Extended-spectrum β-lactamases and plasmid-mediated quinolone resistance in enterobacterial clinical isolates from neonates in Tunisia

• Published in: Microbial pathogenesis 2017-09, Vol.110, p.184-188
• Main Authors: Charfi, Karama, Grami, Raoudha, Ben Jeddou, Abir, Messaoudi, Aziza, Mani, Yosra, Bouallegue, Olfa, Boujaafar, Noureddine, Aouni, Mahjoub, Mammeri, Hedi, Mansour, Wejdène
• Format: Article
• Language: English
• Subjects: Bacterial Proteins - genetics; beta-Lactamases - genetics; Citrobacter freundii - drug effects; Citrobacter freundii - genetics; Cross Infection - microbiology; Disease Transmission, Infectious; Drug Resistance, Bacterial - drug effects; Drug Resistance, Bacterial - genetics; Enterobacter cloacae - drug effects; Enterobacter cloacae - genetics; Enterobacteriaceae; Enterobacteriaceae - drug effects; Enterobacteriaceae - genetics; Enterobacteriaceae - isolation & purification; Enterobacteriaceae Infections - microbiology; ESBL; Escherichia coli - drug effects; Escherichia coli - genetics; Escherichia coli Proteins - genetics; Genotype; Humans; Infant, Newborn; Klebsiella pneumoniae - drug effects; Klebsiella pneumoniae - genetics; Microbial Sensitivity Tests; Molecular Epidemiology; Neonates; Plasmids - genetics; Qnr; Quinolone; Quinolones - pharmacology; Retrospective Studies; Tertiary Care Centers; Tunisia
• ISSN: 0882-4010; 1096-1208
• DOI: 10.1016/j.micpath.2017.06.030

This study was conducted to investigate extended-spectrum-β-lactamase (ESBL) producing Enterobacteriaceae isolates from the Center of Maternity and Neonatology of Monastir, Tunisia. Fourty-six strains out of 283 were found to produce ESBL: Klebsiella pneumoniae (n = 37), Escherichia coli (n = 6), Enterobacter cloacae (n = 2), and Citrobacter freundi (n = 1). Genotyping analysis, using ERIC2 and RAPD, showed that strains were clonally unrelated. PCR amplification followed by sequencing revealed that all strains produced CTX-M-15. This enzyme was co-produced with TEM and SHV determinants in 34 and 36 strains respectively. The blaCTXM-15 gene was bracked by ISEcp1 and/or IS26 in 42 out of the 46 ESBL positive strains. The quinolone resistance determinants were associated to the ESBL producing isolates: we identified the qnrB1 gene in six isolates and the aac(6′)-Ib-cr gene in five isolates. This epidemiological study shows the widespread of CTX-M-15 and qnr determinants among enterobacterial isolates from neonates hospitalized at the center of Maternity and Neonatology of Monastir suggesting either mother portage or horizontal transmission. •Nosocomial infection in neonates.•Emergence of ESBL.•Emergence of qnr resistance genes.