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Emergence of extended spectrum beta-lactamases-producing strains belonging to CTX-M-1 class from intensive care units patients and environmental surfaces in PakistanAuthors Name, Email and Affiliations
Aqsa Ashraf Bukhari1 , Muhammad Imran Arshad1 , Shahbaz Raza1, Mariya Azam1, Sajjad-ur-Rahman1, Mashkoor Mohsin1*
1 Institute of Microbiology, University of Agriculture, Faisalabad, 38040, Pakistan
Shared first authors on this work
*Corresponding author: Dr. Mashkoor Mohsin, Institute of Microbiology, University of Agriculture, Faisalabad,-38000, Pakistan.
E-mail: mashkoormohsin@uaf.edu.pk, Phone +92-30099659046
AAB email; Bukhari aqsa@yahoo.com
MIA email; drimranarshad@yahoo.com
SR email; shahbaz.invincible3182@gmail.com
MA email; Mazam.87@gmail.com
SUR email; sajjadur@uaf.edu.pk
MM email; mashkoormohsin@uaf.edu.pk
Authors Contributions
AAB Sample collection and bacterial cultivation
MIA Sample collection and biochemical confirmations
SR PCR and gel electrophoresis
MA DNA extraction and Quantification
SUR Concept, article writing and revision
MM Study Design, Writing and optimization of standards. Abstract | | | | Aim: The emergence of multidrug resistant (MDR) bacteria is the most dangerous threat for the treatment of infectious diseases. The aim of this study was to detect and characterize extended spectrum beta lactamases (ESBL) and carbapenemase producing Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli) among patients and environment of Intensive Care Units (ICU) of three tertiary care hospitals in Pakistan.
Materials and Methods: A total of 82 samples from ICUs patients and inanimate environment (injection trays, wash basins, door handles, hand swabs of professionals, ICU fridges) were screened for ESBL by culturing on CHROMagar-ESBL. ESBL and carbapenemases production were confirmed by double disc synergy test and Modified Hodges test, respectively. PCR was used to detect ESBL encoding genes blaCTX-M, blaCTX-M-1, blaCTX-M-2, blaCTX-M-9, blaTEM, blaSHV and carbapenemase genes blaKPC, blaNDM-1, blaOXA-48 and blaVIM.
Results: Overall ESBL production was found high 30/82 (36.5%) among isolates of which 15.8% K. pneumoniae and 20.7% E. coli were identified. All the K. pneumoniae and majority of E. coli isolates were MDR i.e. resistance to three or more antimicrobial categories. Molecular characterization showed the blaCTX-M-1 as the predominant genotype found in 17/21 (80%) of the isolates. None of the strains was found positive for carbapenemase encoding genes.
Conclusion: In conclusion, this study demonstrates the emergence of multidrug resistant ESBL producing strains among ICU patients and hospital environment, posing a serious threat for the control of nosocomial infections.
Key words: nosocomial infections, E. coli, K. pneumoniae, antimicrobial resistance, ESBL
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