Prevalence of β-lactamases in clinical isolates of Enterobacter cloacae in the West Bank-Palestine
Publication Type
Original research

The increasing spread of  β-lactamase-producing pathogens represents an emergi ng serious public health threat
specially to treat nosocomial infections. This study was carried out to determine the prevalence and molecular
characterization of  β-lactamase-producing Enterobacter cloacae isolates ;  and to estimate the prevalence of
integrons in these isolates. A total of 41 clinical isolates of E. cloacae were recovered from different hospitals in the
North West Bank-Palestine. Enterobacter cloacae iso lates were identified using API 20E system and β-lactamase
genes (ESBL, MBL and AmpC  β-lactamase genes) detection was carried out using m ultiplex PCR technique. Results
of the current research showed that the prevalence  of β-lactamases among the studied clinical E. cloacae i solates
was (34/41) 82.9%. The prevalence of  ESBLs, MBLs a nd AmpC β-lactamase genes was 80.5%, 14.6% and 9.8%,
respectively. For ESBL, blaTEM gene was the most dominant with a prevalence rate  63.4%. Other detected genes
were 31.7%, 29.3, and 7.3% for bla OXA, blaSHV  and blaCTX-M, respectively. Coexistence of 2 ESBL genes or more  was
detected in 39% of E. cloacae isolates. For AmpC  β-lactamases only bla DHA gene was detected with a prevalence
4.9%, whereas for MBLs, the prevalence of blaIMP alone was 9.8%, blaSPM and bla IMP, and bla SIM and blaSPM together
was 2.4% for each. A total of 8 isolates (19.5%) showed coexistence w ith at least another type of  β-lactamases. In
this study, class 1 integrons were detected only in  β-lactamase-producing E. cloacae isolates with preva lence of
(17/34) 50% among  β-lactamase producers. ERIC-PCR typing of 34 clinical isolates of E. cloacae   harbored
different β-lactamase genes, were grouped into 5 ERIC PCR prof iles (clusters) at a 70% similarity level. Results of
ERIC-PCR typing showed that at lease there are 3 id entical clones circulating among these hospitals an d the
predominant clone is C1CL1. The emergence and increase of  β-lactamase-producing E. cloacae infections is
worrisome. Effective measures should be taken to control the spread  β-lactamase-producing bacteria .

International Journal of Medical Research & Health Sciences
International Journal of Medical Research & Health Sciences
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Publication Type
Online only