Naslov
High prevalence of blaCTX-M-15 ; first report of blaCTX-M-28, blaCTX-M-3 blaCMY, blaDHA and blaFOX producing Enterobacteriaceae causing urinary tract infections in Bosnia and Herzegovina in hospital and community settings

Autori
Ibrahimagić, Amir ; Bedenić, Branka ; Kamberović, Farah ; Uzunović, Selma ; Sivec, Sara

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Skup
23rd european congress of clinical microbiology and infectious diseases

Mjesto i datum
Berlin, Njemačka, 26.04.2013. - 30.04.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
urinary tract infections; extended-spectrum beta-lactamases; CTX-M beta-lactamases; Enterobacteriaceae

Sažetak
Objectives To investigate molecular epidemiology of extended-spectrum (ESBL) and plasmid-mediated AmpC β-lactamase and carbapenemase producing Gram-negative bacteria the cause of urinary tract infections (UTI) in in- and outpatients in Bosnia and Herzegovina (B&H), during December 2009–May 2010. Methods Antibiotic susceptibility of ESBL producing Enterobacteriaceae was determined by disc diffusion and broth microdilution methdos according to CLSI guidelines. Double- disk synergy test was used to screen for ESBLs, and E test for metalo β-lactamase (MBL) production. PCR was used to detect blaESBL, blaampC and blaMBL genes. Genetic relatedness of the strains was tested by pulsed-field gel electrophoresis (PFGE). Results Among 85 UTIs caused by ESBL-producing Gram-negative bacteria, 44 (51.8%) were obtained from in- and 41 (48.2%) from outpatients. Most of hospital UTIs were registered at Paediatric and and Neurology departments, 14 (31.8%) in each. Klebsiella spp. was most frequently isolated, in 28 (63.6%) in-patients. In outpatients, Klebsiella spp. and E. coli were mostly isolated, in 19 (46.3%) and 16 (39.0%) cases, respectively. Resistance rates to gentamicin and ciprofloxacin of in- and outpatients were 40% and 100%, and 50% and 80%, respectively. Twenty one (75.0%) in- and nine (47.4%) outpatients Klebsiella spp. were positive for blaTEM, whereas 27 (96.4%) and 6 (31.6%) were positive for blaCTX-M, respectively (18 in-patient isolates were produced blaCTX-M-15, and two blaCTX-M-3). SHV-1 beta-lactamase was found in all but one in-patient Klebsiella isolate which harboured also SHV- 5 and DHA beta-lactamase. One Klebsiella spp. and one Enterobacter cloacae in-patient stains posessed CTX-M-28 beta-lactamase. Four (out of seven CTX-M ; 57.1%) E. coli in-patient isolates were positive for the blaCTX-M-15 and one for blaCTX-M-3. AmpC β-lactamases were detected by phenotypic test in 20 (45.5%) in- and 21 (51.2%) outpatients. One in-patient strain was positive for blaCMY and two for blaDHA, whereas four outpatient strains were positive for blaCMY and one for blaFOX. Conclusion: The CTX-M-15 was most prevalent β -lactamase in the in- and outpatients. This is the firtst report of blaCTX-M-28, blaCTX-M-3, blaCMY, blaDHA, and blaFOX from B&H. Due to high resistance rates observed for gentamicin and ciprofloxacin, carbapenems remain the antibiotics of choice for the treatment of UTIs caused by β-lactamase-producing Enterobacteriaceae in this region.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti

POVEZANOST RADA