Detection of CTX-M-15 Among Uropathogenic Escherichia coli Isolated from Five Major Hospitals in Tripoli, Libya

Abdulaziz Zorgani; Asma Almagatef; Najib Sufya; Abdulla Bashein; Abdullatif Tubbal

doi:10.5001/omj.2017.61

Detection of CTX-M-15 Among Uropathogenic Escherichia coli Isolated from Five Major Hospitals in Tripoli, Libya

Oman Med J. 2017 Jul;32(4):322-327. doi: 10.5001/omj.2017.61.

Authors

Abdulaziz Zorgani¹, Asma Almagatef², Najib Sufya², Abdulla Bashein³, Abdullatif Tubbal⁴

Affiliations

¹ Medical Microbiology, Faculty of Medicine, University of Tripoli, Tripoli, Libya.
² Microbiology Department, Faculty of Pharmacy, University of Tripoli, Tripoli, Libya.
³ Biochemistry Department, Faculty of Medicine, University of Tripoli, Tripoli, Libya.
⁴ Department of Statistics, Faculty of Science, University of Tripoli, Tripoli, Libya.

Abstract

Objectives: Multidrug resistance (MDR) and emergence of extended-spectrum β-lactamases (ESBLs) among uropathogenic Escherichia coli have been reported worldwide, but there was no information on the detection of bla_CTX-M-15 in major teaching hospitals in Libya. The aim of the study was to investigate the occurrence of CTX-M-15 β-lactamases producers isolated from five teaching hospitals in Tripoli, Libya.

Methods: A total of 346 urine samples were collected from hospitalized patients in five teaching hospitals with a diagnosis of urinary tract infection (UTI). Phenotypic confirmation of ESBLs was confirmed by E-test strip; all ESBL-producing E. coli isolates were screened for the bla_CTX-M-15 gene.

Results: The distribution of ESBL-producing E. coli varied among the five hospitals. The highest proportion was identified in Tripoli Medical Centre (67.6%). There were extremely high proportions of isolates resistant to ceftriaxone, cefepime, and ceftazidime (93.0-100.0%) among ESBL producers compared to non-ESBL producers (2.2-4.7%). MDR was detected in 22.2% of isolates. The majority of isolates (85.9%) in which bla_CTX-M-15 was identified were ESBL producers. There was a correlation (p < 0.001) between expression of CTX-M-15 and resistance to ceftazidime.

Conclusions: The isolation of MDR ESBL-producing uropathogens expressing the CTX-M-15 gene will limit the choices clinicians have to treat their patients with UTIs. Continued surveillance and implementation of efficient infection control measures are required.

Keywords: CTX-M-15 gene; E. coli; ESBL; Libya.