Extended-spectrum beta-lactamase genes among Gram negative bacilli isolates from Egyptian children with diarrhea

Document Type : Original Article


1 Medical Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt

2 Pediatrics, Gastroenterology, Hepatology, Faculty of Medicine, Assiut University Children Hospital

3 Department of Clinical Pathology, Faculty of Medicine, Assiut University Hospital


Background: Faecal carriage of ESBL-producing bacteria is a potential risk for transmission and infection. Antibiotic resistance in diarrheal children is considered a risk factor for these   young aged ones and limit treatment options. This study aimed to investigate the frequency of ESBL-producing Gram negative bacilli (GNB) phenotypically by Vitek and genotypically by PCR. Method: Seventy-three diarrheal isolates from outpatient children at of age range from less than 6 months to 18 months were isolated. Bacterial strains were identified and subjected to antimicrobial susceptibility testing by using the automated Vitek 2 compact system. All isolates were screened for ESBL phenotypically by Vitek and genotypically by PCR for blaCTXM, blaTEM and blaSHV. Results: Seventy three different GNB identified by Vitek system. The frequency of Escherichia coli was 68.5%, Acinetobacter haemolytica was 7 /73 (9.6%), Pseudomonas species (sp.)  4/73 (5.5%), Proteus mirabilis was (2.7%), Salmonella sp. was (1.4%), Enterobacter sp. was (6.8%), Aeromonas salmonicida was (1.4%), and Klebsiella was (4.1%). ESBL carriage was significantly high among isolated strains (64.4 %). High frequency of multidrug resistance (MDR) (90.4%) was found. High resistance was detected to ampicillin (98.6%), followed by cefazolin (93.2%) and ceftazidime (82.2%), trimethoprim-sulphamethoxazol (76.7%). Resistance to carbapenems was detected as (16.4%). blaCTX-M positive was (78.1%), blaTEM positive (53.4%), blaSHV positive (31.5%). Conclusions: The current study reported a high rate of faecal carriage of ESBL-producing and MDR GNB and children below 2 years of age. Resistance was observed to the available antimicrobials that are used for children in treatment. This leaves few treatment options for infections caused by these bacteria.


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