Comparison of Antibiotic Sensitivity Pattern of Escherichia coli which Produce Extended Spectrum Beta-Lactamase Strains Isolated From Various Clinical Specimens In Intensive Care Unit

Yıl 2019, Cilt: 5 Sayı: 1, 33 - 38, 28.04.2019

Tuğba Cebeci , Dilek Keskin , Ahmet Ali Gökal

https://doi.org/10.19127/mbsjohs.525833

Öz

Objective: A retrospective
analysis of the widely
used antibiotics all
susceptibility testing results from Escherichia coli (E. coli) cultured
from clinical specimens private hospital (from January
2017 to November 2018) was performed.  

Methods: The VITEK 2 Compact automated
microbiology system (bioMérieux) is designed for automated rapid antimicrobial
susceptibility testing and identification of clinically relevant bacteria. Minimum
inhibitory concentration (MIC) results previously obtained in recent clinical
isolates with well-defined in isolates with well-characterized resistance
mechanisms with the microdilution method were re-interpreted for the
susceptible, intermediate and resistant categories using the 2018 EUCAST
breakpoints. Clinical
samples are
most commonly isolated from blood, sputum and urine samples.  

Results: The results of
resistance pattern of E. coli
isolates in our locality to antimicrobial agents showed that the 64 E. coli strains tested against fifteen
antimicrobial agents. E. coli
isolates were highly resistant to piperacillin, ceftazidime and aztreonam 98%,
61% and 61% respectively. The most sensitive antibiotics were colistin, tigecycline,
imipenem and meropenem. In the
present study, 73% (47) of the isolates were resistant to at least three to
fourteen antibiotics. All of the isolates showed resistance to at least one
antibiotics. Thirty nine per cent of E.
coli isolates were extended
spectrum beta-lactamase (ESBL) producers.  

Conclusion: Considering the antibiogram, imipenem and meropenem should be preferred drugs
for E. coli infection isolated from
clinical samples.

