High frequency and molecular characterization of ESBL-producing Enterobacteriaceae isolated from wound infections in North Lebanon

ABSTRACT

Background

Extended-spectrum beta-lactamases producing Enterobacteriaceae (ESBL-PE) represent a major problem in wound infections. Here, we investigated the prevalence and molecular characterization of ESBL-PE associated with wound infections in North Lebanon.

Research design and methods

A total of 103 non-duplicated E. coli and K. pneumoniae strains isolated from 103 patients with wound infections, were collected from seven hospitals in North Lebanon. ESBL-producing isolates were detected using a double-disk synergy test. In addition, multiplex polymerase chain reaction (PCR) was used for the molecular detection of ESBLs genes.

Results

E. coli was the predominant bacteria (77.6%), followed by K. pneumoniae (22.3%). The overall prevalence of ESBL-PE was 49%, with a significantly higher rate among females and elderly patients. K. pneumoniae was the common MDR and ESBL-producer bacteria (86.95% and 52.17%) compared to E. coli (77.5% and 47.5%). Most of the isolated ESBL producers harbored multiple resistant genes (88%), where bla_CTX-M was the most predominant gene (92%), followed by bla_TEM (86%), bla_SHV (64%), and bla_OXA genes (28%).

Conclusions

This is the first data on the ESBL-PE prevalence associated with wound infections in Lebanon, showing the emergence of multidrug-resistant ESBL-PE, the dominance of multiple gene producers, and the widespread dissemination of bla_CTX-M and bla_TEM genes.

KEYWORDS:

• Extended-Spectrum Beta-Lactamases producing Enterobacteriaceae (ESBL-PE)
• Lebanon
• Multidrug-resistant
• Wound infection
• blaCTX-M

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Declaration of interest

Peer reviewers in this manuscript have no relevant financial relationships or otherwise to disclose.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14787210.2023.2234082

Author’s contribution

This work was carried out in collaboration between both authors. Author ‘Afnan Mozhar Hamwi’ collected data, wrote the manuscript, and performed the statistical analysis. Author ‘Elie Salem-Sokhn’ supervised the overall work, corrected and proofread the manuscript. Both authors agreed on the journal ‘Expert Review of Anti-infective Therapy’ to which the article will be submitted. They reviewed and agreed on all versions of the article before submission, during revision, the final version was accepted for publication, and any significant changes introduced at the proofing stage. In addition, both authors agreed to take responsibility and be accountable for the contents of the article and to share responsibility to resolve any questions raised about the accuracy or integrity of the published work.

Ethics statement

The research protocol was reviewed and approved by the Institutional Review Board (IRB) Committee of Beirut Arab University. All data were kept confidential and patients identifying information was removed.

Additional information

Funding

This paper was not funded.