The Status of Extended-spectrum &beta;-lactamase and AmpC &beta;-lactamase production in uropathogenic isolates of Escherichia coli and Klebsiella pneumonia in Bangladesh

Md. Habibur Rahman; b; Shamima Begum; Mushtaque Ahmed; and Ariful Islam

doi:10.25163/microbbioacts.512133

MicroBio Pharmaceuticals and Pharmacology | Online ISSN 2209-2161

RESEARCH ARTICLE (Open Access)

Previous Next Contents Vol 5 (1)

The Status of Extended-spectrum β-lactamase and AmpC β-lactamase production in uropathogenic isolates of Escherichia coli and Klebsiella pneumonia in Bangladesh

Md. Habibur Rahman ^a,b, Shamima Begum ^a*, Mushtaque Ahmed ^b, and Ariful Islam ^a

+ Author Affiliations

Microbial Bioactives 5 (1) 181-189 https://doi.org/10.25163/microbbioacts.512133

Submitted: 01 November 2021 Revised: 30 May 2022 Published: 20 June 2022

Abstract

Background: The rapid dissemination of antibiotic resistance as extended-spectrum beta-lactamases (ESBLs) and AmpC β-lactamases in bacteria became a major public health concern worldwide. Hence, this study was carried out to evaluate the status of uropathogenic isolates of Bangladesh especially Escherichia coli and Klebsiella pneumoniae in terms of ESBL and AmpC β-lactamases enzymes production. Methods: A laboratory-based cross-sectional survey was conducted with 553 urine samples at the Department of Microbiology, Popular Diagnostic Centre Ltd. Dhaka, Bangladesh for a period of 2.5 years from July 2017 to December 2019. Pathogens were obtained upon culture, and screened for ESBL production following the cephalosporin disk diffusion method and cephalosporin-clavulanate combination disc test (confirmatory) method. For AmpC β-lactamases enzymes, cefoxitin disc diffusion, and AmpC disc test (confirmatory) methods were performed. The positive isolates were further genotyped for the presence of blaTEM, blaSHV, blaOXA, and blaCTX-M β-lactamases genes in case of ESBL and blaFOX, blaCMY, and blaDHA genes for AmpC β-lactamases by polymerase chain reaction. Results: Of all urine samples, uropathogens were detected among 28.57% (158, n=553) samples. Among them, 46.20% (73) were E. coli and 20.25% (32) were K. pneumoniae. The prevalence of ESBL and AmpC β-lactamases production in E. coli was 34.24% (25) and 17.80% (13) respectively whereas it was 43.75% (14) and 21.87% (7) in Klebsiella pneumoniae isolates respectively. These resistance properties were further confirmed by phenotypic disc test. In case of ESBLs, most typical isolates possessed two or more resistance genes. Overall, the most prevalent gene was blaCTX-M (84.61%) followed by blaTEM (64.10%), blaOXA (46.15%) and blaSHV (25.64%). In case of AmpC β-lactamases FOX gene was most prevalent (45%) followed by CMY (20%) and DHA 3 (15%). Conclusion: The high prevalence of ESBL and AmpC β-lactamases production in our study emphasizes the judicious use of antibiotics in controlling urinary tract infections in Bangladesh.

References

Altoparlak U, Erol S, Aklay MN, Celebi bF, Kadanali A (2004). Time-related changes of antimicrobial resistance patterns and predominant bacterial profiles of burn wounds and body flora of burned patients. Burns30:660-664

https://doi.org/10.1016/j.burns.2004.03.005

Arora S and Bal M., AmpC β-lactamase producing bacterial isolates from Kolkata hospital, Indian J Med Res, 122, 224-233 (2005)

Auer S, Wojna A, Hell M. oral treatment options for ambulatory patients with urinary tract infections caused by extended-spectrum-beta-lactamase-producing Escherichia coli. Antimicrob Agents Chemother 2010; 54:4006-8

https://doi.org/10.1128/AAC.01760-09

Bandekar N, Kumar VCS and Basavarajappa K.G. et al., Beta lactamases mediated resistance amongst gram-negative bacilli in Burn infection, Int J Biological and Medical Resarch, 2(3), 766-770 (2011)

