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Analysis of Extended Spectrum Beta Lactamase Frequency in Klebsiella spp Isolates

Year 2023, Volume: 14 Issue: 1, 1 - 10, 13.04.2023
https://doi.org/10.22312/sdusbed.1206024

Abstract

The issue of increasing resistance to antibiotics in recent years has become an important problem all over the world. Our aim is to determine the antimicrobial resistance profile and Extended Spectrum Beta-Lactamase (ESBL) rates in Klebsiella spp isolates to prevent the gradual increase in multi-resistant isolates as a result of unconscious antibiotic use thereby contributing to the faster effective treatment of infections. A total of 100 Klebsiella spp were isolated and identified from various clinical specimens. Antibiotic susceptibility tests were performed using the Kirby-Bauer method. The presence of extended-spectrum beta-lactamases (ESBL) was detected using the Double Disc Synergy Test (DDST) and E-test methods. The rates of ESBL-producing strains were 46.1% in 6 K. oxytoca and 56.3% in 49 K. pneumoniae. These strains were found to be 38% in 38 adult patients and 17% in 17 pediatric patients, and this difference was statistically significant (p <0.05). The ESBL rate was 31% in 31 male patients and 24% in 24 female patients, and this difference was not statistically significant (p>0.05). This rate was found to be high in patients hospitalized in the pediatric service and intensive care unit. 67 out of 100 strains were found to be suspicious for ESBL by Disk Diffusion Test (DDT). DDST and E-tests were applied as confirmatory tests. The sensitivity of the DDST and E tests was 100%. Screening for ESBL in Klebsiella spp and other members of Enterobacteriaceae isolates is necessary to reduce further selection and spread of these increasingly broad-spectrum antimicrobial-resistant enteric pathogens.

