OBJECTIVES: In the recent years, multidrug resistant (MDR) neonatal septicemia-causing Enterobacterales has been dramatically increased due to the extended-spectrum beta-lactamases (ESBLs) and AmpC enzymes. This study aimed to assess the antibiotic resistance pattern, prevalence of ESBLs/AmpC beta-lactamase genes, and Enterobacterial Repetitive Intergenic Consensus Polymerase Chain Reaction (ERIC-PCR) fingerprints in Enterobacterales isolated from neonatal sepsis. RESULTS: In total, 59 Enterobacterales isolates including 41 (69.5%) Enterobacter species, 15 (25.4%) Klebsiella pneumoniae and 3 (5.1%) Escherichia coli were isolated respectively. Resistance to ceftazidime and cefotaxime was seen in all of isolates. Furthermore, all of them were multidrug-resistant (resistant to three different antibiotic categories). The phenotypic tests showed that 100% of isolates were ESBL-positive. Moreover, AmpC production was observed in 84.7% (n = 50/59) of isolates. Among 59 ESBL-positive isolates, the highest percentage belonged to blaCTX-M-15 gene (66.1%) followed by blaCTX-M (45.8%), blaCTX-M-14 (30.5%), blaSHV (28.8%), and blaTEM (13.6%). The frequency of blaDHA, blaEBC, blaMOX and blaCIT genes were 24%, 24%, 4%, and 2% respectively. ERIC-PCR analysis revealed that Enterobacterales isolates were genetically diverse. The remarkable prevalence of MDR Enterobacterales isolates carrying ESBL and AmpC beta-lactamase genes emphasizes that efficient surveillance measures are essential to avoid the more expansion of drug resistance amongst isolates.
Anti-Bacterial Agents , Bacterial Proteins , Drug Resistance, Multiple, Bacterial , Enterobacteriaceae Infections , Microbial Sensitivity Tests , Neonatal Sepsis , beta-Lactamases , beta-Lactamases/genetics , Humans , Iran/epidemiology , Infant, Newborn , Drug Resistance, Multiple, Bacterial/genetics , Enterobacteriaceae Infections/microbiology , Enterobacteriaceae Infections/epidemiology , Anti-Bacterial Agents/pharmacology , Prevalence , Bacterial Proteins/genetics , Neonatal Sepsis/microbiology , Neonatal Sepsis/epidemiology , Enterobacteriaceae/genetics , Enterobacteriaceae/drug effects , Enterobacteriaceae/enzymology , Enterobacteriaceae/isolation & purification , Klebsiella pneumoniae/genetics , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/isolation & purification , Klebsiella pneumoniae/enzymology , Enterobacter/genetics , Enterobacter/drug effects , Enterobacter/isolation & purification , Enterobacter/enzymology , Escherichia coli/genetics , Escherichia coli/drug effects , Escherichia coli/isolation & purification
