Detection and Dissemination of Extented-Spectrum Beta-Lactamases Genes (CTX-M-15 and SHV-187) Isolated in Multi-Drug Resistant Uropathogenic Klebsiella pneumoniae and Escherichia coli in Cote D'ivoire

Abstract

Enterobacteriaceae are ubiquitous commensal bacteria of humans that have become major causative agents of hospital infections. The objective of the study was to characterized the extended-spectrum beta-lactam resistance genes from multi-drug uropathogenic clinical strains in Côte d'Ivoire. Bacterial strains isolated from various biological products were collected from January 2011 to June 2016 at the Observatoire de la résistance des micro-organismes aux anti-infectieux en Côte d'ivoire (ORMICI).  Two hundred and sixty six (266) enterobacterial strains were collected during this study. Antibacterial susceptibility and the presence of bla genes were determined by the solid-state diffusion method and by PCR, respectively. The presence of ESBL was confirmed by the double disc synergy test method and Sequencing was performed. Of the strains collected, the most isolated were Escherichia coli 53 (39.25%) and Klebsiella pneumoniae 36 (26.66%). Antibiotic resistance of more than 50% was observed for gentamicin, norfloxacin, third generation cephalosporins and tobramicin in E coli. Only imipenem had a low resistance rate of 5.6%. However, apart from norfloxacin, the Klebsiella pneumoniae strains tested expressed resistance to aztreonam and second generation cephalosporins in excess of 50%. The rate of resistance to aztreonam and cefotaxin was statistically different between E. coli and Klebsiella pneumoniae strains (p-value ₌ 0,008 and p-value ₌ 0,032 respectively). The genes blaCTX-M, blaSHV, blaTEM, qnr B and a class I integron were detected. After sequencing, the SHV-1, SHV-28, SHV-187 and CTX-M15 variants were detected. Although these results are of low proportions, this may be considered critical for the future, hence the need for a better antibiotic surveillance strategy in Abidjan.