Black JA, Moland ES, Thomson KS. AmpC disk test for detection of plasmid-mediated AmpC beta-lactamases in Enterobacteriaceae lacking chromosomal AmpC beta-lactamases. J Clin Microbiol 2005; 43:3110-3.

https://doi.org/10.1128/JCM.43.7.3110-3113.2005

Bradford PA. Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001;14(4):933-51.

https://doi.org/10.1128/CMR.14.4.933-951.2001

Bristy FS, Uddin MR, Mahmud SA, Uddin MJ, Talukder AA, Khondoker MU, Jamiruddin MR, Azmuda N, Adnan, N (2018) "Reassessment of Clinical Pathogens Diagnosed by Sub-urban Facilities of Dhaka: Necessity of Comprehensive Techniques to Manage Antibiotic Resistance", Microbial Bioactives, 1(2), 051-058.

https://doi.org/10.25163/microbbioacts.12013C0207101018

CDC 1999, "Laboratory Detection of Extended-spectrum beta-lactamases (ESBLs) http://www.cdc.gov/ncidod/hip

Chandel DS, Johnson JA and Chaudhry R et al., ESBLproducing Gram-negative bacteria causing neonatal sepsis in India in rural and urban settings, Journal of Medical Microbiology, (60), 500-507 (2011)

https://doi.org/10.1099/jmm.0.027375-0

Edelstein M, Pimkin M, Palagin I, Edelstein I, Stratchounski L. Prevalence and molecular epidemiology of CTX-M extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Russian hospitals. Antimicrob Agents Chemother. 2003 Dec; 47(12): 3724-32.

https://doi.org/10.1128/AAC.47.12.3724-3732.2003

Ejaz H, Zafar A, Anwar N, Cheema TA, Shehzad H. Prevalence of bacteria in the urinary tract. Infections among children 2006; Biomedica vol. 22.

Govindaswamy A, Bajpai V, Batra P, Malhotra R, Mathur P. Phenotypic and molecular characterization of extended-spectrum beta-lactamase and AmpC beta-lactamases in Escherichia coli from a tertiary care centre in India. J Patient Saf Infect Control 2018;6: XX-XX.

https://doi.org/10.4103/jpsic.jpsic_11_18

Goyal A, Prasad KN, Prasad A, Gupta S, Ghoshal U, Ayyagari A, et al. Extended-spectrum beta-lactamases in Escherichia coli & Klebsiella pneumoniae & associated risk factors. Indian J Med Res 2009; 129:695-700.

Hasan B, Islam K, Ahsan M, Hossain Z, Rashid M et al. (2014) Fecal carriage of multi-drug resistant and extended-spectrum beta-lactamases producing E. coli in household pigeons, Bangladesh. Vet Microbiol 168: 221-224.

https://doi.org/10.1016/j.vetmic.2013.09.033

Hemalatha V, Padma M, Sekar U, Vinodh TM, Arunkumar AS. Detection of Amp C beta-lactamases production in Escherichia coli & Klebsiella by an inhibitor-based method. Indian J Med Res 2007;126(3):220-3.

Humayun T and Iqbal A. Culture and Sensitivity Pattern of Urinary Tract Infections in Females of Reproductive Age Group. Ann. Pak. Inst. Med. Sci, 2012; 8 (1): 19-22.

Iftikhar Ahmed, Abdus Salam. Extended-spectrum beta-lactamases and bacterial resistance, Pak.J, Med. Sci.2002; 18(2): 151-155

Iraj A, Nilufar YN. Antibiogram of extended-spectrum beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae isolated from hospital samples, Bangladesh. J Med Microbiol. 2010; 4:32-3

https://doi.org/10.3329/bjmm.v4i1.8467

Khan MKR, Thukral SS and Gaind R, Evaluation of a modified double-disc Synergy test for detection of extended-spectrum of β-lactamases in AmpC β-lactamase producing Proteus Mirabilis, IJMM, 26(1), 58-61 (2008)

https://doi.org/10.1016/S0255-0857(21)01994-0

Khan MKR, Thukral SS and Gaind R, Evaluation of a modified double-disc Synergy test for detection of the extended spectrum of β-lactamases in AmpC β-lactamase producing Proteus Mirabilis, IJMM, 26(1), 58-61 (2008)

https://doi.org/10.1016/S0255-0857(21)01994-0

Khan Mohammed Nasir*, Srivastava Preeti, Chophi Vikili and Nirwan Prem Singh., Prevalence of ESBL and AmpC β-Lactamase in Gram-Negative Bacilli in various Clinical Samples at Tertiary Care Hospital, Int. Res. J. Medical Sci. Vol. 3(8), 1-6, August (2015)

M100S27 | Performance Standards for Antimicrobial Susceptibility Testing; 2017. Available from: https://www.clsi.org/standards/ products/microbiology/documents/m100/. [Last accessed on 2019 Dec 30].

