publications
Article
Characteristics of Carbapenemase- and Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae Isolated from Tunisian and Libyan Hospitals |
MATHLOUTHI Najla, AL BAYSSARI Charbel, EL SALABI Allaaeddin, BAKOUR Sofiane, BEN GWIERIF Salha, ZORGANI Abdulaziz, JRIDI Yahia, BEN SLAMA Karim, ROLAIN Jean-Marc, CHOUCHANI Chedly, 2016 |
Journal of Infection in Developping Countries, Juin 2016 |
Résumé
Introduction: The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase and carbapenemase production among clinical isolates of Enterobacteriaceae recovered from Tunisian and Libyan Hospitals.
Methodology: Bacterial isolates were recovered from patients in ICUs and identified by biochemical tests and MALDI-TOF. Antibiotic susceptibility testing was performed by disk diffusion and Etest method. ESBLs and carbapenemases activities were detected using standard microbiological tests. Presence of antibiotic resistance encoding genes were performed by PCR amplification and sequencing. Clonal relationships between Klebsiella pneumoniae strains were carried out using MLST.
Results: A total of 87 isolates were characterized, with 51 and 36 respectively identified as E. coli and K. pneumoniae. Overall the resistance prevalence were high for aminoglycosides (>60%), fluoroquinolones (>80%), and extended-spectrum cephalosporins (>94%) and low for imipenem (11.4%). Among this collection, 58 strains (66.6%) were ESBLs-producers and ten K. pneumoniae strains (11.4%) were carbapenemase-producers. The antibiotic resistance encoding genes detected were blaCTX-M-15 (51.7%), blaTEM-1 (35.6%), several variants of blaSHV (21.8%) and blaOXA-48 (11.4%). The MLST typing of K. pneumoniae isolates revealed the presence of multiple clones and 3 novel STs. Also, close relationships between the OXA-48 producing strains from Tunisia and Libya were demonstrated.
Conclusions: This study is the first paper describing the emergence of carbapenemase and ESBL-producing Enterobacteriaceae, sensible to colistin, isolated in Tunisia and Libya. Active surveillance and testing for susceptibility to colistin should be implemented because resistance to colistin mainly in Klebsiella has been recently reported worldwide.
