Please use this identifier to cite or link to this item: https://scholarhub.balamand.edu.lb/handle/uob/2494
Title: Resistance and clonality in Escherichia coli and Klebsiella spp. and relationship with antibiotic consumption in major Lebanese hospitals
Authors: Daoud, Ziad
Salem-Sokhn, Elie
Dahdouh, Elias
Irani, Jihad
Matar, Ghassan M.
Doron, Shira
Affiliations: Faculty of Medicine 
Faculty of Medicine 
Keywords: Escherichia coli
Klebsiella spp
Antibiotic consumption
Extended-spectrum β-lactamase
ESBL
Cephalosporins
Issue Date: 2017
Part of: Journal of global antimicrobial resistance
Volume: 11
Start page: 45
End page: 51
Abstract: 
Objectives Extended-spectrum β-lactamases (ESBLs) are increasingly detected globally among Escherichia coli and Klebsiella spp. Studies show a link between inappropriate use of antibiotics and resistance. In this study, the profiles of ESBLs in E. coli and Klebsiella spp. isolated from three Lebanese hospitals and their relationship to antibiotic consumption were determined. Methods A total of 300 E. coli and 91 Klebsiella spp. isolates resistant to third- or fourth-generation cephalosporins were collected between May 2011 and December 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 Similar to other Lebanese studies, CTX-M-15 was predominant. Among the Klebsiella spp. isolated in hospitals 1 and 2, 43% harboured four different ESBLs. Eight Klebsiella spp. and fourteen E. coli pulsotypes were detected, showing genetic diversity among isolates. A significant correlation was detected between total use of antimicrobial agents and resistance to various antibiotics. A correlation was also detected between 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 Klebsiella spp. (P < 0.05). Conclusions This study shows the predominance of CTX-M-15 among cephalosporin-resistant E. coli and Klebsiella spp. in Lebanese hospitals. It also shows that the heightened use of antibiotics could be a driving factor for resistance emergence.
URI: https://scholarhub.balamand.edu.lb/handle/uob/2494
DOI: 10.1016/j.jgar.2017.07.011
Ezproxy URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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