Molecular Characterization of Extended-Spectrum β-Lactamase Enterobacteriaceae Isolated from Egyptian Patients with Community- and Hospital-Acquired Urinary Tract Infection

• Published in: The American journal of tropical medicine and hygiene 2019-01, Vol.100 (3), p.522-528
• Main Authors: Shash, Rania Y, Elshimy, Amal A, Soliman, Mohammed Y, Mosharafa, Ashraf A
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anti-Bacterial Agents - pharmacology; beta-Lactamases - genetics; Community-Acquired Infections - epidemiology; Community-Acquired Infections - microbiology; Cross Infection - microbiology; Cross-Sectional Studies; Drug Resistance, Multiple, Bacterial; Egypt - epidemiology; Enterobacteriaceae - drug effects; Enterobacteriaceae - enzymology; Enterobacteriaceae - genetics; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Female; Gene Expression Regulation, Bacterial; Gene Expression Regulation, Enzymologic; Humans; Male; Middle Aged; Urinary tract infections; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology; Urogenital system; Young Adult
• ISSN: 0002-9637; 1476-1645
• DOI: 10.4269/ajtmh.18-0396

Extended-spectrum β-lactamases (ESβLs) pose a serious problem in the treatment of urinary tract infections (UTIs). The ESβL-producing organism is an expanding global health problem. Therefore, screening for ESβL, detection of their drug-resistance pattern, and molecular characterization should be a continuous process. The present study was performed to determine the antibiotic resistance profile and the genetic characterization of ESβL isolates from hospital- and community-acquired UTIs. Two hundred fifty isolates were obtained from urine samples of outpatient clinic attendants and hospitalized patients at Kasr Al-Aini Hospital. By phenotypic screening tests, 100 ESβL isolates were detected among the studied groups. Furthermore, detection of beta-lactamase ( ) cefotaxime (CTX)-M, sulfhydryl variable, and temoneira ESβL genes was investigated by polymerase chain reaction. A subset of 25 CTX-M-positive isolates was further identified by gene sequencing technology. Among the 100 ESβL isolates, 66% were and 34% were spp. There was no statistical difference in the prevalence of ESβL in community-acquired versus hospital-acquired UTIs. The susceptibility of all ESβL isolates to carbapenems was the most prevalent finding. In addition, all ESβL isolates were susceptible to fosfomycin, whereas all community-acquired ESβL isolates were susceptible to nitrofurantoin. A total of 98% of the ESβL isolates harbored -CTX-M genes, with CTX-M-15 being the most prevalent. It could be concluded that ESβL production is present at a high rate among Egyptian patients with hospital- and community-acquired UTI. The high prevalence of CTX-M may suggest it as a candidate for molecular screening of ESβL.