References

  • [1] Dunachie, S.J., Day, N.P., Dolecek, C. 2020. The challenges of estimating the human global burden of disease of antimicrobial resistant bacteria. Curr Opin Microbiol, 57: 95–101.
  • [2] de Rosa, M., Verdino, A., Soriente, A., Marabotti, A. 2021. The odd couple(S): An overview of beta- lactam antibiotics bearing more than one pharmacophoric group. Int J Mol Sci, 22: 1–21.
  • [3] Bush, K. 2018. Past and present perspectives on β-lactamases. Antimicrob Agents Chemother, 24;62(10):e01076-18.
  • [4] Sawa, T., Kooguchi, K., Moriyama, K. 2020. Molecular diversity of extended-spectrum β-lactamases and carbapenemases and antimicrobial resistance. J Intensive Care,8 (13): 2-13.
  • [5] Cheikh, A., Belefquih, B., Chajai, Y., Cheikhaoui, Y., el Hassani, A., et al. 2017. Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) colonization as a risk factor for developing ESBL infections in pediatric cardiac surgery patients: “retrospective cohort study.” BMC Infect Dis, 29;17(1):237.
  • [6] Wang, L., Zhou K.H., Chen, W., Yu, Y., Feng, S.F. 2019. Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015. BMC Infect Dis, 145(19): 2-9.
  • [7] Vincent, J.L., Sakr, Y., Singer, M., Martin-Loeches, I., MacHado, F.R., et al. 2020. Prevalence and Outcomes of Infection among Patients in Intensive Care Units in 2017. Journal of the American Medical Association, 323: 1478–1487.
  • [8] TARAKÇI, A., EROĞLU, E. 2021. The evaluation of Nosocomial Infections Developing in Intensive Care Units of a Tertiary University Hospital. Journal of Contemporary Medicine, 11: 198–202.
  • [9] Toka Özer, T., Deveci, Ö., Yula, E., Tekin, A., Yanık, K., et al. 2015. Nosocomial infections in a district hospital in Turkey. Biomedical Research, 26(2):299-303
  • [10] Shakya, P., Shrestha, D., Maharjan, E., Sharma, V.K., Paudyal, R. 2017. ESBL Production Among E. coli and Klebsiella spp. Causing Urinary Tract Infection: A Hospital Based Study. Open Microbiol J, 11: 23-30.
  • [11] Sarojamma, V., Ramakrishna, V. 2011. Prevalence of ESBL-Producing Klebsiella pneumoniae Isolates in Tertiary Care Hospital. ISRN Microbiol, 2011: 1–5.
  • [12] M’Zali, F.H., Chanawong, A., Kerr, K.G., Birkenhead, D., Hawkey, P.M. 2000. Detection of ESBL in members of the family Enterobacteriaceae: comparison of the MAST DD test, the double disc and the Etest ESBL. J Antimicrob Chemother, 45(6):881-5.
  • [13] Papp-Wallace, K.M., Endimiani, A., Taracila, M.A., Bonomo, R.A. 2011. Carbapenems: Past, present, and future. Antimicrob Agents Chemother, 55: 4943–4960.
  • [14] Aurilio, C., Sansone, P., Barbarisi, M., Pota, V., Giaccari, L.G., et al. 2022. Mechanisms of Action of Carbapenem Resistance. Antibiotics, 21;11(3):421.
  • [15] Hawkey, P.M., Livermore, D.M. 2012. Carbapenem antibiotics for serious infections. BMJ, 31;344:e3236
  • [16] Meletis, G. 2016. Carbapenem resistance: overview of the problem and future perspectives. Ther Adv Infect Dis, 3(1):15-21.
  • [17] Toptan, H. 2020. Detection of the Presence of Extended-Spectrum Beta-Lactamase Enzyme in Gram- negative Bacteria According to CLSI and EUCAST Criteria. Haydarpasa Numune Training and Research Hospital Medical Journal, 60(4):352–356.
  • [18] Gajic, I., Kabic, J., Kekic, D., Jovicevic, M., Milenkovic, M., et al. 2022. Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods. Antibiotics, 11(4): 427.
  • [19] Gharavi, M.J., Zarei, J., Roshani-Asl, P., Yazdanyar, Z., Sharif, M., et al. 2021. Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples. Scientific Reports, 11(1): 578.
  • [20] McDanel, J., Schweizer, M., Crabb, V., Nelson, R., Samore, M., et al. 2017. Incidence of extended- spectrum β-Lactamase (ESBL)-producing Escherichia coli and klebsiella infections in the United States: A systematic literature review. Infect Control Hosp Epidemiol, 38: 1209–1215.
  • [21] Correa-Martínez, C.L., Idelevich, E.A., Sparbier, K., Kostrzewa, M., Becker, K. 2019. Rapid Detection of extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases in Enterobacterales: Development of a screening panel using the MALDI-TOF MS-based direct-on-target microdroplet growth assay. Front Microbiol, 24;10:13.
  • [22] Aila, N.E., Laham, N.A., Ayesh, B. 2022. Prevalence of Extended Spectrum Beta Lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram Negative Bacilli Isolates from Pediatric Patient Population in Gaza strip. Available, 41.390.058.
  • [23] Castanheira, M., Simner, P.J., Bradford, P.A. 2021. Extended-spectrum β-lactamases: An update on their characteristics, epidemiology and detection. JAC Antimicrob Resist,16;3(3):dlab092.
  • [24] Oelschlaeger, P. 2021. β-Lactamases: Sequence, Structure, Function, and Inhibition. Biomolecules, 5;11(7):986.
  • [25] Bahr. G., González, L.J., Vila, A.J. 2021. Metallo-β-lactamases in the Age of Multidrug Resistance: From Structure and Mechanism to Evolution, Dissemination, and Inhibitor Design. Chem Rev, 121: 7957–8094.
  • [26] Rodríguez-Guerrero, E., Callejas-Rodelas, J.C., Navarro-Marí, J.M., Gutiérrez-Fernández, J. 2022. Systematic Review of Plasmid AmpC Type Resistances in Escherichia coli and Klebsiella pneumoniae and Preliminary Proposal of a Simplified Screening Method for ampC. Microorganisms, 10, 611.
  • [27] Llor, C., Bjerrum, L. 2014. Antimicrobial resistance: Risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf, 5: 229–241

Klebsiella spp İzolatlarında Genişletilmiş Spektrumlu Beta Laktamaz Sıklığının Analizi

Year 2023, Volume: 14 Issue: 1, 1 - 10, 13.04.2023
https://doi.org/10.22312/sdusbed.1206024

