جستجوی مقالات مرتبط با کلیدواژه « Enterobacteriaceae » در نشریات گروه « پزشکی »

Carbapenemase-resistant Enterobacteriaceae is a major threat to public health. These microorganisms are resistant to all types of beta-lactam antibiotics.

This cross-sectional study was conducted on 51 Enterobacteriaceae isolates from clinical samples in Sina Hospital and Tehran Heart Center in Iran from 2016 to 2018. Antibiotic susceptibility test was performed by disk diffusion method. Carbapenem-resistant isolates were identified by the Modified Hodge Test (MHT) and Polymerase Chain Reaction (PCR) for surveying the presence of VIM, NDM, IMMP, and OXA-48 genes.

Out of 51 clinical samples, 38 isolates were positive for both MHT and PCR tests, and 5 isolates were negative in both tests. The results of both tests are similar in 84.3% of the isolates.

The MHT is an appropriate and easy method for approving carbapenemase production. Also, a laboratory can detect the carbapenemase production by identification of the KPC genes.

 Since first reported in 2015, the mobile colistin resistance (mcr-1) gene has been found in increasing numbers worldwide. However, only a few studies have been carried out in Morocco. Herein, we aimed to investigate the prevalence of colistin resistance and mcr-like genes among Enterobacteriaceae clinical isolates from the North-West of Morocco.

 The prevalence of colistin resistance was investigated among 338 Enterobacteriaceae clinical isolates. These isolates were collected from Tangier and Tetouan cities between December 2020 and May 2021. The isolates included Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), Enterobacter spp, Citrobacter freundii (C. freundii), and Proteus mirabilis (P. mirabilis). Antibacterial susceptibility tests were performed using disc diffusion assay and minimal inhibitory concentrations (MIC). All isolates that were found resistant to colistin were subjected to PCR and sequencing techniques to screen them for the presence of mcr-like genes (mcr-1 to mcr-5).

 22.78% of isolates were multidrug-resistant (MDR), among which 57.14% of P. mirabilis isolates, 30% of Enterobacter spp isolates, 22.22% of K. pneumoniae isolates, and 22.05% of E. coli isolates. Colistin resistance was found in 51 of 338 isolates, including 33 E. coli, 11 K. pneumoniae, and 7 P. mirabilis. The mcr-1 gene was detected in 3 E. coli isolates. Mcr-2 to mcr-5 genes were absent in this study. Sequencing of PCR amplicons revealed 99–100% similarity to mcr-1 gene.

 This is the first study conducted in Morocco to investigate the prevalence of colistin resistance among clinical isolates, and it has revealed the first three mcr-1 genes circulating in Morocco. This could lead to the dissemination of these genes throughout Morocco.

The emergence of resistant Enterobacteriaceae and the abundance of antibiotic-resistant genes is one of the major problems of the global health system. The present study aimed to determine the phenotypic and genotypic expression levels of metallobetalactamase coding genes (blaVIM, blaNDM, blaIMP, blaSIM, blaSPM, and blaGIM) in Enterobacteriaceae isolates (Escherichia, Enterobacter, Citrobacter, Klebsiella, and Serratia) from patients referred to the clinical centers in Isfahan city and typing of these isolates.

Enterobacteriaceae isolates were identified and isolated after sample collection. Antibiotic sensitivity pattern was investigated by disk diffusion method. MIC was performed in carbapenem-resistant isolates by the E-test method, and the frequency of strains with multidrug resistance was determined. The presence of metallobetalactamase genes was investigated phenotypically using a combined disk test and modified Hodge test. The genotypic identification of the above genes was done by PCR and sequencing techniques. Finally, PCR based on the sequence of repetitive elements was performed for molecular typing of metallobetalactamase-producing Enterobacteriaceae.

