Co-existence of beta-lactamases in clinical isolates of Escherichia coli from Kathmandu, Nepal

BMC Research Notes

Chanwit Tribuddharat¹  Pradeep Kumar Shah³  Rajesh Kafle³  Badri Thapa²  Ram Hari Pokhrel³ 

[1] Department of Microbiology, Siriraj Hospital, Mahidol University, Bangkok, Thailand;Genesis Laboratory and Research, Kathmandu, Nepal;Department of Microbiology, St. Xavier’s College, Kathmandu, Nepal

关键词: Integron element;    Clinical isolates;    Carbapenemases;    ESBL producing Escherichia coli;   

Others  :  1127371
DOI  :  10.1186/1756-0500-7-694

 received in 2014-05-20, accepted in 2014-10-02,  发布年份 2014

【 摘 要 】

Background

The trend of extended-spectrum beta-lactamases producing Escherichia coli (ESBL-EC) is increasing in Nepal. Limited studies have been reported investigating ESBL types and carbapenemases in E. coli.

Methods

A cross sectional study was conducted between June 2012 to January 2013 in Kathmandu Medical College and Teaching Hospital, Nepal. Non-repetitive clinical samples from out-patient department (OPD) and Intensive Care Units (ICU) were processed for bacteriological culture and identification of E. coli. Antibiotic susceptibility test, screening and phenotypic confirmation for ESBLs and carbapenemases and PCR (bla_CTX-M, bla_SHV and bla_TEM-type ESBLs, bla_VIM, bla_IMP and bla_NDM-1-type carbapenemases, and class 1 integron element integrase gene) were performed. Clones were resolved by PCR-Randomly Amplified Polymorphic DNA.

Results

Out of 332 non-repetitive clinical specimens processed for culture and identification 160 (48.2%) were culture positive. Of which, 93 (58.1%) were E. coli. Of these, 24 (25.8%) were phenotypically confirmed as ESBL-EC and 3 (12.50%) of 24 ESBL-EC were carbapenemase producers. bla_CTX-M-type ESBL was most common (23, 95.8%) followed by bla_TEM (7, 29.2%) and bla_SHV (3, 12.5%). bla_VIM, bla_IMP and bla_NDM-1 were present in 3, 2 and 2 ESBL-EC, respectively. Class 1 integron element was present in 18 (75.0%) ESBL-EC. Nine isolates possessed more than one type of beta-lactamases. Interestingly, all carbapenemase producers were isolated form ICU and co-existence of bla_CTX-M, bla_SHV, bla_TEM, bla_IMP, bla_VIM and bla_NDM-1 beta-lactamases was documented in one ESBL-EC (EC104). All most all isolates had different RAPD patterns.

Conclusions

For the first time in Nepal, high prevalence of bla_CTX-M-type ESBL and co-existence of ESBLs and carbapenemases has been described. Continuous monitoring and surveillance and proper infection control and prevention practices will limit the further spread of these super-bugs within this hospital and beyond.

【 授权许可】

   
2014 Pokhrel et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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