in 28/58 (48.3%) isolates. Notably, 23/28 K. pneumoniae isolates produced MBL/NDM (New Delhi metallo-β-lactamase) (82.1%), 5/28 produced VIM (Verona-intergon-encoded metallo-β-lactamase) (14.3%), and one produced MBL/NDM + OXA-48. Carbapenemases were detected in 13 of 16 (81.3%) carbapenem-resistant K. pneumoniae isolates derived from rectal swabs. The significant participation of CRE and CPE isolates in the infections proves the need to test patients admitted to hospital wards for their status as a CPE carrier in order to limit the emergence of new epidemic outbreaks.
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Baraniak, Anna, Janusz Fiett, Agnieszka Mrówka, Jarosław Walory, Waleria Hryniewicz та Marek Gniadkowski. "Evolution of TEM-Type Extended-Spectrum β-Lactamases in Clinical Enterobacteriaceae Strains in Poland". Antimicrobial Agents and Chemotherapy 49, № 5 (2005): 1872–80. http://dx.doi.org/10.1128/aac.49.5.1872-1880.2005.
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ABSTRACT Seventeen extended-spectrum β-lactamase (ESBL)-producing isolates of the family Enterobacteriaceae recovered from 1998 to 2000 in hospitals of five different cities in Poland were analyzed. They expressed several TEM-type ESBLs, TEM-4, TEM-29, TEM-85, TEM-86, TEM-93, and TEM-94. TEM-85 (L21F, R164S, E240K, T265M), TEM-86 (L21F, R164S, A237T, E240K, T265M), TEM-93 (M182T, G238S, E240K), and TEM-94 (L21F, E104K, M182T, G238S, T265M) were identified for the first time. Including the enzymes described earlier, TEM-47, TEM-48, TEM-49, and TEM-68, the group of known ESBLs of the TEM family produced by enterobacteria in Polish hospitals has increased to 10 variants. Comparative sequence analysis of the genes coding for all these β-lactamases revealed a view of their possible evolution, which, apart from the gradual acquisition of various mutations, could also have involved recombination events. Two different bla TEM-1 gene alleles were precursors of the ESBL genes: bla TEM-1A, which was the ancestor of bla TEM-93, and bla TEM-1F, from which all the remaining genes originated. The evolution of the bla TEM-1F-related genes most probably consisted of three major separate lineages, one of which, including bla TEM-4, bla TEM-47, bla TEM-48, bla TEM-49, bla TEM-68, and bla TEM-94, was highly structured itself and could have been initiated by the bla TEM-25 gene, identified exclusively in France so far. Plasmid fingerprinting analysis revealed a high degree of diversity of plasmids carrying related bla TEM genes, which suggested either the intense diversification or transposition of bla TEM genes between different plasmids or some contribution of convergent evolution. The results of this study clearly demonstrate that the environment of Polish hospitals has been highly favorable for the rapid evolution of ESBLs.
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Eltai, Nahla O., Elmoubasher A. Abdfarag, Hamad Al-Romaihi, et al. "Antibiotic Resistance Profile of Commensal Escherichia coli Isolated from Broiler Chickens in Qatar." Journal of Food Protection 81, no. 2 (2017): 302–7. http://dx.doi.org/10.4315/0362-028x.jfp-17-191.
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ABSTRACT Antibiotic resistance (AR) is a growing public health concern worldwide, and it is a top health challenge in the 21st century. AR among Enterobacteriaceae is rapidly increasing, especially in third-generation cephalosporins and carbapenems. Further, strains carrying mobilized colistin resistance (mcr) genes 1 and 2 have been isolated from humans, food-producing animals, and the environment. The uncontrolled use of antibiotics in food-producing animals is a major factor in the generation and spread of AR. No studies have been done to evaluate AR in the veterinary sector of Qatar. This study aimed at establishing primary baseline data for the prevalence of AR among food-producing animals in Qatar. Fecal samples (172) were obtained from two broiler farms and one live bird market in Qatar, and 90 commensal Escherichia coli bacteria were isolated and subjected to susceptibility testing against 16 clinically relevant antibiotics by using the E-test method. The results found that 81 (90%) of 90 isolates were resistant to at least one antibiotic, 14 (15.5%) of 90 isolates were colistin resistant, 2 (2.2%) of 90 isolates were extended-spectrum β-lactamase producers, and 2 (2.2%) of 90 isolates were multidrug resistant to four antibiotic classes. Extended-spectrum β-lactamase–producing E. coli and colistin-resistant isolates were confirmed by using double-disc susceptibility testing and PCR, respectively. Such a high prevalence of antibiotic-resistant E. coli could be the result of a long application of antibiotic treatment, and it is an indicator of the antibiotic load in food-producing animals in Qatar. Pathogens carrying AR can be easily transmitted to humans through consumption of undercooked food or noncompliance with hygiene practices, mandating prompt development and implementation of a stewardship program to control and monitor the use of antibiotics in the community and agriculture.
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Tsekouras, Nikolaos, Zoi Athanasakopoulou, Celia Diezel та ін. "Cross-Sectional Survey of Antibiotic Resistance in Extended Spectrum β-Lactamase-Producing Enterobacteriaceae Isolated from Pigs in Greece". Animals 12, № 12 (2022): 1560. http://dx.doi.org/10.3390/ani12121560.
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This study aimed to estimate the prevalence of extended-spectrum β-lactamase-producing (ESBL) bacteria in swine. Thus, 214 fecal samples were collected from suckling and weaned piglets from 34 farms in Greece (out of an overall population of about 14,300 sows). A subset of 78 (36.5%) ESBL producers were identified as E. coli (69/78, 88.5%), K. pneumoniae spp. pneumoniae (3.8%), P. mirabilis (5.1%), E. cloacae complex (1.3%) and S. enterica spp. diarizonae (1.3%). Resistance to at least one class of non-β-lactam antibiotics was detected in 78 isolates. Among the E. coli strains, resistance was identified with regard to aminoglycosides (n = 31), fluoroquinolones (n = 49), tetracycline (n = 26) and trimethoprim/sulfamethoxazole (n = 46). Of the three K. pneumoniae spp. pneumoniae, two displayed resistances to aminoglycosides and all were resistant to fluoroquinolones, tetracyclines and trimethoprim/sulfamethoxazole. As for the four P. mirabilis isolates, three had a resistant phenotype for aminoglycosides and all were resistant to imipenem, fluoroquinolones, tetracyclines and trimethoprim/sulfamethoxazole. Molecular characterization of the isolates revealed the presence of CTX-M, SHV and TEM genes, as well as of genes conferring resistance to fluoroquinolones, aminoglycosides, sulfonamides, trimethoprim, macrolides and colistin. High levels of antimicrobial resistance (AMR) were demonstrated in Greek swine herds posing a concern for the efficacy of treatments at the farm level as well as for public health.