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British Microbiology Research Journal, ISSN: 2231-0886,Vol.: 4, Issue.: 12 (December)

Original-research-article

Prevalence and Genotypic Characterization of Extended- Spectrum Beta-Lactamases Produced by Gram Negative Bacilli at a Tertiary Care Hospital in Rural South Western Uganda

 

Acaku Moses1, Freddie Bwanga2,3, Yap Boum4 and Joel Bazira1*

1Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda.
2Department of Medical Microbiology, Makerere University College of Health sciences
3MBN Clinical Laboratories Kampala, Uganda.
4Epicenter Mbarara Research Base, Mbarara, Uganda.

Article Information

Editor(s):

(1) Dr. Frank Lafont, Center of Infection and Immunity of Lille, Pasteur Institute of Lille, France.

Reviewers:

(1) Eucharia Nmema, Ondo State University of Science and Technology, Nigeria.

(2) Anonymous

(3) Anonymous

(4) Anonymous

Complete Peer review History: http://www.sciencedomain.org/review-history/5867

Abstracts

Aim: To determine the prevalence and genotypic characterisation of extended spectrum beta-lactamases produced by gram negative bacilli isolated at Mbarara Regional Referral Hospital (MRRH).
Samples: Gram negative clinical isolates.
Study Design: Laboratory-based descriptive cross-sectional study.
Place and Duration of the Study: MRRH, June and August 2012.
Methods: Gram negative clinical isolates were sub cultured, and identified using biochemical tests. They were screened for ESBL by using oxyimino-cephalosporins and confirmed by double disc synergy Genotyping was performed using the PCR for TEM, SHV and CTX-M. Susceptibility pattern for the extended spectrum beta-lactamases, (ESBL) - positive isolates to other antibiotic classes was performed by the Kirby Bauer Technique.
Results: A total of 484 isolates were included in the study. The commonest ESBL producers were Escherichia coli (34%), followed by unidentified coliforms (19.3%) and Klebsiella spp. (12.7%). Phenotypically, 88/484 were ESBL producers while genotypically 213/ 484 possessed ESBL genes. The ESBL genes were blaCTX-M (146; 70%), blaSHV (72; 34%) and blaTEM (100; 47%). 87of 213 isolates expressed more than one ESBL gene. Of these 36 (7.4%) produced blaCTX-M/blaSHV, 28 (5.8%) blaCTX-M /blaTEM, 4 (0.8%) blaSHV/ blaTEM and 19 (3.9%) blaCTX-M/blaSHV/blaTEM. Sixty two (16%) were phenotypically and genotypically positive, 12 (3%) of the isolates were phenotypically positive but genotypically negative and 140 (37%) isolates were phenotypically negative but genotypically positive. The ESBL producers were highly susceptible to imipenem (95%), nitrofurantoin (66%) but less susceptible to ampicillin (4%) and ticarcillin (7%).
Conclusion: ESBL production among the Gram-negative clinical isolates at MRRH is very high with several isolates possessing multiple genes. The ESBL producers are highly susceptible to imipenem, but very resistant to ciprofloxacin.

Keywords :

Antibiotics; resistance patterns; sensitivity patterns; ESBL; Uganda.

Full Article - PDF    Page 1541-1550

DOI : 10.9734/BMRJ/2014/9792

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