Abstract
Antimicrobial resistance gene profile characterization and dissemination offer useful detail on the possible challenge in treating bacteria. The development of aminoglycoside modifying enzymes (AMEs) is considered as the primary mechanism of resistance to aminoglycosides, in addition to the 16S rRNA methylases. This study aimed at isolation and characterization of aminoglycosides resistant clinical isolates of enterobacteriaceae family from different clinical samples. Over a period of 24 months, thirty samples were collected and 49 clinical isolates of E. coli [n=25], Klebsiella [n=13], Enterobacter species (n=7) and Proteus species (n=4) were isolated from Egyptian clinical laboratories. The identities of the cultures were confirmed following standard microbiological procedures. Resistance of the isolates to aminoglycosides was determined by the disc diffusion method and isolates with highest resistance (n=9) were selected and investigated for 16S rRNA methylase and AMES encoding genes by polymerase chain reaction (PCR) and sequencing. In general, aminoglycoside resistance was found in 95% of the isolates; the isolates displayed the highest rate of resistance to netilmicin (75%) and kanamycin (55%), while resistance to gentamycin (18%) and tobramycin (16%) was low. A total of 9 isolates have the highest aminoglycoside resistant rate, showed the highest appearance for aac(6′)-Ib as well as ant (3″)-Ia resistant genes, with aac (3)-II (44%) and ant (4′)-IIb (34%) following closely. The high prevalence of AMEs observed among resistant isolates in this study suggests the urgent need for more efficient treatment designs to mitigate the selection burden as well as improved care of patients who have been infected with these drug-resistant organisms.
Highlights
Gram-negative bacteria (E.coli and Klebsiella) have long been suspected major causes of nosocomial infections, including infections of the urinary tract (UT), respiratory system and bacteremia.[1,2] Resistance of antibiotics, to Gram-negative bacteria, has arisen as worldwide epidemic in the Twenty-First Century
On the basis of 16S rRNA gene sequence analysis, seven of these nine isolates were identified as E. coli and assigned accession numbers as follows: E. coli strain 008 (Accession number LR880734.1), Escherichia coli strain 144 (Accession number MH671464.1), Escherichia coli strain EcPF7 (Accession number CP054232.1), Escherichia coli strain 91 (Accession number MH671447.1), Escherichia coli strain[54] (Accession number MH671431.1), Escherichia coli strain152-a blue (Accession number MN208228.1), Escherichia coli strain SCU-103 (Accession number CP054457.1)
The current study showed that Klebsiella and Escherichia coli isolated from clinical samples exhibited a high rate of resistance to aminoglycosides
Summary
E.coli and Klebsiella) have long been suspected major causes of nosocomial infections, including infections of the urinary tract (UT), respiratory system and bacteremia.[1,2] Resistance of antibiotics, to Gram-negative bacteria, has arisen as worldwide epidemic in the Twenty-First Century. Their resistance to diverse antibiotic classes limits available therapeutic options for their control.
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