Abstract
Article history: Received on: 13/11/2015 Revised on: 20/12/2015 Accepted on: 04/01/2016 Available online: 26/01/2016 The prevalence and molecular epidemiology of Escherichia coli that produce extended spectrum β-lactamase (ESBL) in Cairo, Egypt was investigated. Ninety E. coli isolates were collected along the period of September to November 2012 from hospital and community settings. Antibiotic susceptibility of the E. coli isolates was determined by disk diffusion method. All isolates were screened phenotypically for ESBL production by combination disk method. The presence of bla CTX-M-I, bla CTX-M-IV, bla TEM and bla SHV genes in ESBLproducing E. coli was examined by PCR and sequencing experiments. The results showed high prevalence of ESBL-producing E. coli, 52% of the collected isolates were ESBL producers. The ESBL-producing isolates significantly (P < 0.05) had increased resistance compared with non–ESBL producers to cefuroxime, cefotaxime, ceftazidime, cefepime, ciprofloxacin, and co-trimoxazole. Imipenem was the most effective drug against ESBL producing isolates. All ESBL producing E. coli isolates were multi drug resistant (MDR) to eight antibiotics or more. Detection of ESBL genes in selected MDR-ESBL producing E. coli revealed that bla CTX-M-I was the most prevalent ESBL type. It is clear that the prevalence of ESBL producing E. coli in Cairo, Egypt is alarming high. This study is useful for clinician in order to improve the empiric treatment.
Highlights
In the early 1980s, third-generation cephalosporins were introduced to the clinical practice as β-lactam antibiotics able to overcome resistance caused by the common β-lactamases produced by Escherichia coli (Livermore, 2012)
ESBLs are commonly found in E. coli isolates from patients in nursing homes and long term- care facilities, and even in patients with community-acquired infections (Lahlaoui et al, 2014)
In another study from Egypt, which included only blood stream infections in patients admitted to intensive care units (ICUs), the proportion of ESBL-producing E. coli was 39% (Saied et al, 2011)
Summary
In the early 1980s, third-generation cephalosporins were introduced to the clinical practice as β-lactam antibiotics able to overcome resistance caused by the common β-lactamases produced by Escherichia coli (Livermore, 2012). ESBLs are enzymes capable of conferring bacteria resistance to penicillins, 1st, 2nd, 3rd, 4th generation cephalosporins, and monobactams by hydrolysis of these antibiotics. Genes encoding ESBLs are frequently found on the same plasmid as genes encoding resistance for other classes of antibiotics such as aminoglycosides, tetracyclines, and sulfonamides. This study was carried out to determine the prevalence of ESBLproducing E. coli in hospital and community settings in Cairo, Egypt and to assess antibiotic susceptibility patterns of these isolates in order to define appropriate antimicrobial therapy. We are aimed to reveal basic aspects of the molecular epidemiology of these isolates in Cairo, Egypt
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