TY - JOUR AU - Haider, Muhammad H AU - Ain, Noor U AU - Abrar, Samyyia AU - Riaz, Saba PY - 2020/12/31 Y2 - 2024/03/29 TI - blaOXA, blaSHV-, and blaTEM- extended-spectrum β-lactamases in Gram-negative strains from burn patients in Lahore, Pakistan JF - The Journal of Infection in Developing Countries JA - J Infect Dev Ctries VL - 14 IS - 12 SE - Original Articles DO - 10.3855/jidc.12828 UR - https://jidc.org/index.php/journal/article/view/33378283 SP - 1410-1417 AB - <p>Introduction: Gram-negative bacterial pathogens are associated with complications of post-burn infections that showed significant association with different genotypic variants of extended-spectrum β-lactamases. In this study, we aimed to determine the distribution of ESBL gene variants among bacterial pathogens from post-burn infections.</p><p>Methodology: Cephalosporin-resistant isolates were collected from Jinnah Burn and Reconstructive Surgery Centre, Lahore. Phenotypic testing: double-disk synergy test, combination disk test, multiplex PCR for <em>bla</em><sub>OXA</sub>, <em>bla</em><sub>TEM</sub>, and <em>bla</em><sub>SHV</sub> genes were performed.</p><p>Results: Of the 53.5% cephalosporin-resistant isolates, 50.7% were community-acquired and 49.3% were nosocomial pathogens. Seventy-two percent of post-burn infections were found in males (p-value = 0.92, OR = 1.04). The age of burn victims ranged from 4 to 85 years (mean = 28.9, SD = 15.6). <em>Pseudomonas aeruginosa</em> was most predominant at a rate of 49%. There were 83.3% multidrug-resistant isolates, which showed susceptibility to meropenem, imipenem, and amikacin in 28.7%, 25.3%, and 26% respectively. In phenotypic tests 16% ESBLs detected by the DDST and 14% confirmed by the CDT. Molecular detection proved effective for the detection of 79.7% <em>bla</em><sub>TEM</sub>, 37.7%<em> bla</em><sub>OXA</sub>, and 18.8% <em>bla</em><sub>SHV</sub> isolates. <em>bla</em><sub>TEM </sub>genes were confirmed in 18.1% CDT-positive isolates, with 62.6% diagnostic accuracy (95% CI = 54.7-70) and 88% specificity (95% CI = 80.4-93.4).</p><p>Conclusions: The antimicrobial resistance associated with the ESBL-producing <em>Pseudomonas</em> spp. and <em>Enterobacteriaceae</em> is becoming a challenge for the treatment and survival of burn patients. The high rate <em>bla</em><sub>TEM</sub>, <em>bla</em><sub>OXA</sub>, and <em>bla</em><sub>SHV </sub>genes confirm the need to improve the management of burn patients in order to prevent post-burn infections.</p> ER -