PHENOTYPIC AND MOLECULAR CHARACTERIZATION OF MULTI-DRUG RESISTANT ENTEROBACTERALES ISOLATED FROM CLINICAL SAMPLES, PALESTINE.

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dc.contributor.authorIbaideya, Mamoun
dc.date.accessioned2024-12-18T07:53:33Z
dc.date.available2024-12-18T07:53:33Z
dc.date.issued2024-11-11
dc.description.abstractBackground: Infections resulting from multidrug-resistant Enterobacterales (MDRE) pose a growing global threat, presenting challenges in treatment and contributing significantly to morbidity and mortality rates. The main objective of this study was to characterize phenotypically and genetically MDRE isolated from clinical samples in the West Bank, Palestine. Methods: A cross-sectional study was conducted in October 2023 on clinical bacterial isolates collected from five governmental hospitals in the West Bank, Palestine. The isolates obtained from the microbiology laboratories of the participating hospitals, underwent identification and antibiotic susceptibility testing (AST) using the VITEK® 2 Compact system, and colistin tests. MDRE was determined by the Vitek2 Compact system. A modified carbapenem inactivation method (mCIM) was employed to identify carbapenemase-producing Enterobacterales (CPE). Resistance genes were detected by real-time PCR. Results: Out of the total 1380 collected isolates, we randomly selected 600 isolates for analysis. Our analysis indicated that 287 (47.83%) were extended-spectrum beta-lactamase producers (ESBLE), and 102 (17%) were carbapenem-resistant Enterobacterales (CRE) isolates. A total of 424 isolates (70.67%) were identified as multidrug-resistant Enterobacterales (MDRE). The most prevalent ESBL species were Klebsiella pneumoniae (n=124; 43.2%), Escherichia coli (n=119; 41.5%) and Enterobacter cloacae (n=31; 10.8%). Among the CRE isolates, 85 (83.33%) were CPE. The most frequent CRE species were K. pneumoniae (n=63; 61.7%), E. coli (n=25; 24.5%) and E. cloacae (n=13; 12.8%). Additionally, 47out of 600 (7.83%) isolates exhibited resistance to colistin, with 38 out of 101 (37.62%) being colistin-resistant CRE, and 9 out of 274 (3.3%) being colistin-resistant ESBLE. MDRE exhibited varied resistance patterns across different none ꞵ-lactam antibiotic classes. We noticed that 11 isolates (6 K. pneumoniae and 5 E. cloacae) demonstrated sensitivity to carbapenems by phenotype but carried silent CPE genes (1 blaOXA48, and 6 blaNDM, 4 blaOXA48, blaNDM). Conclusion: This study showed the high burden of the ESBLE and CRE among the samples collected from the participating hospitals. The most common species were K. pneumoniae and E. coli. There was a high prevalence of blaCTXm. Adopting both conventional and molecular techniques is essential for better surveillance of the emergence and spread of MDRE infections in Palestine.
dc.identifier.urihttps://hdl.handle.net/20.500.11888/19764
dc.language.isoen
dc.publisherAn-Najah National University
dc.supervisorQadi, Mohammad
dc.supervisorAbu Taha, Adham
dc.titlePHENOTYPIC AND MOLECULAR CHARACTERIZATION OF MULTI-DRUG RESISTANT ENTEROBACTERALES ISOLATED FROM CLINICAL SAMPLES, PALESTINE.
dc.title.alternativeاستخدام النمط الظاهري السلوكي والنمط الجزيئي الجيني للكشف عن البكتيريا المعوية المقاومة للمضادات الحيوية المعزولة من عينات المرضى في فلسطين
dc.typeThesis
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