In the present study, 580 isolates of Enterobacteriaceae were isolated by examining 3500 samples. Klebsiella and Escherichia were the most common isolates, and the frequency of MDR was 60% in Klebsiella and 59.53% in Escherichia. Moreover, MIC results showed that 33.7% Klebsiella, 4.1% Escherichia, 5.7% Enterobacter, 3.5% Citrobacter, and 5.5% Serratia were resistant to carbapenems. Frequency of isolates with multidrug resistance in Escherichia (MDR 59.53% and XDR 1.5%), Klebsiella (MDR 60%, XDR% 3 and PDR 0.8%), Enterobacter (MDR 44%), Citrobacter (MDR 53.5%) and Serratia (MDR 55.5%) were reported. Metallobetalactamase production was confirmed by phenotypic analysis in Escherichia (1.8%) and Klebsiella (10.4%). Genotypic tests showed that blaSIM, blaSPM, and blaGIM genes were absent in any Enterobacteriaceae isolates. The presence of blaVIM, blaIMP, and blaNDM genes was confirmed in 6.2% of Klebsiella isolates and 1.3% of Escherichia isolates. The frequency of detected metallobetalactamase genes in Klebsiella and Escherichia isolates was 4.58% and 1.39% for blaVIM, 0.83% and 1.39% for blaIMP and 0.83% and 1.39% for blaNDM. The rep-PCR results showed that 11 metallobetalactamase-producing Klebsiella isolates are in 4 main groups, and 9 Escherichia isolates and 4 Enterobacter isolates are classified in two main clusters.

The present study shows the prevalence of Klebsiella and Escherichia isolates and their resistance to metallobetalactamase-producing Enterobacteriaceae. These genes in the horizontal transfer of antibiotic resistance identification of metallobetalactamase-producing isolates in clinical environments are essential to reduce the spread of antibiotic resistance. The high homology of resistant isolates of Enterobacteriaceae in clinical samples indicates the high power of these genotypes in causing infection in hospitalized patients, which can play an important role in increasing antibiotic resistance.

Escherichia albertii is a gram-negative and facultatively anaerobic bacterium that has been isolated as a causative agent of diarrhea in recent years. Due to the lack of sufficient information on the phenotypic and biochemical characteristics of this bacterium, it is difficult to distinguish it from other species of the Enterobacteriaceae, especially Escherichia coli pathotypes. So, the aim of this study was to evaluate the prevalence of E. albertii in the urine and stool samples of patients with urinary tract and gastrointestinal tract infection in Kermanshah hospitals using culture and molecular methods.

Four hundred samples consisted of 200 urine and 200 stool samples confirmed as Enterobacteriaceae phenotypically were collected. After subculture and biochemical tests, finally white colonies on XRM-McConkey agar (suspected to be E. albertii) were selected and subjected to PCR using specific primer for cdt gene (Eacdt). SPSS version 16 software was used for the statistical analysis of the data, and the p-value less than 0.05 was considered statistically significant.

Only 5 samples (1.25%) were positive in the final culture on XRM-MacConkey agar. None of them were then confirmed as E. albertii by the PCR.

According to the phenotypic isolation of this bacterium in present study and previous studies on the prevalence of it, it seems that the use of Eacdt specific primer is not efficient for the detection of this bacterium. However, further studies are recommended to confirm it.

Onychophagia, commonly known as nail biting, is considered a compulsive behavioral disorder primarily observed in children and adolescents. Nail biting behavior leads to an increased presence of various opportunistic microorganisms in the oral cavity. This study aimed to investigate the association between nail biting and mental health in children aged 10 to 16 years. It further compares the load of Enterobacteriaceae in nail-biters and non-nail biters.

A case control study was conducted on 50 nail biters (cases) and 50 non-nail biters (controls). Data were collected by using convenient sampling technique from school going students aged 10 to 16 years, using pre-designed and self-administered questionnaires, the Massachusetts General Hospital-Nail Biting Questionnaire (MGH-NBQ) and the Strengths and Difficulties Questionnaire (SDQ) as well as saliva samples taken and tested for bacterial growth. All ethical issues were taken into consideration. SPSS v23 was used to analyze the data using descriptive statistics to calculate the mean and standard deviation. The independent t test was used to compare mean SDQ scores between nail biters and non-nail biters. P-values<0.05 were considered statistically significant.

Among the 50 cases, 44 (88.0%) of the students had positive Enterobacteriaceae growth, while 13 (26.0%) of thecontrols did not. Nail biters had considerably higher mean scores for emotional symptoms, conduct problems, hyperactivity, and peer problems than non-nail biters (P value<0.001). All of the SDQ domains and nail biting were found to have a statistically significant (P=0.05) association.

The study highlights the persistent and burdensome nature of nail biting, which poses risks in terms of disease transmission. Additionally, nail biting has been associated with various behavioural and emotional disorders. Awareness of the harmful consequences of nail biting, along with appropriate preventive and treatment approaches, can assist young individuals in discontinuing this habit.

