A survey on ESBL, MBL Enzymes, and AcrAB-TolC EffluxPump Frequency Correlation with MDR in Clinical Enterobacter spp.

Background and Aim : Enterobacter cloaca and Enterobacter aerogenes are opportunisticpathogens that cause nosocomial infections. Multidrug resistance, in particular, the presence ofExtended-spectrum beta-lactamase enzymes, Metallo-beta-lactamases, and efflux pumps haveposed major problems in treatment. The aim of this study was to evaluation of ESBL, MBLenzymes, and AcrAB-TolC efflux pump in Enterobacter isolated from hospitals of Hamadan andTehran.Methods : A total of ۴۲ isolates were identified as Enterobacter species and were evaluated forantibiotic susceptibility using the disk agar diffusion method, the MIC of cefotaxime was usingthe E-test strip. PCR method was used to identify ESBL, MBL beta-lactamase, and AcrAB-TolCefflux pump genes, using the Double-Disk Synergy Test and Imipenem-EDTA combined disc.Statistical analysis was performed using SPSS software (Version ۲۴).Results : Ceftazidime had the highest percentage of antibiotic resistance (۷۱.۵%), while TGC hadthe lowest resistance to antibiotics (۴.۶%). ۷۶% of the isolates were resistant to cefotaxime (MICtest) and ۷۴.۶% of the isolates were MDR. In phenotypic analyses, ۸۸.۵% of isolates were ESBLpositive and ۶% were MBL positive. Furthermore, PCR test results for ESBL genes revealed thatthe largest presence of genes was connected to TEM (۹۶%), SHV (۶۶%), and CTX-M (۶۸%),which were among six separate gene groups. CTX-M genes CTX-M۱ (۷۲%) and CTX-M۱۵ (۶۸%)were discovered in the isolates. Furthermore, the frequency of AcrAB-TolC efflux pump geneswas Acr-A, Tol-C, and Acr-B, ۲۸%, ۱۸% and ۱۲%, respectively.Conclusion : The high incidence of Enterobacter strains to produce ESBLs with the TEM, SHV,and CTX-M genes found in this study has been identified as a severe concern in hospitals, posingserious issues for infection management and antibiotic therapy. On the other hand, there was acorrelation between the existence of the IMP Metallo-beta-lactamase genes and the developmentof antibiotic resistance, also the presence of the AcrAB-TolC efflux pump genes. Colistin,amikacin, tigecycline, and imipenem have a low resistance to isolates and can be used to treatinfections.

کلیدواژه ها:

Enterobacter cloacae ، Enterobacter aerogenes ، ESBL ، MBL ، AcrAB-TolC ، Effluxpumps ، Biofilm