{"title":"尼泊尔中部三级医疗机构发现的耐头孢他啶大肠埃希菌中 blaCTX-M 和 blaTEM 基因的流行情况：描述性横断面研究","authors":"Rani Kumari Sah, Pragyan Dahal, Ranjana Parajuli, Gorkha Raj Giri, Era Tuladhar","doi":"10.1155/2024/5517662","DOIUrl":null,"url":null,"abstract":"Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by <i>Escherichia coli</i> and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) in cephalosporin-resistant <i>E. coli</i>. Altogether, 1050 urine samples were processed to obtain 165 isolates of <i>E. coli</i>. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby–Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant <i>E. coli</i>. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as <i>E. coli.</i> The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the <i>E. coli</i> isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the <i>bla</i><sub>CTX-M</sub> gene was 55.26%. The prevalence of MDR <i>E. coli</i> harboring the <i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub> genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.","PeriodicalId":501415,"journal":{"name":"Canadian Journal of Infectious Diseases and Medical Microbiology","volume":"1 1","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study\",\"authors\":\"Rani Kumari Sah, Pragyan Dahal, Ranjana Parajuli, Gorkha Raj Giri, Era Tuladhar\",\"doi\":\"10.1155/2024/5517662\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by <i>Escherichia coli</i> and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) in cephalosporin-resistant <i>E. coli</i>. Altogether, 1050 urine samples were processed to obtain 165 isolates of <i>E. coli</i>. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby–Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant <i>E. coli</i>. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as <i>E. coli.</i> The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the <i>E. coli</i> isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (<i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub>) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the <i>bla</i><sub>CTX-M</sub> gene was 55.26%. The prevalence of MDR <i>E. coli</i> harboring the <i>bla</i><sub>CTX-M</sub> and <i>bla</i><sub>TEM</sub> genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.\",\"PeriodicalId\":501415,\"journal\":{\"name\":\"Canadian Journal of Infectious Diseases and Medical Microbiology\",\"volume\":\"1 1\",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Canadian Journal of Infectious Diseases and Medical Microbiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2024/5517662\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Canadian Journal of Infectious Diseases and Medical Microbiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2024/5517662","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Prevalence of blaCTX-M and blaTEM Genes in Cefotaxime-Resistant Escherichia coli Recovered from Tertiary Care at Central Nepal: A Descriptive Cross-Sectional Study
Urinary tract infections (UTIs) are highly prevalent globally, and various antibiotics are employed for their treatment. However, the emergence of drug-resistant uropathogens towards these antibiotics causes a high rate of morbidity and mortality. This study was conducted at the Microbiology Laboratory of Grande International Hospital from November 2021 to May 2022 and aimed to assess the prevalence of UTI caused by Escherichia coli and their antibiotic susceptibility pattern with a focus on extended-spectrum beta-lactamases (ESBLs) and the prevalence of two genes (blaCTX-M and blaTEM) in cephalosporin-resistant E. coli. Altogether, 1050 urine samples were processed to obtain 165 isolates of E. coli. The isolates were identified by colony morphology and biochemical characteristics. Antimicrobial susceptibility tests (ASTs) were determined by the Kirby–Bauer disk diffusion method, and their ESBL enzymes were estimated by the combined disk method (CDM). Two ESBL genes (blaCTX-M and blaTEM) were investigated by polymerase chain reaction (PCR) in cefotaxime-resistant E. coli. Among the 1050 urine samples that were processed, 335 (31.9%) were culture-positive with 165 (49.2%) identified as E. coli. The age group ≥60 years (30.3%) had greater susceptibility to bacterial infections. AST revealed that meropenem was highly effective (95.7% susceptibility), while ampicillin showed the least sensitivity (42.4%). Among the E. coli isolates, 86 were multidrug resistant (MDR) and 10 were extensively drug resistant (XDR). Of these, 46 MDR (96%) and 2 XDR (4%) were ESBL producers. The prevalence of ESBL genes (blaCTX-M and blaTEM) was 49.3% and 54.8%, respectively. The overall accuracy of CDM as compared to PCR for the detection of the blaCTX-M gene was 55.26%. The prevalence of MDR E. coli harboring the blaCTX-M and blaTEM genes underscores the imperative role of ESBL testing in accurately identifying both beta-lactamase producers and nonproducers.
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