Research Article Phenotypic and Genotypic Characterization of Extended- Spectrum Beta-Lactamases Produced by Escherichia coli Colonizing Pregnant Women Nahed Ghaddar, 1 Elie Anastasiadis, 2,3 Rawad Halimeh , 2 Ali Ghaddar, 4 Ghassan M. Matar, 5 Antoine Abou Fayad, 5 Nour Sherri, 5 Rita Dhar , 6 Wadha AlFouzan, 6,7 Hoda Yusef, 1 and Mira El Chaar 8 1 Faculty of Science, Biological Sciences Department, Beirut Arab University, Beirut, Lebanon 2 Department of Obstetrics and Gynecology, Saint George Hospital, Beirut, Lebanon 3 Faculty of Medicine, University of Balamand, Beirut, Lebanon 4 Department of Biomedical Sciences, Lebanese International University, Beirut, Lebanon 5 Dept. of Experimental Pathology, Immunology and Microbiology, Center for Infectious Diseases Research, WHO Collaborating Center for Reference & Research on Bacterial Pathogens, Faculty of Medicine, American University of Beirut, Beirut, Lebanon 6 Microbiology Unit, Department of Laboratories, Farwania Hospital, Kuwait 7 Department of Microbiology, Health Sciences Center, Kuwait University, Kuwait 8 Faculty of Health Sciences, University of Balamand, Beirut, Lebanon Correspondence should be addressed to Mira El Chaar; mira.elchaar@balamand.edu.lb Received 5 August 2019; Accepted 12 October 2019; Published 23 January 2020 Academic Editor: David Baker Copyright © 2020 Nahed Gaddar et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Introduction. Infections caused by extended spectrum beta lactamase (ESBL) producing bacteria continue to be a challenge for choosing the appropriate therapy since they may exhibit coresistance to many other classes of antibiotics. e aim of the study was to screen pregnant women for ESBL producing bacteria in Beirut, Lebanon, to examine their phenotypic and genotypic characterization and to study the association between ESBL colonization with adverse neonatal outcomes. Method. In this cross-sectional study, vaginal samples from 308 pregnant women at 35–37 weeks of gestation were studied during a one-year period. e samples were plated on MacConkey agar and selective MacConkey agar supplemented with ceſtazidime. Phenotypic confirmation of ESBL production was performed by double-disc synergy test and all isolates were screened by PCR for the resistance genes bla SHV , bla TEM , and bla CTX-M . Clonal relatedness of Escherichia coli isolates was investigated by pulsed-field gel electrophoresis. Results. In total, 59 women out of 308 (19.1%) were colonized by ESBL producing gram negative bacteria. Two babies born to mothers colonized with ESBL were diagnosed with sepsis. e susceptibility rates of isolates to other antibiotics were 39% to co-trimoxazole, 49.2% to ciprofloxacin, 91.5% to gentamicin, 18.6% to aztreonam and 35.6% to cefepime. Most of isolates were highly sensitive to meropenem and imipenem, with a susceptibility of 93.2%. PCR was performed on all E. coli isolates to detect the most common ESBL producing genes; bla CTX-M was the predominant gene (90.7%), followed by bla TEM (88.4%) and finally bla SHV (44.2%). PFGE analysis of 34 E. coli isolates revealed 22 distinct clusters showing more than 85% similarity. Conclusion. In conclusion, this study showed that Lebanon has a high prevalence of ESBL carriage in pregnant women. Further studies that include a continuous screening of pregnant women and follow up of their newborn clinical status should be conducted to foresee the risk of transmission. 1. Introduction Neonatal sepsis is a blood infection that occurs during the first month aſter birth. Early onset neonatal sepsis (EOS) is consid- ered the main cause of mortality and morbidity in neonates [1]. It occurs in the first three days of life and usually transmit- ted from mother to baby during delivery [1]. e infection may be also transmitted vertically when the amniotic membrane ruptures or prior to the onset of labor causing intra amniotic infection [1, 2]. e organisms most frequently associated with Hindawi Infectious Diseases in Obstetrics and Gynecology Volume 2020, Article ID 4190306, 7 pages https://doi.org/10.1155/2020/4190306