Risk factors for colonization with extended-spectrum beta-lactamase-producing enterobacteriaceae on admission to rehabilitation centres
Efraim BilavskyElizabeth TemkinYaffa LermanAlexander RabinovichJ. SalomonC. LawrenceAngelo RossiniA. SalviaJoan VidalJ. FierroMical PaulJ. HartMarek GniadkowskiM. HochmanM. KazmaAnat KleinAmos AdlerMitchell J. SchwaberYehuda Carmeli
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Emergence of ESBL & amp C β-Lactamase enzymes among clinical isolates of poses a significant public health concern. Antimicrobial agents like 3 generation cephalosporins, clavulanic acid, imipenem etc. can induce amp C enzyme production. Sometimes the automated antimicrobial susceptibility testing systems fails to detect Amp C phenotype due to presence of multiple resistance mechanisms in gram negative bacilli. To overcome such difficulty, the study was undertaken to detect the presence ESBL and Amp C enzymes among clinical isolates of by phenotypic methods. strains isolated from various clinical samples were included in the study. Strains resistant to two or three groups of antibiotics (MDR) were further tested for the presence of ESBL enzyme by combination disk method. Amp C enzymes were detected by cefoxitin- cloxacillin disc method. A total1059 strains were isolated from various clinical samples. Out of these, 170 MDR strains were further processed. ESBL enzymes were detected in 104 (61%) strains and Amp C in 35 (20.5%) strains. 26(15.2%) strains were co-producers. Detection of ESBL and Amp C enzymes will help clinician in choosing the right antimicrobial treatment for the patient. Routine reporting of presence of Amp C & ESBL enzymes by phenotypic methods can be easily implemented by clinical microbiology laboratory. Cefoxitin-cloxacillin disk test is simple & rapid method for detection of Amp C β- lactamase enzyme.
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ObjectivesTo determine the prevalence of CTX-M β-lactamase-producing Enterobacteriaceae in stool specimens obtained from healthy individuals in a rural area of Thailand.
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This study aimed for the molecular detection of TEM and SHV genes in Extended-Spectrum beta-lactamases (ESBLs) clinical isolates of Enterobacteriace (Eshericichia coli, Klebsiella pneumoniae and Proteus spp.).ESBLs are one of the main cause of resistance of Enterobacteriace family to beta-lactam antibiotics.The susceptibility of isolates to different beta-lactam and nonbeta lactam antimicrobial agents was performed to identify the proper antimicrobial chemotherapeutics for treatment of infections in case of development of resistance to Extended spectrum beta-lactams.Ninety clinical isolates belong to Enterobacteriacae family (54 E. coli, 28 Kl.Pneumonia and 8 Proteus spp) recovered from 220 different clinical specimens (urine, blood, pus and sputum).Thirty (33.3%) out of 90 isolates were ESBLs producers.The ESBLs producers were more frequent among E. coli isolates (40.7%), followed by Proteus (25%) and klebsiella pneumoniae (21.4%).Susceptibility testing to Beta-lactams and non beta-lactams was performed by disk diffusion method to all isolates.The bla TEM gene was identified in 14 of E. coli isolates at 504 bp.The blaSHV-625 gene was identified in two isolates of Klebsiella pneumoniae at 625bp.Meanwhile blaSHV-1,107 was not detected in any clinical isolates.
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This study evaluated the impact of preenrichment on the detection of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-E) in clinical stool samples. ESBL-E were detected in 41 of 343 patients (12.0%). As 31.7% of the ESBL-E carriers were identified by preenrichment, only this additional diagnostic step significantly improved the detection of ESBL-E.
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กลไกสำคญทเชอกลมเอนเทอโรแบคเทอรซอดอตอสารตานจลชพ ไดแก การสรางเอนไซมบตา-แลคทาเมส ชนดฤทธขยายและแอมพซ บตา-แลคทาเมส การศกษานม วตถประสงค : เพอตรวจหาเชอกลมเอนเทอโรแบคเทอรซอทสรางเอนไซมบตา-แลคทาเมสชนดฤทธขยายและแอมพซ บตา-แลคทาเมส ในเชอทแยกไดจากผปวยทเขารบการรกษา ณ โรงพยาบาลวชรพยาบาล กรงเทพมหานคร วธการศกษา : เชอทศกษาแยกไดจากสงสงตรวจ จำนวน 400 ไอโซเลท นำมาตรวจหาการสรางเอนไซมบตา-แลคทาเมสชนดฤทธขยาย โดยวธ double disc synergy test และตรวจหาเอนไซมแอมพซ บตา-แลคทาเมส โดยวธ AmpC disc test ผลการศกษา: พบเชอทสรางเอนไซมบตา-แลคทาเมส ชนดฤทธขยาย จำนวน 170 ไอโซเลท คดเปนรอยละ 42.5 เชอทสรางเอนไซมแอมพซ บตา-แลค ทาเมส จำนวน 21 ไอโซเลท คดเปนรอยละ 5.3 พบเชอทสรางทงเอนไซมบตา-แลคทาเมสชนดฤทธขยายและ แอมพซ บตา-แลคทาเมส จำนวน 7 ไอโซเลท คดเปนรอยละ 1.8 Detection of Extended-Spectrum beta-Lactamase and AmpC beta-Lactamase in Enterobacteriaceae The crucial antibiotic resistant mechanism of Enterobacteriaceae is the production of Extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase. The aimed of this study was to investigate ESBL and AmpC beta-lactamase production in Enterobacteriaceae isolated from patients in Vajira Hospital, Bangkok. Method: A total of 400 clinical isolates of Enterobacteriaceae were examined for ESBL production by double disc synergy test and AmpC-producing strains were detected by AmpC disc test. Results: ESBL and AmpC - producing Enterobacteriaceae were 170 isolates (42.5%) and 21 isolates (5.3%), respectively. This study also found 7 isolates (1.8%) produced both ESBL and AmpC beta-lactamase.
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The occurrence of extended-spectrum beta-lactamase- (ESBL) and/or AmpC beta-lactamase- (AmpC) producing Enterobacteriaceae in livestock, especially in broiler fattening flocks, has been demonstrated in previous studies. Nevertheless, data on transmission routes of these resistant bacteria into the fattening farms are rare. Therefore, seven broiler fattening flocks were investigated for the occurrence of ESBL-/AmpC-producing Enterobacteriaceae during the course of the fattening period with the special focus on horizontal transmission routes. ESBL-/AmpC-producing Enterobacteriaceae from both individual animals and their housing environment were isolated at different time points and the housing environment was even sampled before the arrival of the chickens. All obtained ESBL-/AmpC-producing Enterobacteriaceae were examined for their bacterial species, Escherichia coli phylogroup, and occurrence of resistance genes. Selected isolates were further analyzed via whole-genome sequencing. All seven investigated flocks were tested positive for ESBL-/AmpC-producing Enterobacteriaceae with widely varying prevalence between the flocks. In one flock, the ESBL-/AmpC-producing Enterobacteriaceae were already detected in the housing environment before the arrival of the animals. In general, among the different types of ESBL-/AmpC-producing Enterobacteriaceae determined E. coli harboring a blaCMY-2 gene was the most frequent. Using whole-genome analyses we observed a horizontal transmission of ESBL-/AmpC-producing Enterobacteriaceae through contaminated housing environment as two flocks consecutively fattened in the same farm harbored closely related ESBL-producing isolates. This demonstrates the influence of a previous fattened flock on the ESBL-/AmpC-status of a following broiler flock and, therefore, the importance of hygiene measures on farm level.
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