Abstract

Son yıllarda antibiyotik direncinin artması konusu tüm dünyada önemli bir sorun haline gelmiştir. Amacımız, Klebsiella spp izolatlarında antimikrobiyal direnç profilini ve Genişletilmiş Spektrumlu Beta- Laktamaz (ESBL) oranlarını belirleyerek bilinçsiz antibiyotik kullanımı sonucunda multi-dirençli izolatlarda kademeli artışı önlemek ve böylece enfeksiyonların daha hızlı etkin tedavisine katkıda bulunmaktır. Çeşitli klinik örneklerden toplam 100 Klebsiella türü izole edilmiş ve tanımlanmıştır. Antibiyotik duyarlılık testleri Kirby-Bauer yöntemi kullanılarak yapıldı. Genişletilmiş spektrumlu beta-laktamazların (GSBL) varlığı, Çift Disk Sinerji (DDST) ve E-test yöntemleri kullanılarak tespit edildi. GSBL üreten suşların oranları 6 K. oxytoca (%46,1) ve 49 K. pneumoniae (%56,3) idi. Bu suşlar 38 erişkin hastada %38, 17 pediatrik hastada %17 olarak bulundu. Sonuçlarımız istatistiksel olarak anlamlıydı (p<0,05). GSBL oranı 31 erkek hastada %31, 24 kadın hastada %24 idi ve cinsiyete göre bu fark anlamlı bulunmamıştır (p>0,05). Çocuk servisi ve yoğun bakım ünitesinde yatan hastalarda bu oran yüksek bulundu. Disk Difüzyon Testi (DDT) ile 100 suştan 67'si ESBL açısından şüpheli bulundu. Doğrulayıcı testler olarak DDST ve E-testleri uygulandı. DDST ve E testlerinin duyarlılığı %100 idi. Klebsiella spp ve Enterobacteriaceae izolatlarının diğer üyelerinde ESBL taraması, giderek artan geniş spektrumlu antimikrobiyal dirençli enterik patojenlerin daha fazla seçimini ve yayılmasını azaltmak için gereklidir.

