Prevalence of extended-spectrum beta-lactamases in uropathogenic Enterobacteriaceae isolated from a community setting, Meknes, Morocco

Abstract

The aim of this study is to assess the prevalence and molecular characterization of uropathogenic extended spectrum β-lactamases (ESBLs) producing Enterobacteriaceae (E-ESBL) isolated from the external consultants of the two big hospitals of Meknes, Moulay Ismail military hospital and Mohamed V regional hospital. During 3 years (2012–2014), 787 uropathogenic Enterobacteriaceae strains were isolated. These Enterobacteriaceae isolates were examined phenotypically for ESBL production. ESBL strains were subjected to antimicrobial susceptibility testing and were investigated for the presence of plasmid mediated quinolone resistance genes by using conventional PCR and DNA sequencing. The genetic transfer of the plasmids was carried out by conjugation. The overall prevalence of E-ESBL was 7.37%. The blaCTX-M-15 (76.78%) was the most frequently detected in ESBL isolates, followed by blaTEM-1 and the blaSHV-1 and blaSHV-11 variants respectively. Identification of plasmid mediated quinolone resistance genes showed that 23.59% of E-ESBL isolate is carrying the qnrB gene and 7.86% carrying the qnrS gene. The variant aac(6′)-Ib-cr was found in 82.02% of ESBLs. Bacterial conjugation tests have shown the existence of high molecular weight conjugative plasmids carrying the blaCTX-M-15, blaTEM, blaSHV genes. Community dissemination of EESBLs could pose a public health problem. Thus, a policy of surveillance of the resistance seems necessary.