Molecular Characterization of Extended-Spectrum β-Lactamase Enterobacteriaceae Isolated from Egyptian Patients with Community- and Hospital-Acquired Urinary Tract Infection
| Autor: | Amal A. Elshimy, Rania Y. Shash, Ashraf A. Mosharafa, Mohammed Y. Soliman |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cefotaxime Adolescent 030231 tropical medicine Fosfomycin medicine.disease_cause Gene Expression Regulation Enzymologic beta-Lactamases law.invention Microbiology Young Adult 03 medical and health sciences 0302 clinical medicine Antibiotic resistance Enterobacteriaceae law Drug Resistance Multiple Bacterial Virology medicine Humans Outpatient clinic Escherichia coli Polymerase chain reaction Aged Cross Infection biology Enterobacteriaceae Infections Articles Gene Expression Regulation Bacterial Middle Aged bacterial infections and mycoses biology.organism_classification Anti-Bacterial Agents Community-Acquired Infections Cross-Sectional Studies Infectious Diseases Nitrofurantoin Urinary Tract Infections Egypt Female Parasitology medicine.drug |
| Zdroj: | The American Journal of Tropical Medicine and Hygiene. 100:522-528 |
| ISSN: | 1476-1645 0002-9637 |
| Popis: | Extended-spectrum β-lactamases (ESβLs) pose a serious problem in the treatment of urinary tract infections (UTIs). The ESβL-producing organism is an expanding global health problem. Therefore, screening for ESβL, detection of their drug-resistance pattern, and molecular characterization should be a continuous process. The present study was performed to determine the antibiotic resistance profile and the genetic characterization of ESβL isolates from hospital- and community-acquired UTIs. Two hundred fifty Enterobacteriaceae isolates were obtained from urine samples of outpatient clinic attendants and hospitalized patients at Kasr Al-Aini Hospital. By phenotypic screening tests, 100 ESβL isolates were detected among the studied groups. Furthermore, detection of beta-lactamase (bla) cefotaxime (CTX)-M, sulfhydryl variable, and temoneira ESβL genes was investigated by polymerase chain reaction. A subset of 25 CTX-M–positive isolates was further identified by gene sequencing technology. Among the 100 ESβL isolates, 66% were Escherichia coli and 34% were Klebsiella spp. There was no statistical difference in the prevalence of ESβL Enterobacteriaceae in community-acquired versus hospital-acquired UTIs. The susceptibility of all ESβL isolates to carbapenems was the most prevalent finding. In addition, all ESβL E. coli isolates were susceptible to fosfomycin, whereas all community-acquired ESβL isolates were susceptible to nitrofurantoin. A total of 98% of the ESβL isolates harbored bla-CTX-M genes, with CTX-M-15 being the most prevalent. It could be concluded that ESβL production is present at a high rate among Egyptian patients with hospital- and community-acquired UTI. The high prevalence of bla-CTX-M may suggest it as a candidate for molecular screening of ESβL. |
| Databáze: | OpenAIRE |
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