High Prevalence and Significant Association of ESBL and QNR Genes in Pathogenic Klebsiella pneumoniae Isolates of Patients from Kolkata, India. - Related Documents




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122801.0000High Prevalence and Significant Association of ESBL and QNR Genes in Pathogenic Klebsiella pneumoniae Isolates of Patients from Kolkata, India. Pathogenic Klebsiella pneumoniae, resistant to beta-lactam and quinolone drugs, is widely recognized as important bacteria causing array of diseases. The resistance property is obtained by acquisition of plasmid encoded blaTEM, blaSHV, blaCTX-M, QNRA, QNRB and QNRS genes. The aim of this study was to document the prevalence and association of these resistant genes in K. pneumoniae infecting patients in India. Approximately 97 and 76.7 % of the 73 K. pneumoniae isolates showed resistance towards beta-lactam and quinolone drugs respectively. Bla genes were detected in 74 % of K. pneumoniae isolates; with prevalence in the following order: blaTEM > blaSHV > blaCTXM. QNR genes were detected in 67 % samples. Chi-square analysis revealed significant association between presence of bla and qnr genes in our study (P value = 0.000125). Sequence analysis of some blaTEM, blaSHV, blaCTX-M and QNRB PCR products revealed presence of blaTEM1 (GenBank accession: JN193522), blaTEM116 (JN193523 and JN193524), blaSHV11, blaCTXM72 variants (JF523199) and QNRB1 (JN193526 and JN193527) in our samples.201224293710
98610.9992The Frequency of qnr Genes in Extended-Spectrum β-lactamases and non-ESBLs Klebsiella pneumoniae Species Isolated from Patients in Mashhad, Iran. BACKGROUND AND OBJECTIVES: Since the fluoroquinolones are the broad-spectrum antibiotics, they affect both Gram-negative and Gram-positive bacteria. These antibiotics are widely prescribed by physicians. As a result, some bacteria, especially Enterobacteriaceae, have shown a resistance to this family of antibiotics. The current study aimed at detecting the frequency of qnrA, qnrB, and qnrS genes, novel plasmid-mediated quinolone-resistance genes, among extended-spectrum β-lactamases (ESBL)-positive and ESBL-negative Klebsiella pneumoniae isolates. MATERIALS AND METHODS: One hundred and thirty isolates of K. pneumoniae were collected from Imam Reza Hospital and its associated clinics from May 2011 to July 2012. The isolates were tested for ESBLs by the conventional methods. Polymerase chain reaction (PCR) was performed to amplify qnr A, B, and S. RESULTS: Thirty-eight (29.3%) isolates were ciprofloxacin-resistant. Among 130 K. pneumoniae infectious isolates, 56 (43%) were capable of producing ESBL; 10.8% (n=14), 15.4% (n=20), and 20.8% (n=27) of ESBL-producing K. pneumonia were positive for qnrA, qnrS, and qnrB, respectively, and 13.8% (n=18) of the isolates harbored 2 or 3 qnr genes. CONCLUSION: The results of the current study showed that quinolone-resistance genes were more frequent in ESBL-producing K. pneumoniae (37.5%) isolates, compared with the ESBL-negative isolates (20.89%). The prevalence of qnr genes was high in K. pneumoniae isolates, with higher frequency in ESBL-positive strains. Most of the isolates were positive for all 3 groups of qnr genes and the qnrB was the most common one.201729563934
111120.9992Molecular Characterization of Cotrimoxazole Resistance Genes and Their Associated Integrons in Clinical Isolates of Gram-Negative Bacteria from Tanzania. Cotrimoxazole is widely used, particularly as a prophylactic drug in HIV patients. We assessed resistance mechanisms among cotrimoxazole resistant-Gram negative bacterial isolates (n = 123) obtained from blood (n = 69) and urine (n = 54) from Tanzanian patients. sul genes were detected in 98% (121/123) of the isolates. Coexistence of sul1 and sul2 was common (49/123). The dfr genes were found in 63% (77/123) of all isolates. sul1, dfrA15, and dfrA5 genes predominated among Klebsiella pneumoniae, while sul2 and dfrA1 genes were frequent in Escherichia coli isolates. Two isolates, both K. pneumoniae, carried sul3. Integrons were detected in 81.3% (100/123) of all isolates. Class 1 integrons were found in 95% (42/44), 53% (23/43), and 80.6% (25/31) of K. pneumoniae, E. coli, and other Enterobacteriaceae isolates, respectively. Class 2 integrons were found in 14% of E. coli, but not in K. pneumoniae. All sul1 genes in K. pneumoniae were carried in class 1 integrons. Gene cassette arrays dfrA5 and dfrA15-aadA1 were most frequently associated with class 1 integrons, while class 2 integrons contained only dfrA1-sat2-aadA1 gene cassettes. This is the first report of sul3 gene in K. pneumoniae from human sources. The finding that mechanisms differ between E. coli and K. pneumoniae may broaden our understanding of cotrimoxazole resistance.201727533639
