scholarly journals Antimicrobial Resistance Patterns in Clinical Isolates of Enterobacteriaceae from a Tertiary Care Hospital, Kathmandu, Nepal

2018 ◽  
Vol 1 (2) ◽  
pp. 74-78
Author(s):  
Ram Prasad Adhikari ◽  
Subha Shrestha ◽  
Junu Richhinbung Rai ◽  
Ritu Amatya
Keyword(s):  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
College Teaching ◽  
Clinical Isolates ◽  
High Rate ◽  
Clinical Samples ◽  
Care Hospital ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Introduction: Multidrug resistance among Enterobacteriaceae is in increasing trend these days. The objective of this study was to determine the antibiogram of clinical isolates of Enterobacteriaceae with special reference to multidrug resistance and  extended spectrum beta-lactamases production.Materials and Methods: A descriptive cross sectional study was conducted over a period of six months (February -July, 2017) in the microbiology laboratory of Nepal Medical College Teaching Hospital, Kathmandu, Nepal. A total of 936 bacterial isolates of Enterobacteriaceae from clinical specimens were processed for antimicrobial susceptibility testing and screened for multidrug resistance. ESBL production was detected among potential isolates by combination disk diffusion test.Results: The rate of multidrug resistance and extended spectrum beta-lactamases production was 54.2% and 23.8% respectively. Of the total ESBL producers 92.4% were multidrug resistance. The rate of multidrug resistance and extended spectrum beta-lactamases production were higher in organisms isolated from clinical samples collected from inpatients. High rate of multidrug resistance and extended spectrum beta-lactamases production was seen in E. coli (54.4% & 27.7%), Klebsiella spp. (67.1% & 28.2%) and Citrobacter spp. (70.3% & 10.9%). The antimicrobial resistance rate was highest against ampicillin (76.7%) followed by cefixime (54. 0%), ceftazidime (51.5%), ceftriaxone (51.0%), cotrimoxazole (48.7%), ciprofloxacin (43.9%) and ofloxacin (41.1%).Conclusions:  Multidrug resistance is common among Enterobacteriaceae. These bacteria have high rate of resistance against commonly used groups of antibiotics like cephalosporins and quinolones. Continuous monitoring, surveillance of antimicrobial resistance, proper infection control and practices are important to combat with these issues.

scholarly journals Extended Spectrum Beta-Lactamases Producers among Gram-negative Bacteria from Clinical and Environmental Sources in Two Tertiary Hospitals in Makurdi, Nigeria

2020 ◽  
pp. 42-53
Author(s):  
Florence Bose Omoregbe ◽  
Obasola Ezekiel Fagade
Keyword(s):  
Clinical Isolates ◽  
Diffusion Method ◽  
Clinical Samples ◽  
Multiple Drug ◽  
Gram Negative Bacteria ◽  
Disc Diffusion ◽  
Gram Negative ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases

Extended Spectrum Beta-Lactamases (ESBLs) enzymes are produced by many Gram-negative bacteria to nearly all antibiotics. Clinical bacteria isolates were obtained from various clinical samples from the two healthcare facilities. Sewer wastewater and sediments were also collected from both hospitals using standard sampling techniques and bacteria isolated using pour plate technique. Multiple drug resistant patterns were determined using disc diffusion technique. Antibiotics sensitivity of the isolates was verified using disc diffusion method. Detection of ESBL producing bacteria was done using double disc synergy test. Data obtained were analysed using descriptive statistics. Clinical bacteria (403) were obtained, out of which 299 were confirmed Gram-negative, 218 from Federal Medical Centre (FMC) and 81 from Benue State Teaching Hospital (BSUTH). Thirty-nine Gram-negative bacteria were also isolated from the environmental samples. The ESBL producers in clinical isolates were 69 (FMC) and 42 (BSUTH) while in environmental isolates they were eight and four respectively. Out of a total of 338 environmental and clinical isolates from the two hospitals, 216 shown resistance/intermediate resistance to Ceftazidime. Of these 216, 123(36.39%) were positive for ESBLs production.- space From FMC, ESBLs producing bacteria are highly sensitive to imipenem with sensitivity frequency of 62 while they were highly resistant to ceftazidime with a frequency of 52. Age groups 0-5 had the highest percentage distribution of 21.43% and 10.14% from BSUTH and FMC respectively. ESBLs producing bacteria showed multidrug resistance.

