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Background: The fecal carriage of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) is a major driver of the global spread of these antibiotic resistance determinants. Here we determined the rate of fecal ESBL-PE carriage in pediatric hospitals and community-serving healthcare centers serving adults and children in the Gaza Strip, Palestine. Methods: A total of 373 fecal and rectal samples were collected from different hospitals and clinics in Gaza. The antibiotic susceptibility was determined using the disk diffusion method and interpreted according to CLSI guidelines. The bacterial isolates were tested for ESBL production using phenotypic methods (double disk synergy test and growth on selective chromogenic media). BlaCTX−M, blaSHV, and blaTEM genes were sought by PCR. Results: Out of the 373 isolates tested, 138 (37%) were considered ESBL positive as revealed by phenotypic tests. The prevalence of ESBLs among hospitalized patients was 39.1% (hospital setting) whereas, among outpatients attending community healthcare centers, it was 35.1% (community setting). ESBL production among Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, Proteus mirabilis, and Klebsiella aerogenes isolates was 52.8%, 39.1%, 26.7%, 2.8%, and 2.1% respectively. Meropenem and amikacin were the most effective antibiotics against ESBL producers (68.9% and 73.6% susceptibility, respectively), while only 15.2%, 22.5%, and 24.6% remained susceptible to ceftazidime, cefotaxime, and ceftriaxone, respectively. Out of 138 phenotypically ESBL-positive isolates, 98 randomly chosen were screened for blaCTX−M, blaTEM, and blaSHV genes. The prevalence rate of blaCTX−M was 45.9%, while blaTEM and blaSHV genes were detected in 16.8% and 5.2% of CTX-M-negative isolates (corresponding mostly for K. pneumoniae isolates in the case of SHV-PCR), respectively. Conclusions: The study revealed an alarmingly high prevalence of fecal carriage of ESBL-producing Enterobacterales among hospitalized children but also in the community of the Gaza Strip. In addition, 30% of ESBL-producers were already resistant to carbapenems, the treatment of choice of infections with ESBL-producers. [ABSTRACT FROM AUTHOR]

The purpose of the study was to examine the prevalence of Escherichia coli in shrimps and mussels, and to determine the distribution of β-lactam, aminoglycoside, quinolone, and multi-drug resistance phenotypically and genotypically in E. coli isolates obtained from mussels and shrimps in Istanbul. Faecal samples were collected from mussels (n = 96) and shrimps (n = 96) from the Marmara Sea coastline and fish markets in Istanbul. For the detection of antibiotic susceptibilities, seven antibiotic groups were used. β-lactamase, aminoglycoside, and quinolone genes were also determined. A total of 34 (17.7%, 15 shrimps, and 19 mussels) E. coli were isolated, and 17 (50%) were found to be resistant to one or more antimicrobials. The highest resistance was seen against aminoglycosides with 11 isolates (32.35%), followed by quinolones with 10 isolates (29.41%) and extended-spectrum β-lactamase (ESBL) with 4 isolates (11.76%). Multi-drug resistance was detected in 5 isolates (14.7%) from 3 shrimp and 2 mussel samples. The prevalence of ESBL genes was demonstrated at 3.84% in mussels and shrimp samples. There were no AmpC and carbapenemase-producing genes. These samples harbored blaCTX-M-1 (n = 3) and blaTEM (n = 4). Ten isolates were resistant to aminoglycosides genotypically. Resistance genes detected were strB in 2 isolates, aadA in 5, strB and aadA together in 3, ANT(')-Ia, aphA1 and aphA2 simultaneously in 3, aphA1 in 1, aac(3)- IIa in 1 isolate. aac(6')-Ib-cr gene was detected in only one of 10 phenotypically resistant isolates to quinolones. [ABSTRACT FROM AUTHOR]