124130.9991Spectrum of Bacterial Colonization in Patients Hospitalized for Treatment of Multidrug-Resistant Tuberculosis. This study investigated the bacterial colonization in patients admitted for treatment of drug-resistant tuberculosis in a specialized TB hospital. Identification and antimicrobial susceptibility testing of bacterial isolates (n = 62) from nasal, groin, and rectal swabs [patient cohort (n = 37)] were determined by the VITEK-MS system. Resistance gene analysis was by PCR and DNA sequencing. Molecular typing of Klebsiella pneumoniae isolates was by Multilocus Sequencing Typing (MLST). Patients (n = 13/37; 35%) were colonized by multidrug-resistant (MDR) bacteria (ESBL and MRSA) on admission. Of the 24 patients who were not colonized by MDR bacteria on admission, 46% (17/37) became colonized by MDR bacteria within 1 month of admission, mostly with ESBL-producing Enterobacteriales and resistance to aminoglycosides and fluoroquinolones. ESBL Escherichia coli (41/62; 66%) and K. pneumoniae (14/62; 23%) predominated. Genes encoding for ESBLs (bla(CTX-M-14), bla(CTX-M-15), bla(SHV-28), bla(OXA-1), and bla(OXY-2)) and plasmid-mediated quinolone resistant genes (qnrB1, qnrB4, and qnrB10) were detected. MLST revealed genetic diversity among the K. pneumoniae isolates from hospitalized patients. This study provides insight into bacterial pathogen colonization in hospitalized TB patients with the first occurrence of the qnrB4 and qnrB10 genes and co-expression of genes: qnrB4+aac(6')-lb-cr, qnrB10+aac(6')-lb-cr, qnrB4+qnrS1, and qnrB10+qnrS1 in fluoroquinolone-resistant E. coli isolates within South Africa. However, the source and colonization routes of these isolates could not be determined.202133074767
106940.9991High Prevalence of Antimicrobial Resistance in Gram-Negative Bacteria Isolated from Clinical Settings in Egypt: Recalling for Judicious Use of Conventional Antimicrobials in Developing Nations. This study was designed to investigate, at the molecular level, the antimicrobial resistance mechanisms of different antimicrobial resistance genes, including, extended-spectrum β-lactamases, AmpC β-lactamases, class 1 and 2 integrons, and plasmid-mediated quinolone resistance genes of Gram-negative bacteria isolated from clinical settings in Egypt. A total of 126 nonduplicate Gram-negative isolates were recovered from different clinical samples taken from hospitalized patients in Egypt in 2014. Antimicrobial susceptibility testing showed that, 93.6% (118/126) of the isolates had a multidrug-resistant phenotype. Interestingly, we reported a high level of antimicrobial resistance nearly for all tested antibiotics; to our knowledge, this is the first report from Egypt indicating very high level of antibiotic resistance in Egypt. Polymerase chain reaction screening and DNA sequencing revealed that, 75.4% (95/126) of the isolates harbored at least one extended-spectrum β-lactamase-encoding gene, with bla(CTX-M) being the most prevalent (65.9%), followed by bla(SHV) (46.8%). The AmpC β-lactamase, bla(CMY), was detected in 7.1% (9/126) of bacterial isolates, with bla(CMY-42) being the most prevalent. Class 1 integrons were detected in 50.8% (64/126) of the isolates, and class 2 integrons were detected in 2.4% (3/126) of the isolates. The plasmid-mediated quinolone resistance gene, qnr, was detected in 58.7% (74/126) of the tested isolates, with qnrS being the most prevalent. Several antimicrobial resistance determinants were identified in Egypt for the first time, such as SHV-27, SHV-28, SHV-33, SHV-63, SHV-71, SHV-82, SHV-142, CMY-42, CMY-6, and the new CMY-72 like. This study highlights the importance of the conscious use of conventional antimicrobials to overcome the multidrug resistance problem.201930681401
112450.9991Molecular Identification of Extended-Spectrum β-lactamase and Integron Genes in Klebsiella Pneumonia. INTRODUCTION: Infections caused by Gram negative bacteria, producing extended-spectrum β-lactamase, including Klebsiella pneumoniae are increasing all over the world with high morbidity and mortality. The aim of the present study was determined antimicrobial profile susceptibility and the prevalence of antibiotic resistance genes by multiplex PCR. METHODS: In the present study, we obtained one-hundred isolates of K. pneumoniae from different clinical samples. The antibiotic susceptibility testing was done in thirteen antibiotic and, therefore, M-PCRs were conducted using the DNA amplification for detection of ESBLs (blaTEM, blaCTX-M, blaSHV) and