Incidence of Extended Spectrum β-Lactamase Genes (ESBLs) among community and health care infection in Mansoura University Hospital, Egypt.

BACKGROUND

Multidrug-resistant (MDR) Gram-negative bacteria pose a significant challenge due to their limited treatment options. The production of extended-spectrum β-lactamases (ESBLs) is an important mechanism of resistance. This study aimed to identify the incidence and characteristics of ESBL-encoding genes (blaCTX-M, blaTEM, blaSHV, and blaOXA) in MDR isolates.

MATERIALS AND

METHODS

A cross-sectional study was conducted from September 2022 to May 2023. ESBL-producing isolates (n = 105) out of 412 were recovered from hospitalized and outpatient settings and analyzed. Standard microbiological methods were used for isolates identification, susceptibility testing, and phenotypic ESBL detection. Additionally, blaCTX-M, blaTEM, blaSHV, and blaOXA genes were identified using conventional PCR.

RESULTS

Molecular profiling of β-lactamase determinants was conducted via PCR targeting blaCTX-M, blaTEM, blaSHV, and blaOXA genes. Among phenotypically confirmed (100%) ESBL producers, 98% harbored one or more target genes, with blaCTX-M predominant (81%), followed by blaSHV (70.4%), blaTEM (62%), and blaOXA (30.4%). Carbapenem resistance was higher in ESBL-producing strains compared to non-ESBL strains. Extensively drug-resistant (XDR) isolates were the most common across hospital departments and outpatients.

DISCUSSION: This study highlights the significant prevalence of ESBL genes and multidrug resistance among Gram-negative bacteria. The dominance of blaCTX-M and the existence of multiple resistance genes raise concerns about limited treatment options. The findings emphasize the need for stricter antibiotic stewardship and infection control measures to curb the spread of MDR pathogens.

CONCLUSION

This study provides valuable insights into the alarming incidence of ESBL genes and MDR in Mansoura, Egypt. Continuous surveillance and implementation of effective control strategies are crucial to combat this growing public health threat.