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In recent years, a dramatic increase in the prevalence of Escherichia coli strains producing extended-spectrum β-lactamases (ESBLs) has been observed — both in the community and in healthcare settings. This multicentric study aimed to characterize ESBLs produced by E. coli isolates causing hospital-onset and community urinary tract infections, as well as to compare their antimicrobial sensitivity patterns, β-lactamase content and plasmid types. Phenotypic tests for the detection of ESBLs and plasmid-mediated AmpC β-lactamases were initially pursued, followed by molecular detection of resistance genes, plasmid characterization, genotyping with pulsed-field gel electrophoresis and whole genome sequencing (WGS). The isolates exhibited high level of resistance to expanded-spectrum cephalosporins (ESC) and carried CTX-M (cefotaximase-Munich) or TEM (Temoniera) β-lactamases. All six representative isolates subjected to WGS belonged to the widespread clone ST131. In conclusion, our study demonstrated dissemination of group 1 CTX-M positive E. coli in different geographic regions of Croatia, but also different components of the health care systems (hospitals, nursing homes and the community) and confirmed the switch from SHV-2 (suphydril variant) and SHV-5 ESBLs to the nation-wide predominance of group 1 CTX-M β-lactamases. Different plasmids were shown to be associated with the dissemination of blaCTX-M genes in different geographic regions of Croatia. [ABSTRACT FROM AUTHOR]

This survey was focused to gain insight into the emergence of antimicrobial resistance mechanisms within overall of 913 Escherichia coli isolates and risk factors for cohort of 77 randomly selected patients. Host-related risk factors mostly involved lower urinary tract disease 50 (64.9%) times, renal insufficiency in 28 (36.4%) subjects, introduced urinary catheter in 43 (55.8%) as well as previous antibiotic therapy within 66 (85.7%) patients. Out of all investigated E. coli, 726 (79.5%) were determined as ESBL producers, 43 (4.7%) ESBL and AmpC producers, 46 (5.1%) AmpC positive and 87 (9.5%) were multidrug-resistant. Most of the times were revealed the following genes: blaCTX-M 767 (84.0%, p < 0.001), blaTEM 682 (74.7%, p < 0.001), blaSHV 89 (9.7%, p = 0.001). Less frequently accounted for resistance determinants as follows genes: blaCIT 38 (4.2%), blaDHA 32 (3.5%, p = 0.001), blaEBC 17 (1.9%, p < 0.001) and blaFOX 21 (2.3%, p < 0.05). Concerning 32 (3.5%) E. coli isolates from bloodstream infections, 26 (81.2%) posed CTX-M-15 producers and 2 (6.2%) isolates were CTX-M-3 originators. Within presumed E. coli pathogens, RFLP assessment exhibited in 2 patterns extended-spectrum character of mutations on blaTEM genes encoding positions considering amino acid sites 104, 238 and 240. Regarding antimicrobial resistance, the lowest rate was ascertained toward meropenem (0.4%), ertapenem (3.8%), tigecycline (1.4%) and amikacin (6.3%). [ABSTRACT FROM AUTHOR]

The microbiological quality of bathing water and the surfaces of the surrounding pool platforms of two pools was estimated. ESBL- and MBL-producing Gram-negative bacteria isolated from water and surface samples were also studied. The water samples were satisfactory in 31 (86.1 %) out of 36 cases. Pseudomonas aeruginosa as well as Escherichia coli were identified in only 2 (5.5 %) cases. There were no correlations between the HPC and number of enterobacteria in the pool water and those found in the surface samples. Isolated strains were resistant to ticarcillin with clavulanic acid in 52.3 % of cases; all of them were susceptible to ciprofloxacin. The sequences for blaCTX-M were found in 21.6 % of strains, mostly from the groups blaCTX-M9 and blaCTX-M25, whilst the genes for chosen carbapenemases were noted in 15 (17.0 %) of strains. It is necessary to implement new approaches to monitoring resistant bacteria, not only clinical ones but also those found in other public environments. [ABSTRACT FROM AUTHOR]