Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals

  • Najla Mathlouthi Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
  • Charbel Al-Bayssari Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
  • Allaaeddin El Salabi Faculty of Public Health, University of Benghazi, Benghazi, Libya
  • Sofiane Bakour Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
  • Salha Ben Gwierif The Libyan Academy, Benghazi, Libya
  • Abdulaziz A. Zorgani Faculty of Medicine, University of Tripoli, Libya
  • Yahia Jridi Hôpital Régionale de Kasserine, Kasserine, Tunisie
  • Karim Ben Slama Université Tunis El-Manar, Faculté des Sciences de Tunis, El-Manar II, Tunisie
  • Jean-Marc Rolain Faculté de Médecine et de Pharmacie, Aix-Marseille-Université, Marseille, France
  • Chedly Chouchani Université Tunis El-Manar, Faculté des Sciences de Tunis, El-Manar II, Tunisie
Keywords: Escherichia coli, Klebsiella pneumoniae, ESBLs, carbapenemases, Tunisia, Libya

Abstract

Introduction: The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase production among clinical isolates of Enterobacteriaceae recovered from Tunisian and Libyan hospitals.

Methodology: Bacterial isolates were recovered from patients in intensive care units and identified by biochemical tests and MALDI-TOF. Antibiotic susceptibility testing was performed by disk diffusion and the E-test method. ESBL and carbapenemase activities were detected using standard microbiological tests. Antibiotic resistance-encoding genes were screened by PCR and sequencing. Clonal relationships between Klebsiella pneumoniae strains were carried out using multi-locus sequence typing (MLST).

Results: A total of 87 isolates were characterized, with 51 and 36, respectively, identified as E. coli and K. pneumoniae. Overall the resistance prevalence was high for aminoglycosides (> 60%), fluoroquinolones (> 80%), and extended-spectrum cephalosporins (> 94%), and was low for imipenem (11.4%). Among this collection, 58 strains (66.6%) were ESBL producers and 10 K. pneumoniae strains (11.4%) were carbapenemase producers. The antibiotic resistance-encoding genes detected were blaCTX-M-15 (51.7%), blaTEM-1 (35.6%), several variants of blaSHV (21.8%), and blaOXA-48 (11.4%). The MLST typing of K. pneumoniae isolates revealed the presence of multiple clones and three novel sequence types. Also, close relationships between the OXA-48-producing strains from Tunisia and Libya were demonstrated.

Conclusions: This study is the first paper describing the emergence of carbapenemase- and ESBL-producing Enterobacteriaceae, sensitive to colistin, isolated in Tunisia and Libya. Active surveillance and testing for susceptibility to colistin should be implementing because resistance to colistin, mainly in Klebsiella, has been recently reported worldwide.

Published
2016-08-02
How to Cite
1.
Mathlouthi N, Al-Bayssari C, El Salabi A, Bakour S, Ben Gwierif S, Zorgani A, Jridi Y, Ben Slama K, Rolain J-M, Chouchani C (2016) Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals. J Infect Dev Ctries 10:718-727. doi: https://doi.org/10.3855/jidc.7426
Section
Original Articles