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Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women

INTRODUCTION: Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. The aim of the study was to screen pregnant women for ESBL producing...

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Autores principales: Ghaddar, Nahed, Anastasiadis, Elie, Halimeh, Rawad, Ghaddar, Ali, Matar, Ghassan M., Abou Fayad, Antoine, Sherri, Nour, Dhar, Rita, AlFouzan, Wadha, Yusef, Hoda, El Chaar, Mira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168714/
https://www.ncbi.nlm.nih.gov/pubmed/32327921
http://dx.doi.org/10.1155/2020/4190306
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author Ghaddar, Nahed
Anastasiadis, Elie
Halimeh, Rawad
Ghaddar, Ali
Matar, Ghassan M.
Abou Fayad, Antoine
Sherri, Nour
Dhar, Rita
AlFouzan, Wadha
Yusef, Hoda
El Chaar, Mira
author_facet Ghaddar, Nahed
Anastasiadis, Elie
Halimeh, Rawad
Ghaddar, Ali
Matar, Ghassan M.
Abou Fayad, Antoine
Sherri, Nour
Dhar, Rita
AlFouzan, Wadha
Yusef, Hoda
El Chaar, Mira
author_sort Ghaddar, Nahed
collection PubMed
description INTRODUCTION: Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. The aim of the study was to screen pregnant women for ESBL producing bacteria in Beirut, Lebanon, to examine their phenotypic and genotypic characterization and to study the association between ESBL colonization with adverse neonatal outcomes. METHOD: In this cross-sectional study, vaginal samples from 308 pregnant women at 35–37 weeks of gestation were studied during a one-year period. The samples were plated on MacConkey agar and selective MacConkey agar supplemented with ceftazidime. Phenotypic confirmation of ESBL production was performed by double-disc synergy test and all isolates were screened by PCR for the resistance genes bla(SHV), bla(TEM), and bla(CTX-M). Clonal relatedness of Escherichia coli isolates was investigated by pulsed-field gel electrophoresis. RESULTS: In total, 59 women out of 308 (19.1%) were colonized by ESBL producing gram negative bacteria. Two babies born to mothers colonized with ESBL were diagnosed with sepsis. The susceptibility rates of isolates to other antibiotics were 39% to co-trimoxazole, 49.2% to ciprofloxacin, 91.5% to gentamicin, 18.6% to aztreonam and 35.6% to cefepime. Most of isolates were highly sensitive to meropenem and imipenem, with a susceptibility of 93.2%. PCR was performed on all E. coli isolates to detect the most common ESBL producing genes; bla(CTX-M )was the predominant gene (90.7%), followed by bla(TEM) (88.4%) and finally bla(SHV) (44.2%). PFGE analysis of 34 E. coli isolates revealed 22 distinct clusters showing more than 85% similarity. CONCLUSION: In conclusion, this study showed that Lebanon has a high prevalence of ESBL carriage in pregnant women. Further studies that include a continuous screening of pregnant women and follow up of their newborn clinical status should be conducted to foresee the risk of transmission.
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spelling pubmed-71687142020-04-23 Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women Ghaddar, Nahed Anastasiadis, Elie Halimeh, Rawad Ghaddar, Ali Matar, Ghassan M. Abou Fayad, Antoine Sherri, Nour Dhar, Rita AlFouzan, Wadha Yusef, Hoda El Chaar, Mira Infect Dis Obstet Gynecol Research Article INTRODUCTION: Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. The aim of the study was to screen pregnant women for ESBL producing bacteria in Beirut, Lebanon, to examine their phenotypic and genotypic characterization and to study the association between ESBL colonization with adverse neonatal outcomes. METHOD: In this cross-sectional study, vaginal samples from 308 pregnant women at 35–37 weeks of gestation were studied during a one-year period. The samples were plated on MacConkey agar and selective MacConkey agar supplemented with ceftazidime. Phenotypic confirmation of ESBL production was performed by double-disc synergy test and all isolates were screened by PCR for the resistance genes bla(SHV), bla(TEM), and bla(CTX-M). Clonal relatedness of Escherichia coli isolates was investigated by pulsed-field gel electrophoresis. RESULTS: In total, 59 women out of 308 (19.1%) were colonized by ESBL producing gram negative bacteria. Two babies born to mothers colonized with ESBL were diagnosed with sepsis. The susceptibility rates of isolates to other antibiotics were 39% to co-trimoxazole, 49.2% to ciprofloxacin, 91.5% to gentamicin, 18.6% to aztreonam and 35.6% to cefepime. Most of isolates were highly sensitive to meropenem and imipenem, with a susceptibility of 93.2%. PCR was performed on all E. coli isolates to detect the most common ESBL producing genes; bla(CTX-M )was the predominant gene (90.7%), followed by bla(TEM) (88.4%) and finally bla(SHV) (44.2%). PFGE analysis of 34 E. coli isolates revealed 22 distinct clusters showing more than 85% similarity. CONCLUSION: In conclusion, this study showed that Lebanon has a high prevalence of ESBL carriage in pregnant women. Further studies that include a continuous screening of pregnant women and follow up of their newborn clinical status should be conducted to foresee the risk of transmission. Hindawi 2020-01-23 /pmc/articles/PMC7168714/ /pubmed/32327921 http://dx.doi.org/10.1155/2020/4190306 Text en Copyright © 2020 Nahed Ghaddar et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ghaddar, Nahed
Anastasiadis, Elie
Halimeh, Rawad
Ghaddar, Ali
Matar, Ghassan M.
Abou Fayad, Antoine
Sherri, Nour
Dhar, Rita
AlFouzan, Wadha
Yusef, Hoda
El Chaar, Mira
Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women
title Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women
title_full Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women
title_fullStr Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women
title_full_unstemmed Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women
title_short Phenotypic and Genotypic Characterization of Extended-Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women
title_sort phenotypic and genotypic characterization of extended-spectrum beta-lactamases produced by escherichia coli colonizing pregnant women
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7168714/
https://www.ncbi.nlm.nih.gov/pubmed/32327921
http://dx.doi.org/10.1155/2020/4190306
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