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Title: Susceptibility trends and molecular characterization of Gram-negative bacilli associated with urinary tract and intra-abdominal infections in Jordan and Lebanon: SMART 2011-2013
Authors: Hayajneh, Wail A
Hajj, Aline
Hulliel, Fawzi
Sarkis, Dolla Karam
Irani-Hakimeh, Noha
Kazan, Lama
Badal, Robert E
Affiliations: Faculty of Medicine 
Keywords: Beta-lactamases
Intra-abdominal infection
Molecular characterization
Urinary tract infection
Issue Date: 2015
Part of: International Journal of Infectious Diseases
Volume: 35
Issue: e56
Start page: e61
To investigate phenotypic and genotypic patterns of antimicrobial resistance among Gram-negative bacilli associated with urinary tract infection (UTI) and intra-abdominal infection (IAI) in medical centres of Jordan and Lebanon.

Gram-negative bacilli from the SMART study, collected between the years 2011 and 2013, were first identified at local laboratories. These isolates were shipped to a central laboratory where re-identification, susceptibility testing, and molecular characterization were performed using standard methods.

Among the 523 UTI-associated isolates, Escherichia coli , Klebsiella pneumoniae , and Proteus mirabilis were the most frequent (70%, 14%, and 5%, respectively). E. coli , K. pneumoniae , and Pseudomonas aeruginosa were the most frequent species among the 527 IAI-associated isolates (46%, 14%, and 12%, respectively). Incidence rates of extended-spectrum beta-lactamase (ESBL) producers among UTI-associated E. coli , K. pneumoniae , and P. mirabilis were 43%, 54%, and 4%, respectively. Corresponding rates among IAI-associated isolates were 49%, 56%, and 12%, respectively. Acinetobacter baumannii and P. aeruginosa isolates showed very disturbing low susceptibility patterns. CTX-M-15 was the most prevalent ESBL produced. Seventeen isolates were non-susceptible to carbapenems (estimated prevalence of 1.6%).

The alarmingly high rates of ESBL production and emergence of carbapenemases emphasize the urgent need to develop antimicrobial stewardship initiatives and to maintain antimicrobial resistance surveillance systems.
ISSN: 12019712
DOI: 10.1016/j.ijid.2015.04.011
Open URL: Link to full text
Type: Journal Article
Appears in Collections:Faculty of Medicine

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