int (I, II, III) genes. RESULTS: The results of resistance to amoxicillin/clavulanate, ciprofloxacin, amikacin, trimethoprim-sulfamethoxazole, cefotaxime, ampicillin, aztreonam, imipenem, gentamicin, ceftazidime, Cefepime, ceftriaxone and levofloxacin were obtained 37%, 37%, 93%, 84%, 52%, 87%, 59%, 8%, 24%, 67%, 52%, 43% and 26%, respectively. The frequency of the extended-spectrum β-lactamase K. pneumoniae was obtained 37%. The prevalence of resistance genes of ESBLs in the M-PCR method showed that the blaTEM, blaCTX and blaSHV were 38%, 24% and 19%, respectively, however, only 8 (8%) out of 100 isolates were found to have positive outcomes for the existence of class 1 integrons and there were no detected class 2 or class 3 integrons. CONCLUSIONS: Our results recommend the likely co-carriage of some ESBLs genes and antibiotic resistance integrons on the same plasmids harboring the MDR genes.201627935927
124060.9991Prevalence and characterization of quinolone resistance and integrons in clinical Gram-negative isolates from Gaza strip, Palestine. BACKGROUND: Gram-negative bacteria with quinolone resistance and extended-spectrum beta-lactamases (ESBLs) present significant treatment challenges. This study evaluated the prevalence and characteristics of quinolone resistance in Gram-negative strains, investigating the relationship between plasmid-mediated quinolone resistance (PMQR), ESBLs, and integrons. METHODS AND RESULTS: We collected 146 Gram-negative isolates from patients in three Palestinian hospitals. For quinolone resistance isolates, the presence and characterization of PMQR, β-lactamase genes and integrons were studied by PCR and sequencing. Out of 146 clinical isolates, 64 (43.8%) were resistant to quinolones, with 62 (97%) being multidrug-resistant (MDR) and 33 (51.5%) ESBL-producers. PMQR-encoding genes were present in 45 (70.3%) isolates, including aac(6')-Ib-cr (26.6%), qnrA (18.8%), qnrS1 (20.8%), and qnrB (6.4%). Bla(CTX-M) genes were detected in 50% (32/64) of isolates, with bla(CTX-M-15) being the most common. Bla(TEM-1), bla(SHV-1) and bla(VIM) genes were found in 13, 6, and 4 isolates, respectively. Class I integrons were found in 31/64 (48%) of isolates, with 14 containing gene cassettes conferring resistance to trimethoprim (dhfr17, dfrA12, dfrA1) and aminoglycosides resistance genes (aadA1, aadA2, aadA5, and aadA6). CONCLUSIONS: This study found a high rate of quinolone resistance, ESBL and integrons in clinical Gram-negative isolates from our hospitals. Urgent measures are crucial, including implementing an antimicrobial resistance surveillance system, to control and continuously monitor the development of antimicrobial resistance.202439066817
144770.9991Molecular detection of β-lactamase and integron genes in clinical strains of Klebsiella pneumoniae by multiplex polymerase chain reaction. INTRODUCTION: Infections caused by β-lactamase-producing gram-negative bacteria, such as Klebsiella pneumoniae, are increasing globally with high morbidity and mortality. The aim of the current study was to determine antimicrobial susceptibility patterns and the prevalence of antibiotic resistance genes (β-lactamase and integron genes) using multiplex PCR. METHODS: One-hundred K. pneumoniae isolates were collected from different clinical samples. Antibiotic susceptibility testing was performed with thirteen different antibiotics. Multiplex-PCR was used to detect β-lactamase (bla TEM, bla CTX-M, bla SHV , bla VEB, bla PER, bla GES, bla VIM, bla IMP, bla OXA, and bla KPC) and integron genes (int I, int II, and int III). RESULTS: The highest and lowest rate of resistance was exhibited against amikacin (93%) and imipenem (8%), respectively. The frequency of β-lactamase-positive K. pneumoniae was 37%, and the prevalence of the bla TEM, bla CTX-M, bla SHV , bla VEB, bla PER, bla GES, bla VIM, bla IMP, bla OXA, and bla KPC genes was 38%, 24%, 19%, 12%, 6%, 11%, 33%, 0%, 28%, and 23%, respectively. Of the 100 isolates, eight (8%) were positive for class I integrons; however, class II and III integrons were not detected in any of the strains. CONCLUSIONS: These results indicate co-carriage of a number of β-lactamase genes and antibiotic resistance integrons on the same plasmids harboring multi-drug resistance genes. It seems that these properties help to decrease treatment complications due to resistant bacterial infections by rapid detection, infection-control programs and prevention of transmission of drug resistance.201728700049
