Volume 19, Issue 4 (Iranian South Medical Journal 2016)                   Iran South Med J 2016, 19(4): 536-548 | Back to browse issues page

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Nematolahi S, Mosadegh A, Mardaneh J, Poorabbas B. Identification of ESBL-producing and blaSHV gene Harboring Enterobacter spp. Isolated from Bloodstream Infections of Hospitalized Patients During 10 Years in South of Iran (Shiraz). Iran South Med J 2016; 19 (4) :536-548
URL: http://ismj.bpums.ac.ir/article-1-812-en.html
Identification of ESBL-producing and blaSHV gene Harboring Enterobacter spp. Isolated from Bloodstream Infections of Hospitalized Patients During 10 Years in South of Iran (Shiraz)
Sedegheh Nematolahi1 , Ahmad Mosadegh * 2, Jalal Mardaneh3 , Bahman Poorabbas4
1- Department of Microbiology, School of Medicine, International Campus, Yazd Shahid Sadoghi University of Medical Sciences, Yazd, Iran
2- Department of Microbiology, School Member, Yazd Shahid Sadoghi University of Medical Sciences,Yazd, Iran , mosadegh14@yahoo.com
3- Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, Iran
4- Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract:   (7275 Views)

Background: Multidrug resistance is emerging among gram negative bacteria that cause hospital infections or community acquired around the world. The aims of this study were (1) determination of antibiotic susceptibility profile of Enterobacter spp. isolates recovered from blood, (2) phenotypic identification of ESBL and AmpC-producing isolates, (3) identify MDR strains, and (4) identification isolates harboring blaSHV gene using PCR method.

Materials and Methods: In this cross-sectional study, 90 isolates of Enterobacter spp. isolated from blood stream infection from patients admitted to hospitals in Shiraz using BACTEC 9240 automated system during 10 years (2004-2014). The isolates again were identified by using embedded biochemical tests in the Enterobacteriaceae API-20E diagnostic system. According to proposed protocol by CLSI (2014), standard disc diffusion method and DDST phenotypic test were used for antibiotic susceptibility test, and identification of ESBL-producing strains, respectively. PCR molecular method was used to identify blaSHV gene in strains.

Results: In this study, as observed, meropenem (98.9%), imipenem (95.6%) and colistin (93.3%) were the most effective antibiotics against isolates. Isolates showed the best response to ceftazidime (47.8%) and ceftriaxone (42.2%), respectively, among the third generation of cephalosporins which were investigated. Results showed that 11.1% of isolates were MDR. 15.5% isolates were positive ESBL and positive AmpC, simultaneously. As revealed, 11.1% of isolates were MDR. The results of PCR to search for blaSHV gene in Enterobacter isolates revealed that 7.8% of the strains harboring this gene.

Conclusion: Results showed that the resistance of Enterobacter isolates to the third generation of cephalosporins has become a national health-threatening problem. Epidemiologic studies are crucial in order to presentation of comprehensive national program to preventing emergence and dissemination of resistant bacteria in the country. We believe that carbapenems should be used for the treatment of strains resistant to other antibiotics in order to preservation of carbapenems as strategies for the treatment of Enterobacter spp.