 Widespread and inappropriate use of antibiotics has led to an increase in antibiotic-resistant bacteria worldwide. Extended-spectrum β-lactamases (ESBLs) are among the most important resistance mechanisms in members of Enterobacteriaceae, which can pose a threat to patients.

 This study aimed to investigate the carrier status and alteration in the fecal transmission of ESBL-producing Enterobacteriaceae (ESBL-E) on admission and during the hospital stay, as well as its correlation with the usage of antibiotics among children in a pediatric intensive care unit (PICU). Molecular typing between the primary and secondary isolates was done to detect the homotypic clonal strains.

 Demographic and medical data of PICU children were collected, and the carrier status of ESBL-E was investigated in pairs of their rectal swab samples at the admission and discharge time. Detection of ESBL phenotype and antimicrobial susceptibility to 12 antibiotics were performed by double-disk synergy and disc diffusion methods, respectively. Polymerase chain reaction for detection of blaTEM, blaSHVblaPER, blaCTX-M, and blaVEB genes was performed using specific primers. The phylogenetic relations were analyzed by the enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) method.

 Extended-spectrum β-lactamase-producing Enterobacteriaceae was detected in 48% of the samples at admission and 42% at discharge time. The highest frequency of resistance was observed in cephazolin, amoxicillin-clavulanic acid, and ampicillin. Children with a history of meropenem administration showed a significantly higher frequency of meropenem resistance Enterobacteriaceae in their samples. Moreover, the administration of metronidazole increased the isolation of ESBL-Escherichia species in hospitalized children. The most common gene associated with the ESBL phenotype was blaCTX-M, while blaPER and blaVEB were not detected in the ESBL-E isolates. The phylogenetic analysis did not confirm the occurrence of the cross-transmission of ESBL-E in the patients during hospitalization.

 Our results showed a high frequency of ESBL-E in the feces of children upon admission to the PICU, which did not change significantly during the hospital stay. Although the prescription of metronidazole showed an association with the enrichment of ESBL-E due to observed diversity in the molecular types and resistance phenotypes of the isolates, the community seems to be the primary source of ESBL-E transmission in children. Further investigations are needed to understand the role of hospital stay in the colonization and enrichment of ESBL-E in the intestinal tract of children and their association with infections during the medical interventions in the PICU.

The goal of this project was to assay the prevalence of fecal carriage of ESΒL-producing Enterobacteriaceae (ESΒL-PE), and to identify the risk factors for carriage in neonates hospitalized in a Neonatal Intensive Care Unit (NICU) of an educational therapeutic hospital (Vali-e-Asr) of Birjand city, east of Iran.

Rectal swabs were taken from 200 neonates at the beginning of hospitalization, every week in case of hospitalization and at the time of discharge. Bacterial isolates were identified using different biochemical experiments. Screening of ESΒL-PE was first done by phenotypic test (DD test) and then antibiotic resistance genes were detected by PCR assay.

In our research, 42 Enterobacteriaceae were obtained from 200 neonates. The total prevalence rate of neonatal rectal carriage of ESΒL-PE was 42/200 (21%), mostly Escherichia coli, 18 (42.8%). blaCTX-M and blaCTX-M-15 were the most prevailing β-lactamase-encoding genes recognized by PCR tests. Intestinal carriage of ESβL among neonates displayed a statistically significant relationship with the use of the mechanical ventilation (p=0.025), APGAR score (p=0.005) and gestational age (weeks) (p=0.044).

Our findings highlighted the importance of consistent screening for resistant ESΒL-PE among neonates (especially preterm newborns) and minimizing invasive ventilation whenever possible.

 Carbapenems are broad-spectrum antibiotics used to treat the family of gram-negative Enterobacteriaceae, especially those that are resistant to first-line antibiotics. Because these drugs are usually prescribed as the last line of treatment, resistance to these antibiotics carries irreparable risks to treatment systems, and screening high-risk individuals in medical centers and using infection control measures are critical strategies for eliminating them.

 We investigated the prevalence of colonization of different strains of Enterobacteriaceae, Klebsiella, Enterobacter, and Escherichia coli and their risk factors in hospitalized children.

 In this descriptive cross-sectional study, stool samples were taken from patients during the first 48 hours of hospitalization in a tertiary children’s hospital and were cultured on Makcanki culture medium or EMB. Cultured Enterobacteriaceae samples were transferred to Müller-Hinton agar medium, and their antibiotic susceptibility was evaluated with meropenem and imipenem discs by disc diffusion method. In the next step, five common carbapenemase genes, including (VIM, IMP, OXA-48, NDM-1, and SPM-1) were examined by PCR method and reported accordingly.

