Detection of CTX-M and SHV genes in Extended Spectrum Beta-Lactamase producing Klebsiella pneumoniae and Pseudomonas aeruginosa in a Tertiary Hospital in North-central Nigeria. https://doi.org/10.60787/NMJ-64-2-159
Main Article Content
Keywords
ESBL genes, Jos, Klebsiella pneumoniae, Pseudomonas aeruginosa
Abstract
Background: Antimicrobial resistance (AMR) is an emerging threat to global health security. Globally, an estimated 700,000 deaths are attributed to AMR annually. Annual deaths due to AMR are projected to reach 10 million by 2050 if current trends persist. Extended Spectrum β-Lactamases (ESBLs) have the ability to hydrolyse penicillins, cephalosporins up to the third generation, and monobactams, but not β-lactamase inhibitors such as clavulanic acid. ESBLs undergo continuous mutation, leading to the development of new enzymes with over 400 different ESBL variants described. This study aimed to detect selected CTX-M genes, SHV,and TEM genes in Extended Spectrum Beta-Lactamase producing Klebsiella pneumoniae and Pseudomonas aeruginosa in Jos, Nigeria.
Methodology: A total of 110, non-replicated isolates of Klebsiella pneumonia and 125 isolates of Pseudomonas aeruginosa were identified phenotypically from clinical specimens of patients at a tertiary hospital in Jos, North-central Nigeria. The isolates were screened for ESBL production using the disk diffusion method of the Clinical Laboratory Standard Institute (CLSI) breakpoints. Phenotypic confirmation of ESBL production was done using the double-disc synergy test. Multiplex PCR was used to detect ESBL genes.
Results: Fifty (45.5%) of the 110 isolates of Klebsiella pneumoniae and 9(7.2%) of the 125 isolates of Pseudomonas aeruginosa were ESBL-positive. Typing of 20 representative ESBL isolates (17 Klebsiella and 3 Pseudomonas spp) showed the presence ofblaCTX-M1, blaCTX-M9, and blaSHV genes in these isolates. All 20 (100%) isolates had the blaCTX-M1 gene. The blaSHV gene was detected in 16(80%) while CTX-M9 was detected in 6(30%) of the isolates studied.
Conclusion: The study showed that there is a high prevalence of ESBL genes among isolates of Klebsiella pneumoniae and Pseudomonas aeruginosa in North-central Nigeria. This emphasizes the need for continuous surveillance and coordinated infection prevention and control to curtail its spread.
References
2. El-Masry EA, Melake NA, Taher IA. Phenotypic and molecular characterization of extended-spectrum β-lactamase producing klebsiella spp. From nosocomial infections in Egypt. Int Med J. 2019; 26:376–80.
3. Alekshun MN, Levy SB. Molecular Mechanisms of Antibacterial Multidrug Resistance.Cell. 2007; 128:1037–50.
4. Rawat D, Nair D. Extended-spectrum ß-lactamases in gram negative bacteria. J Glob Infect Dis. 2010; 2:263–74.
5. Jacoby GA, Munoz-Price LS. The New β-Lactamases. N Engl J Med. 2005;352:380–91.
6. Ventola L. The Antibiotics Resistance Crisis. Compr Biochem. 2015;40:181–224.
7. Iroha I, Ezeifeke G, Amadi E, Umezurike C. Occurrence of ESBL producing Resistant E. coli and K. pneumoniae in clinical isolates and associated risks factors. Res J Biol Sci. 2009;4:588–92.
8. Horcajada JP, Montero M, Oliver A, Sorlí L, Luque S, Gómez-Zorrilla S, et al. Epidemiology and treatment of multidrug-resistant and extensively drug-resistant Pseudomonas aeruginosa infections. Clin Microbiol Rev. 2019; 32:e00031-19.
9. Prestinaci F, Pezzotti P, Pantosti A. Antimicrobial resistance: A global multifaceted phenomenon.Pathog Glob Health.2015;109:309–18.
10. Sasirekha B. Prevalence of ESBL, AmpC B-lactam
11. CLSI. Clinical and Laboratory Standards Institute (CLSI).Performance standards for antimicrobial susceptibility testing. Twenty-ninth informational Suppl M100-S29. 2018;32.
12. da Silva ER, da Silva N. Coagulase gene typing of Staphylococcus aureusisolated from cows with mastitis in southeasternBrazil. Can J Vet Res. 2005; 69:260–4.
13. Mohamed Hamed Al-Agamy. Genetic basis of cefotaxime resistant isolates of Klebsiella pneumoniae from Cairo. African J Microbiol Res.2012;6:20–7.