Keywords: Blood circulation infection, Enterobacter spp., antibiotic susceptibility, ESBL-producing, blaSHV gene.
Full-Text [PDF 432 kb]   (2650 Downloads)    
Type of Study: Original | Subject: Microbiology and Immunology
Received: 2015/06/24 | Accepted: 2015/09/6 | Published: 2016/09/7
References
1. Wilberger MS, Anthony KE, Rose S, et al. Beta-Lactam antibiotic resistance among Enterobacter spp. Isolated from infection in animals. Advan Microbiol 2012; 2(2): 129-37. [Google Scholar]
2. v Dijk Y, Bik EM, Hochstenbach-Vernooij S, et al. Management of an outbreak of Enterobacter cloacae in a neonata unit using simple preventive measures. J Hosp Infect 2002; 51(1): 21-6. [PubMed] [Google Scholar]
3. Liu CP, Wang NY, Lee CM, et al. Nosocomial and community-acquired Enterobacter cloacae bloodstream infection: risk factors and prevalence of SHV-12 in multiresistant isolates in a medical centre. J Hosp Infect 2004; 58(1): 63-77. [PubMed] [Google Scholar]
4. Soltani J, Poorabbas B, Miri N, et al. Health care associated infections, antibiotic resistance and clinical outcome: A surveillance study from Sanandaj, Iran. World J Clin Cases 2016; 4 (3): 63-70. [PubMed] [Google Scholar]
5. Anvarinejad M, Pouladfar G, Japoni A, et al. Isolation and Antibiotic Susceptibility of the Microorganisms Isolated from Diabetic Foot Infections in Nemazee Hospital, Southern Iran. J Pathog 2015; 2015: 328796. [PubMed] [Google Scholar]
6. M'Zali FH, Heritage J, Gascoyne-Binzi DM, et al. Transcontinental importation into the UK of Escherichia coli expressing a plasmid-mediated AmpC-type beta-lactamase exposed during an outbreak of SHV-5 extended-spectrum beta-lactamase in a Leeds hospital. J Antimicrob Chemother 1997; 40(6): 823-31. [PubMed] [Google Scholar]
7. Anvarinejad M, Pouladfar GR, Pourabbas B, et al. Detection of Salmonella spp. with the BACTEC 9240 Automated Blood Culture System in 2008-2014 in Southern Iran (Shiraz): Biogrouping, MIC, and Antimicrobial Susceptibility Profiles of Isolates. Jundishapur J Microbiol 2016; 9 (4): e26505. [PubMed] [Google Scholar]
8. Paterson DL. Resistance in gram-negative bacteria: enterobacteriaceae. Am J Med 2006; 119(6 Suppl 1): S20-8. [Google Scholar]
9. Manzur A, Tubau F, Pujol M, et al. Nosocomial outbreak due to extended-spectrum-beta-lactamase-producing Enterobacter cloacae in a cardiothoracic intensive care unit. J Clin Microbiol 2007; 45(8): 2365-9. [PubMed] [Google Scholar]
10. Schwaber MJ, Graham CS, Sands BE, et al. Treatment with a broad-spectrum cephalosporin versus piperacillin-tazobactam and the risk for isolation of broad- cephalosporin-resistant Enterobacter species. Antimicrob Agents Chemother 2003; 47(6): 1882-6. [PubMed] [Google Scholar]
11. Kang CI, Kim SH, Park WB, et al. Bloodstream infections caused by Enterobacter species: predictors of 30-day mortality rate and impact of broad-spectrum cephalosporin resistance on outcome. Clin Infect Dis 2004; 3996): 812-8. [Google Scholar]
12. Anvarinejad M, Pouladfar GR, Pourabbas B, et al. Detection of Salmonella spp. with the BACTEC 9240 Automated Blood Culture System in 2008-2014 in Southern Iran (Shiraz): Biogrouping, MIC, and Antimicrobial Susceptibility Profiles of Isolates. Jundishapur J Microbiol 2016; 9(4): e26505. [PubMed] [Google Scholar]
13. Briñas L, Zarazaga M, Sáenz Y, et al. Beta-Lactamases in ampicillin-resistant Escherichia coli isolates from foods, humans, and healthy animals. Antimicrob Agents Chemotherapy 2002; 46(10): 3156-63. [Google Scholar]
14. Chen HL, Lu JH, Wang HH, et al. Clinical analysis of Enterobacter bacteremia in pediatric patients: a 10-year study. J Microbiol Immunol Infect 2014; 47(5): 381-6. [PubMed] [Google Scholar]
15. Mardaneh J, Soltan Dallal MM, Taheripoor M, et al. Isolation, Identification and Antimicrobial Susceptibility Pattern of Tatumella ptyseos Strains Isolated from Powdered Infant Formula Milk Consumed in Neonatal Intensive Care Unit: First Report from Iran. Jundishapur J Microbiol 2014; 47(5): 381-6. [PubMed] [Google Scholar]
16. Potz NA, Hope R, Warner M, et al. Prevalence and mechanisms of cephalosporin resistance in Enterobacteriaceae in London and South-East England. J Antimicrob Chemother 2006; 58(2): 320-6. [PubMed] [Google Scholar]
17. Pai H, Hong JY, Byeon JH, et al. High prevalence of extended-spectrum beta-lactamase-producing strains among blood isolates of Enterobacter spp. collected in a tertiary hospital during an 8-year period and their antimicrobial susceptibility patterns. Antimicrob Agents Chemother 2004; 48(8): 3159-61. [PubMed] [Google Scholar]
18. Lee CC, Lee NY, Yan JJ, et al. Bacteremia due to extended-spectrum-beta-lactamase-producing Enterobacter cloacae: role of carbapenem therapy. Antimicrob Agents Chemother 2010; 54(9): 3551-6. [PubMed] [Google Scholar]
19. Poorabbas B, Mardaneh J, Rezaei Z, et al. Nosocomial Infections: Multicenter surveillance of antimicrobial resistance profile of Staphylococcus aureus and Gram [PubMed] [Google Scholar]
20. Poorabbas B, Mardaneh J, Rezaei Z, et al. Nosocomial Infections: Multicenter surveillance of antimicrobial resistance profile of Staphylococcus aureus and Gram negative rods isolated from blood and other sterile body fluids in Iran. Iranian J Microbiol 2015; 7: 127-135. [PubMed] [Google Scholar]
21. Towne TG, Lewis JS, Herrera M, et al. Detection of SHV-type extended-spectrum beta-lactamase in Enterobacter isolates. J Clin Microbiol 2010; 48: 298-299. [PubMed] [Google Scholar]
22. Ahmadi K, Farajzadeh Sheikh A, Mardaneh J, et al. Detection of Enterobacter sakazakii in neonatal sepsis by PCR on 16S ribosomal RNA. Iran South Med J 2014; 17 (3): 272-279. (Persian) [Google Scholar]
23. Mardaneh J, Soltan Dallal MM, Taheri Poor M. Isolation and determination antimicrobial susceptibility pattern of Enterobacter cloacae strains isolated from consumed powdered infant formula milk in NICU ward. Iran South Med J 2014; 17 (5): 907-915. (Persian) [Google Scholar]
24. Mardaneh J, Soltan Dallal MM. Isolation and Identification Enterobacter asburiae from Consumed Powdered Infant Formula Milk (PIF) in the Neonatal Intensive Care Unit (NICU). Acta Med Iran 2016; 54 (1): 39-43. [PubMed] [Google Scholar]
25. Mardaneh J, Soltan Dallal MM. Isolation and Identification of E. cowanii from Powdered Infant Formula in NICU and Determination of Antimicrobial Susceptibility of Isolates. Iran J Pediatr 2014; 24 (3): 261-6. [PubMed] [Google Scholar]
26. Mardaneh J, Soltan Dallal M, Taheri Poor M. Isolation and determination antimicrobial susceptibility pattern of Enterobacter amnigenus biogroup 1 strains isolated from consumed powdered infant formula milk in NICU ward. Iran South Med J 2015; 18(1): 46-53. (Persian) [Google Scholar]
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