Main Article Content
Due to the recent appearance of organisms that are resistant to several drugs (multidrug-resistant) like Enterobacteriaceae that produce extended-spectrum ?-lactamase (ESBL, concerns have remarkably increased regarding the suitable treatment of infections. The present study was an investigation into ESBL molecular characteristics among clinical isolates of Klebsiella pneumoniae and Escherichia coli resulting in UTIs and their pattern of antimicrobial resistance in order to come up with helpful information on the epidemiology of these infections and risk factors accompanied with them. In order to conduct the study, 20 K. pneumoniae and 48 E. coli were isolated and retrieved from thalassemia center in Erbil, Iraq during July 2016 and September 2016. The collected strains were analyzed and the profile of their antimicrobial susceptibility was specified. In order to spot ?-lactamase genes (i.e. blaTEM, blaSHV, and blaCTX-M), polymerase chain reaction was conducted. The results obtained from multiplex PCR assay showed that out of the collected strains of ESBL-producing E. coli, 37 had 81% blaTEM, 16.2% blaSHV, and 32.4% blaCTX-M genes. Similarly, 64.7% blaTEM, 35.2% blaSHV, and 41.1% blaCTX-M genes existed in the isolates of K. pneumoniae. It was found that antibiotic resistance pattern of E. coli and K. pneumoniae isolates to 20 antibiotics varied widely. It was also concluded that the majority of the K. pneumoniae and E. coli isolates were multi-drug resistant (MDR). Moreover, 75% and 87.5% of respectively K. pneumoniae and E. coli isolates showed the MDR phenotypes. TEM prevalence was high among other types of ESBLs. Over all, the most active antimicrobial agents in vitro remained to be the carbapenems.
Downloads month by month
www.mjhid.orgMediterr J Hematol Infect Dis 2019; 11; e2019041Pag. 7/7B, Carmeli Y. Occurrence and phenotypic characteristics of extended-spectrum ?-lactamases among members of the family Enterobacteriaceae at the Tel-Aviv Medical Center (Israel) and evaluation of diagnostic tests. J Clin Microbiol. 2003;41(1):155-8.https://doi.org/10.1128/JCM.41.1.155-158.2003PMid:12517841 PMCid:PMC14963627.Grover SS, Sharma M, Chattopadhya D, Kapoor H, Pasha ST, Singh G.Phenotypic and genotypic detection of ESBL mediated cephalosporin resistance in Klebsiella pneumoniae: emergence of high resistance against cefepime, the fourth generation cephalosporin. J Infect. 2006 ;53(4):279-88.https://doi.org/10.1016/j.jinf.2005.12.001PMid:1648847628.Jorgensen JH, McElmeel ML, Fulcher LC, Zimmer BL. Detection of CTX-M-type extended-spectrum beta-lactamase (ESBLs) by testing with MicroScan overnight and ESBL confirmation panels. J Clin Microbiol. 2010;48(1):120-3.https://doi.org/10.1128/JCM.01507-09PMid:19889896 PMCid:PMC281226829.Manoharan A, Premalatha K, Chatterjee S, Mathai D; SARI Study Group. Correlation of TEM, SHV and CTX-M extended-spectrum beta lactamases among Enterobacteriaceae with their in vitro antimicrobial susceptibility. Indian J Med Microbiol. 2011;29(2):161-4.https://doi.org/10.4103/0255-0857.81799PMid:2165411230.Moghnieh RA, Kanafani ZA, Tabaja HZ, Sharara SL, Awad LS, Kanj SS.Epidemiology of common resistant bacterial pathogens in the countries of the Arab League.Lancet Infect Dis. 2018;18(12):e379-e394https://doi.org/10.1016/S1473-3099(18)30414-631.Khalaf EA, Al-Ouqaili MTS.Molecular detection and sequencing of SHV gene encoding for extended-spectrum ?-lactamases produced by multidrug resistance some of the Gram-negative bacteria.Intern J Green Pharm 2018; 12 (4): S918https://doi.org/10.22377/ijgp.v12i04.227432.Teawtrakul N, Jetsrisuparb A, Sirijerachai C, Chansung K, Wanitpongpun C.Severe bacterial infections in patients with non-transfusion-dependent thalassemia: prevalence and clinical risk factors.Int J Infect Dis. 2015 ;39:53-6https://doi.org/10.1016/j.ijid.2015.09.001PMid:2635885533.Ricciardi W, Giubbini G, Laurenti P.Surveillance and Control of Antibiotic Resistance in the Mediterranean Region.Mediterr J Hematol Infect Dis. 2016;8(1):e2016036https://doi.org/10.4084/mjhid.2016.036PMid:27413528 PMCid:PMC492853734.Devrim F, Serdaro?lu E, Ça?lar ?, Oruç Y, Demiray N, Bayram N, A??n H, Çalkavur S, Sorguç Y, Dinçel N, Ayhan Y, Y?lmaz E, Devrim I.The Emerging Resistance in Nosocomial Urinary Tract Infections: From the Pediatrics Perspective.Mediterr J Hematol Infect Dis. 2018 Sep 1;10(1):e2018055.https://doi.org/10.4084/mjhid.2018.055PMid:30210748 PMCid:PMC613110035.Girmenia C, Serrao A, Canichella M.Epidemiology of Carbapenem Resistant Klebsiella pneumoniae Infections in Mediterranean Countries.Mediterr J Hematol Infect Dis. 2016 ;8(1):e2016032.https://doi.org/10.4084/mjhid.2016.032PMid:27441063 PMCid:PMC494306