 Two hundred and ninety-five stool samples were examined, of which 242 (82%) samples were cultured positively with Enterobacteriaceae. The prevalence of carbapenem resistance was reported to be 37% among 295 samples using the phenotypic method. Resistance rates were high in patients with a history of antibiotic use, with frequent hospitalizations (more than two episodes in the last six months), and in patients with an underlying disease) malignancy, GI diseases, immunodeficiency, neurologic diseases such as cerebral palsy and epilepsy, endocrine diseases. Most of the genes found were OXA-48, followed by IMP and VIM. NDM-1 was found in 3 samples, and SPM was not found in any of the samples. In 13% of resistant samples, more than one carbapenemase gene was found.

 The results of this study showed that the frequency of carbapenem resistance in stools colonized with Enterobacteriaceae is high in our patients. On the other hand, the presence of carbapenemase genes in these bacteria, which are located on the plasmids that can be rapidly spread in the hospital environment, is an alarm for the hospital infection control committee to take preventive measures in order to prevent the spread of these bacteria in the hospital.

The worldwide emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a major therapeutic concern to medical institutions. To date, no study has determined the frequency and risk factors of inpatients with CRE fecal carriage in Southern Iran. We studied the features of carbapenemase-producing Enterobacteriaceae (CPE) collected from the central ICU of a university hospital.

Totally, 173 samples, including 124 stool samples from 46 ICU inpatients on admission and different follow-ups, 9 ICU staff, and 40 environmental samples were included. CRE was identified using microbiological methods. Antimicrobial susceptibility was investigated by using the disk diffusion method and E-test. Carbapenemase producers were detected using the mCIM method. Seven carbapenemase genes were characterized. The genetic relationship among 20 CPE was elucidated by PFGE. 

The overall fecal carriage rate was 28.2%, while CRE acquisition was 6.1%. CRE were classified as Klebsiella pneumoniae (71.4%), Escherichia coli (23.8%), and Enterobacter aerogenes (4.8%). From 21 CRE, 20 (95.2%) produced carbapenemases, of which 10, 15, 10, 25, 5, and 65% were blaKPC, blaSME, blaIMP, blaVIM, blaNDM and blaOXA-48-positive, respectively. Out of 20 CPE, 14 different PFGE patterns were observed, categorized into six clusters, suggestive of non-clonal spread. No difference between the examined risk factors with CRE carriage was shown. 

The data indicate a high CRE fecal carriage rate among inpatients. Our findings implicate the widespread of OXA-48 carbapenemase together with heterogeneity among CRE with great concern for dissemination and therapeutic threat. Early diagnosis and monitoring of CRE among inpatients are urgent.

Urinary tract infection is one of the most common bacterial infections affecting human health. Since Enterobacteriaceae bacteria are common causes of urinary tract infections, this study aimed to determine the frequency and pattern of Enterobacteriaceae antibiotic resistance in patients with urinary tract infections to prevent increased antibiotic resistance of these bacteria and prevent increased treatment costs. This cross-sectional analytical study was performed on 3 different age groups of Clienteles referred to Valiasr Clinic Laboratory in Mashhad. Detection of bacterial species was performed using conventional microbiological methods and biochemical tests, and according to the instructions of the Institute of Clinical and Laboratory Standard 2021, the pattern of antibiotic resistance of isolates was evaluated by the disk diffusion method. Out of 438 urine cultures with positive results in terms of Enterobacteriaceae, Escherichia coli with a prevalence of 76.7%, Klebsiella 14.4%, Enterobacter 4.3%, Proteus 3%, and other bacterial species with a prevalence of 1.6% Were observed. Bacterial isolates showed the lowest antibiotic resistance against Piperacillin-Tazobactam (13%) and Amikacin (17.2%), and also had the highest antibiotic resistance against Cefazolin (81.5%) and Co-trimoxazole (62.5%). Due to the frequency of urinary tract infections and to prevent their serious complications, it is necessary to study the pattern of regional antibiotic resistance in medical centers for effective and timely treatment. Therefore, it is recommended that Amikacin and Piperacillin-Tazobactam antibiotics be considered for the experimental treatment of urinary tract infections caused by Enterobacteriaceae.