14. Yarima A, Haroun AA, Bulus T, Manga MM. Occurrence of Extended Spectrum Beta Lactamase Encoding Genes among Urinary Pathogenic Escherichia coliand Klebsiella pneumoniaeIsolates Obtained from a Tertiary Hospital in Gombe Nigeria. J Biosci Med.2020;8:42–55.
15. Xu L, Ensor V, Gossain S, Nye K, Hawkey P. Rapid and simple detection of blaCTX-M genes by multiplex PCR assay. J Med Microbiol. 2005;54:1183–7.
16. Lee PY, Costumbrado J, Hsu CY, Kim YH. Agarose gel electrophoresis for the separation of DNA fragments. J Vis Exp. 2012;62:3923.
17. Ibtihaji K, Dadah A, Abdulfatai K. Prevalence of extended spectrum beta-lactamase producing Klebsiella pneumoniaeand Pseudomonas aeruginosaamong women with urinary tract infections attending antenatal care in Kaduna, Nigeria. Sci World J.2021;16:312–8.
18. Chourasia E, Singh KP, Kher SK. Extended Spectrum Beta Lactamases in clinical isolates of Gram-negative bacilli in Ajman, United Arab Emirates. Gulf Med J.2015;4:14–21.
19. Ibrahim Y, Sani Y, Saleh Q, Saleh A, Hakeem G. Phenotypic Detection of Extended Spectrum Beta lactamase and Carbapenemase Co-producing Clinical Isolates from Two Tertiary Hospitals in Kano, North West Nigeria. Ethiop J Health Sci.2017;27:3–10.
20. Vasaikar S, Obi L, Morobe I, Bisi-Johnson M. Molecular characteristics and antibiotic resistance profiles ofKlebsiellaisolates in Mthatha, Eastern Cape province, South Africa. Int J Microbiol. 2017;5:1–7.
21. Dalela G. Prevalence of extended spectrum beta lactamase (ESBL) producers among Gram negative bacilli from various clinical isolates in a tertiary care hospital at Jhalawar, Rajasthan, India. J Clin Diagnostic Res. 2012;6:182–7.
22. Poorabbas B, Mardaneh J, Rezaei Z, Kalani M, Pouladfar G, Alami MH, et al. Nosocomial infections: Multicenter surveillance of antimicrobial resistance profile ofStaphylococcus aureusand Gram negative rods isolated from blood and other sterile body fluids in Iran. Iran J Microbiol. 2015;7:127–35.
23. Odumosu BT, Ajetunmobi O, Dada-Adegbola H, Odutayo I. Antibiotic susceptibility pattern and analysis of plasmid profiles of Pseudomonas aeruginosafrom human, animal and plant sources. Springerplus. 2016;5:1381.
24. Ahmed OB, Omar AO, Asghar AH, Elhassan MM. Prevalence of TEM, SHV and CTX-M genes in Escherichia coliand Klebsiella sppurinary isolates from Sudan with confirmed ESBLphenotype. Life Sci J. 2013; 10:191–5.
25. Begum S, Salam MA, Alam KF, Begum N, Hassan P, Haq JA. Detection of extended spectrum β-lactamase in Pseudomonasspp. isolated from two tertiary care hospitals in Bangladesh. BMC Res Notes. 2013;6:7.
26. Adegoke AA, Faleye AC, Singh G, Stenström TA. Antibiotic resistant superbugs: Assessment of the interrelationship of occurrence in clinical settings and environmental niches.Molecules. 2017;22:29.
27. Weiner LM, Webb AK, Limbago B, Dudeck MA, Patel J, Kallen AJ, et al. Antimicrobial-Resistant Pathogens Associated with Healthcare-Associated Infections: Summary of Data Reported to the National Healthcare Safety Network at the Centers for Disease Control and Prevention, 2011-2014. Infect Control Hosp Epidemiol.2016;37:1288–301.
28. Cairns S, Reilly J, Booth M. Prevalence of healthcare-associated infection in Scottish intensive careunits. J Hosp Infect. 2010; 76:308–10.
29. Mahamat OO, Lounnas M, Hide M, Dumont Y, Tidjani A, Kamougam K, et al. High prevalence and characterization of Extended-spectrum ß-lactamase producing Enterobacteriaceae in Chadian hospitals. BMC Infect Dis. 2019;19:205.
30. Gautam V, Thakur A, Sharma M, Singh A, Bansal S, Sharma A, et al. Molecular characterization of extended-spectrum β-lactamases among clinical isolates of Escherichia coliandKlebsiella pneumoniae: A multi-centric study from tertiary care hospitals in India. Indian J Med Res. 2019; 149:208–15.
31. Gilbert GL, Kerridge I. Hospital Infection Prevention and Control (IPC) and Antimicrobial Stewardship (AMS): Dual Strategies to Reduce Antibiotic Resistance (ABR) in Hospitals.2020;89–108.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.