scholarly journals Phenotypic detection of Extended Spectrum Beta-Lactamases and Amp C Beta- Lactamases among nosocomial isolates in a tertiary care hospital

2013 ◽  
Vol 12 (4) ◽  
pp. 378-384
Author(s):  
V Vijayvergia ◽  
AK Sahni ◽  
M Lall ◽  
K Vijay ◽  
ID Khan
Keyword(s):  
Tertiary Care ◽  
Clinical Samples ◽  
Simultaneous Occurrence ◽  
Kappa Statistics ◽  
Care Hospital ◽  
Beta Lactamase ◽  
Beta Lactamases ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Disk Test

Background & objectives: Extended-Spectrum Beta-Lactamases (ESBLs) is an important resistance mechanism in Enterobacteriaceae infections. Lack of standard guidelines from Clinical Laboratory Standards Institute (CLSI) for Amp C beta-lactamase detection poses a problem. This study was undertaken to detect ESBLs by phenotypic tests and Amp C beta-lactamase by inhibitor based method. Material and Methods: 200 consecutive non-repetitive isolates of E.coli, Klebsiella and Proteus from clinical samples were screened for ESBLs as per CLSI guidelines and confirmed by PCDT, DDST and E-tests (AB Biodisk, Biomerieux). Amp C beta lactamases were screened by cefoxitin resistance and confirmed by inhibitor (Cloxacillin) based method. Simultaneous occurrence of Amp C and ESBLs was detected by combined disk test (Neo-Sensitabs and Diatabs). Descriptive and Kappa statistics were used. Results: Out of 200 isolates studied, 131 were initially screened as ESBL producers and later 114 (57%) were confirmed by phenotypic methods. E-Test was found most sensitive phenotypic test as compared to PCDT and DDST. 13 strains resistant to cefoxitin (30?g) were found to be pure Amp C producers. Combined disk test detected 36 to be ESBL and Amp C co-producers. Surprisingly, six isolates found sensitive to cefoxitin disk were confirmed as Amp C producers by cloxacillin disk inhibition test. Conclusion: 57% ESBLs and 27.5% Amp C producers were isolated from nosocomial pathogens showing significant resistance to 3rd generation cephalosporins. Phenotypic confirmation by E-test, PCDT & DDST were useful for ESBL identification and for detection of Amp C, cloxacillin was found to be an effective inhibitor. DOI: http://dx.doi.org/10.3329/bjms.v12i4.13309 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 378-384

scholarly journals Prevalence Of Extended Spectrum Beta-Lactamases (ESBLs)-Producing Escherichia Coli Isolated From UTI Patients Attending some Selected Hospitals In Minna, Nigeria

2021 ◽  
Vol 37 (2) ◽  
pp. 56-73
Author(s):  
F Iseghohi ◽  
J.C Igwe ◽  
M Galadima ◽  
A.F Kuta ◽  
A.M Abdullahi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistance ◽  
Urine Samples ◽  
Antibiotics Resistance ◽  
Healthy Individuals ◽  
Beta Lactamases ◽  
E Coli ◽  
Extended Spectrum ◽  
Extended Spectrum Beta Lactamases ◽  
Tract Infections

