Evaluation of ESBL Frequency in Enterobacteriaceae Isolated from Clinical Specimens in an AJA Hospital in Tehran
AbstractBackground: Antibiotic resistance among bacteria has been one of the health problems in the world since the past. A type of resistance is due to the production of enzymes called beta-lactamases which is cause resistance to beta-lactam drugs and led to the emergence of new types of Extended-Spectrum Beta-Lactamases (ESBLs). Due to the importance of ESBL producing strain in uncontrolled hospital infections, the present study was Designed for evaluation of ESBL frequency in isolated Enterobacteriaceae from clinical specimens in an AJA hospital in Tehran.Methods: In this study, 100 clinical specimens collected from AJA. All specimens were identified by standard bacteriological and biochemical methods and antimicrobial susceptibility test was performed using disc diffusion method. Production of broad-spectrum beta-lactamase enzymes was evaluated using a mixed disk method with cefotaxime and ceftazidime antibiotics with clavulanic acid or alone. Results were interpreted according to CLSI guidelines.Results: From 100 specimen, 75 isolates (75%) were confirmed as an Enterobacteriaceae family. Most sensitivities observed in Imipenem (97.33%), Meropenem (94.66%), Piperacillin (68%), and Gentamicin (64%). Overall 42.66% of isolates produced ESBLs.Conclusion: According to the results, broad-spectrum beta-lactamase production in isolated bacteria from a clinical specimen of AJA hospital was high and 42.66% of isolates produced ESBLs. Due to the high resistance of these strains to most common antibiotics, identification of these pathogens, applying control methods in relation to the production and release of this type of bacteria and the correct use of antibiotics should be put on the agenda.
David L, Paterson DL, Robert A. et al. Extended-spectrum beta-lactamases: a clinical update. Clinic Microb Review 2005; 18(4):657-86.
Knothe H, Shah PDP, Krcmery V, et al. Transferable resistance to cefotaxime, cefoxitin, cefamandole and cefuroxime in clinical isolates of Klebsiella pneumoniae and Serratia marcescens. Infection J 1983; 11(6):315-7.
Samaha-Kfoury JN, Araj GF. Recent development in β-lactamase and extended spectrum β- lactamases. BMJ 2003; 327:1209-13.
Jeong HS, Song W, Park JM, et al. Boronic acid disk tests for identification of extended-spectrum lactamase production in clinical isolates of Enterobacteriaceae producing chromosomal Amp C Beta lactamases. Int J Antimicrob Agents 2008; 31:467-71.
Chaudhary U, Aggarwal R. Extended spectrum - betalactamases (ESBL) - an emerging threat to clinical therapeutics. Indian J Med Microbiol 2004; 22:75-80.
Mehrang H, Rahbar M. Prevalence Of extended spectrum B-lactamase-producing Escherichia coli in a tertiary care hospital in Tehran, Iran. Int J Antimicrob Agents 2008; 31:147-51.
Sturenburg E, Mack D. Extended spectrum beta-lactamases: implication for the clinical microbiology, therapy and infection control. J Infect 2003; 47:273-295.
Rastgarlari MF, Salekmoghaddam A. laboraties Susceptibility of Ofloxasin with Ceftriaxon by minimum inhibitory concentration (MIC) method. Arak medical university journal 2001; 5(4):1-15. (In Persian)
Murray P, Rosenthal K, Kobayashi G. et al. 2010. Medical microbiology, 6rd ed. Mosby Inc.St.Louis, Missouri.
Clinical and laboratory standards institute (CLSI), 2013. Performance standards for antimicrobial susceptibility testing, 22nd informational supplement. CLSI, Wayne.
Mirsalehian A, Jabalameli F, Mirafshar SM, et al. Determination of antimicrobial resistance patterns and extended spectrum β lactamases in clinical isolates of E.coli. J Tehran Uni Med Sciences 2008; 66(6):373-8.
Zaboli F, Mehdi-Pour Mir SM. Evaluation of Antibiotic Resistance Pattern and Ctx-M Gene in ESBL producers Escherichia coli by PCR method from urine samples patients referred to Shahid Yahyanejad Hospital in Babol. Jorjani Biomed J 2017; 2(4):38-42.
Shahcheraghi NV, shoraj F. Evaluationexistance of blaTEM and blashv Beta-lactamasegenes in resistance antibiotic Escherichia coli strains isolated from clinical samples obtained from Tehran Hospitals. Iran J Med Microbiol 2016; 1(4):21-7.
