Prevalence of Extended Spectrum β-Lactamases and Molecular Screening of klebsiella pneumoniae in the West Bank, Palestine

International Journal of Medical Science
© 2018 by SSRG - IJMS Journal
Volume 5 Issue 8
Year of Publication : 2018
Authors : Mohammad A.A. Shawabka and Gabi M.Abusada
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Mohammad A.A. Shawabka and Gabi M.Abusada, "Prevalence of Extended Spectrum β-Lactamases and Molecular Screening of klebsiella pneumoniae in the West Bank, Palestine," SSRG International Journal of Medical Science, vol. 5,  no. 8, pp. 9-17, 2018. Crossref, https://doi.org/10.14445/23939117/IJMS-V5I8P103

Abstract:

Klebsiella are Gram negative, non-motile, rod-shaped, lactose-fermenting, facultative anaerobic bacteria and encapsulated with a polysaccharide capsule. It causes opportunistic and nosocomial infections. Klebsiella produce plasmid-mediated extended-spectrum beta lactamases (ESBLs) which gives the bacteria the ability to resist beta-lactam antibiotics. The prevalence of ESBLs among clinical isolates of Klebsiella pneumonia was determined. In addition, the specific molecular characterization of CTX-M genes were also determined. Sixty seven urine, pus, and wound swabs were collected from patients of gynecology, surgery, medicine, Intensive Care Unit (ICU), and orthopedics from different parts of the West Bank of Palestine, mainly Ramallah, Hebron, and Jerusalem. Antibiotic sensitivity were done by combination disk method and double-disk synergy test. ESBL genes were detected by Polymerase Chain Reaction (PCR) and multiple PCR. Results showed that 48 samples were positive for CTX-M universal gene. Sixty four samples were positive for SHV gene, and 51 samples were positive for TEM gene. Forty two samples were positive for CTX-M1 gene, 38 samples were positive for CTX-M9 gene. Seven samples from 42 samples were positive for CTX-M1 only, 3 samples from 38 samples were positive for CTX-M9 only, and 35 samples were positive for both genes (CTX-M1 and CTX-M9). Our results were close to several studies around the world mainly in Egypt and Israel. In conclusion, bacteria are becoming more complex and highly spread in hospitals and the community in Palestine.

Keywords:

ESBLs, Intensive Care Unit, Klebsiella, PCR, CTX-M

References:

[1] Lal P, Kapil A, Das BK, Sood S (2007) Occurrence of TEM & SHV gene in extended spectrum β-lactamases (ESBLs) producing Klebsiella spp. isolated from a tertiary care hospital. Indian Journal of Medical Research, 125 2: 173–178. 
[2] Paterson DL, Bonomo RA (2005) Extended spectrum β-lactamases : a clinical update. Clinical Microbiology Reviews 18 4: 657- 686. 
[3] Pitout JD, Laupland KB (2008) Extended spectrum β-lactamase– producing Enterobacteriaceae: an emerging public health concern, The Lancet Infectious Diseases 8 3 159–166. 
[4] Gupta V (2007) An update on newer β-lactamases. Indian Journal of Medical Research 126 5: 417–427. 
[5] Clinical Laboratory Standards Institute CLSI (2006) Performance standards for antimicrobial susceptibility testing in Proceedings of the 16th International Supplement (M100-S16). National Committee for Wayne, Pa, USA. 
[6] Shukla I, Tiwari R, Agrawal M (2004) Prevalence of extended spectrum β-lactamase producing Klebsiella pneumoniae in a tertiary care hospital. Indian Journal of Medical Microbiology 22 2: 87–91. 
[7] Emery CL, Weymouth LA (1997) Detection and clinical significance of extended-spectrum β-lactamases in a tertiary care medical center. Journal of Clinical Microbiology, 35 8: 2061–2067. 
[8] Clinical Laboratory Standards Institute (2010) M100-520 VOL-30 Performance Standards For Antimicrobial Susceptibility Testing , Twentieth Informational Supplement (M100-520 VOL30) . 
[9] Sasirekha B, Manasa R, Ramya P, Sneha R (2010) Antimicrobial sensitivity Pattern β-lactamase in E.coll and Klebseilla pneumoniae isolated in Tertiary Care Hospital. Journal Medical Science 3 4:265-271. 
[10] Haque R, Sal M, MA (2010) Detection of ESBL producing nosocomial gram negative bacteria from a tertiary hospital in Bangladesh. PK J MD SCI 26 0 4:887-891. 
[11] Rhe YJ, Park, YK, Lee MY, Peck KR, KK (2010) KPC- Producing Extreeme Drug – Resistant Klebseilla Pneumoniae Isolated From Patients with Diabetes Mellitus and Chronic Renal Failure On Haemodialysis in south Korea. Antimicrobial Agents and Chemotherapy 54: 2278-2279. 
[12] Taslima, Y (2012) Prevalence of ESBL among E. coli and Klebsiella spp. In a tertiary care hospital and molecular detection of important ESBL producing genes by Multiple PCR. Department of Microbiology and Immunology Mymensingh Medical College. Mymensingh. 
[13] Amaya E, Caceres M, Fang H, Ramirez AT, Palmagren AC, Nord CE, Weintraub A (2009) Extended spectrum beta- lactamase producing Klebseilla Pneumoniae in Neonatal intensive care unit in leon, Nicaragwa. International Journal of Antimicrobial Agents 33:386-387. 
[14] Gruteke P, Goessens W, Gils JV, Peerbooms P, Toom NL, Bekum AV, Verbrug H (2003) Microbiology, 41 3:1161-1166. 
[15] Rahman MM, Haque JA, Hossain MA, Sultana R, Islam F, Islam AHMS (2004) Prevelance of extended spectrum beta lactamase–producing E.coli and Klebseilla pneumoniae in an urban hospital in Dhaka Bangladesh. International journal of antimicrobial agents 24 5: 508-510.