Extended Spectrum Beta Lactamase Producing Bacteria Research Articles

Perinatal colonization with extended-spectrum beta-lactamase-producing and carbapenem-resistant Gram-negative bacteria: a hospital-based cohort study

BackgroundAntimicrobial resistance (AMR) is a growing global health threat that contributes to substantial neonatal mortality. Bangladesh has reported some of the highest rates of AMR among bacteria causing neonatal sepsis. As AMR colonization among newborns can predispose to infection with these bacteria, we aimed to characterize the frequency of and risk factors for colonization of mothers and newborns during hospitalization for delivery.MethodsWe enrolled pregnant women presenting for delivery to a tertiary care hospital in Faridpur, Bangladesh. We collected vaginal and rectal swabs from mothers pre- and post-delivery, rectal swabs from newborns, and swabs from the hospital environment. Swabs were plated on agars selective for extended-spectrum-beta-lactamase producing bacteria (ESBL-PB) and carbapenem-resistant bacteria (CRB). We performed logistic regression to determine factors associated with ESBL-PB/CRB colonization.ResultsWe enrolled 177 women and their newborns during February-October 2020. Prior to delivery, 77% of mothers were colonized with ESBL-PB and 15% with CRB. 79% of women underwent cesarean deliveries (C-section). 98% of women received antibiotics. Following delivery, 98% of mothers and 89% of newborns were colonized with ESBL-PB and 89% of mothers and 72% of newborns with CRB. Of 290 environmental samples, 77% were positive for ESBL-PB and 69% for CRB. Maternal pre-delivery colonization was associated with hospitalization during pregnancy (RR for ESBL-PB 1.24, 95% CI 1.10–1.40; CRB 2.46, 95% CI 1.39–4.37). Maternal post-delivery and newborn colonization were associated with C-section (RR for maternal CRB 1.31, 95% CI 1.08–1.59; newborn ESBL-PB 1.34, 95% CI 1.09–1.64; newborn CRB 1.73, 95% CI 1.20–2.47).ConclusionsIn this study, we observed high rates of colonization with ESBL-PB/CRB among mothers and newborns, with pre-delivery colonization linked to prior healthcare exposure. Our results demonstrate this trend may be driven by intense use of antibiotics, frequent C-sections, and a contaminated hospital environment. These findings highlight that greater attention should be given to the use of perinatal antibiotics, improved surgical stewardship for C-sections, and infection prevention practices in healthcare settings to reduce the high prevalence of colonization with AMR organisms.

Antibacterial Activity of Padikara Parpam against ESBL Producing Escherichia coli and Klebsiella pneumoniae

Aims: To evaluate the antibacterial activity of Padikara Parpam against Extended-Spectrum Beta-Lactamase (ESBL) producing Escherichia Coli and Klebsiella Pneumoniae using agar well diffusion method. To identify ESBL producing bacteria by phenotypic confirmatory test using disk diffusion method.
 Study Design: Analysis of Antibacterial activity of Padikara Parpam using agar well diffusion method.
 Place and Duration of Study: Central Research Laboratory, Meenakshi Academy of higher Education and Research, Chennai, between June 2021 and November 2021.
 Methodology: Clinical isolates of ESBL were isolated by subculture into MacConkey agar and was identified by phenotypic confirmatory test. Padikara parpam's antibacterial activity was evaluated using the Agar well diffusion method at different concentrations of 0.5 %, 1 %, 1.5 %, and 2 % drugs. 30 µg Cefotaxime and 30 µg amoxicillin-clavulanic acid disk were used as controls to standardize the antibacterial activity test and to identify the ESBL by phenotypic confirmatory test.
 Results: In this study, Padikara parpam at various doses of 0.5 %, 1 %, 1.5 %, and 2 %, revealed significant antibacterial efficacy against ESBL producing bacteria. Padikara parpam was more active against ESBL Escherichia coli than ESBL Klebsiella pneumoniae. As a result, it may be recommended as an antibacterial agent against ESBL.
 Conclusion: Our findings suggest that Siddha Herbo mineral formulations of padikara parpam hold phenomenal antimicrobial activity against ESBL producing bacteria. Based on our findings, the drug may be prescribed successfully for urinary tract infections, which is caused by ESBL producing bacteria.

