Abstract
Objective This study aimed to determine the Enterobacteriaceae strains among patients who are suffering from diarrhea, phenotypic, and genotypic characterization of extended-spectrum beta-lactamase (ESBL)-producing isolates in Jeddah, Saudi Arabia.
Methods Stool samples were collected and cultured to determine the different Enterobacteriaceae strains. PCR was done for the isolates to detect the different ESBLs genes and antibiotic susceptibility against different antibiotics.
Results The total number of patients in this study was 200 (114 males [5796] and 86 females [43%]). The patients were categorized to teenagers (21,10.5%), adults (92, 46%), middle age (25, 12.5%), and elderlies (25, 12.5%) according to age. Five Enterobacteriaceae strains were found: Enterobacter doaca (7, 3.5%), Escherichia toll (111, 55.5%), Klebsiella pneumoniae (75, 37.5%), Proteus mira bilis (6, 3.0%), and Pseudomonas aeruginosa (1.0, 0.5%). P aeruginosa was absent in all female patients under investigation. The response of the isolated (E. coli, K pneumoniae, and E. cloaca) strains to ampicillin, cefotaxime, cefotaxime-clavulanate, ceftriaxone, cephalothin, chloramphenicol, ciprofloxacin, nalidixic acid, streptomycin, tetracycline, and trimethoprim-sulphamethoxazole was highly resistant while the response was highly susceptible to ampicillin sulbactam, ceftazidime, ceftazidime-clavula nate, and imipenem.The most frequent gene was bla(CTX-M) (195) followed by bla(TEM )(149), bla(SHV) (73), and blo(OXA) (3), while the highest pair of genes in the same organism was bla(TEM)+bla(CTX-M) (134) followed by bla(SHV)+bla(CTX-M) (64), bla(SHV)+bla(TEM) (52), and the least pairs were bla(TEM)+bla(OXA), (3) and bla(CTX-M)+blo(OXA) (2). bla(SHV)+bla(CTX-M)+bla(TEM ) was found in 44 organisms and bla(CTX-M)+bla(TEM)+bla(OXA) in 2 organisms only. The bla(SHV)+bla(OXA), bla(SHV)+bla(CTX-M)+bla(OXA), bla(SHV)+bla(TEM)+bla(OXA) and bla(CTX-M)-bla(TEM)+bla(OXA)+bla(SHV) were not present in any organism under investigation.
Conclusions In teenager group, there were no organism that contained bla(OXA) gene, while blo(OXA) was present in E. cloaca and P mirabilis only. bla(SHV) gene was absent in E. coil but present in E. cloaca and K pneumoniae. The most susceptible group to infection with Enterobacteriaceae was adults' group, while teenage was more resist to infection.