Manoharan A, Sugumar M, Kumar A, Jose H, Mathai D, Khilnani GC, et al. Phenotypic & molecular characterization of AmpC β-lactamases among Escherichia coli, Klebsiella spp. & Enterobacter spp. From five Indian medical centers. Indian J Med Res 2012;135:359-64.

Mayo SJ, Aboud S, Kasubi M, Lyamuya EF and Maselle. Antimicrobial resistance among producers and non-producers of extended-spectrum beta-lactamases in urinary isolates at a tertiary Hospital in Tanzania 2010.

https://doi.org/10.1186/1756-0500-3-348

Medeiros A A, 1993 "Nosocomial outbreaks of multiresistant bacteria: extended-spectrum beta-lactamase have arrived in North America", Annals of Internal Medicine, 119(5): 428-429.

https://doi.org/10.7326/0003-4819-119-5-199309010-00015

Moland SE, Black JA, Ourada J, Reisbig MD, Hanson ND, Thomson KS. Occurrence of newer β-lactamase in Klebsiella pneumonia isolates from 24 U.S. hospitals. Antimicrobials Agents Chemother 2002; 46:3837-42.

https://doi.org/10.1128/AAC.46.12.3837-3842.2002

Mugnaioli C, Luzzaro F, De Luca F, Brigante G, Perilli M, et al. (2006) CTXM- type extended-spectrum beta-lactamases in Italy: molecular epidemiology of an emerging countrywide problem. Antimicrob Agents Chemother 50: 2700- 2706.

https://doi.org/10.1128/AAC.00068-06

National Committee \for Clinical Laboratory Standards, 1999, performance standards for antimicrobial susceptibility testing. NCCLS approved standard, M100-S9, National Committee for Clinical Laboratory Standards, Wayne, PA.

Nemeth J, Ledergerber B, Preiswerk B, Nobile A, Karrer S, Ruef C, et al. Multidrug-resistant bacteria in travelers hospitalized abroad: prevalence, characteristics, and influence on clinical outcome. J Hosp Infect 2012;82(4):254-9.

https://doi.org/10.1016/j.jhin.2012.08.017

Parveen RM, Khan MA, Menezes GA, Harish BN, Parija SC, Hays JP, et al. Extended-spectrum β-lactamase producing Klebsiella pneumoniae from blood cultures in Puducherry, India. Indian J Med Res 2011; 134:392-5.

Patel MH, Trivedi GR, Patel SM, Vegad MM. Antibiotic susceptibility pattern in urinary isolates of gram-negative bacilli with special reference to AmpC β-lactamase in a tertiary care hospital. Urol Ann 2010;2(1):7-11.

https://doi.org/10.4103/0974-7796.62915

Polsfuss S, Bloemberg GV and Giger J et al., Practical Approach for Reliable Detection of AmpC Beta- Lactamase-Producing Enterobacteriaceae, Journal of clinical microbiology, 49(8), 2798-2803 (2011)

https://doi.org/10.1128/JCM.00404-11

Prelog M, Fille M, Prodinger W, Grif K, Brunner A, et al. (2008) CTX-M-1- related extended-spectrum beta-lactamases producing Escherichia coli: so far, a sporadic event in Western Austria. Infection 36: 362-367.

https://doi.org/10.1007/s15010-008-7309-7

Qureshi AM. Organisms causing urinary tract infection in pediatric patients at Ayub Teaching Hospital Abbottabad. J Ayub Med. Coll. Abbottabad, 2005; 17 (1): 72-4.

