Phenotypic, Targeted Genotypic, and Antimicrobial Susceptibility Profiling of Extended-Spectrum β-Lactamase Production and Exclusive blaOXA -48 Gene Detection in Escherichia coli and Klebsiella pneumoniae Isolates From a South Lebanese Hospital.

Abstract

Background: Globally, multidrug resistance (MDR), including extended-spectrum β-lactamase (ESBL) and carbapenemase production in Enterobacteriaceae, is increasing. Data concerning their presence in South Lebanon are scarce. This study aimed to determine the prevalence of ESBL and carbapenem-resistant Enterobacteriaceae (CRE) in Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) isolates from the Saida region.

Methods: In Hammoud Hospital University Medical Center (HHUMC), and over a period of 9 months, identification and susceptibility testing of the isolates using the Kirby-Bauer method were performed and then confirmed as recommended by the Clinical and Laboratory Standards Institute (CLSI). Molecular analysis of the genes encoding ESBL and carbapenemases was investigated by polymerase chain reaction (PCR).

Results: A total of 200 isolates (171 E. coli and 29 K. pneumoniae) were obtained from different clinical specimens (urine, rectal swabs, blood, sputum, pus, wound/tissue, nasal swabs, vaginal swabs) and were subsequently studied. Nearly 89.5% (179/200) and 10.5% (21/200) of the isolates were producers of ESBL and carbapenemase, respectively. The ESBL isolates showed high sensitivity toward carbapenem drugs, whereas the CRE isolates were most sensitive to tigecycline. Of 67 studied ESBL isolates, bla_CTX-M (44.8%) was the most prevalent gene, followed by bla_TEM (37.3%) and bla_SHV (13.4%). Among the CRE isolates, only two of 21 collected isolates were positive for the bla_OXA-48 gene.

Conclusion: This type of scenario highlights the necessity of using antibiotics sparingly and putting stringent measures in place to prevent infections.