Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a hospital in Havana

Authors

Keywords:

E. coli, K. pneumonia, extended-spectrum beta-lactamases, beta-lactam antibiotics.

Abstract

Introduction: Beta-lactamase production is the most common resistance mechanism in gram-negative microorganisms. Extended-spectrum beta-lactamases are an important group of enzymes capable of inactivating third- and fourth-generation cephalosporins and aztreonam. Their detection is important to indicate the optimum treatment as well as isolation measures aimed at preventing the spread of carrier microorganisms.

Objectives: Determine the incidence and main characteristics of isolates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae from non-urogenital samples.

Methods: A cross-sectional study was conducted at Salvador Allende hospital during the year 2017. Determination was made of the frequency of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae, their origin by hospital service, the type of clinical sample and their antimicrobial sensitivity. Identification of extended-spectrum beta-lactamases was based on the Jarlier double disc method.

Results: Of the total Escherichia coli and Klebsiella pneumoniae isolates studied, 46% and 50%, respectively, were extended-spectrum beta-lactamase producers. Most had been obtained from samples taken in wards of the Institute of Angiology; the most effective antimicrobial was meropenem; sensitivity to the remaining antimicrobials was below 80%; no isolates were sensitive to third-generation cephalosporins.

Conclusions: A high incidence was found of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates at Salvador Allende Hospital in Havana, more noticeably in Institute of Angiology wards and skin samples.

 

Downloads

Download data is not yet available.

Author Biographies

Lorena Monté, Hospital Salvador Allende

Microbiología, Médico Microbiólogo

Raiza Martínez, Hospital Salvador Allende

Microbiología, Jefa de Dpto

References

Marston HD, Dixon DM, Knisely JM, Palmore TN, Fauci AS. Antimicrobial resistance. JAMA[Internet]. 2016[acceso 19 Mar 2019];316(11):1193-1204. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27654605/

Cantón R, Loza E, Aznar J, Barrón-Aduriz R, Calvo J, Castillo FJ, et al. Antimicrobial susceptibility trends and evolution of isolates with extended spectrum β-lactamases among Gram-negative organisms recovered during the SMART study in Spain (2011-2015). Rev Esp Quimioter[Internet]. 2018[acceso 19 Mar 2019];31(2):136-45. http://pubmed.ncbi.nlm.nih.gov/29532655/.

Thaden J, Fowler V, Sexton D, Anderson D. Increasing Incidence of Extended-Spectrum β-Lactamase-Producing Escherichia coli in Community Hospitals throughout the Southeastern United States. Infect Control Hosp Epidemiol[Internet]. 2016[acceso 19 Mar 2019];37(1):49-54.Disponible en: https://pubmed.ncbi.nlm.nih.gov/26458226/

Galindo M. Caracterización molecular y patrón de susceptibilidad antimicrobiana de Escherichia coli productora de β-lactamasas de espectro extendido en infección del tracto urinario adquirida en la comunidad. Rev Chilena Infectol[Internet]. 2018[acceso 19 Mar 2019];35(1):29-35.Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_abstract&pid=S0716-10182018000100029&lng=es&nrm=iso

Salame-Khouri L, Contreras-Pichardo B, Arias-Rodríguez S, Mondragón-Soto M, Cataneo-Serrato JL, Nuñez-Martínez M, et al. Epidemiología de las bacteriemias por Escherichia coli en dos hospitales de tercer nivel de la Ciudad de México. An Med Asoc Med Hosp ABC[Internet]. 2018[acceso 4 May 2019];63(2):91-5.Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=80254

Quirós-Del Castillo AL, Apolaya-Segura M. Prevalencia de infección de la vía urinaria y perfil microbiológico en mujeres que finalizaron el embarazo en una clínica privada de Lima, Perú. Ginecol Obstet Mex[Internet]. 2018[acceso 4 May 2019];86(10):634-639.Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=83451

Yábar MN, Curi-Pesantes B, Torres CA, Calderón-Anyosa R, Riveros M, Ochoa TJ. Multirresistencia y factores asociados a la presencia de betalactamasas de espectro extendido en cepas de Escherichia coli provenientes de urocultivos. Rev Perú Med Exp Salud Pública[Internet]. 2017[acceso 14 Jul 2019];34(4):660-665. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342017000400012

Castillo-Tokumori F, Irey-Salgado C, Málaga J. Worrisome high frequency of extended-spectrum beta-lactamase-producing Escherichia coli in community-acquired urinary tract infections: a case–control study. Int J Infect Dis[Internet]. 2017[acceso 14 Jul 2019];55:16-19. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27979787/

Zurita J, Solís MB, Ortega-Paredes D, Barba P, Paz A, Sevillano G. High prevalence of B2-ST131 clonal group among extended-spectrum β-lactamase-producing Escherichia coli isolated from bloodstream infections in Quito, Ecuador. J Global Antimicrob Resist[Internet]. 2019[acceso 11 Sep 2019];19:216-221. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31077859/