Unsafe water supplies are of public health concern, especially in developing countries. This article aims to investigate the microbiological quality of water from eight Wells in Iwo and to explore for the extended-spectrum β-lactamase (ESBL) and carbapenemase genes contained in isolated enteric bacteria from in the water samples.

Bacterial isolation and identification were done using standard conventional methods. Antibiotic susceptibility testing was conducted using the Kirby–Bauer method. Ten phenotypically carbapenem-resistant isolates were further subjected to genotypic analysis (PCR amplification) for the detection of ESBL and carbapenemase gene.

A total of 148 Enterobacteriaceae isolates belonging to seven (7) genera were isolated and identified which included E. coli, Enterobacter spp., Klebsiella spp., Salmonella, Citrobacter sp, Proteus, and Shigella. Results showed that 55% of isolates were resistant to tetracycline, 28% to cefepime, the least resistance was shown in moxifloxacin and gentamicin which had 6% and 9%, respectively, of the total isolates. For the two carbapenems used, results showed meropenem and imipenem had resistant values of 14% each, respectively. Two isolates carried the blaCTX-M gene while the carbapenemase gene (blaKPC, blaNDM, and blaOXA) was not detected in all the ten isolates.

There was also negative chromosomal detection of carbapenemase in MDR isolates from well waters in Iwo town. Consequently, resistance to carbapenem antibiotics in these isolates may not be mediated by carbapenemase but by the production of extended-spectrum β-lactamases and through other mechanisms of resistance.

Gastrointestinal colonization with resistant pathogens is significant because they could be easily transmitted to other hosts or spread to different microbiota through mobile genetic elements.

This study assessed the prevalence of fecal carriage of extended-spectrum β-lactamase-producing and carbapenemaseproducing Enterobacteriaceae (ESBL-E and CPE, respectively) among hemodialysis patients and the factors affecting its occurrence in a hospital in Tehran.

From January 2018 to May 2019, 150 hemodialysis patients referred to a hospital in Tehran were sampled in this study. Stool samples of the patients were diluted in saline and cultured on MacConkey agar plates containing cefotaxime, ceftazidime, imipenem, and meropenem discs. The clinical data were analyzed to identify the risk factors using a logistic regression model.

The colonization rate of ESBL-E was 48.6%, while only 2% of patients were identified as the carriers of CPE (3 of 150). A higher prevalence rate was obtained for intestinal carriage of ESBL-E among hemodialysis patients aged 18 to 42 years using multivariate analysis. The prevalence rate of multidrug-resistant isolates was 73.8%. The blaCTX-M1 gene was identified as the most prevalent ESBL gene. Among carbapenemase-encoding genes, blaKPC and blaoxa-48 were found in 12 and two isolates, respectively.

These results demonstrated a high prevalence rate of ESBLs among hemodialysis patients, although this rate was low for carbapenemases. Therefore, more control measures should be taken in hospitals to prevent the spread of antibiotic resistance genes in healthcare settings.

Mahyaveh is a traditional Iranian fish sauce produced by fermentation and hydrolysis. The main production of Mahyaveh has been traditionally and scientific research and industrial measures has not been done on it with the aim to achieve a production with less microbial load. Therefore, the aim of this research was to study the type of fish, salt concentration and fermentation time on the bacterial population of Iranian fish sauce (Mahyaveh).

For this purpose, the effects of fish type (tuna, anchovy and sardine), salt concentration (15%, 25% and 35%) and fermentation time (30, 75 and 120 days) on the total microbial count, Micrococcus, Enterobacteriaceae and Bacillus were investigated. 15 treatments were designed according to the Box-Behnken Response Surface Methodology.

Simultaneous optimization to achieve the minimum total microbial count, Micrococcus, Enterobacteriaceae and Bacillus in the Mahyaveh sauce was obtained with 99.49% desirability at the time of 103.63 days of fermentation with the third type of fish (Sardine) and at a salt concentration of 29.38%.

By optimizing the conditions of producing Mahyaveh sauce, fish sauce can be produced with the least amount of microbial load with more health safety.

Prostatitis affects about 16% of men in their lifetime and sometimes leading to prostate cancer. Bacterial infections are the most common causes of prostatitis. Diagnosis of the causative agents of bacterial prostate infections plays an essential role in timely treating and preventing secondary complications. This study isolated bacterial infectious agents in patients’ surgical prostate and evaluated them by routine and molecular microbiological methods.

