title: Characterization of extended-spectrum β-lactamase (ESBL)-producing Klebsiella, Enterobacter, and Citrobacter obtained in environmental samples of a Tunisian hospital.
abstract: The assessment of the hospital environment as a reservoir of ESBL-producing Enterobacteriaceae in Tunisian hospitals is scarcely analyzed, except for Escherichia coli. The aim of this study was to evaluate the presence of ESBL-producing non-E. coli Enterobacteriaceae (ESBL-EbNoEc) in 300 samples of abiotic surfaces and the hands of patients and staff of a Tunisian Hospital, and to characterize the ESBL genes of the recovered isolates. ESBL-EbNoEc were recovered in 28 of 300 (9.3%) analyzed samples and were identified as Klebsiella pneumoniae (n= 11), Enterobacter cloacae (n=11), Citrobacter freundii (n=4) and Klebsiella oxytoca (n=2). The bla genes identified by PCR and sequencing among the strains were as follows: 11 K.pneumoniae strains [blaCTX-M-15+ blaTEM-1+ blaSHV-11 (n=6); blaCTX-M-15+ blaTEM-1+ blaSHV-28 (n=3); blaCTX-M-15+ blaTEM-1+ blaSHV-1 (n=2)], 11 E. cloacae strains [blaCTX-M-15 (n=6); blaCTX-M-15+ blaTEM-1b (n=2); blaCTX-M-15+ blaTEM-1b+ blaOXA-1 (n=1);blaCTX-M-15+ blaOXA-1 (n=1);blaSHV-12 (n=1)], 4 C. freundii strains [blaCTX-M-15] and 2 K. oxytoca strains [blaCTX-M-15 (n=1); blaSHV-12 (n=1)]. The ISEcp1 and orf477 sequences were identified upstream and downstream of the blaCTX-M-15 gene, respectively, in 3 K. pneumoniae and 3 E. cloacae isolates. The PFGE analysis demonstrated three unrelated pulsotypes in K. pneumoniae strains and five pulsotypes in E. cloacae. The uncontrolled dissemination of ESBL-producing bacteria, even in the hospital environment, has become a real problem and new strategies and hygienic rules are needed to stop this bacterial dissemination.
authors: Laboratoire des Microorganismes et Biomolécules actives, Faculté des Sciences de Tunis, Université de Tunis El Manar, 2092 Tunis, Tunisie.
authors: Raoudha
authors: R
authors: Dziri
authors: Laboratoire des Microorganismes et Biomolécules actives, Faculté des Sciences de Tunis, Université de Tunis El Manar, 2092 Tunis, Tunisie.
authors: Naouel
authors: N
authors: Klibi
authors: Area de Bioquímica y Biología Molecular, Universidad de La Rioja, 26006 Logroño, Spain.
authors: Carla Andrea
authors: CA
authors: Alonso
authors: Laboratoire des Microorganismes et Biomolécules actives, Faculté des Sciences de Tunis, Université de Tunis El Manar, 2092 Tunis, Tunisie.
authors: Leila Ben
authors: LB
authors: Said
authors: Service d'hygiène hospitalière et de protection de l'environnement, Hôpital Militaire de Tunis HMPIT, Tunis, Tunisie.
authors: Ridha
authors: R
authors: Bellaaj
authors: Laboratoire des Microorganismes et Biomolécules actives, Faculté des Sciences de Tunis, Université de Tunis El Manar, 2092 Tunis, Tunisie; Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El Manar, Tunis, Tunisie.
authors: Karim Ben
authors: KB
authors: Slama
authors: Laboratoire des Microorganismes et Biomolécules actives, Faculté des Sciences de Tunis, Université de Tunis El Manar, 2092 Tunis, Tunisie.
authors: Abdellatif
authors: A
authors: Boudabous
authors: Area de Bioquímica y Biología Molecular, Universidad de La Rioja, 26006 Logroño, Spain. Electronic address: carmen.torres@unirioja.es.
authors: Carmen
authors: C
authors: Torres
mesh_terms: D002954:Citrobacter / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D004754:Enterobacter / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D004783:Environmental Microbiology; D005838:Genotype; D006225:Hand / Q000382:microbiology; D006282:Health Personnel; D006761:Hospitals; D006801:Humans; D007709:Klebsiella / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D010361:Patients; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014416:Tunisia; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D001618:beta-Lactamases
keywords: CTX-M; ESBL; Enterobacter; Hospital environment; Klebsiella; Tunisia