Infective endocarditis caused by Enterobacteriaceae: phenotypic and molecular characterization of Escherichia coli and Klebsiella pneumoniae in Rio de Janeiro, Brazil

AbstractThe etiological agent for infective endocarditis (IE), a life-threatening disease, is usually gram-positive bacteria. However, gram-negative bacteria can rarely cause IE and 4% of cases are associated with morbidity and mortality. This study aimed to characterize Escherichia coli and Klebsiella pneumoniae isolates from the blood of patients with IE. The characteristics of blood isolates were compared with those of urinary isolates from patients with urinary tract infections (UTIs). The results of this study revealed that K. pneumoniae isolates from patients with IE were phylogenetically related to those from patients with UTI. Additionally, the resistance phenotype, resistance gene, virulence gene, and plasmid profiles were similar between the blood and urinary isolates. The isolates belonging to the sequence types (STs) 76, 36, 101 (K. pneumoniae), and 69 (E. coli) are reported to be associated with drug resistance. The Enterobacteriaceae isolates from patients with IE did not produce extended-spectrum β-lactamase or carbapenemase. Additionally, this study investigated the virulence phenotype, biofilm formation ability, and the ability to adhere to the epithelial cells in vitro of the isolates. The isolates from patients with IE exhibited weaker biofilm formation ability than the urinary isolates. All isolates from patients with IE could adhere to the renal epithelial cells. However, three isolates from patients with UTIs could not adhere to the epithelial cells. The closely related K. pneumoniae isolates (648, KP1, KP2, KP3, and KP4) could not form biofilms or adhere to the epithelial cells. In summary, the molecular analysis revealed that the genetic characteristics of IE-causing K. pneumoniae and E. coli were similar to those of UTI-causing isolates. These isolates belonged to the STs that are considered treatable. Genetically similar isolates did not exhibit the same virulence phenotype. Thus, these non-hypervirulent clones must be monitored as they can cause complex infections in susceptible hosts.

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Risk Factors for Amoxicillin-Clavulanate Resistance in Community-Onset Urinary Tract Infections Caused by Escherichia coli or Klebsiella pneumoniae: The Role of Prior Exposure to Fluoroquinolones

Antibiotics ◽

10.3390/antibiotics10050582 ◽

2021 ◽

Vol 10 (5) ◽

pp. 582

Author(s):

Javier Martínez-Casanova ◽

Silvia Gómez-Zorrilla ◽

Nuria Prim ◽

Agustina Dal Molin ◽

Daniel Echeverría-Esnal ◽

...

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

E Coli ◽

Amoxicillin Clavulanate ◽

Tract Infections ◽

Community Onset ◽

Urinary Isolates

Background: High rates of amoxicillin-clavulanate (AMC) resistance among Enterobacterales isolated from urinary tract infections (UTIs) were observed in our area. The aim of this study was to identify risk factors associated with AMC resistance in patients with community-onset UTI in emergency departments (EDs). Methods: A retrospective study was performed of all ED patients with positive urine cultures for Escherichia coli or Klebsiella pneumoniae in a Spanish tertiary-care hospital. Results: 330 urine cultures in all were included: 261 (79.1%) for E. coli and 69 (20.90%) for K. pneumonia. Rates of AMC resistance were 14.94% and 34.78%, respectively. UTI was clinically confirmed in 212 (64.24%) cases. Previous antimicrobial exposure was independently associated with AMC resistance development in E. coli and K. pneumoniae urinary isolates (OR = 2.94, 95% CI = 1.55–5.58). Analyses of infected patients revealed that previous exposure to fluoroquinolones (OR = 3.33, 95% CI = 1.10–10.12, p = 0.034) and to AMC (OR = 5.68, 95% CI = 1.97–16.44, p = 0.001) was significantly associated with isolation of AMC-resistant strains. Conclusions: Prior antibiotic exposure, particularly to AMC or fluoroquinolones, was the only independent risk factor associated with development of AMC resistance in E. coli and K. pneumoniae urinary isolates from patients attending the ED.