In this cross-sectional study, 72 prostate biopsy specimens were collected from the Orology Departmen of hospitals of Qazvin University of Medical Sciences. All samples were cultured in aerobic and anaerobic conditions. Antibiotic susceptibility test by Kirby-Bauer standard method was performed for all isolated bacteria. In addition, all isolated bacteria were identified using 16S rDNA PCR and sanger sequencing methods. Also, TaqMan real-time PCR was applied to detect Ureaplasm aurealyticum, Mycoplasma hominins, and Mycoplasma genitalium.

In conventional culture method, out of 18 positive samples, 15 samples (83.3%) were Gram-negative bacteria and 3 samples (16.6%) were Gram-positive bacteria, containing Escherichia coli (55.5%), Klebsiella pneumoniae (11.1%), Enterobacter cloacae (5.5%), Pseudomonas aeruginosa (11.1%), Staphylococcus aureus (11.1%), and Enterococcus faecalis (5.5%). The results of molecular identification methods were the same as conventional culture results. Also, four patients were Ureaplasm aurealyticum, and three patients were positive for Mycoplasma hominis.

Most bacteria isolated from prostate specimens belonged to the Enterobacteriaceae family, especially Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae. Staphylococcus aureus and Enterococcus faecalis were cocci isolated in the specimens too. Also, Ureaplasma urealyticum, and Mycoplasma hominis were identified in prostatitis.

This study aimed to determine the frequency of extended-spectrum beta-lactamases (ESBL) and different drug resistance phenotypes in Enterobacteriaceae isolated from clinical specimens in Gonbad-e Kavus, Golestan Province.

220 clinical samples of urine, blood, pus, sputum, CSF, body fluids, and ear and eye discharge were collected during six months from April to September 2021 at a referral hospital. The samples were cultured on blood and MacConkey agar and incubated overnight at 37 °C. Standard biochemical tests and the API20E enteric identification system were used to identify bacteria. The Kirby-Bauer disk diffusion method determined the antibiotic resistance pattern, and the phenotypic confirmatory test was used for detecting ESBL producers.

108 Enterobacteriaceae isolates were identified from different clinical specimens out of the samples. The isolates were Escherichia coli (36.1%), Klebsiella pneumonia (25%), Enterobacter cloacae (18.5%), Citrobacter freundii (11.1%) and Proteus mirabilis (9.2%). The highest resistance and susceptibility among the isolates belonged to sulfamethoxazole-trimethoprim (68.5%) and meropenem (11.1%), respectively. The highest prevalence of multidrug-resistant (MDR) and ESBL were observed in E. coli and Proteus mirabilis isolates.

In this study, the high frequency of MDR phenotypes in the isolates may suggest an increasing trend of antibiotic resistance in Enterobacteriaceae. This could greatly impact the management and treatment of infections caused by these drug-resistant bacteria. Therefore, infection-control measures and continuous monitoring is recommended for controlling the spread of ESBL-producing strains in different geographical areas.

Fecal carriage of extended-spectrum β-lactamase (ESBL)-producing bacteria is a potential risk for transmission and infection. Genotypes known to be associated with ESBL-producing Enterobacteriaceae are cefotaximases (CTX-M), temoniera (TEM), and sulfhydryl variable (SHV). Unfortunately, data on ESBL prevalence in Indonesia, especially in South Sulawesi, is still limited, so further research on the community is needed.

This study aimed to investigate the prevalence of fecal carriage of ESBL-producing Enterobacteriaceae among school children in South Sulawesi, Indonesia.

The research was conducted among school-children in South Sulawesi, Indonesia. Detection of ESBL gene using polymerase chain reaction (PCR) methods. A total of 245 stool samples were collected.

The prevalence of fecal carriage of ESBL-producing Enterobacteriaceae among school children was 76.7% (188/245). Genotyping of EBSL-producing Enterobacteriaceae encoding genes using PCR found that TEM genes, 92.6% (174/188), were higher than SHV genes, 38.8% (73/188) and CTX-M genes, 4.3% (8/188). It was also revealed a combination of ESBL-producing genes of Enterobacteriaceae. The most combination genes were found in TEM + SHV genes, including 55 of 188 (29.26%).

The presence of ESBL gene careers suggests that antibiotic resistance has spread in the community, which needs to be of concern since it can be an ESBL gene reservoir that can be transmitted to many pathogenic bacteria.

In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world.

For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index.

Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%).

The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.