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Analysis of ?-lactamase phenotypes and carriage of selected... » Isaúde
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BMC microbiology [electronic resource]
2012-07-29 03:30:04

Analysis of ?-lactamase phenotypes and carriage of selected ?-lactamase genes among Escherichia coli strains obtained from Kenyan patients during an 18-year period

Descrição: Background:Although beta-lactam antibiotics are heavily used in many developing countries, the diversity of beta-lactamase genes (bla) is poorly understood. We screened for major beta-lactamase phenotypes and diversity of bla genes among 912 E. coli isolates obtained from clinical samples obtained between 1992 and 2010 from hospitalized and non-hospitalized patients.Results:None of the isolates was resistant to carbapenems but 30% of all isolates were susceptible to cefepime, cephamycins and piperacillin-tazobactam. Narrow spectrum beta-lactamase (NSBL) phenotype was observed in 278 (30%) isolates that contained blaTEM-1 (54%) or blaSHV-1 (35%) or both (11%). Extended Spectrum beta-lactamase (ESBL) phenotype was detected in 247 (27%) isolates which carried blaCTX-M-14 (29%), blaCTX-M-15 (24%), blaCTX-M-9 (2%), blaCTX-M-8 (4%), blaCTX-M-3 (11%), blaCTX-M-1 (6%), blaSHV-5 (3%), blaSHV-12 (5%), and blaTEM-52 (16%). Complex Mutant TEM-like (CMT) phenotype was detected in 220 (24%) isolates which carried blaTEM-125 (29%), while blaTEM-50, blaTEM-78, blaTEM-109, blaTEM -152 and blaTEM-158 were detected in lower frequencies of between (7%) and (11%). Majority of isolates producing a combination of CTX-M-15+OXA-1+TEM-1 exhibited resistance phenotypes barely indistinguishable from those of CMT-producers. Although 73 (8%) isolates exhibited Inhibitor Resistant TEM-like (IRT) phenotype, blaTEM-103 was the only true IRT-encoding gene identified in 18 (25%) of strains with this phenotype while the rest produced a combination of TEM-1+OXA-1. The pAmpCs-like phenotype was observed in 94 (10%) isolates of which 77 (82%) carried blaCMY-2 while 18% contained blaCMY-1.Isolates from urine accounted for 53%, 53%, 74% and 72% of strains exhibiting complex phenotypes such as IRT-, ESBL-, CMT- or pAmpC-like respectively. On the contrary, 55% isolates from stool exhibited the relatively susceptible NSBL-like phenotype. All the phenotypes, and majority of the bla genes, were present both in isolates from hospitalized and non-hospitalized patients but complex phenotypes were particularly common among strains obtained between 2000 and 2010 from urine of hospitalized patients.Conclusions:The phenotypes and diversity of bla genes in E. coli strains implicated in clinical infections in non-hospitalized and hospitalized patients in Kenya is worryingly high. In order to preserve the efficacy of beta-lactam antibiotics, culture and susceptibility data should guide therapy and surveillance studies for beta-lactamase-producers in developing countries should be launched.

Identificador: doi:10.1186/1471-2180-12-155
Volume: 0
Página: 1 a


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