Characterization of cephalosporin-resistant clinical Enterobacteriaceae for CTX-M ESBLs in Bahrain

OBJECTIVE@#To detect the presence of specific CTX-M class of extended spectyum β-lactamases (ESBLs) in a collection of cephalosporin-resistant Enterobacteriaceae isolates from Bahrain.@*METHODS@#A subset of 80 cephalosporin-resistant Enterobacteriaceae collected from Salmaniya Medical Complex, Bahrain, were characterized further for the presence of specific genogroups of CTX-M β-lactamases by multiplex- and monoplex- PCRs. The primers used for the multiplex and monoplex PCRs were of genogroups- 1, 2, 8, 9 and 25. Sequencing of the representative isolates was performed to find the circulating CTX-M-types.@*RESULTS@#A total of 93.8% (75/80) isolates showed the amplicons corresponding to any of the genogroups (1, 2, 8, 9, 25) and the remaining 6.2% isolates turned out negative in multiplex PCR. Some of the isolates demonstrated multiple bands corresponding to the sizes of different genogroups. Further confirmation with respective monoplex PCR on these 75 isolates demonstrated that 93.3% (70/75) harbored CTX-M genogroup-1 and 6.7% (5/75) harbored genogroup-9. We did not find the presence of genogroups 2, 8, and 25 in these isolates by monoplex PCR. Sequencing results of genogroup-1 isolates demonstrated the presence of CTX-M-15-like ESBL, however, discrepant results were noticed in genogroup-9 isolates, sequencing showed them as CTX-M-55-like ESBL.@*CONCLUSIONS@#This is the first report from Bahrain characterizing the CTX-M genogroups of ESBLs and reporting the emergence of blaCTX-M-55-like gene in this region.

Characterization of cephalosporin-resistant clinical Enterobacteriaceae for CTX-M ESBLs in Bahrain

Objective: To detect the presence of specific CTX-M class of extended spectyum β-lactamases (ESBLs) in a collection of cephalosporin-resistant Enterobacteriaceae isolates from Bahrain. Methods: A subset of 80 cephalosporin-resistant Enterobacteriaceae collected from Salmaniya Medical Complex, Bahrain, were characterized further for the presence of specific genogroups of CTX-M β-lactamases by multiplex- and monoplex- PCRs. The primers used for the multiplex and monoplex PCRs were of genogroups- 1, 2, 8, 9 and 25. Sequencing of the representative isolates was performed to find the circulating CTX-M-types. Results: A total of 93.8% (75/80) isolates showed the amplicons corresponding to any of the genogroups (1, 2, 8, 9, 25) and the remaining 6.2% isolates turned out negative in multiplex PCR. Some of the isolates demonstrated multiple bands corresponding to the sizes of different genogroups. Further confirmation with respective monoplex PCR on these 75 isolates demonstrated that 93.3% (70/75) harbored CTX-M genogroup-1 and 6.7% (5/75) harbored genogroup-9. We did not find the presence of genogroups 2, 8, and 25 in these isolates by monoplex PCR. Sequencing results of genogroup-1 isolates demonstrated the presence of CTX-M-15-like ESBL, however, discrepant results were noticed in genogroup-9 isolates, sequencing showed them as CTX-M-55-like ESBL. Conclusions: This is the first report from Bahrain characterizing the CTX-M genogroups of ESBLs and reporting the emergence of bla

Prevalence of extended-spectrum beta-lactamase-producing enterobacteriaceae in Bahrain

To determine the occurrence of extended-spectrum beta-lactamase [ESBL]-producing Enterobacteriaceae in Bahrain. Retrospective analysis of records [January 2005-December 2006] at the Microbiology Laboratory of the Salmaniya Medical Complex, Bahrain which is the major national diagnostic laboratory. Out of a total of 11,886 member of family of Enterobacteriaceae isolated, 2695 [22.6%] were ESBL producers. Majority of ESBL isolates were from inpatients [n = 2363; 87.7%]. Escherichia coli [52.2%] and Klebsiella pneumoniae [24.3%] were predominant and distributed comparatively in the hospital wards while Proteus spp. [17.6%] was predominant in medical wards. Urine was the major source [52.2%] with low occurrence in blood cultures. No carbapenem resistant isolates was identified but resistance to three classes of antibiotics was exhibited by >25% of the isolated ESBL strains. Nitrofurantoin resistance was identified in 38.2% of urinary isolates. This is the first report from Bahrain and it indicates that the prevalence of ESBL-producing isolates is high. Carbapenems were the most active drug against the ESBL-producing isolates. We recommend strict infection control to prevent trafficking into the community

[Microbial profile and antibiotics sensitivities of gram-negative rods in a neonatal intensive care unit]

Infection in neonatal intensive care unit [NICUs] causes significant morbidity and mortality worldwide. The microbial profile and antibiotic sensitivity are important contributing factors. The aim of this study is to investigate the incidence of various invasive pathogens in an NICU and to describe the antibiotic resistance patterns in Gram-negative rods isolated from NICU. Data from the microbiology laboratory at Salmaniya Medical Complex from January 2002 till December 2007 were reviewed pertaining to organisms isolated, type of samples, and antibiotic resistance pattern of Gram-negative rods [GNRs]. Data were grouped into Group 1 [2002-2004] data and Group 2 [2005-2007] data. There was no significant difference between the two groups with regard to percentage of positive culture 17.3% Group 1 and 18.6% Group 2. There was a significant increase of multi-drug resistant [MDR], Acinetobacter beurmanni and extended spectrum beta lactamase [ESBL] producing organisms. Resistance to third and fourth generation cephalosporins was alarmingly high. Our study documented increase of resistant organisms and high resistance tocephalosporin. The use of ampicillin and gentamycin as empirical therapy should be reviewed. Further surveillance studies are needed to monitor both organisms and antibiotic resistance