Incidence of Extended-Spectrum Be-ta-Lactamase-Producing Klebsiella pneumoniae among Patients and in the Environment of Hassan II Hospital, Settat, MoroccoReportar como inadecuado




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Aim: The aim of the current study is to determine: 1the prevalence of extended-spectrum β-lactamase-producing K. pneumoniae ESBL-Kp isolated from clinical samples and a hospital environmentin Hassan II Hospital Settat, Morocco; 2 the associated risk factors of ESBL-Kpinfections; 3 the link between clinical and environmental isolates. Methods: During the study period April2010 to March 2011, all patients infected and hospital environment sites contaminatedby K. pneumoniae were considered as the potential study population and environmentalsite. The clinical data were collected to identify risk factors for ESBL carriageof K. pneumoniae infection. Screening of ESBL-and carbapenemase-producingisolates was performed by using a double-disk synergy test and the modified Hodgetest, respectively. ESBL-Kp isolates were tested for the presence of genes encoding β-lactamases and were investigated by PCR. The clonal relationship between ESBL-producing isolates was analysed by ERIC- and REP-PCR method. Results: The overall prevalence of ESBL-Kpamong clinical and environmental K. pneumoniae isolates was 35.13% 13-37and 4.04% 4-99, respectively. The main risk factors for carrying ESBL-Kp wererenal disease 46.15%, recent surgery 53.84%, previous hospitalisation 76.92%,and the presence of many invasive devices 53.84%. All ESBL isolates were multidrugresistant. The blaCTX-M group1and blaSHV 70.58%for each were the most prevalent followed by blaTEM 52.94%.Thirteen strains expressed at least two bla genes. One isolate was positivein the modified Hodge test and was a blaOXA-48 producer. ERICand Rep-PCR methods revealed an epidemic clonal dissemination of these isolates.Conclusion: The emergence of OXA-48 carbapenemase, endemic clonal disseminationand multi-drug resistance of ESBL-Kp isolates in our institution is highly alarming.

KEYWORDS

ESBL-Producing K. pneumoniae Infections, Hospital Environment, Risk Factors

Cite this paper

Natoubi, S. , Barguigua, A. , Zriouil, S. , Baghdad, N. , Timinouni, M. , Hilali, A. , Amghar, S. and Zerouali, K. 2016 Incidence of Extended-Spectrum Be-ta-Lactamase-Producing Klebsiella pneumoniae among Patients and in the Environment of Hassan II Hospital, Settat, Morocco. Advances in Microbiology, 6, 152-161. doi: 10.4236-aim.2016.63015.





Autor: Samira Natoubi1,2*, Abouddihaj Barguigua3,4, Sanaa Bouhali Zriouil4, Nezha Baghdad1, Mohammed Timinouni3, Abderraouf Hilali2, Sou

Fuente: http://www.scirp.org/



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