Navarro F, Calvo J, Cantón R, Fernández-Cuenca F, Mirelis B. Detección fenotípica de mecanismos de resistencia en microorganismos gramnegativos. Enferm Infecc Microbiol Clin[Internet] 2011[acceso 11 Sep 2019];29(7):524-534. Disponible en: https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-deteccion-fenotipica-mecanismos-resistencia-microorganismos-S0213005X11001546

González-Mesa L, González-Leyva MA, Zayas-Tamayo AM, Curbelo-Álvarez M, Garrido-Nicot Y. Relación genética de aislados clínicos de Escherichia coli productores de Beta-Lactamasas de Espectro Extendido (BLEE) en un hospital de la Habana, Cuba. Revista CENIC Ciencias Biológicas[Internet] 2017[acceso 19 Nov 2019];48(3):107-112.Disponible en: https://www.redalyc.org/pdf/1812/181253610005.pdf

Marrero C, Mora M, Hernández R, Báez M, García T, Espinosa I. Identificación de enterobacterias productoras de betalactamasas de espectro extendido (BLEEs) en instalaciones porcinas de la provincia Matanzas.Rev Salud Anim [Internet] 2017 [citado 19 Nov 2019];39(3):[aprox. 12 p.] Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0253-570X2017000300006&lng=es.

Quiñones Pérez D, Carmona Cartaya Y, Rivero Rivero M, Pereda Novales N, Zallas Illas A, Marrero Carralero D, et al. Escherichia coli multidrogorresistente en Cuba: emergencia del clon pandémico ST 131[Internet].Convención Internacional de Salud.La Habana: Cuba Salud; 2018 [citado 19 Nov 2019]. Disponible en: http://www.convencionsalud2018.sld.cu/index.php/connvencionsalud/2018/paper/download/1909/687.

Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing[Internet]. 26ed. USA: CLSI; 2016[citado 7 Dic 2019].Disponible en: https://www.facm.ucl.ac.be/intranet/CLSI/CLSI-2016-M100-S26.pdf.

Jarlier V, Nicolas M, Fournier G, Philippon A. Extended broad-spectrum β-lactamases conferring transferable resistance to newer β-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility pattern. Rev Infect Dis[Internet] 1988[citado 7 Dic 2019];10(4):867-78. Disponible en: https://pubmed.ncbi.nlm.nih.gov/3263690/

European Centre for Disease Prevention and Control. Surveillance of antimicrobial resistance in Europe – Annual report of the European Antimicrobial Resistance Surveillance Network (EARS-Net) 2017[Internet]. Stockholm: ECDC; 2018 [citado 18 Dic 2019] Disponible en: https://www.ecdc.europa.eu/sites/portal/files/documents/AMR-surveillance-EARS-Net-2017.pdf

Hoffman H, Luepke K, Tabak Y, Mohr J, Johannes RS, Gupta V. National Prevalence of Extended-Spectrum Beta-lactamase Producing Enterobacteriaceae (ESBL) in the Ambulatory and Acute Care Settings in the United States in 2015. Open Forum Infectious Diseases[Internet]. 2016[citado 13 Feb 2020];3 Suppl 1:369.Disponible en: https://www.researchgate.net/publication/313381167_National_Prevalence_of_Extended-Spectrum_Beta-lactamase_Producing_Enterobacteriaceae_ESBL_in_the_Ambulatory_and_Acute_Care_Settings_in_the_United_States_in_2015

Doi Y, Iovleva A, Bonomo RA. The ecology of extended-spectrum β-lactamases (ESBLs) in the developed world. Journal of Travel Medicin[Internet] 2017[citado 13 Feb 2020];24 Suppl 1:S44-51.

Disponible en: https://pubmed.ncbi.nlm.nih.gov/28521000/

Paterson DL, Bonomo RA. Extended-Spectrum B-Lactamases: a Clinical Update. Clin Microbiol Rev[Internet] 2005[citado 13 Feb 2020];18(4):657-686.

Disponible en: https://pubmed.ncbi.nlm.nih.gov/16223952/

Goodman KE, Lessler J, Cosgrove SE, Harris AD, Lautenbach E, Han JH, et al. A Clinical Decision Tree to Predict Whether a Bacteremic Patient Is Infected With an Extended-Spectrum β-Lactamase–Producing Organism. Clin Infect Dis[Internet] 2016[citado 20 Mar 2020];63(7):896-903.Disponible en: https://pubmed.ncbi.nlm.nih.gov/27358356/

Richard JL, Sotto A, Lavigne JP. New insights in diabetic foot infection. World J Diabetes[Internet]. 2011[citado 20 Mar 2020];2(2):24-32.Disponible en: https://pubmed.ncbi.nlm.nih.gov/21537457/

Akhi MT, Ghotaslou R, Azgharsadeh M, Varshochi M, Pirzadeh T, Memar MY, et al. Bacterial etiology and antibiotic susceptibility pattern of diabetic foot infections in Tabriz, Iran. GMS Hyg Infect Control[Internet] 2015[citado 20 Mar 2020];10:Doc02.Disponible en. https://pubmed.ncbi.nlm.nih.gov/25699225/

Vignoli R, García-Fulgueira V, Cordeiro NF, Bado I, Seija V, Aguerrebere P, et al. Extended-spectrum β-lactamases, transferable quinolone resistance, and virulotyping in extra-intestinal E. coli in Uruguay. J Infect Dev Ctries[Internet] 2016[citado 18 Abr 2020 ];10(1):43-52.