144480.9991The Prevalence of bla VIM, bla KPC, bla NDM, bla IMP, bla SHV, bla TEM, bla CTX-M, and class I and II integrons Genes in Aeromonas hydrophila Isolated from Clinical Specimens of Qom, Iran. BACKGROUND: Aeromonas hydrophila is an opportunistic gram-negative bacillus that causes diseases such as gastroenteritis, muscle infections, soft tissue, sepsis, and skin diseases in humans. Today, the prevalence of antibiotic resistance in bacteria has led to treatment failure and prolonged treatment. Therefore, the aim of this study was to evaluate the level of antibiotic resistance in isolates carrying bla VIM, bla KPC, bla NDM, bla IMP, bla SHV, bla TEM, bla CTX-M and class I and II integrons in Aeromonas hydrophila. METHODS: In this cross-sectional study, Aeromonas hydrophila were collected from different clinical specimens in Hazrat Masoumeh Hospital, Qom Province, Iran, from 2018 to 2020. The collected isolates were identified by standard biochemical tests. Then, using specific primers bla VIM, bla KPC, bla NDM, bla IMP, bla SHV, bla TEM, bla CTX-M genes, and class I and II integrons were evaluated by PCR method. Then, data were analyzed using SPSS software and chi-squared tests, and the significance level was determined as p ≤ 0.05. RESULTS: During the sample collection period, 100 Aeromonas hydrophila were collected. Based on the results of the antibiotic resistance pattern, the highest and lowest rate of antibiotic resistance to ampicillin (92%) and azithromycin (4%) were determined for both. Among the 100 isolates, 60 isolates produced broad-spectrum beta-lactamase (ESBL) and 50 isolates produced carbapenemase. Among the studied beta-lactamase genes, the highest and lowest frequencies were related to bla CTX-M (58%) and bla TEM (1%), respectively. The frequency of class I and II integron genes was 27% and 15%, respectively. CONCLUSIONS: The results of the study of antibiotic resistance, beta-lactamase, and carbapenemase genes showed high resistance in Aeromonas hydrophila, which raises concerns with regard to controlling infection in medical centers. Also, the study of antibiotic resistance in the presence of beta-lactamase genes showed that there was only a significant relationship between the presence of bla CTX-M gene and resistance to imipenem (p = 0.037).202336649515
141690.9991Prevalence of extended-spectrum β-lactamase (ESBL) and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Enterobacteriaceae isolates from patients in Khartoum, Sudan. INTRODUCTION: the emergence of antibiotic resistance pathogens is an important health risk. Usually Gram negative bacteria acquire resistance to beta-lactam antibiotics by beta-lactamase production. The objectives of this study was to assess the prevalence of ESBL and to detect the frequency of blaTEM, blaSHV and blaCTX-M genotypes among ESBL producing Enterobacteriaceae isolates from patients in Khartoum, Sudan. METHODS: a total of 171 isolates of Enterobacteriaceae were recovered from hospitals in Khartoum, Sudan (2014 -2015) were used to detect ESBL production using disc diffusion method. blaTEM, blaSHV and blaCTX-M genes were investigated by PCR based methods using gene-specific primers. RESULTS: the high resistance among Enterobacteriaceae was noticed in ciprofloxacin (72%) and ofloxacin (73%). ESBL production was mainly in Escherichia Coli (38%) and Klebsiella pneumonia (34%). Prevalent genotypes were blaTEM (86%), blaCTX-M (78%) and blaSHV (28%). These were found mainly in Escherichia Coli (38%, 37%, 2%) and K. pneumonia (34%, 31%, 26.1%). The majority of ESBL producing isolates possess more than one ESBL genes. CONCLUSION: the ESBL production in Enterobacteriaceae was high, with blaTEM and blaCTX-M genotypes more prevalent. Public health and laboratory standard of excellence is needed to reducing the spread of resistant pathogens.202033520052
1116100.9991Detection of blaCTX-M genes in ESBL-producing Klebsiella isolates from animals in Croatia. This study investigated the frequency of third-generation cephalosporin resistance in Klebsiella spp. isolated from animals in Croatia and the presence of blaCTX-M genes. A total of 711 enteric bacteria were isolated from clinical samples, and Klebsiella spp. isolates accounted for 6.9% (n = 49). Thirteen Klebsiella isolates (26.5%) were ESBL producers, nine isolates from the Klebsiella pneumoniae species complex (69.2%), and four (30.8%) Klebsiella oxytoca isolates. All carried the blaCTX-M-15 gene, and antimicrobial susceptibility testing revealed them as multidrug resistant. All were resistant to all tested cephalosporins, fluoroquinolones, aminoglycosides and aztreonam, 92.3% showed resistance to tetracycline, 84.6% to trimethoprim-sulfamethoxazole and 69.2% to nitrofurantoin. No isolate showed resistance to imipenem and meropenem. It can be concluded that ESBL-producing Klebsiella expressing the blaCTX-M gene are not rare among Klebsiella isolates from animals in Croatia.202337027245
