High prevalence of multidrug-resistant Enterobacterales carrying extended-spectrum beta-lactamase and AmpC genes isolated from neonatal sepsis in Ahvaz, Iran

• Published in: BMC microbiology 2024-04, Vol.24 (1), p.136-11, Article 136
• Main Authors: Mansouri, Sima, Savari, Mohammad, Malakian, Arash, Abbasi Montazeri, Effat
• Format: Article
• Language: English
• Subjects: AmpC; Analysis; Anti-Bacterial Agents - pharmacology; Antibiotic resistance; Antibiotics; Antimicrobial agents; Bacteria; Bacterial pneumonia; Bacterial Proteins - genetics; Beta lactamases; beta-Lactamases - genetics; Care and treatment; Cefotaxime; Ceftazidime; Complications and side effects; Drug resistance; Drug resistance in microorganisms; Drug Resistance, Multiple, Bacterial - genetics; E coli; Enterobacter - drug effects; Enterobacter - enzymology; Enterobacter - genetics; Enterobacter - isolation & purification; Enterobacterales; Enterobacteriaceae - drug effects; Enterobacteriaceae - enzymology; Enterobacteriaceae - genetics; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Enzymes; ERIC-PCR; ESBL; Escherichia coli - drug effects; Escherichia coli - genetics; Escherichia coli - isolation & purification; Genes; Genetic testing; Humans; Imipenem; Infant, Newborn; Infants (Newborn); Iran - epidemiology; Klebsiella; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - enzymology; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Microbial Sensitivity Tests; Multidrug resistance; Multidrug resistant; Neonatal sepsis; Neonatal Sepsis - epidemiology; Neonatal Sepsis - microbiology; Neonates; Pathogens; Pneumonia; Polymerase chain reaction; Prevalence; Prevention; Sepsis; Septicemia; Statistical analysis; β Lactamase
• ISSN: 1471-2180; 1471-2180
• DOI: 10.1186/s12866-024-03285-6

In the recent years, multidrug resistant (MDR) neonatal septicemia-causing Enterobacterales has been dramatically increased due to the extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes. This study aimed to assess the antibiotic resistance pattern, prevalence of ESBLs/AmpC beta-lactamase genes, and Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) fingerprints in Enterobacterales isolated from neonatal sepsis. In total, 59 Enterobacterales isolates including 41 (69.5%) Enterobacter species, 15 (25.4%) Klebsiella pneumoniae and 3 (5.1%) Escherichia coli were isolated respectively. Resistance to ceftazidime and cefotaxime was seen in all of isolates. Furthermore, all of them were multidrug-resistant (resistant to three different antibiotic categories). The phenotypic tests showed that 100% of isolates were ESBL-positive. Moreover, AmpC production was observed in 84.7% (n = 50/59) of isolates. Among 59 ESBL-positive isolates, the highest percentage belonged to bla gene (66.1%) followed by bla (45.8%), bla (30.5%), bla (28.8%), and bla (13.6%). The frequency of bla , bla , bla and bla genes were 24%, 24%, 4%, and 2% respectively. ERIC-PCR analysis revealed that Enterobacterales isolates were genetically diverse. The remarkable prevalence of MDR Enterobacterales isolates carrying ESBL and AmpC beta-lactamase genes emphasizes that efficient surveillance measures are essential to avoid the more expansion of drug resistance amongst isolates.