Journal Article

The Rising Tide of Antibiotic Resistance: A Study on Extended‐Spectrum Beta‐Lactamase and Carbapenem‐Resistant Escherichia coli and Klebsiella pneumoniae

Hamad, Ismail, Farhana, Aisha, Junaid, Kashaf, Younas, Sonia, Atif, Muhammad, Ejaz, Hasan, Mazhari, Bi Bi Zainab, Farooq, Ali, Batool, Alia, Selim, Samy, Qamar, Muhammad Usman, Alruways, Mashael W., Alruwaili, Muharib, Lone, Durreshahwar

2024

Overview

Background The global spread of extended‐spectrum beta‐lactamase (ESBL)‐producing and carbapenem‐resistant Enterobacterales (CRE) poses a significant concern. Acquisition of antimicrobial resistance genes leads to resistance against several antibiotics, limiting treatment options. We aimed to study ESBL‐producing and CRE transmission in clinical settings. Methods From clinical samples, 227 ESBL‐producing and CRE isolates were obtained. The isolates were cultured on bacterial media and confirmed by VITEK 2. Antibiograms were tested against several antibiotics using VITEK 2. The acquired resistance genes were identified by PCR. Results Of the 227 clinical isolates, 145 (63.8%) were Klebsiella pneumoniae and 82 (36.1%) were Escherichia coli; 76 (33.4%) isolates were detected in urine, 57 (25.1%) in pus swabs, and 53 (23.3%) in blood samples. A total of 58 (70.7%) ESBL‐producing E. coli were resistant to beta‐lactams, except for carbapenems, and 17.2% were amikacin‐resistant; 29.2% of E. coli isolates were resistant to carbapenems. A total of 106 (73.1%) ESBL‐producing K. pneumoniae were resistant to all beta‐lactams, except for carbapenems, and 66.9% to ciprofloxacin; 38 (26.2%) K. pneumoniae were resistant to carbapenems. Colistin emerged as the most effective antibiotic against both bacterial types. Twelve (20.6%) E. coli isolates were positive for blaCTX‐M, 11 (18.9%) for blaTEM, and 8 (33.3%) for blaNDM. Forty‐six (52.3%) K. pneumoniae isolates had blaCTX‐M, 27 (18.6%) blaTEM, and 26 (68.4%) blaNDM. Conclusion This study found a high prevalence of drug‐resistant ESBL‐producing and CRE, highlighting the need for targeted antibiotic use to combat resistance. This study investigates the transmission of extended‐spectrum beta‐lactamase‐producing and carbapenem‐resistant Klebsiella pneumoniae and Escherichia coli. Widespread resistance among these pathogens underscores the need for a comprehensive analysis of antibiotic resistance patterns to mitigate resistance effectively.

• Publisher: John Wiley & Sons, Inc
• Subject: Adolescent / Adult / Aged / Amikacin / Anti-Bacterial Agents - pharmacology / Anti-Bacterial Agents - therapeutic use / Antibiotic resistance / Antibiotics / Antimicrobial agents / Antimicrobial resistance / antimicrobial resistance genes / Automation / Bacteria / beta-Lactamases - genetics / beta‐lactam antibiotics / Carbapenem-Resistant Enterobacteriaceae - drug effects / Carbapenem-Resistant Enterobacteriaceae - genetics / Carbapenem-Resistant Enterobacteriaceae - isolation & purification / Carbapenems / Carbapenems - pharmacology / carbapenem‐resistant Enterobacterales / Catheters / Child / Child, Preschool / Ciprofloxacin / Clinical isolates / Colistin / Drug resistance / drug resistance prevalence / Drug Resistance, Bacterial - genetics / E coli / ESBL / Escherichia coli / Escherichia coli - drug effects / Escherichia coli - enzymology / Escherichia coli - genetics / Escherichia coli - isolation & purification / Escherichia coli Infections - drug therapy / Escherichia coli Infections - epidemiology / Escherichia coli Infections - microbiology / Female / Females / Genetic testing / Humans / Klebsiella Infections - drug therapy / Klebsiella Infections - epidemiology / Klebsiella Infections - microbiology / Klebsiella pneumoniae / Klebsiella pneumoniae - drug effects / Klebsiella pneumoniae - enzymology / Klebsiella pneumoniae - genetics / Klebsiella pneumoniae - isolation & purification / Male / Microbial Sensitivity Tests / Microorganisms / Middle Aged / Mortality / Nosocomial infections / Pathogens / Polymerase chain reaction / Urine / Young Adult / β Lactamase / β-Lactam antibiotics