Phenotypic Characterization of Multidrug-resistant Escherichia Coli with Special Reference to Extended-spectrum-beta-lactamases and Metallo-beta-lactamases in a Tertiary Care Center

  • Basudha Shrestha Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Shovita Shrestha Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Shyam Kumar Mishra Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Hari Prasad Kattel Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Tatsuya Tada Department of Infectious Diseases, Research Institute, Japan.
  • Hiroshi Ohara Department of International Medical Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
  • Teruo Kirikae Department of Infectious Diseases, Research Institute, Japan.
  • Basista Prasad Rijal Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Jeevan Bahadur Sherchand Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
  • Bharat Mani Pokhrel Department of Microbiology, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
Keywords: e. coli; extended-spectrum-β-lactamase; metallo-β-lactamase; multidrug-resistance.

Abstract

Introduction: The increasing reports on extended-spectrum-beta-lactamase and metallo-betalactamase producing Escherichia coli have addressed a potential threat to global health since it is found to be highly resistance to most of the currently available antibiotics including carbapenems. The present study was aimed to determine the antibiogram of extended-spectrum-beta-lactamase and metallo-beta-lactamase producing MDR E. coli isolates from various clinical samples.

Methods: This was a cross-sectional study conducted over a period of seven months (December 2013 to July 2014) at bacteriology laboratory of Tribhuvan University Teaching Hospital. A total of 250 clinical specimens (urine, pus, sputum, blood, body fluid, bile, tissue and central venous pressure line tip) were processed from inpatients, with multidrug-resistant Escherichia coli infections. Standard microbiological techniques were used for isolation and identification of the isolates. The presence of extended-spectrum-beta-lactamase was detected by phenotypic confirmatory test recommended by Clinical and Laboratory Standards Institute and imipenem (IMP) /EDTA combined disc method was performed to detect metallo-beta-lactamase mediated resistance mechanism.

Results: We found high level of beta lactamase mediated resistance mechanism as part of multidrug resistance. Among 250 MDR isolates, 60% isolates were extended-spectrum-beta-lactamase producers and 17.2% isolates were metallo-beta-lactamase producers. Co-existence of extended-spectrum-betalactamase and metallo-beta-lactamase identified in 6.8% isolates.

Conclusions: Beta-lactamase mediated resistance mechanisms are accounting very high in the multidrug resistant isolates of E. coli. Therefore, early detection of beta lactamase mediated resistant strains and their current antibiotic susceptibility pattern is necessary to avoid treatment failure and prevent the spread of MDR. 

Keywords: e. coli; extended-spectrum-β-lactamase; metallo-β-lactamase; multidrug-resistance.

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Published
2015-06-30
How to Cite
Shrestha, B., Shrestha, S., Mishra, S. K., Kattel, H. P., Tada, T., Ohara, H., Kirikae, T., Rijal, B. P., Sherchand, J. B., & Pokhrel, B. M. (2015). Phenotypic Characterization of Multidrug-resistant Escherichia Coli with Special Reference to Extended-spectrum-beta-lactamases and Metallo-beta-lactamases in a Tertiary Care Center. Journal of Nepal Medical Association, 53(198), 83-88. https://doi.org/10.31729/jnma.2768
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Original Article