1118110.9991Detection and characterization of extended-spectrum β-lactamases (blaCTX-M-1 and blaSHV ) producing Escherichia coli, Salmonella spp. and Klebsiella pneumoniae isolated from humans in Mizoram. AIM: The present study was conducted to isolate and characterize the extended spectrum β-lactamases (ESBLs) producing enteric bacteria in human beings in Mizoram, India. MATERIALS AND METHODS: Fecal samples were collected from human beings with or without the history of diarrhea from different hospitals of Mizoram. Samples were processed for isolation and identification of Escherichia coli, Salmonella and Klebsiella pneumoniae. All the isolates were subjected to antibiotic sensitivity assays. Phenotypically, ESBLs production ability was determined by double discs synergy test (DDST) method. ESBLs producing isolates were subjected to polymerase chain reaction (PCR) for detection of ESBLs genes. Plasmids were cured by acridine orange. Transfer of resistance from a donor to recipient strains was done by in vitro horizontal method. RESULTS: A total of 414 enteric bacteria were isolated from 180 fecal samples (113 were from diarrheic patients and 67 were from non-diarrheic patients), of which 333 (80.44%), 52 (12.56%), and 29 (7.00%) were E. coli, K. pneumoniae and Salmonella spp., respectively. Double discs synergy test (DDST) exhibited 72 (21.62%) E. coli, 12 (23.08%) K. pneumoniae and 4 (13.79%) Salmonella spp. were ESBLs producers. Altogether, 24 (13.04%) isolates were found to be positive for at least one resistance genes under this study. A total of 36 (8.70%) E. coli, 4 (0.97%) K. pneumoniae and 2 (0.48%) Salmonella spp. were found to be positive for blaCTX-M-1 gene by PCR. Similarly, 5 (1.21%) E. coli and 4 (0.97%) K. pneumoniae isolates were found to be positive for blaSHV gene. A total of 3 (0.72%) K. pneumoniae isolates were recorded as positive for both blaCTX-M-1 and blaSHV genes. All the isolates were carrying plasmids ranging between 0.9 kb and ~30 kb. The resistance plasmid could not be transferred to a recipient by in vitro horizontal gene transfer method. CONCLUSION: ESBLs producing enteric bacteria are circulating in human population in North Eastern Region of India. Indiscriminate use of antibiotics should be avoided to control the menace of multidrug resistance bacteria in the environment, animals, and human beings.201527047141
1107120.9991Prevalence of plasmid-mediated quinolone resistance genes among ciprofloxacin-nonsusceptible Escherichia coli and Klebsiella pneumoniae isolated from blood cultures in Korea. OBJECTIVES: To analyze the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants in ciprofloxacin-nonsusceptible Escherichia coli and Klebsiella pneumoniae isolated from patients at a tertiary care hospital in Korea. METHODS: A total of 102 nonduplicate isolates of ciprofloxacin-intermediate or ciprofloxacin-resistant E coli (n=80) and K pneumoniae (n=22) from blood cultures were obtained. The qnr (qnrA, qnrB, qnrS), aac(6')-Ib-cr, qepA and oqxAB genes were detected using polymerase chain reaction (PCR) and confirmed using direct sequencing. To determine whether the PMQR-positive plasmid was horizontally transferable, conjugation experiments were performed. RESULTS: Of the 102 isolates, 81 (79.4%) had one or more PMQR genes; these consisted of 59 (73.8%) E coli and 22 (100%) K pneumoniae isolates. The qnr genes were present in 15 isolates (14.7%): qnrB4 was detected in 10.8% and qnrS1 was detected in 3.9%. The aac(6')-Ib-cr, qepA and oqxAB genes were detected in 77.5%, 3.9% and 10.8%, respectively. In conjugation experiments, PMQR genes were successfully transferred from seven (8.6%) isolates. The range of minimum inhibitory concentrations of ciprofloxacin for these seven transconjugants increased to 0.5 mg/L to 1 mg/L, which was 16- to 33-fold that of the recipient E coli J53 bacteria. CONCLUSIONS: PMQR genes were highly prevalent among ciprofloxacin-nonsusceptible E coli and K pneumoniae from blood cultures in the authors' hospital. Therefore, it is necessary to monitor for the spread of PMQR genes of clinical isolates and to ensure careful antibiotic use in a hospital setting.201425285114
