Chapter title |
Defining the Relationship Between Phenotypic and Genotypic Resistance Profiles of Multidrug-Resistant Enterobacterial Clinical Isolates
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Chapter number | 208 |
Book title |
Advances in Microbiology, Infectious Diseases and Public Health
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Published in |
Advances in experimental medicine and biology, January 2018
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DOI | 10.1007/5584_2018_208 |
Pubmed ID | |
Book ISBNs |
978-3-03-035468-8, 978-3-03-035469-5
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Authors |
Lamis Galal, Neveen A. Abdel Aziz, Walaa M. Hassan, Galal, Lamis, Abdel Aziz, Neveen A., Hassan, Walaa M. |
Abstract |
Fluoroquinolones and aminoglycosides offer effective therapy for extended-spectrum beta-lactamase (ESBL)-producing enterobacterial infections, but their usefulness is threatened by increasing resistant strains. This study was conducted to demonstrate the phenotypic outcomes of the coexistence of genetic determinants mediating resistance to extended-spectrum cephalosporins and quinolones in enterobacterial isolates collected from patients with health-care-associated infections in Egypt. ESBL phenotype was determined using double-disk synergy test (DDST). The PCR technique was used to detect the presence of the genes mediating quinolone resistance (qnr and aac(6')-Ib-cr) and coexistence with ESBL genes. We also examined the association between the genetic makeup of the isolates and their resistance profiles including effect on MIC results. Phenotypically ESBLs were detected in 60-82% of the enterobacterial isolates. ESBL, qnr and aac(6')-Ib-cr genes were detected with the following percentages in Citrobacter isolates (69%, 69%, and 43%, respectively), E.coli isolates (65%, 70%, and 45%, respectively), Enterobacter isolates (56%, 67%, and 33%, respectively), and finally Klebsiella isolates (42%, 66%, and 25%, respectively). The coexistence of these multiresistant genetic elements significantly increased the MIC values of the tested antibiotics from different classes. We suggest using blaTEM, blaCTX-M-15, qnr, and aac(6')-Ib-cr genes for better and faster prediction of suitable antibiotic therapy with effective doses against ESBL-producing isolates harboring plasmid-mediated quinolone resistance (PMQR) determinants. Amikacin, meropenem, gentamicin, and imipenem seem to be better choices of treatment for such life-threatening infections, because of their remaining highest activity. |
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Australia | 1 | 50% |
Unknown | 1 | 50% |
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Type | Count | As % |
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Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
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Unknown | 19 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Ph. D. Student | 4 | 21% |
Researcher | 3 | 16% |
Student > Master | 3 | 16% |
Student > Postgraduate | 2 | 11% |
Unknown | 7 | 37% |
Readers by discipline | Count | As % |
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Immunology and Microbiology | 3 | 16% |
Biochemistry, Genetics and Molecular Biology | 2 | 11% |
Nursing and Health Professions | 1 | 5% |
Business, Management and Accounting | 1 | 5% |
Other | 2 | 11% |
Unknown | 6 | 32% |