ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption

Introduction: Extended-spectrum – beta lactamases (ESBLs) are increasingly detected globally among Escherichia coli and Klebsiella pneumoniae. The correlation between antibiotics use and resistance, though not fully described, has been addressed and shown in several studies. In this study, the prof...

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Main Authors: Anas Obeid, Peter Maliha, Samah Abdallah, Estelle Akl, Maria Deeb, Hassan El Moussawi, Elie Salem-Sokhn, Ghassan Matar, Ziad Daoud
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2018-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/10038
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author Anas Obeid
Peter Maliha
Samah Abdallah
Estelle Akl
Maria Deeb
Hassan El Moussawi
Elie Salem-Sokhn
Ghassan Matar
Ziad Daoud
author_facet Anas Obeid
Peter Maliha
Samah Abdallah
Estelle Akl
Maria Deeb
Hassan El Moussawi
Elie Salem-Sokhn
Ghassan Matar
Ziad Daoud
author_sort Anas Obeid
collection DOAJ
description Introduction: Extended-spectrum – beta lactamases (ESBLs) are increasingly detected globally among Escherichia coli and Klebsiella pneumoniae. The correlation between antibiotics use and resistance, though not fully described, has been addressed and shown in several studies. In this study, the profiles of ESBLs in E. coli and K. pneumoniae isolated from two Lebanese hospitals and their relationship to antibiotic consumption were determined. Methodology: A total of 205 E. coli and 67 K. pneumoniae isolates resistant to third- or fourth-generation cephalosporins were collected between January 2011 and January 2012. Antibiotic susceptibility and consumption data were also collected from 2010–2012. Double-disk synergy and Etest ESBL assays were performed, followed by PCR for ESBL genes. Pulsed-field gel electrophoresis (PFGE) was performed for representative isolates. Statistical analysis for consumption and susceptibility data over 3 years was performed. Results: As expected, CTX-M-15 was predominant. In both hospitals, strains of E. coli and K. pneumoniae harbored at least one ESBL, and in some cases (23%) harboured four different ESBLs. A significant correlation was detected between total use of antimicrobial agents and resistance to various antibiotics. This was obvious for the use of penicillins and resistance to aztreonam, ceftazidime and ciprofloxacin, and use of third- and fourth-generation cephalosporins and resistance to ceftazidime, cefuroxime, cefoxitin and ciprofloxacin in both bacteria. Conclusions: This study shows the predominance of CTX-M-15 among cephalosporin-resistant E. coli and K. pneumoniae in Lebanese hospitals and highlights the direct relationship between the use of antibiotics and the emergence of resistance in bacteria.
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spelling doaj-art-04bd4e516aec4820adfe5bacd480947a2025-08-20T02:16:14ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802018-02-011202.110.3855/jidc.10038ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumptionAnas Obeid0Peter Maliha1Samah Abdallah2Estelle Akl3Maria Deeb4Hassan El Moussawi5Elie Salem-Sokhn6Ghassan Matar7Ziad Daoud8Faculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, LebanonDepartment of experimental pathology, Microbiology, and Immunology, American University of Beirut, Beirut, LebanonFaculty of Medicine and Medical Sciences- University of Balamand, Beirut, Lebanon Introduction: Extended-spectrum – beta lactamases (ESBLs) are increasingly detected globally among Escherichia coli and Klebsiella pneumoniae. The correlation between antibiotics use and resistance, though not fully described, has been addressed and shown in several studies. In this study, the profiles of ESBLs in E. coli and K. pneumoniae isolated from two Lebanese hospitals and their relationship to antibiotic consumption were determined. Methodology: A total of 205 E. coli and 67 K. pneumoniae isolates resistant to third- or fourth-generation cephalosporins were collected between January 2011 and January 2012. Antibiotic susceptibility and consumption data were also collected from 2010–2012. Double-disk synergy and Etest ESBL assays were performed, followed by PCR for ESBL genes. Pulsed-field gel electrophoresis (PFGE) was performed for representative isolates. Statistical analysis for consumption and susceptibility data over 3 years was performed. Results: As expected, CTX-M-15 was predominant. In both hospitals, strains of E. coli and K. pneumoniae harbored at least one ESBL, and in some cases (23%) harboured four different ESBLs. A significant correlation was detected between total use of antimicrobial agents and resistance to various antibiotics. This was obvious for the use of penicillins and resistance to aztreonam, ceftazidime and ciprofloxacin, and use of third- and fourth-generation cephalosporins and resistance to ceftazidime, cefuroxime, cefoxitin and ciprofloxacin in both bacteria. Conclusions: This study shows the predominance of CTX-M-15 among cephalosporin-resistant E. coli and K. pneumoniae in Lebanese hospitals and highlights the direct relationship between the use of antibiotics and the emergence of resistance in bacteria. https://jidc.org/index.php/journal/article/view/10038EnterobacteriaceaeESBLantibiotic consumption
spellingShingle Anas Obeid
Peter Maliha
Samah Abdallah
Estelle Akl
Maria Deeb
Hassan El Moussawi
Elie Salem-Sokhn
Ghassan Matar
Ziad Daoud
ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
Journal of Infection in Developing Countries
Enterobacteriaceae
ESBL
antibiotic consumption
title ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
title_full ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
title_fullStr ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
title_full_unstemmed ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
title_short ESBL-producing Escherichia coli and Klebsiella pneumoniae in two major Lebanese hospitals: molecular epidemiology and correlation with consumption
title_sort esbl producing escherichia coli and klebsiella pneumoniae in two major lebanese hospitals molecular epidemiology and correlation with consumption
topic Enterobacteriaceae
ESBL
antibiotic consumption
url https://jidc.org/index.php/journal/article/view/10038
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