1446130.9991One-Day Prevalence of Extended-Spectrum β-Lactamase (ESBL) and Carbapenemase-Producing Bacteria in Fecal Samples from Surgical Patients: A Concerning Trend of Antibiotic Resistance. PURPOSE: Extended-spectrum β-lactamase (ESBL) and carbapenemase producing bacteria are of increasing concern due to their multidrug resistance and infection potential. This study determines the one-day prevalence of faecal carriage of ESBL and carbapenemase producing Gram-negative bacilli. METHODS: Fecal samples were collected from 30 post-surgery patients (hospitalized for at least 48 hours) in each of the four hospitals involved in the study and were analyzed for antibiotic-resistant bacteria. Identification was done using Maldi Tof mass spectrometry, and antibiotic susceptibility was tested using disk diffusion and specialized tests for ESBL (double disk synergy technique) and carbapenem (NG-TEST CARBA 5) resistance detection. PCR was conducted on isolates to detect betalactam resistance genes, carbapenemase genes and quinolone resistance genes. FINDINGS: Out of the 120 patients enrolled, 38.33% (n = 46) and 49.16.33% (n = 59) were found to carry ESBL- and carbapenemase-producing bacteria, respectively, in their fecal samples. Among the isolates, 51.08% (n = 47) exhibited ESBL production, with Escherichia coli (44.56%) being the most common species. The identification of bacteria with resistance to carbapenems showed a predominance of the species Escherichia coli (44.45%) followed by the species Klebsiella pneumoniae (16.06%) and Acinetobacter baumanii (13.58%). The study of the association of variables shows a high degree of association (p < 0.05) for the factors independent walking and use of a wheelchair with ESBL production. The most frequently detected genes among ESBL producing bacteria were bla(CTXM-1) (91.49%), qnrB (70.21%) and qnrs (63.82%). bla(NDM) (54.68%) was the most detected carbapenemase genes among carbapenemase producing isolates. CONCLUSION: This study demonstrates, for the first time, a significant prevalence of ESBL and carbapenemase producing gram-negative bacteria among surgical patients in Benin, with multiple resistance genes detected. Findings should be interpreted in light of the cross-sectional design and >48-hour hospitalization criterion.202540635768
985140.9991TEM & SHV genes in extended spectrum beta-lactamase producing Klebsiella species beta their antimicrobial resistance pattern. BACKGROUND & OBJECTIVES: Extended spectrum beta-lactamases (ESBLs) are often plasmid mediated derived from mutations in the classic TEM and SHV genes by one or more amino acid substitution around the active site. Detection of TEM and SHV genes by molecular methods in ESBL producing bacteria and their pattern of antimicrobial resistance can provide useful information about its epidemiology and risk factors associated with these infections. We investigated the presence of TEM and SHV genes in ESBL producing Klebsiella spp. and their antimicrobial resistance pattern in cases of neonatal septicaemia in a tertiary care hospital. METHODS: A total of 130 clinical isolates of Klebsiella spp. isolated from septicaemic neonates of a neonatal intensive care unit (NICU) from a tertiary care hospital in north India, were screened for ESBL production by combined disk diffusion method. PCR was used to detect TEM and SHV genes in ESBL positive isolates. Isoelectric points of ESBL enzymes from a few isolates (n = 6) were noted for typing of ESBL by isoelectric focusing. RESULTS: Of the 64 ESBL producing Klebsiella spp. isolates, 17 (26.5%) had both TEM and SHV genes, 31 (48.4%) had TEM alone and 13 (20.3%) had SHV gene alone. Three (4.6%) ESBL positive isolates were negative for both TEM and SHV. Isolates with both TEM and SHV genes were highly resistant to antibiotics used. Degree of resistance for 3(rd) generation cephalosporins was also high in these isolates. Six randomly selected isolates were subjected to isoelectric focussing. Results of isoelectric focussing were comparable with PCR. INTERPRETATION & CONCLUSION: Presence of TEM gene in ESBL producing Klebsiella spp. was more common than SHV gene. Frequency of antibiotic resistance was high in isolates having both TEM and SHV genes.200819246801
1109150.9991Quinolone Susceptibility and Detection of qnr and aac(6')-Ib-cr Genes in Community Isolates of Klebsiella pneumoniae. BACKGROUND: Plasmid-mediated quinolone resistance genes (PMQR) have been shown to play not only an important role in quinolone resistance, but also resistance to other antibiotics, particularly β-lactams and aminoglycosides. These genes are mainly associated with clinical isolates of Enterobacteriaceae. However, detection of PMQR genes in the community isolates can increase the dissemination rate of resistance determinants among bacteria. OBJECTIVES: This study aimed to investigate quinolone resistance and distribution of qnr and aac (6')-Ib-cr genes among the community isolates of Klebsiella pneumoniae. MATERIALS