TY - JOUR AU - Mathlouthi, Najla AU - Al-Bayssari, Charbel AU - El Salabi, Allaaeddin AU - Bakour, Sofiane AU - Ben Gwierif, Salha AU - Zorgani, Abdulaziz A. AU - Jridi, Yahia AU - Ben Slama, Karim AU - Rolain, Jean-Marc AU - Chouchani, Chedly PY - 2016/08/02 Y2 - 2024/03/29 TI - Carbapenemases and extended-spectrum β-lactamases producing Enterobacteriaceae isolated from Tunisian and Libyan hospitals JF - The Journal of Infection in Developing Countries JA - J Infect Dev Ctries VL - 10 IS - 07 SE - Original Articles DO - 10.3855/jidc.7426 UR - https://jidc.org/index.php/journal/article/view/27482803 SP - 718-727 AB - <p class="SmallText">Introduction: The aim of the study was to investigate the prevalence of extended-spectrum β-lactamase (ESBL) and carbapenemase production among clinical isolates of <em>Enterobacteriaceae</em> recovered from Tunisian and Libyan hospitals.</p> <p class="SmallText">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 <em>Klebsiella pneumoniae </em>strains were carried out using multi-locus sequence typing (MLST).</p> <p class="SmallText">Results: A total of 87 isolates were characterized, with 51 and 36, respectively, identified as <em>E. coli</em> and <em>K. pneumoniae</em>. Overall the resistance prevalence was high for aminoglycosides (&gt; 60%), fluoroquinolones (&gt; 80%), and extended-spectrum cephalosporins (&gt; 94%), and was low for imipenem (11.4%). Among this collection, 58 strains (66.6%) were ESBL producers and 10 <em>K. pneumoniae </em>strains (11.4%) were carbapenemase producers. The antibiotic resistance-encoding genes detected were <em>bla</em><sub>CTX-M-15 </sub>(51.7%), <em>bla</em><sub>TEM-1 </sub>(35.6%), several variants of <em>bla</em><sub>SHV</sub> (21.8%), and <em>bla</em><sub>OXA-48 </sub>(11.4%). The MLST typing of <em>K. pneumoniae </em>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.</p> <p class="SmallText">Conclusions: This study is the first paper describing the emergence of carbapenemase- and ESBL-producing <em>Enterobacteriaceae</em>, 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 <em>Klebsiella</em>, has been recently reported worldwide.</p> ER -