EXTENDED SPECTRUM BETA LACTAMASE PRODUCING UROPATHOGENS IN A TERTIARY CARE HOSPITAL IN SOUTH INDIA: A CLINICO MICROBIOLOGICAL STUDY

Introduction: Urinary Tract Infection (UTI) is the most common bacterial infection encountered in both hospital and community setup and the presence of drug resistance carries remarkable clinical implication. Drug resistant phenotypes like ESBL (Extended Spectrum Beta lactamase producers) are difcult to treat causing increased morbidity. Aims: The present study aims to determine the prevalence of ESBL producing Enterobacteriacea among Uropathogens and to determine the Antibiotic susceptibility pattern. Materials and Methods :A total of 726 urine samples were obtained and processed as per standard microbiological techniques .Antibiotic susceptibility testing was done by Kirby Bauer disc diffusion method. All the isolates were screened for ESBL production and conrmed by Double Disc Synergy test (DDST).Differences between the antibiotic susceptibility pattern ,Various risk factors were assessed among the ESBL producing and non ESBLproducing bacteria and the signicance was analyzed . Statistical analysis used:Chi square test.(p < 0.05 signicant) Results: A total of 726 urine samples were processed of which 421 bacteria belonging to Enterobacteriaceae were included in the study. Most common organism isolated was Escherichia coli 279 (66.27%).Highest susceptibility was observed for Imipenem 361 (85.7%) and Amikacin 356 (84.5%).Out of 461 isolates, 235 (55.8%) isolates were positive for ESBL screening all the isolates were conrmed with DDST. There was a signicant difference for Diabetes mellitus, CAUTI and Inpatients among the antibiotic susceptibility pattern between ESBL and non ESBL producers.(p<0.0001) Conclusions: Early detection of Multidrug resistance isolates like ESBLproducers in routine testing could help avoid treatment failure. Screening for ESBL production needs to be carried out regularly in every clinical diagnostic laboratory to guide clinicians in proper selection of antibiotics. Continued monitoring of the susceptibility pattern of ESBLproducing bacteria will provide valuable information regarding the local antimicrobial susceptibility pattern which in turn will guide in choosing the initial empirical therapy

Evaluation of Phenotypic Methods to Identify Extended Spectrum Beta-lactamase (ESBL) Producing Gram negative Bacteria

Extended spectrum beta-lactamase (ESBL) producing Gram negative bacteria are usually multiple drug resistant and their cephalosporin and aztreonam resistance is not reliably detected by susceptibility tests.This study was carried out to find out a cost effective easy standard method to identify ESBL producing bacteria in a laboratory associated with tertiary care hospital and to determine the incidence of ESBL positive bacteria isolated from different clinical specimens. Thereby isolated 124 Gram negative bacteria from various samples were subjected to screening test, double disc synergy test (DDST)and E test ESBL method.Screening test detected 69.35%, DDST identified 37.1% and E test ESBL method confirmed 55.65% ESBL producing strains. Screening test and DDST was compared to E test ESBL method. Considering E test as standard the sensitivity and specificity of screening test were 97.10% and 65.45% respectively and that of DDST were 62.31% and 94.55% respectively. Low specificity of screening test reflects detection of many false positive strains and low sensitivity of DDST signals many missed identification. This study suggested the use of E test ESBL method to confirm screening positive ESBL isolates at microbiology laboratory.Bangladesh J Med Microbiol 2014; 08 (01): 21-24

Quantitation of antibiotic resistance genes pollution in hospital waste water effluent and Urban Clinton River Water, Michigan, USA

Hospitals are the major antibiotic consumers and thus facilitate the spread of antibiotic resistance. Hospital wastewaters definitely play an important role in the evolution and dissemination of antibiotic-resistant genes. In this study, we evaluated the occurrence of three common groups of extended spectrum beta lactamase (ESBL) and their resistance genes in the hospital effluent and urban river as possible sources. A total of 156 bacteria were isolated from upstream and downstream of hospital waste-water treatment plant. Waste water samples were analyzed for the copy number of three groups of ESBL; SHV, TEM and CTX-M-1 genes. The bacteria isolated were approximately 40–65% resistant to cefotaxime, 25–40% to chloramphenicol, 30–40% to tetracycline, 25–65% to ciprofloxacin and finally 30–50% to gentamicin. Of these 156 bacteria, 34 (22%) were found to be ESBL producing bacteria. The copy numbers1 are 102, 104 and 103, respectively. Based on the data, the abundance of blaSHV and blaCTX-M-1 remained similar in both populations whereas the quantity of blaTEM decreased to an order of 102 in Urban Clinton River Water (UCRW). Hospital effluent and urban rivers are potential routes for dissemination of ESBL producing bacteria and their respective genes into the natural environment and pose a hazard to environmental and public health.

Caracterización de infecciones por bacterias productoras de BLEE en un hospital de referencia nacional.