AND METHODS: Fifty-two K. pneumoniae isolates were collected from the Central Laboratory in Karaj between July 2010 and January 2011. Antibacterial susceptibility was determined by the disc diffusion method. Quinolone and/or cephalosporin-resistant isolates were screened for the presence of qnrA, qnrB, qnrS and aac (6')-Ib-cr genes by polymerase chain reaction (PCR). RESULTS: Of the 52 K. pneumoniae isolates, 23 were resistant to cephalosporins and/or quinolones. Overall, 7 out of the 23 resistant isolates harbored qnr and/or aac (6')-Ib-cr genes (30.4%). Among these, 5 isolates were resistant to both classes of antibiotics of which; 3 carried the aac (6')-Ib-cr gene, one had the qnrS, and one harbored both aac (6')-Ib-cr and qnrB genes. None of the isolates contained qnrA. Two isolates were sensitive to quinolones and resistant to cephalosporins of which; one had qnrS and the other carried the aac (6')-Ib-cr gene. CONCLUSIONS: Our study showed that 30.4% of the quinolone and/or cephalosporin resistant community isolates of K. pneumoniae carried PMQR genes. These results confirm that community isolates can be an important source for spreading antibiotic resistance determinants among Gram negative pathogens. This is the first report from Iran on detection of PMQR in the community isolates of K. pneumoniae.201425368793
1445160.9991Rapid Detection of Beta-Lactamases Genes among Enterobacterales in Urine Samples by Using Real-Time PCR. The objective of this study was to develop and evaluate newly improved, rapid, and reliable strategies based on real-time PCR to detect the most frequent beta-lactamase genes recorded in clinical Enterobacterales strains, particularly in Tunisia (bla(SHV12) , bla(TEM) , bla(CTX-M-15) , bla(CTX-M-9) , bla(CMY-2) , bla(OXA-48) , bla(NDM-1) , and bla(IMP) ) directly from the urine. Following the design of primers for a specific gene pool and their validation, a series of real-time PCR reactions were performed to detect these genes in 78 urine samples showing high antibiotic resistance after culture and susceptibility testing. Assays were applied to DNA extracted from cultured bacteria and collected urine. qPCR results were compared for phenotypic sensitivity. qPCR results were similar regardless of whether cultures or urine were collected, with 100% sensitivity and specificity. Out of 78 multiresistant uropathogenic, strains of Enterobacterales (44 E. coli and 34 K. pneumoniae strains) show the presence of the genes of the bla group. In all, 44% E. coli and 36 of K. pneumoniae clinical strains harbored the bla group genes with 36.4%, 52.3%, 70.5%, 68.2%, 18.2%, and 4.5% of E. coli having bla(SHV-12) , bla(TEM) , bla(CTX-M 15) , bla(CTX-M-9) , bla(CMY-2) , and bla(OXA-48) group genes, respectively, whereas 52.9%, 67.6%, 76.5%, 35.5%, 61.8, 14.7, and 1.28% of K. pneumoniae had bla(SHV-12) , bla(TEM) , bla(CTX-M 15) , bla(CTX-M-9) , bla(CMY-2) , bla(OXA-48) , and bla(NDM-1) group genes, respectively. The time required to have a result was 3 hours by real-time PCR and 2 to 3 days by the conventional method. Resistance genes of Gram-negative bacteria in urine, as well as cultured bacteria, were rapidly detected using qPCR techniques. These techniques will be used as rapid and cost-effective methods in the laboratory. Therefore, this test could be a good candidate to create real-time PCR kits for the detection of resistance genes directly from urine in clinical or epidemiological settings.202235978630
2176170.9991Evaluation of phenotypic and genotypic patterns of aminoglycoside resistance in the Gram-negative bacteria isolates collected from pediatric and general hospitals. The purpose of the current study was to evaluate the phenotypic and genotypic patterns of aminoglycoside resistance among the Gram-negative bacteria (GNB) isolates collected from pediatric and general hospitals in Iran. A total of 836 clinical isolates of GNB were collected from pediatric and general hospitals from January 2018 to the end of December 2019. The identification of bacterial isolates was performed by conventional biochemical tests. Susceptibility to aminoglycosides was evaluated by the disk diffusion method (DDM). The frequency of genes encoding aminoglycoside-modifying enzymes (AMEs) was screened by the PCR method via specific primers. Among all pediatric and general hospitals, the predominant GNB isolates were Acinetobacter spp. (n = 327) and Escherichia coli (n = 144). However, E. coli (n = 20/144; 13.9%) had the highest frequency in clinical samples collected from pediatrics. The DDM results showed that 64.3% of all GNB were resistant to all of the tested aminoglycoside