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Title: Characterisation of antibiotic resistance mechanisms in Gram-negative bacteria from Tripoli and Benghazi, Libya
Author: El Salabi, Allaaeddin Ali
ISNI:       0000 0004 2752 0305
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2011
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As very little information is known of the antibiotic resistance in Gram-negative bacteria in Libya in addition to the desperate need for insight knowledge of the antibiotic resistance in Libyan hospitals, this study was undertaken to investigate the mechanism of antibiotic resistance in isolates collected from clinical, non-clinical and environmental samples from Tripoli and Benghazi, Libya. Bacterial collection include samples taken from patients admitted to the hospitals in ICUs and other wards, they also include swabs randomly collected from hospitals environment. These swabs were from walls, bedsides, curtains, floors, toilets, workstations, mechanical ventilators, stainless steel containers and instruments used in particular ICUs. This study clearly demonstrates the emergence of MDR Gram-negative bacteria in Tripoli and Benghazi hospitals, these MDR bacteria were clinical and non clinical revealing the long standing infection control problem in these hospitals. K. pneumoniae was found as the most frequently isolated strain being disseminated in hospitals and outside hospitals followed by E. coli. K. pneumoniae and E. coli were detected harbouring blacjx-M group 1 in association with ISEcpl the enhancer of the p-lactamase gene movement. More importantly, &/ ctx-m-i5 in association with ISEcpl were detected carried on conjugative plasmids of different sizes and able to move via Libyan K. pneumoniae and E. coli to sensitive bacteria via conjugation. Some isolates of K. pneumoniae were clonally related and were in some cases found in different hospital revealing the outbreak of MDR K. pneumoniae in Libyan hospitals. E. coli strains showed the emergence of more than one clone in one hospital which indicates to the lack of hospital hygiene. Three novel sequence types among K. pneumoniae were discovered in this study, one of which K. pneumoniae AES817 that assigned ST511 was collected from one of Benghazi streets and was found carrying blacrx-M-is and ISEcpl on a plasmid of 400kb. Characterisation of P. aeruginosa showed the emergence of clonally related strains carrying blaym-i, one was isolated from a patient admitted to Al-Jalla hospital in Benghazi and the other from a stainless steel container from the same hospital but different ward, this MBL was found on a novel integron in both strains. Interestingly, 6/A. xylosoxidans, it is moreover the first MBL discovered in Libya.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available