Anahtar Kelimeler

Esherichia coli, antibiotic sensitivity, clinical specimens, intensive care unit

Kaynakça

• Abreu AG, Marques SG, Monteiro-Neto V, Carvalho RM, Goncalves AG. Nosocomial infection and characterization of extended-spectrum beta-lactamases-producing Enterobacteriaceae in Northeast Brazil. Rev Soc Bras Med Trop. 2011; 44(4) :441–6.
• Akter F, M. Mahboob Hossain, Arifur Rahman, Mukta Shaha and Amani El Abd Abu Amo Amani, Antimicrobials Resistance Pattern of Escherichia coli Collected from Various Pathological Specimens. Pakistan Journal of Biological Sciences 2012; 15: 1080-1084.
• Albayrak N, and S. Kaya. Extended spectrum beta lactamases production and antimicrobial resistance ratio of the Esherichia coli and Klebsiella pneumoniae strains isolated from various clinical specimens. Turkish Society of Microbiology Journal 2009; 39: 16–21.
• Al-Mijalli SHS. Bacterial Uropathogens in Urinary Tract in Riyadh Hospital, Saudi Arabia. Cell Mol Med 2017, 3:1.
• Ashgar, A. H. Frequency and antimicrobial susceptibility patterns of bacterial pathogens isolated from septisemic patients in Makkah hospitals. Saudi Medical Journal 2006; 27(3): 361-367.
• Apisarnthanarak A, Kiratisin P, Mundy LM. Predictors of mortality from community-onset bloodstream infections due to extendedspectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae. Infect Control Hosp Epidemiol 2008; 29(7): 671–4.
• Batarseh A, Soneah S, Mardeni R, Elmadni K, Noor M, Ashour NA. Antibiotic resistance patterns of multidrug resistant and extended-spectrum β -lactamase producing Esherichia coli urinary isolates at queen Rania al-abdullah hospital for children. Jordan Z U M J. 2013;19(5):286–93.
• Cappuccino, J.G., N. Sherman, Microbiology: A Laboratory Manual. 7th Edn., 2004. Pearson Education (Singapore), Indian Branch, New Delhi, ISBN: 080532836X pp: 544.
• Chander A, Shrestha CD. Prevalence of extended spectrum beta lactamase producing Escherichia coli and Klebsiella pneumoniae urinary isolates in a tertiary care hospital in Kathmandu, Nepal. BMC ResNotes 2013; 6:487. doi: 10.1186/1756-0500-6-487.
• Daoud,Z., N. Hakime. Prevalence and susceptibility patterns of extended-spectrum beta-lactamaseproducing Escherichia coli and Klebsiella pneumoniae in a general university hospital in Beirut, Lebanon. Rev Esp Quimioter 2003; 16(2): 233-8.
• Drieux L, Brossier F, Sougakoff W, Jarlier V. Phenotypic detection of extended spectrum β-lactamase production in Enterobacteriaceae: review and bench guide. Clin. Microbiol. Infect. 2008;14(Suppl 1): 90–103.
• Duttaroy B, S. Mehta,. Extended spectrum beta-lactamases (ESBL) in clinical isolates of Klebsiella pneumoniae and Escherichia coli. Indian J Pathol Microbiol 2005; 48: 45-8.
• Elsayed TI, Ismail HA, Elgamal SA. The Occurrence of Multidrug Resistant E. coli which Produce ESBL and Cause Urinary Tract Infections. J Appl Microbiol Biochem. 2017; 1: 2-8.
• Falagas ME, Karageorgopoulos DE. Extended-spectrum betalactamase-producing organisms. J Hosp Infect. 2009; 73(4): 345–54.
• Gunasekaran, P. Laboratory Manual in Microbiology. New Age :International, New Delhi;2000.
• Iqbal M, Patel IK, Shah SH, Ain Q, Barney N, Kiani Q, Rabbani KZ, Zaidi G, Mehdi B. Susceptibility patterns of Escherichia coli: prevalence of multidrug-resistant isolates and extended spectrum beta-lactamase phenotype. Journal of Pakistan Medical Association 2002; 52(9): 407-11.
• Jafri SA, Qasim M, Masoud MS. Antibiotic resistance of E. coli isolates from urine samples of urinary tract infection (UTI) patients in Pakistan. Bioinformation 2014; 10: 419-422.
• Jang WH, Yoo DH, Park SW. Prevalence of and Risk Factors for Levofloxacin-Resistant E. coli Isolated from Outpatients with Urinary Tract Infection. Korean J Urol 2011; 52: 554-559.
• Jensen US, Skjot-Rasmussen L, Olsen SS, FrimodtMoller N, Hammerum AM, on behalf of the DANRES Study Group. Consequences of increased antibacterial consumption and change in pattern of antibacterial use in Danish hospitals. J Antimicrob Chemother 2009; 63: 812-815.
• Kafilzadeh F., Farsimadan F. Investigating multidrug efflux pumps in relation to the antibiotic resistance pattern in Escherichia coli strains from patients in Iran. Biomedical Research 2016; 27 (4): 1130-1135.
• Kaftandzhieva, A., Kotevska, V., G. Jankoska,. Extended-spectrum beta-lactamase- producing E. coli and Klebsiella pneumoniae in children at University pediatric clinic in Skopje. Macedonian J Med Sci 2009; 2(1): 36-41.
• Khanfar HS, Bindayna KM, Senok AC, Botta GA. Extended spectrum beta-lactamases (ESBL) in Escherichia coli and Klebsiella pneumoniae: trends in the hospital and community settings. J Infect Dev Ctries 2009; 3(4):295–9.
• Krumperman, P.H. Multiple antibiotic resistance indexing of Escherichia coli to identify high-risk sources of fecal contamination of foods. Applied and Environmental Microbiology 1985; 46: 165– 170.
• Kumar D, Singh AK, Ali MR, Chander Y. Antimicrobial Susceptibility Profile of Extended Spectrum β-Lactamase (ESBL) Producing Escherichia coli from Various Clinical Samples. Infectious Diseases: Research and Treatment 2014;7:1–8.