agents. Acinetobacter spp. and Klebsiella pneumoniae with 93.6%, Pseudomonas aeruginosa with 93.4%, and Enterobacter spp. with 86.5% exhibited very high levels of resistance to gentamicin. Amikacin was the most effective antibiotic against E. coli isolates. In total, the results showed that the aac (6')-Ib gene with 59% had the highest frequency among genes encoding AMEs in GNB. The frequency of the surveyed aminoglycoside-modifying enzyme genes among all GNB was found as follows: aph (3')-VIe (48.7%), aadA15 (38.6%), aph (3')-Ia (31.3%), aph (3')-II (14.4%), and aph (6) (2.6%). The obtained data demonstrated that the phenotypic and genotypic aminoglycoside resistance among GNB was quite high and it is possible that the resistance genes may frequently spread among clinical isolates of GNB.202235119565
2111180.9991Antimicrobial Resistance and Resistance Determinant Insights into Multi-Drug Resistant Gram-Negative Bacteria Isolates from Paediatric Patients in China. INTRODUCTION: The emergence of multi-drug-resistant Gram-negative bacteria (GNB) is a concern in China and globally. This study investigated antimicrobial resistance traits and resistance determinant detection in GNB isolates from paediatric patients in China. METHODS: In the present study, a total of 170 isolates of GNB including the most prevalent Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii were collected from Shenzhen Children's Hospital, China. ESBLs production was confirmed by using the combination disc diffusion method, and carbapenemase production was confirmed by using a carbapenem inactivation method followed by antimicrobial susceptibility. In addition, β-lactamase-encoding genes and co-existence of plasmid-borne colistin resistance mcr-1 gene were determined by PCR and sequencing. RESULTS: Overall, 170 etiological agents (GNB) were recovered from 158 paediatric patients. The most prevalent species was E. coli 40% (n=68), followed by K. pneumoniae 17.64% (n=30), and Enterobacter cloacae 14.11% (n=24). Of 170 GNB, 71.76% (n=122) were multi-drug-resistant, 12.35% (n=21) extreme-drug resistant, and 7.64% (n=13) single-drug-resistant, while 8.23% (n=14) were sensitive to all of the studied antibiotics. The prevalence of ESBLs and carbapenemase producers were 60% and 17%, respectively. bla (CTX-M) was the most prevalent resistance gene (59.42%), followed by bla (TEM) (41.17%), bla (SHV) (34.270%), bla (KPC) (34.11%), bla (OXA-48) (18.82%) and bla (NDM-1) (17.64%). CONCLUSION: The present study provides insights into the linkage between the resistance patterns of GNB to commonly used antibiotics and their uses in China. The findings are useful for understanding the genetics of resistance traits and difficulty in tackling of GNB in paediatric patients.201931819545
1127190.9991Extended spectrum beta-lactamase and aminoglycoside modifying enzyme genes in multi drug resistant Gram-negative bacteria: A snapshot from a tertiary care centre. BACKGROUND: This study aims to enhance the existing knowledge of the prevalence of genes responsible for beta-lactam resistance and aminoglycoside resistance in gram negative organisms by molecular detection of extended spectrum beta-lactamase and aminoglycoside modifying enzymes in multidrug-resistant gram-negative bacteria. METHODS: Out of 864 gram-negative isolates, 710 were phenotypically identified as multidrug-resistant by antibiotic susceptibility testing. From the above isolates, 102 representative isolates as per sample size calculated were selected for further molecular studies. The presence of blaTEM, blaCTX-M blaSHV, and five AmpC genes was detected by real-time polymerase chain reaction (PCR). Conventional PCR was performed to detect seven aminoglycoside modifying enzyme genes namely aac(6')-Ib, aac(6')-Ic, aac(3)-Ia, aac(3)-Ib, aac(3)-IIa, ant(2'')-Ia, and ant(4'')-IIa. RESULTS: Most common multidrug-resistant isolate was Klebsiella pneumoniae (35%) followed by Escherichia coli (30%). Among the 102 selected isolates all harboured blaTEM gene, 71 (69.6%) harboured blaCTX-M gene and 48 (47%) blaSHV gene. Among the selected isolates 60% showed the presence of AmpC genes. Most common aminoglycosie modifying enzyme gene was AAC 6' Ib (51%) followed by ANT 2" Ia (36%). CONCLUSION: This study suggests a wider use of molecular methods using specific PCR amplification of resistance genes. It would be beneficial to perform the molecular identification of antimicrobial resistance genes to effectively monitor and manage antibiotic resistance, administer appropriate antimicrobial medication, practice antimicrobial stewardship and improve hospital infection control procedures.202439734850