Surveillance of Enterobacteriaceae from Diabetic Foot Infections in a Tunisian Hospital: Detection of E. coli-ST131-blaCTX-M-15 and K. pneumoniae-ST1-blaNDM-1 Strains

  1. Arfaoui, Ameni 3
  2. Martínez-Álvarez, Sandra 1
  3. Abdullahi, Idris Nasir 1
  4. Fethi, Meha 3
  5. Sayem, Noureddine 2
  6. Melki, Salma Ben Khelifa 2
  7. Ouzari, Hadda-Imene 3
  8. Torres, Carmen 1
  9. Klibi, Naouel 3
  1. 1 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

  2. 2 Service of Biology, International Hospital Center Carthagene of Tunisia, Tunis, Tunisia.
  3. 3 Université de Tunis El Manar
    info

    Université de Tunis El Manar

    Túnez, Túnez

    ROR https://ror.org/029cgt552

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Revista:
Microbial Drug Resistance

ISSN: 1076-6294,  1931-8448

Año de publicación: 2024

Tipo: Artículo

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DOI: 10.1089/MDR.2023.0335 GOOGLE SCHOLAR

Otras publicaciones en: Microbial Drug Resistance

Resumen

The study determined the prevalence, antimicrobial resistant (AMR) determinants, and genetic characteristics of Escherichia coli and Klebsiella pneumoniae isolates from patients with diabetic foot infection (DFI) in a Tunisian hospital. A total of 26 Escherichia spp. and Klebsiella spp. isolates were recovered and identified by MALDI-TOF-MS. Antimicrobial susceptibility testing, the detection of AMR determinants and Shiga-like toxin genes, phylogenetic grouping, and molecular typing were performed. Twelve E. coli, 10 K. pneumoniae, 3 K. oxytoca, and 1 E. hermanii were isolated. A multidrug-resistant phenotype was detected in 65.4% of the isolates. About 30.8% of isolates were extended-spectrum β-lactamase (ESBL) producers and mainly carried blaCTX-M-15 and blaCTX-M-14 genes. One blaNDM-1-producing K. pneumoniae-ST1 strain was identified. Class 1 integrons were detected in 11 isolates and 5 gene cassette arrangements were noted: dfrA1+aadA1 (n = 1), dfrA12+aadA2 (n = 3), and dfrA17+aadA5 (n = 1). Other non-β-lactam resistance genes detected were as follows (number of isolates): aac(3')-II (3), aac(6')–Ib-cr(8), qnrB (2), qnrS (4), cmlA (2), floR (4), sul1 (11), sul2 (11), and sul3 (2). The phylogroup B1 was the most frequent (41.7%) among E. coli, and two ESBL-producing isolates corresponded to the ST131-B2 lineage. The ESBL- and carbapenemase-producing Enterobacteriaceae in DFIs are described for the first time in Tunisia.

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