Sara M Atmani
Houari Boumediene University of Sciences and Technology, Algeria
Title: Prevalence and molecular characterization of antimicrobial resistance in uropathogenic Enterobacteriaceae isolated from patients in Algeria
Biography
Biography: Sara M Atmani
Abstract
The study aimed to investigate the antimicrobial resistance and involved mechanisms in uropathogenic Enterobacteriaceae strains isolated from patients in Algeria. The study concerned 41 non repetitive strains isolated between from 2018-2019. Bacterial identification by the API 20E system showed Escherichia coli (n=18) as a dominant uropathogen followed by Klebsiella pneumoniae (n=13), Enterobacter cloacae (n=6), Providencia rettgeri, Morganella morganii, Proteus mirabilis and Proteus vulgaris (n=1). Antibiotic susceptibility by the disc diffusion method showed a high prevalence of acquired resistance to β-lactams (78%) which was extended to 3rd and 4th generation cephalosporins in 21.9% strains (all positive by the double-disc synergy test). Among non-beta-lactams, resistance rates were of 46.3% (aminoglycosides), 22% (sulfamethoxasole-trimethoprim) and 17.1% (quinolones/fluoroquinolones). A rate of 21.9% of isolates were MDR phenotype (4 E. cloacae, 3 K. pneumoniae, M. morganii and P. mirabilis), all but one were ESBL-producers. PCR screening showed the presence of blaSHV (31.7%, all K. pneumoniae); blaTEM (46.3%); blaCTX-M in ESBL-producers; plasmid-mediated quinolone resistance determinants identified as qnrB (24.4%), aac(6’)-Ib-cr (14.6%) and qnrS (9.7%); aminoglycoside-modifying enzyme genes aac(6’)-Ib (24%) and aac(3)-II (24%); sulfamethoxasole-trimethoprim resistance genes identified as sul2 (83.3%), sul1 (50%), sul3 (8.3%), dfrA5 (66.6%), dfrA12 (25%), dfrA1 (16.7%) and dfrA7 (8.33%). Class 1 integrons were detected in 31.7% of isolates. The study showed a high prevalence of acquired resistance to antibiotics among uropathogenic Enterobacteriaceae. The presence of MDR ESBL strains is an important clinical concern. A constant monitoring of antimicrobial resistance is required to ensure therapeutic efficacy and prevent the emergence and spread of multidrug resistance.