Globally, urinary tract infections are one of the most common infections in need of urgent clinical attention. The prevalence of extended spectrum beta-lactamases (ESBL)- producing Escherichia coli isolated from urine samples of some UTI patients and s of apparently healthy individuals in Minna, Nigeria, is investigated. Standard microbiological techniques were used to conduct this study. A total of 170 catch midstream urine samples submitted to the Medical Microbiology Laboratories of 4 different hospitals (and samples from healthy individuals) were randomly collected for 5 months and examined for microbial growths. Female patients (65.9%) submitted more urine samples for UTI test than their male counterpart (34.1%). The age ranges of 21 -30 (26.5%) and 31 - 40 (25.3%) had the highest percentages of infection rate while those within the ages 1- 10 (3.5%) and ≥ 71 (2.3%) were the least infected. This study observed a prevalence of 23.5% of E. coli in Minna metropolis and a significant number (30%) of healthy individuals (HI) was observed to harbor the E. coli in their urine. The isolates were highly susceptible to Gentamicin (65%), Ofloxacin (65%), Tetracycline (62.5%), Cotrimoxazole (62.5%), and Streptomycin (57.5%). Mildly susceptible to Pefloxacin (37.5%), Chloramphenicol (37.5%), and Ciprofloxacin (35%). There were significant resistance to most of the beta-lactames tested [Cefuroxime (80%), Amoxicillin (42.5%), Augmentin (40), Cefotaxime (20%) and Ceftaxidime (7.5%)]. Two of the isolates were resistant to all the 13 antibiotics tested; 70% (28) of the isolates had multiple antibiotics resistance index (MARI) ≥0.3. Multidrug resistance was expressed in 37.5% of the isolates tested. The study showed a vast resistant pool in the environment. Only 25% of the E. coli isolated from the urine samples produced beta-lactamases phenotypically, most of which expressed resistance to more than 5 of the antibiotics tested and had MARI of ≥ 0.5. Further evaluation showed that 25% (10/40) of the E. coli isolated from the UTI patients in Minna, Nigeria, were ESBL- producers and could harbor one or two of the genes. TEM gene was expressed in 70% (7) of the isolates that produced ESBL phenotypically, 60% 6) harbored CTXM gene, 20% (2) had the OXA gene while none of the bacteria harbored the SHV gene. The study established a 5.9% ESBL prevalence among the E. coli isolated from UTI in the environment studied. This study established that E. coli is one of the prevalent bacteri urea majorly isolated from UTI patients in Minna. The prevalent E. coli are multidrug resistant and could harbor more than one ESBL gene . keywords: Escherichia coli, Minna, UTI, ESBL, Multidrug resistance

First Detection of OXA-10 Extended-Spectrum Beta-Lactamases and the Occurrence of mexR and nfxB in Clinical Isolates of Pseudomonas aeruginosa from Nigeria

Chemotherapy ◽  
2015 ◽  
Vol 61 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Bamidele T. Odumosu ◽  
Bola A. Adeniyi ◽  
Ram Chandra
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Efflux Pump ◽  
Clinical Isolates ◽  
Beta Lactamases ◽  
First Report ◽  
Extended Spectrum ◽  
Pcr Rflp ◽  
Extended Spectrum Beta Lactamases ◽  
Regulator Genes

Background: The characterization of β-lactamase production in Pseudomonasaeruginosa is rarely reported in Nigeria. The objective of this study was to investigate the occurrence and characterize the different β-lactamases as well as mechanisms of fluoroquinolones resistance among P. aeruginosa isolated from various clinical sources from Nigeria. Materials and Method: Isolates were investigated using PCR, RFLP and sequencing for the detection of various β-lactamases and efflux pump regulator genes. Result: The prevalence of OXA-10, AmpC, CTX-M and SHV in P. aeruginosa was 80, 70, 5 and 5%, respectively. The coexistence of blaOXA-10 with blaAmpC, blaSHV and blaCTX-M was reported in 40, 5 and 5% of isolates, respectively. The efflux pump regulator genes mexR and nfxB were both amplified in 45% of the OXA-10-positive isolates. Conclusion: This is the first report of the characterization of OXA-10 extended-spectrum β-lactamases and occurrence of mexR and nfxB efflux regulator genes in clinical isolates of P. aeruginosa in Nigeria.

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