RESUMEN
Background The presence of Extended-spectrum ß-lactamase (ESBL) positive bacteria in hospital setting is an aggravating influential factor for hospitalized patients, and its consequences may be hazardous. Therefore, there is a need for rapid detection methods for newly emerging drug-resistant bacteria. This study was aimed at the molecular characterization of ESBL-positive Klebsiella pneumoniae isolates recovered from clinical samples. Methods A total of 513 K. pneumoniae isolates were obtained from various clinical samples during June 2019 to May 2020. The collected isolates were investigated for antimicrobial susceptibility (antibiogram), and PCR and DNA sequencing were performed to analyse the ESBL genes. Results Among the 513 isolates, as many as 359 (69.9%) were ESBL producers and 87.5% were multi-drug resistant, while none had resistance to imipenem. PCR scored 3% blaTEM, 3% blaSHV, and 60% blaCTX-M-15 genes for the tested isolates. Conclusion The study showed that CTX-M-15 was the major prevalent ESBL type among the isolates. Additionally, all the isolates were susceptible to carbapenems. Screening and detection of ESBL tests are necessary among all isolates from the enterobacteriaceae family in routine microbiology laboratory to prevent associated nosocomial infections. A larger study is essential to understand molecular epidemiology of ESBL producing organisms to minimize morbidities due to these multidrug resistant organisms.
Asunto(s)
Infecciones por Klebsiella , Klebsiella pneumoniae , Hospitales de Enseñanza , Humanos , Infecciones por Klebsiella/tratamiento farmacológico , Infecciones por Klebsiella/epidemiología , Klebsiella pneumoniae/genética , Epidemiología Molecular , Pakistán/epidemiología , beta-Lactamasas/genéticaRESUMEN
PURPOSE: To identify the Acinetobacter baumannii infection among transfusion dependent thalassemia patients. METHODS: A quantitative approach was employed to assess Acinetobacter baumannii infection in transfusion dependent thalassemia patients. Samples were collected from 916 patients, which have shown bacterial growth on MacConkey and blood agar culture media. A. baumannii strains were identified by microbiological methods and Gram's staining. API 20 E kit (Biomerieux, USA) was used for final identification. RESULTS: From 916 cultured blood specimens, 107 (11.6%) showed growth of A. baumannii. Serum ferritin in thalassemic patients without bacterial infections was 3849.5 ± 1513.5 µg/L versus 6413.5 ± 2103.9 µg/L in those with bacterial infections (p = 0.0001). Acinetobacter baumannii infected patients have shown higher serum ferritin levels (p = 0.0001). Serum ferritin in thalassemic patients was 3849.5 ± 1513.5 µg/L versus 6413.5 ± 2103.9 µg/L in those with bacterial infections (p = 0.0001). Acinetobacter baumannii infected patients showed high serum ferritin levels (p = 0.0001). The clinical symptoms have been found with A. baumannii +ve with a mean and standard deviation of 47 (5.1%) and A. baumannii -ve with mean and standard deviation of 60 (6.5%). CONCLUSION: Isolation of asymptomatic A. baumannii from the thalassemia patients shows an alarming situation of bacterial infections. A continuous surveillance of transfusion dependent thalassemia patients is recommended for bacterial sepsis.