References

  • [1] Dunachie, S.J., Day, N.P., Dolecek, C. 2020. The challenges of estimating the human global burden of disease of antimicrobial resistant bacteria. Curr Opin Microbiol, 57: 95–101.
  • [2] de Rosa, M., Verdino, A., Soriente, A., Marabotti, A. 2021. The odd couple(S): An overview of beta- lactam antibiotics bearing more than one pharmacophoric group. Int J Mol Sci, 22: 1–21.
  • [3] Bush, K. 2018. Past and present perspectives on β-lactamases. Antimicrob Agents Chemother, 24;62(10):e01076-18.
  • [4] Sawa, T., Kooguchi, K., Moriyama, K. 2020. Molecular diversity of extended-spectrum β-lactamases and carbapenemases and antimicrobial resistance. J Intensive Care,8 (13): 2-13.
  • [5] Cheikh, A., Belefquih, B., Chajai, Y., Cheikhaoui, Y., el Hassani, A., et al. 2017. Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) colonization as a risk factor for developing ESBL infections in pediatric cardiac surgery patients: “retrospective cohort study.” BMC Infect Dis, 29;17(1):237.
  • [6] Wang, L., Zhou K.H., Chen, W., Yu, Y., Feng, S.F. 2019. Epidemiology and risk factors for nosocomial infection in the respiratory intensive care unit of a teaching hospital in China: A prospective surveillance during 2013 and 2015. BMC Infect Dis, 145(19): 2-9.
  • [7] Vincent, J.L., Sakr, Y., Singer, M., Martin-Loeches, I., MacHado, F.R., et al. 2020. Prevalence and Outcomes of Infection among Patients in Intensive Care Units in 2017. Journal of the American Medical Association, 323: 1478–1487.
  • [8] TARAKÇI, A., EROĞLU, E. 2021. The evaluation of Nosocomial Infections Developing in Intensive Care Units of a Tertiary University Hospital. Journal of Contemporary Medicine, 11: 198–202.
  • [9] Toka Özer, T., Deveci, Ö., Yula, E., Tekin, A., Yanık, K., et al. 2015. Nosocomial infections in a district hospital in Turkey. Biomedical Research, 26(2):299-303
  • [10] Shakya, P., Shrestha, D., Maharjan, E., Sharma, V.K., Paudyal, R. 2017. ESBL Production Among E. coli and Klebsiella spp. Causing Urinary Tract Infection: A Hospital Based Study. Open Microbiol J, 11: 23-30.
  • [11] Sarojamma, V., Ramakrishna, V. 2011. Prevalence of ESBL-Producing Klebsiella pneumoniae Isolates in Tertiary Care Hospital. ISRN Microbiol, 2011: 1–5.
  • [12] M’Zali, F.H., Chanawong, A., Kerr, K.G., Birkenhead, D., Hawkey, P.M. 2000. Detection of ESBL in members of the family Enterobacteriaceae: comparison of the MAST DD test, the double disc and the Etest ESBL. J Antimicrob Chemother, 45(6):881-5.
  • [13] Papp-Wallace, K.M., Endimiani, A., Taracila, M.A., Bonomo, R.A. 2011. Carbapenems: Past, present, and future. Antimicrob Agents Chemother, 55: 4943–4960.
  • [14] Aurilio, C., Sansone, P., Barbarisi, M., Pota, V., Giaccari, L.G., et al. 2022. Mechanisms of Action of Carbapenem Resistance. Antibiotics, 21;11(3):421.
  • [15] Hawkey, P.M., Livermore, D.M. 2012. Carbapenem antibiotics for serious infections. BMJ, 31;344:e3236
  • [16] Meletis, G. 2016. Carbapenem resistance: overview of the problem and future perspectives. Ther Adv Infect Dis, 3(1):15-21.
  • [17] Toptan, H. 2020. Detection of the Presence of Extended-Spectrum Beta-Lactamase Enzyme in Gram- negative Bacteria According to CLSI and EUCAST Criteria. Haydarpasa Numune Training and Research Hospital Medical Journal, 60(4):352–356.
  • [18] Gajic, I., Kabic, J., Kekic, D., Jovicevic, M., Milenkovic, M., et al. 2022. Antimicrobial Susceptibility Testing: A Comprehensive Review of Currently Used Methods. Antibiotics, 11(4): 427.
  • [19] Gharavi, M.J., Zarei, J., Roshani-Asl, P., Yazdanyar, Z., Sharif, M., et al. 2021. Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples. Scientific Reports, 11(1): 578.
  • [20] McDanel, J., Schweizer, M., Crabb, V., Nelson, R., Samore, M., et al. 2017. Incidence of extended- spectrum β-Lactamase (ESBL)-producing Escherichia coli and klebsiella infections in the United States: A systematic literature review. Infect Control Hosp Epidemiol, 38: 1209–1215.
  • [21] Correa-Martínez, C.L., Idelevich, E.A., Sparbier, K., Kostrzewa, M., Becker, K. 2019. Rapid Detection of extended-spectrum β-lactamases (ESBL) and AmpC β-lactamases in Enterobacterales: Development of a screening panel using the MALDI-TOF MS-based direct-on-target microdroplet growth assay. Front Microbiol, 24;10:13.
  • [22] Aila, N.E., Laham, N.A., Ayesh, B. 2022. Prevalence of Extended Spectrum Beta Lactamase and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Gram Negative Bacilli Isolates from Pediatric Patient Population in Gaza strip. Available, 41.390.058.
  • [23] Castanheira, M., Simner, P.J., Bradford, P.A. 2021. Extended-spectrum β-lactamases: An update on their characteristics, epidemiology and detection. JAC Antimicrob Resist,16;3(3):dlab092.
  • [24] Oelschlaeger, P. 2021. β-Lactamases: Sequence, Structure, Function, and Inhibition. Biomolecules, 5;11(7):986.
  • [25] Bahr. G., González, L.J., Vila, A.J. 2021. Metallo-β-lactamases in the Age of Multidrug Resistance: From Structure and Mechanism to Evolution, Dissemination, and Inhibitor Design. Chem Rev, 121: 7957–8094.
  • [26] Rodríguez-Guerrero, E., Callejas-Rodelas, J.C., Navarro-Marí, J.M., Gutiérrez-Fernández, J. 2022. Systematic Review of Plasmid AmpC Type Resistances in Escherichia coli and Klebsiella pneumoniae and Preliminary Proposal of a Simplified Screening Method for ampC. Microorganisms, 10, 611.
  • [27] Llor, C., Bjerrum, L. 2014. Antimicrobial resistance: Risk associated with antibiotic overuse and initiatives to reduce the problem. Ther Adv Drug Saf, 5: 229–241
There are 27 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Araştırma Articlesi
Authors

Mehmet Tevfik Bayraktar 0000-0003-2306-6531

Esma Ceylan 0000-0003-2417-1982

Bashar Ibrahım 0000-0003-3086-0995

Publication Date April 13, 2023
Submission Date November 17, 2022
Published in Issue Year 2023 Volume: 14 Issue: 1

Cite

Vancouver Bayraktar MT, Ceylan E, Ibrahım B. Analysis of Extended Spectrum Beta Lactamase Frequency in Klebsiella spp Isolates. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2023;14(1):1-10.

SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.