Rahman MM, Haq JA, Hossain MA, Sultana R, Islam F, et al. (2004) Prevalence of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in an urban hospital in Dhaka, Bangladesh. Int J Antimicrob Agents 24: 508-510.

https://doi.org/10.1016/j.ijantimicag.2004.05.007

Rudresh S.M. and Nagarathnamma T., Two simple modifications of modified three-dimensional extract test for detection of AmpC β-lactamases among the members of family Enterobacteriaceae, Chronicles of Young Scientists, 2(1), 42-6 (2011)

https://doi.org/10.4103/2229-5186.79349

Sasirekha B., Prevalence of ESBL, AMPC β-Lactamases and MRSA Among Uropathogens and its Antibiogram, EXCLI Journal, 12, 81-88 (2013)

Shahid M, Malik A, Agrawal M, Singhal S. Phenotypic detection of extended-spectrum and AmpC beta-lactamases by a new spot-inoculation method and modified three-dimensional extract test: Comparison with the conventional three-dimensional extract test. J Antimicrob Chemother 2004; 54:684-7.

https://doi.org/10.1093/jac/dkh389

Shaikh S, Fatima J, Shakil S, Rizvi SMD, Kamal MA. Risk factors for acquisition of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in North-Indian hospitals. Saudi J Biol Sci. 2015;22(1): 37-41.

https://doi.org/10.1016/j.sjbs.2014.05.006

Sharma M, Pathak S and Srivastava P, Prevalence and antibiogram of ESBL producing Gram-negative bacilli and further molecular characterization of ESBL producing Escherichia coli and Klebsiella spp., Journal of Clinica and Diagnostic Research, 7(10).

Singhal S, Mathur T, Khan S, Upadhyay DJ, Chugh S, Gaind R, et al. Evaluation of methods for AmpC beta-lactamase in gram-negative clinical isolates from tertiary care hospitals. Indian J Med Microbiol 2005;23(2):120-4.

https://doi.org/10.1016/S0255-0857(21)02652-9

https://doi.org/10.4103/0255-0857.16053

Sinha P, Sharma R, Rishi S, Sharma R, Sood S, Pathak D. Prevalence of extended-spectrum beta-lactamase and AmpC beta-lactamase producers among Escherichia coli isolates in a tertiary care hospital in Jaipur. Indian J Pathol Microbiol 2008;51(3):367-9.

https://doi.org/10.4103/0377-4929.42512

Sturenburg E, Lang M, Horstkotte MA, LaufsR, Mack D. Evaluation of the MicroScan ESBL plus confirmation panel for detection of extended-spectrum β-lactamases in clinical isolates of oxyimino-cephalosporin-resistant Gram-negative bacteria. J Antimicrob Chemother. 2004 Nov; 54(5): 870-5.

https://doi.org/10.1093/jac/dkh449

Talukdar PK, Rahman M, Nabi A, Islam Z, Hoque MM, et al. (2013) Antimicrobial resistance, virulence factors and genetic diversity of Escherichia coli isolates from the household water supply in Dhaka, Bangladesh. PLoS One 8(4): e61090.

https://doi.org/10.1371/journal.pone.0061090

Taneja N, Singh G and Singh M et al., High occurrence of blaCMY-1 AmpC lactamase producing Escherichia coli in cases of complicated urinary tract infection (UTI) from a tertiary health care centre in north India, Indian J MedRes, 136, 289-291 (2012)

Tenover F C, Mohammed M J, Gorton T S and Dembek Z, 1999, "Detection and reporting of organism producing extended-spectrum ?-lactamases; survey of laboratories on Connecticut". JCM, 37(12): 4065-4070.

https://doi.org/10.1128/JCM.37.12.4065-4070.1999

Wadekar MD, Anuradha K and Venkatesha D, Phenotypic detection of ESBL and MBL in clinical isolates of Enterobacteriaceae, International journal of current research and academic review, 1(3), 89-95 (2013).

Wayne PA. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twentieth Informational Supplement M100- S20; 2010.

Yu Y, Zhou W, Chen Y, Ding Y, Ma Y. Epidemiological and antibiotic-resistant study on extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Zhejiang Province. Chin Med J (Engl) 2002;115(10):1479-82.

PDF
Abstract
Export Citation

View Dimensions

View Plumx

View Altmetric

Save

0
Citation

1033
View

Share