Introducción: La resistencia mediante la producción de betalactamasa de espectro extendido (BLEE) es la resistencia microbiana más común y de importancia en salud pública. Objetivos: Describir las características de las infecciones por bacterias productoras de BLEE en un hospital de referencia nacional. Diseño Estudio transversal descriptivo. Lugar: Hospital Nacional Daniel Alcides Carrión, Callao, Perú. Materiales: Registros de los cultivos de secreciones realizados en el Laboratorio de Microbiología del HNDAC en el año 2012. Métodos: Se analizó datos del paciente (edad, sexo y servicio del cual se recibió la muestra) y datos de la muestra (fecha de obtención, el tipo de muestra, el microrganismo encontrado, el antibiograma detallado y su calificación como bacteria productora de BLEE). Principales medidas de resultados: Características de las infecciones por bacterias productoras de BLEE. Resultados Se recolectó 3 149 muestras, 70,9% (2 235) fueron de mujeres; 29,4% fueron cultivos positivos para bacterias productoras de BLEE. Los servicios críticos obtuvieron la mayor prevalencia, y los meses donde se encontró mayor presencia fueron abril (34,7%) y julio (34,7%). Tanto E. coli (72,4%) como Klebsiella sp. (20%) fueron las prevalentes. No se encontró resistencia para imipinem, tanto para E. coli como para Klebsiella sp. Conclusiones La prevalencia fue similar a la de América Latina (34,6%). Se presenta más evidencias de una alta presencia en consulta externa y en mayores de 46 años; siendo así un problema de salud pública.

TEM mediated extended spectrum cephalosporin resistance in clinical & environmental isolates of Gram negative bacilli: A report from northeast India

TEM mediated extended spectrum cephalosporin resistance in clinical & environmental isolates of Gram negative bacilli: A report from northeast India

Extended-Spectrum-Beta-Lactamase Producing Bacteria Related Urinary Tract Infection in Renal Transplant Recipients and Effect on Allograft Function

BackgroundUrinary tract infection (UTI) is a well-recognized early complication in renal transplant recipients (RTR) and can have significant bearing on their outcome. The recent rise in incidence of extended spectrum beta lactamase (ESBL) producing bacteria causing UTI among RTR poses new and significant challenges in terms of management and outcome. Our aim is to analyze the effect of ESBL producing bacteria causing UTI in these patients and its impact on allograft function.MethodsWe reviewed the medical records of 147 RTR who were followed at a tertiary care hospital affiliated transplant center between January 2007 and May 2013 and noted five RTR who developed episodes of ESBL producing bacteria related UTI during follow up. Multiple patient characteristics including demographics, immunosuppression, recurrences, allograft function and outcome were analyzed.ResultsFive patients (3.4%) out of 147 had ESBL producing bacteria related UTI. We found all patients to be above 60 years of age, with three out of five being females, and all five patients had diabetes mellitus. We identified a total of 37 episodes of UTI among these five patients during this period. Two of these patients had elevated creatinine values during the episodes of UTI and three of them developed bacteremia. Of the five patients, four of them had a favorable outcome except for one patient who developed persistent allograft dysfunction.ConclusionRTR are at a higher risk for developing ESBL producing bacteria associated UTI. Early diagnosis along with appropriate and judicious use of antibiotics will ensure long term success in allograft and patient outcome.

Multi-Drug Resistant Bacterial Strains in Lower Respiratory Tract Infections, Antibiotic Sensitivity Patterns and Risk Factors

Isolation of multidrug resistant bacteria such as extended spectrum beta-lactamase (ESBL), metallo beta–lactamase (MBL) producing and Methicillin resistant Staphylococcus aureus (MRSA) causing lower respiratory tract infection (LRTI) is associated with various risk factors and a major challenge in treatment. So, the study determined bacterial etiology of lower respiratory tract infection and antibiotic sensitivity pattern with special reference to ESBL, MBL, and MRSA strains along with risk factors associated with such strains. A total of 120 specimens were collected from patients with lower respiratory tract infection along with clinical details. Combination disk method was done for the detection of ESBL and MBL producing isolates and oxacillin disc was used to detect MRSA. Out of 120 specimens, 87.5% was monomicrobial while 12.5% was polymicrobial infection. Pseudomonas aeruginosa (36.19%) was the predominant followed by Acinetobacter baumannii (28.57%), Klebsiella pneumoniae (20.95%), Escherichia coli (8.57%) and Staphylococcus aureus (5.72%). Total 33 (31.43%) out of 105 monomicrobial isolate were MDR. All MDR E. coli, K. pneumoniae, P. aeruginosa were ESBL producers and (6, 20%) out of total A. baumannii isolated produced MBL and was not found to produce ESBL. All MDR S. aureus isolates were found to be resistant to methicillin. Carbapenems followed by amikacin were found to be the most effective antibiotic for Gram negative bacilli causing LRTI. Vancomycin, Teicoplanin & Linezolid were found to be the most effective antibiotics for MRSA. 28 out of 33 MDR isolate possessing patients had comorbid illness. Isolation of MRSA, ESBL and MBL producing bacteria in LRTI are increasing in number. Increased prevalence of MDR bacterial strains form patients with comorbid illness is a major problem in healthcare centers. Nepal Journal of Science and Technology Vol. 13, No. 1 (2012) 157-163 DOI: http://dx.doi.org/10.3126/njst.v13i1.7454