High prevalence of multidrug-resistant Enterobacterales carrying extended-spectrum beta-lactamase and AmpC genes isolated from neonatal sepsis in Ahvaz, Iran.

Publisher: BioMed Central Country of Publication: England NLM ID: 100966981 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2180 (Electronic) Linking ISSN: 14712180 NLM ISO Abbreviation: BMC Microbiol Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

beta-Lactamases*/genetics ; Drug Resistance, Multiple, Bacterial*/genetics ; Enterobacteriaceae Infections*/microbiology ; Enterobacteriaceae Infections*/epidemiology ; Anti-Bacterial Agents*/pharmacology ; Bacterial Proteins*/genetics ; Microbial Sensitivity Tests* ; Neonatal Sepsis*/microbiology ; Neonatal Sepsis*/epidemiology; Humans ; Iran/epidemiology ; Infant, Newborn ; Prevalence ; Enterobacteriaceae/genetics ; Enterobacteriaceae/drug effects ; Enterobacteriaceae/enzymology ; Enterobacteriaceae/isolation & purification ; Klebsiella pneumoniae/genetics ; Klebsiella pneumoniae/drug effects ; Klebsiella pneumoniae/isolation & purification ; Klebsiella pneumoniae/enzymology ; Enterobacter/genetics ; Enterobacter/drug effects ; Enterobacter/isolation & purification ; Enterobacter/enzymology ; Escherichia coli/genetics ; Escherichia coli/drug effects ; Escherichia coli/isolation & purification

Objectives: In the recent years, multidrug resistant (MDR) neonatal septicemia-causing Enterobacterales has been dramatically increased due to the extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes. This study aimed to assess the antibiotic resistance pattern, prevalence of ESBLs/AmpC beta-lactamase genes, and Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) fingerprints in Enterobacterales isolated from neonatal sepsis.
Results: In total, 59 Enterobacterales isolates including 41 (69.5%) Enterobacter species, 15 (25.4%) Klebsiella pneumoniae and 3 (5.1%) Escherichia coli were isolated respectively. Resistance to ceftazidime and cefotaxime was seen in all of isolates. Furthermore, all of them were multidrug-resistant (resistant to three different antibiotic categories). The phenotypic tests showed that 100% of isolates were ESBL-positive. Moreover, AmpC production was observed in 84.7% (n = 50/59) of isolates. Among 59 ESBL-positive isolates, the highest percentage belonged to bla CTX-M-15 gene (66.1%) followed by bla CTX-M (45.8%), bla CTX-M-14 (30.5%), bla SHV (28.8%), and bla TEM (13.6%). The frequency of bla DHA , bla EBC , bla MOX and bla CIT genes were 24%, 24%, 4%, and 2% respectively. ERIC-PCR analysis revealed that Enterobacterales isolates were genetically diverse. The remarkable prevalence of MDR Enterobacterales isolates carrying ESBL and AmpC beta-lactamase genes emphasizes that efficient surveillance measures are essential to avoid the more expansion of drug resistance amongst isolates.
(© 2024. The Author(s).)

PLoS One. 2020 Nov 12;15(11):e0241984. (PMID: 33180785)
J Glob Antimicrob Resist. 2023 Jun;33:208-217. (PMID: 36868310)
PLoS One. 2023 May 8;18(5):e0285170. (PMID: 37155660)
Infect Drug Resist. 2019 Apr 29;12:1001-1010. (PMID: 31118706)
BMC Infect Dis. 2018 May 30;18(1):244. (PMID: 29843632)
Am J Infect Control. 2019 Aug;47(8):951-955. (PMID: 30738720)
Antibiotics (Basel). 2021 Apr 06;10(4):. (PMID: 33917430)
Infection. 2019 Jun;47(3):363-375. (PMID: 30840201)
Braz J Microbiol. 2010 Jul;41(3):596-602. (PMID: 24031534)
J Lab Physicians. 2015 Jan-Jun;7(1):32-7. (PMID: 25949057)
J Clin Diagn Res. 2014 Jun;8(6):DC24-7. (PMID: 25120982)
Virulence. 2014 Jan 1;5(1):170-8. (PMID: 24185532)
Microb Pathog. 2017 Sep;110:184-188. (PMID: 28648624)
BMC Pediatr. 2019 Sep 7;19(1):320. (PMID: 31493789)
J Pediatric Infect Dis Soc. 2015 Mar;4(1):11-20. (PMID: 26407352)
PLoS One. 2020 Jan 24;15(1):e0227570. (PMID: 31978069)
Iran J Microbiol. 2013 Jun;5(2):126-31. (PMID: 23825729)
Front Microbiol. 2019 Jan 24;10:13. (PMID: 30733710)
Antibiotics (Basel). 2023 Mar 03;12(3):. (PMID: 36978375)
J Clin Microbiol. 2011 Aug;49(8):2798-803. (PMID: 21632895)
Curr Microbiol. 2011 Jun;62(6):1664-70. (PMID: 21400083)
Lancet Respir Med. 2018 Mar;6(3):223-230. (PMID: 29508706)
Biomedicines. 2023 Oct 30;11(11):. (PMID: 38001938)
Infect Drug Resist. 2017 Jan 13;10:19-25. (PMID: 28144154)
Infect Drug Resist. 2020 May 06;13:1319-1326. (PMID: 32440169)
Exp Ther Med. 2017 Mar;13(3):1117-1126. (PMID: 28450951)
Pediatr Res. 2022 Jan;91(2):337-350. (PMID: 34728808)
Indian J Pediatr. 2020 Feb;87(2):122-124. (PMID: 31900849)
Mol Biol Rep. 2020 Sep;47(9):7097-7106. (PMID: 32894435)
PLoS One. 2022 Nov 17;17(11):e0271652. (PMID: 36395172)
BMC Infect Dis. 2020 Sep 17;20(1):682. (PMID: 32942989)
BMC Infect Dis. 2021 Jun 9;21(1):546. (PMID: 34107906)
PLoS One. 2017 Jan 31;12(1):e0171216. (PMID: 28141845)
Curr Opin Infect Dis. 2017 Jun;30(3):281-288. (PMID: 28306563)
Am J Trop Med Hyg. 2016 Feb;94(2):285-8. (PMID: 26643537)
BMC Infect Dis. 2016 Oct 20;16(1):587. (PMID: 27765017)
J Antimicrob Chemother. 2013 May;68(5):1036-42. (PMID: 23335112)
Iran J Pediatr. 2011 Mar;21(1):83-7. (PMID: 23056769)

Keywords: Enterobacterales; AmpC; ERIC-PCR; ESBL; Multidrug resistant; Neonatal sepsis

EC 3.5.2.6 (beta-Lactamases)
0 (Anti-Bacterial Agents)
0 (Bacterial Proteins)
EC 3.5.2.6 (AmpC beta-lactamases)

Date Created: 20240424 Date Completed: 20240425 Latest Revision: 20240427

20240427

PMC11040821

10.1186/s12866-024-03285-6

38658819