Ghanaat SA. Microbial resistance to Hospital infections. The Iranian Journal of otorhinolaryngology 2001; 13(27):44-5.
Eslami M, Najar Peerayeh. Phenotypic and molecular detection of TEM, PER, and VEB betalactamases in clinical strains of Escherichia coli. Arak Medical University Journal (AMUJ) 2012; 15(60):1-9.
Cheong Y, Lim V, Jegathesan M, Suleiman A. Antimicrobial resistance in 6 Malaysian general hospitals. The Medical journal of Malaysia 1994; 49(4):260-5.
Mansouri S, Abbasi S. Prevalence of multiple drugs resistant clinical isolates of extended-spectrum beta-lactamase producing Enterobacteriaceae in southeast Iran. Iran J Med Sci 2010; 35(2):101-8.
Mohamadi Mehr M, Faizabadi MM, Bahadori O. Antibiotic resistance patterns of gramnegative bacilli responsible for nosocomial infections in hospital intensive care department of family. J Army Uni Med Sciences 2010; 8(4):283-90.
Mohamadi M. Survey Antibiotic susceptibility of bacterial strains isolated from urinary tract infections. Islamic Azad Uni J Med Sciences 2006; 16(2):95-9.
Madani SH, Khazaee S, Kanani M, Shahi M. Antibiotic resistance pattern of E.coli isolated from urine culture in Imam Reza Hospital Kermanshah. J Kermanshah Uni Med Sciences 2008; 12(3):287-95.
Moyo S, Aboud S, Kasubi M, et al. Antimicrobial resistance among producers and non-producers of extended spectrum betalactamases in urinary isolates at a tertiary Hospital in Tanzania. BMC Res Notes 2010; 3:348.
Kader AA, Kumar A. Prevalence and antimicrobial susceptibility of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a general hospital. Ann Saudi Med 2005; 25(3):239-42.
Gulay Z, Thomson CJ, Yulug N, et al. High prevalence of extended spectrum beta-lactamase production among Klebsiella pneumoniae strains isolated at a University Hospital in Turkey. J Chemother 2000; 12(2):145-52.
Christine D.S, Kamile J R, Susannah K H, et al. Characterization of clinical isolates of Klebsiella pneumoniae from 19 laboratories using the national committee for clinical laboratory standards extended spectrum beta lactamase detection methods . J Clinic Microbiol 2001; 39:2864-72.
Occurance PE, Coudron PE, Moland ES, et al. Detection of Extended Spectrum b-lactamases in Members of the Family Enterobacteriaceae at a Veterans Medical Centre: Seek and You May Find. J Clin Microbilogy 1997; 35:2593-7.
Tashkori M, Farokhnia M, Zia Sheikhaleslami N, et al. evaluation of producing extended spectrum beta-Lactamase among isolated Escherichia coli from patients suffering from urinary tract infections. J Rafsanjan Univ Med Sciences 2011; 10(1):62-8.
Nakhaee Moghaddam M, Moshrefi S. Determining the antibiotic resistance pattern of urinary isolates of Escherichia coli and prevalence of extended-spectrum β-lactamase (ESBLs) among them. J Sabzevar Uni Med Sciences 2010; 16(4):228-33.
Behroozi A, Rahbar M, Vand Yousefi J. A study on prevalence of extended-spectrum β- lactamase (ESBLs) producing Klebsiella pneumoniae and Escherichia coli isolated from urinary specimens in Milad Hospital. J Med Microbiol 2010; 4(1):27-34.
Babaii Kochaksaraii M, NasrolahiOmran A, Javid N, et al. Extended spectrum beta lactamase producing E.coli isolated from Gorgan, North of Iran. J Gorgan Univ Med Sciences 2010-11; 6(1):51-58.
Sharifi Yazdi MK, Azarsa M, Shirazi MH, et al. The Frequency of Extended Spectrum Beta Lactamase and CTX M-I of Escherichia coli isolated from the urinary tract infection of patients by phenotypic and PCR methods in the city of Khoy in Iran. J Zanjan Uni Med Sciences 2011; 19(77):53-61.
Masjedian Jazi F, Valehi F, Talebi A, et al. Molecular evaluation of resistance to extended spectrum B-lactamases producing E. coli and K. pneumoniae. Med Microbiol J Iran. 2007; 1:27-34.