Disponible en: https://pubmed.ncbi.nlm.nih.gov/26829536/

Guzmán M, Salazar E, Cordero V, Castro A, Villanueva A, Rodulfo H, et al. Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela. Biomédica[Internet] 2019[citado 18 Abr 2020];39 Suppl 1:S96-106. Disponible en: https://pubmed.ncbi.nlm.nih.gov/31529852/

Cantón R, Valverde A, Novais A, Baquero F, Coque T. Evolución y panorama actual de las BLEE. Enferm Infecc Microbiol Clin[Internet] 2007[citado 18 Abr 2020];25 Suppl 2:S2-10. https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-evolucion-panorama-actual-blee-13112082.

Meneses R, De Pinho WL, Rodrigues CK, Silva J, Brito V, Araujo M, et al. High Rates Of Antimicrobial Resistance Of ESBL-Producing Klebsiella spp. Causing Bloodstream Infections In Northeast Of Brazil. IOSR Journal Pharm[Internet] 2018[citado 18 Abr 2020];8(4):43-46.Disponible en: https://www.researchgate.net/publication/325176820.

Gurieva T, Dautzenberg M, Gniadkowski M, Derde L, Bonten M, Bootsma M. The Transmissibility of Antibiotic-Resistant Enterobacteriaceae in Intensive Care Units. CIin Infect Dis[Internet] 2018[citado 2 May 2020];66(4):489-493.Disponible en: https://pubmed.ncbi.nlm.nih.gov/29020273/

López-Cerero L. Papel del ambiente hospitalario y los equipamientos en la transmisión de las infecciones nosocomiales. Enferm Infecc Microbiol Clin[Internet]. 2014[citado 2 May 2020];32(7):459-464. Disponible en: https://www.seimc.org/contenidos/documentoscientificos/eimc/seimc_eimc_v32n07p459a464.pdf

Miao Z, Li S, Wang L, Song W, Zhou Y. Antimicrobial Resistance and Molecular Epidemiology of ESBL-Producing Escherichia coli Isolated from Outpatients inTown Hospitals of Shandong Province, China. Front Microbio[Internet]. 2017[citado 2 May 2020];8:63

Disponible en: https://pubmed.ncbi.nlm.nih.gov/28174570/

Singh N, Pattnaik D, Neogi DK, Jena J, Mallick B. Prevalence of ESBL in Escherichia coli Isolates Among ICU Patients in a Tertiary Care Hospital. J Clin Diagn Res[Internet] 2016[citado 11 Jun 2020];10(9):19-22. Disponible en: https://pubmed.ncbi.nlm.nih.gov/27790433/

Surgers L, Boersma P, Girard PM, Homor A, Geneste D, Arlet G, et al. Molecular epidemiology of ESBL-producing E. coli and K. pneumoniae: establishing virulence clusters. Infec Drug Resist[Internet] 2018[citado 11 Jun 2020];12:119-127.Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318714/

Mehdi Y, Mehrnaz R, Hazar H, Negin E, Alireza A, Sirous J, et al. Bacteria Producing Extended Spectrum β-lactamases (ESBLs) in Hospitalized Patients: Prevalence, Antimicrobial Resistance Pattern and its Main Determinants. Iran J Pathol[Internet] 2019[citado 4 abr 2020];14(1):61-7.Disponible en: https://pubmed.ncbi.nlm.nih.gov/31531102/

Oliver A, Cantón R. Enterobacterias productoras de β-lactamasas plasmídicas de espectro extendido[Internet].Madrid:SEIMC; 2003 [citado 4 abr 2020]. Disponible en: https://www.seimc.org/contenidos/ccs/revisionestematicas/bacteriologia/Blees.pdf

Paterson DL. Tratamiento de las infecciones por microorganismos productores de BLEE. Enferm Infecc Microbiol Clin[Internet]. 2007[citado 4 abr 2020];25(Supl. 2):60-3.Disponible en: https://www.elsevier.es/es-revista-enfermedades-infecciosas-microbiologia-clinica-28-articulo-tratamiento-las-infecciones-microorganismos-productores-blee-13112090.

Published

2021-02-27

How to Cite

1.
Monté L, Martínez R. Extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a hospital in Havana. Rev. cuba. hig. epidemiol. [Internet]. 2021 Feb. 27 [cited 2025 Dec. 11];58. Available from: https://revepidemiologia.sld.cu/index.php/hie/article/view/412

Issue

Section

ARTÍCULOS ORIGINALES