• Kumarasinghe G, Chow C, Koh BL, Chiang, KL., Liew, HY., Ti, TY. Antimicrobial resistance problem in a university hospital. Pathology 1995; 27: 67–70.
• Kumarasinghe G, Chow C, Tambyah PA. Widespread resistance to new antimicrobials in a university hospital before clinical use. International Journal of Antimicrob Agents 2001; 18(4): 391-393.
• Lavigne JP, Bouziges, N., Chanal, C., Mahamat, A., Michaux-Charachon, S., Sotto, A. Molecular epidemiology of Enterobacteriaceae isolates producing extended-spectrum beta-lactamases in a French hospital. J ClinMicrobiol 2004; 42: 3805-8.
• Ling TK, Tam PC, Liu ZK, Cheng AF. Evaluation of VITEK 2 rapid identification and susceptibility testing system against gram-negative clinical isolates. J. Clin. Microbiol. 2001; 39: 2964-6.
• MacFaddin, FJ. Biochemical Tests for Identification of Medical Bacteria., 3rd Edn., Philadelphia, USA, 2000 p.912.
• Matyar, F., Kaya, A., Dinçer, S. Antibacterial agents and heavy metal resistance in Gram-negative bacteria isolated from seawater, shrimp and sediment in Iskenderun Bay, Turkey. Science Total and Environment 2008; 407: 279-285.
• Mos I, Micle O, Zdrâncă M, Mureşan M, Vicaş L. Antibiotic Sensitivity of the Escherichia coli Strains Isolated from Infected Skin Wounds. Farmacia 2010; 58 (5): 637-44.
• Moyo SJ, Aboud S, Kasubi M, Lyamuya EF, Maselle SY. Antimicrobial resistance among producers and non-producers of extended spectrum beta-lactamases in urinary isolates at a tertiary Hospital in Tanzania. BMC Res Notes. 2010; 3:348.
• National Committee for Clinical Laboratory Standards. 2003. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. Approved standard M7–A6, 6th ed. National Committee for Clinical Laboratory Standards, Wayne, Pa.
• Ozsahin D., Digrak M., Kiran OE. The Investigation on resistance Properties of Esherichia coli against Beta Lactam Groups Antibiotics. KSU, Journal Of science and Engineering 2005;8(2):8-12.
• Paterson DL, Bonomo RA. Extended-spectrum β-lactamases: a clinical update. Clin Microbiol Rev, 2005; 18:657–686.
• Philippon A, Labia R, Jacoby G. Extended-spectrum beta-lactamases. Antimicrob Agents Chemother 1989; 33:1131–6.
• Rhomberg PR, Jones, RN. Contemporary activity of meropenem and comparator broad-spectrum agents: MYSTIC program report from the United States component (2005). Diagn. Microbiol. Infect. Dis, 2007; 57:207-215.
• Ringertz S, Bellete B, Karlsson I, Öhman G, Gedebou M, Kronvall G. Antibiotic susceptibility of Escherichia coli isolates from inpatients with urinary tract infections in hospitals in Addis Ababa and Stockholm. Bull World Health Organ 1990; 68(1): 61-68.
• Rodriguez-Bano J, Alcala JC, Cisneros JM, Grill F, Oliver A, Horcajada JP. Community infections caused by extended-spectrum beta-lactamase-producing Escherichia coli. Arch Intern Med 2008; 168(17):1897–902.
• Sabir S, Anjum AA, Ijaz T (2014) Isolation and antibiotic susceptibility of E. coli from urinary tract infections in a tertiary care hospital. Pak J Med Sci. 2014; 30(2):389-92. Shahid, M., Malik, A., Akram, M. Prevalent phenotypes and antibiotic resistance in Escherichia coli and Klebsiella pneumonia at an Indian tertiary care hospital: plasmid-mediated cefoxitin resistance. Int J Infect Dis, 2008;12(3): 256-64.
• Sharafi R., Ceckler, R. Childs, S. Treatment of urinary tract infections: Selecting an appropriate broad-spectrum antibiotic for nosocomial infections. Am. J. Med., 1996; 100: 76-82.
• Sohail M, Khurshid M, Saleem HGM, Javed H, Khan AA. Characteristics and Antibiotic Resistance of Urinary Tract Pathogens Isolated From Punjab, Pakistan, Jundishapur J Microbiol. 2015; 8(7):e19272.
• Tasli, H., Bahar, IH. Molecular characterization of TEM- and SHV-derived extended spectrum beta-lactamases in hospital-based Enterobacteriaceae in Turkey. Jpn J Infect Dis. 2005; 58(3): 162-7.
• Tinelli M, Cataldo MA, Mantengoli E, Cadeddu C, Cunietti E, Luzzaro F, et al. Epidemiology and genetic characteristics of extended-spectrum beta-lactamase-producing Gram-negative bacteria causing urinary tract infections in long-term care facilities. J Antimicrob Chemother. 2012; 67(12):2982–7.
• Torok ME, Cooke FJ, Moran E. Escherichia coli in Handbook of Infectious Diseases and Microbiology, Oxford University Press 2010; 324-6.
• Torok ME, Cooke FJ, Moran E. Infectious diarrhoea in Handbook of Infectious Diseases and Microbiology. Oxford University Press 2010; 688-9.
• Villegas, M.V., Correa, A., Perez, F., Miranda, MC., Zuluaga, T., Quinn, JP. Prevalence and characterization of extended-spectrum beta-lactamases in Klebsiella pneumoniae and Escherichia coli isolates from Colombian hospitals. DiagnMicrobiol Infect Dis. 2004; 49(3): 217-22.
• Wu,T.L., Chia, JH, Su, LH., Kuo, AJ., Chu, C., Chiu, CH. Dissemination of extended-spectrum beta-lactamase-producing Enterobacteriaceae in pediatric intensive care units. J ClinMicrobiol. 2003; 41(10): 4836-8.
• Zhou, L. Pathogens and associated factors of infections in PICU. Shanghai second medical university afflicted shanghai children medical center. 2001.