Abstract
The proportions and similarities of extended-spectrum β-lactamase (ESBL) producing K. pneumoniae (ESBL-KP) and E. coli (ESBL-EC) carrying multiple ESBL genes is poorly known at our setting. This study investigated the existence of multiple ESBL genes (blaCTX-M, blaTEM, and blaSHV) among ESBL-KP and ESBL-EC concurrently isolated from clinical, colonization, and contamination samples from neonatology units in Mwanza-Tanzania. Twenty and 55 presumptive ESBL-EC and ESBL-KP, respectively, from a previous study archived at −80 °C were successfully recovered for this study. Isolates were screened and confirmed for production of ESBLs by phenotypic methods followed by multiplex PCR assay to determine ESBL genes. All (100%) and 97.3% of presumptive ESBL isolates were phenotypically confirmed by Clinical and Laboratory Standards Institute (CLSI) and modified double-disc synergy methods, respectively. About 93.3% (70/75) of phenotypically confirmed ESBL isolates had at least one ESBL gene, whereby for 62.9% (44/70), all ESBL genes (blaCTX-M, blaTEM, and blaSHV) were detected. Eight pairs of ESBL bacteria show similar patterns of antibiotics susceptibility and ESBL genes. ESBL-KP and ESBL-EC, concurrently isolated from clinical, colonization and contamination samples, harbored multiple ESBL genes. Further, eight pairs of ESBL isolates had similar patterns of antibiotics susceptibility and ESBL genes, suggesting transmission of and/or sharing of mobile genetic elements (MGEs) among ESBL-KP and ESBL-EC.
Highlights
IntroductionExtended-spectrum β-lactamases (ESBLs) are enzymes which hydrolyze the betalactam ring of β-lactam antibiotics conferring bacterial resistance to penicillins (e.g., ampicillin and amoxicillin); first- (e.g., cephalexin), second- (e.g., cefuroxime) and third- (e.g., ceftriaxone and cefotaxime) generation cephalosporins; and monobactams (e.g., aztreonam) [1,2]
Extended-spectrum β-lactamases (ESBLs) are enzymes which hydrolyze the betalactam ring of β-lactam antibiotics conferring bacterial resistance to penicillins; first, second- and third- generation cephalosporins; and monobactams [1,2]
This study investigated the existence of ESBL genes by multiplex PCR assay among phenotypically confirmed ESBL-KP and ESBL-EC concurrently isolated from clinical, colonization and contamination samples
Summary
Extended-spectrum β-lactamases (ESBLs) are enzymes which hydrolyze the betalactam ring of β-lactam antibiotics conferring bacterial resistance to penicillins (e.g., ampicillin and amoxicillin); first- (e.g., cephalexin), second- (e.g., cefuroxime) and third- (e.g., ceftriaxone and cefotaxime) generation cephalosporins; and monobactams (e.g., aztreonam) [1,2]. ESBL producing bacteria respond poorly to β-lactams, leading to higher medical costs, prolonged hospital stays, loss of prophylactic protection, and increased mortality [3,4]. ESBLs are not effective in hydrolyzing cephamycins (e.g., cefoxitin and cefotetan) and carbapenems (e.g., imipenem and meropenem), these antibiotic agents—notably carbapenems, are recommended for the treatment of infections due to ESBL producers [5,6].
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