ArticleBMC infectious diseases2016
Neonatal infections with multidrug-resistant ESBL-producing E. cloacae and K. pneumoniae in Neonatal Units of two different Hospitals in Antananarivo, Madagascar.
Article in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed, 29 citations in OpenAlex.
- The Role of Neonatal Ward Environment as a Reservoir for the Dissemination of Multidrug-Resistant Klebsiella pneumoniae in Algeria.MicrobiologyOpen · 2026Article
- Risk factors for neonatal multidrug-resistant Gram-negative bacilli infection in a neonatal intensive care unit in South China: a 5-year clinical analysis.BMC pediatrics · 2026Article
- Neonatal Infections Caused by Multidrug-Resistant Bacteria: An Analysis of Prevalence, Risk Factors, and Therapeutic Implications-A Narrative Review.Pathogens (Basel, Switzerland) · 2026Review
- Molecular and clinical insights into extended-spectrum β-lactamase genes of Klebsiella pneumoniae isolated from neonatal sepsis in Ethiopia.BMC infectious diseases · 2024Article
- ESBL-Type and AmpC-Type Beta-Lactamases in Third Generation Cephalosporin-ResistantAnimals : an open access journal from MDPI · 2024Article
- Observational
- Observational
- Article
- Neonatal multidrug-resistant gram-negative infection: epidemiology, mechanisms of resistance, and management.Pediatric research · 2022Review
- Antimicrobial Resistance among Neonates with Bacterial Sepsis and Their Clinical Outcomes in a Tertiary Hospital in Kathmandu Valley, Nepal.Tropical medicine and infectious disease · 2021Article
- Risk Factors of Extended-Spectrum β-Lactamase Producing Enterobacteriaceae Occurrence in Farms in Reunion, Madagascar and Mayotte Islands, 2016-2017.Veterinary sciences · 2018Article
- TheInternational journal of genomics · 2018Article
- Transmission Dynamics of Hyper-Endemic Multi-Drug ResistantFrontiers in microbiology · 2018Article
- The potential role of microbiota for controlling the spread of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) in neonatal population.F1000Research · 2017Review
- Review of Antibiotic Resistance in the Indian Ocean Commission: A Human and Animal Health Issue.Frontiers in public health · 2017Review
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe investigated the molecular mechanism of ß-lactam resistance in extended-spectrum ß-lactamase (ESBL)-producing Enterobacterial strains isolated in neonatal units of different hospitals in Anatnanarivo, Madagascar.
methodsBacteria were identified by standard biochemical methods, disc diffusion antibiograms and Etest. Resistance genes were sought by PCR. Strains were characterized by Rep-PCR (Diversilab), plasmid analysis and rep-typing.
resultsFrom April 2012 to March 2013, 29 ESBL-producing E. cloacae and 15 K. pneumoniae were isolated from blood culture (n = 32) or gastric samples (n = 12) performed at day 0 or 2 from 39/303 newborns suspected of early neonatal infection. These infants were treated with expanded spectrum cephalosporins, due to lack of carbapenems, leading to a high mortality rate (45 %). Isolates recovered were all, but 4, multidrug resistant, particularly to fluoroquinolones (FQ) except for 21 E. cloacae isolates. Isolates produced TEM-1 and CTX-M-15 ß-lactamases and their genes were located on several self-transferable plasmids of variable sizes sizes that could not be linked to a major plasmid incompatibility group. E. cloacae isolates belonged to 6 Rep-types among which two counted for 11 isolates each. The FQ resistant E. cloacae isolates belonged to one clone, whereas the FQ susceptible E. cloacae isolates belonged to four clones. The K. pneumoniae isolates belonged to 9 Rep-types among which one included five isolates.
conclusionThis study is the first molecular characterization of ESBL-producing isolates from neonatology units in Madagascar, a country with limited epidemiological data. It revealed an important multi-clonal dissemination of CTX-M-15-producing isolates reflecting both the high community carriage and the very early nosocomial contamination of the neonates.
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