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Antimicrobial Resistance Patterns and ESBL of Uropathogens Isolated from Adult Females in Najran Region of Saudi Arabia

Clinics and Practice ◽

10.3390/clinpract11030080 ◽

2021 ◽

Vol 11 (3) ◽

pp. 650-658

Author(s):

Mohammed Yahia Alasmary

Keyword(s):

Escherichia Coli ◽

Saudi Arabia ◽

Antimicrobial Resistance ◽

Klebsiella Pneumoniae ◽

Urine Samples ◽

Klebsiella Species ◽

E Coli ◽

Government Hospitals ◽

Resistance Patterns ◽

Tract Infections

Background: To explore the prevalence of urinary tract infections (UTIs) among female patients in the Najran region of Saudi Arabia and determine their antimicrobial resistance pattern. Methods: This study was conducted on 136 urine samples collected from outpatient departments (OPDs) of the different government hospitals in the Najran region of Saudi Arabia. Over one year, the results of susceptibility testing reports of outpatient midstream urine samples from three government hospitals were prospectively evaluated. Results: Of 136 urine samples, only 123 (90.45%) were found to show significant growth for UTIs, from which 23 different uropathogens were identified. Escherichia coli (58.5%) was the most commonly isolated organism, followed by Klebsiella pneumoniae (8.1%). The isolated microorganism showed increased resistance patterns from 3.3% to 62.6%, with an overall resistance of 27.19%. Meropenem was the most effective antimicrobial, followed by amikacin and ertapenem (0.47%, 0.91%, and 1.5% resistance, respectively). At the same time, ampicillin and cephazolin were the least (62.6% and 59.5% resistance, respectively) effective. Overall, eleven (8.94%) uropathogens isolates were ESBLs, among which there were eight (6.5%) Escherichia coli, one (0.81%) Klebsiella pneumoniae, one (0.81%) Klebsiella oxytoca, and one (0.81%) Citrobacter amalonaticus. Conclusions: E. coli remains the most commonly isolated causative uropathogens, followed by Klebsiella species. The prevalence of pathogenic E. coli and Klebsiella species underscores the importance of developing cost-effective, precise, and rapid identification systems to minimize public exposure to uropathogens. Antibiotic susceptibility data revealed that most of the isolates were resistant to the majority of the antibiotics. The patients with UTIs in the Najran region of Saudi Arabia are at a high risk of antibiotic resistance, leading to significant problems in outpatient department (OPD) treatment outcomes and raising the alarm for the physician to change their empiric treatment.

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Detection of biofilm among uropathogenic Escherichia coli and its correlation with antibiotic resistance pattern

Journal of Laboratory Physicians ◽

10.4103/jlp.jlp_98_18 ◽

2019 ◽

Vol 11 (01) ◽

pp. 017-022 ◽

Cited By ~ 5

Author(s):

Rashmi M. Karigoudar ◽

Mahesh H. Karigoudar ◽

Sanjay M. Wavare ◽

Smita S. Mangalgi

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Biofilm Formation ◽

Agar Plate ◽

Diffusion Method ◽

Resistance Pattern ◽

Susceptibility Pattern ◽

Sensitivity Testing ◽

E Coli ◽

Tract Infections

Abstract BACKGROUND: Escherichia coli accounts for 70%–95% of urinary tract infections (UTIs). UTI is a serious health problem with respect to antibiotic resistance and biofilms formation being the prime cause for the antibiotic resistance. Biofilm can restrict the diffusion of substances and binding of antimicrobials. In this context, the present study is aimed to perform in vitro detection of biofilm formation among E. coli strains isolated from urine and to correlate their susceptibility pattern with biofilm formation. MATERIALS AND METHODS: A total of 100 E. coli strains isolated from patients suffering from UTI were included in the study. The identification of E. coli was performed by colony morphology, Gram staining, and standard biochemical tests. The detection of biofilm was carried out by Congo Red Agar (CRA) method, tube method (TM), and tissue culture plate (TCP) method. Antimicrobial sensitivity testing was performed by Kirby–Bauer disc diffusion method on Muller–Hinton agar plate. RESULTS: Of the 100 E. coli strains, 49 (49%) and 51 (51%) were from catheterized and noncatheterized patients, respectively. Biofilm production was positive by CRA, TM, and TCP method were 49 (49%), 55 (55%), and 69 (69%), respectively. Biofilm producers showed maximum resistance to co-trimoxazole (73.9%), gentamicin (94.2%), and imipenem (11.6%) when compared to nonbiofilm producers. Significant association was seen between resistance to antibiotic and biofilm formation with a P = 0.01 (<0.05). CONCLUSION: A greater understanding of biofilm detection in E. coli will help in the development of newer and more effective treatment. The detection of biofilm formation and antibiotic susceptibility pattern helps in choosing the correct antibiotic therapy.

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Biofilm Formation by Salmonella enterica Serovar Typhimurium and Escherichia coli on Epithelial Cells following Mixed Inoculations

Infection and Immunity ◽

10.1128/iai.73.8.5198-5203.2005 ◽

2005 ◽

Vol 73 (8) ◽

pp. 5198-5203 ◽

Cited By ~ 15

Author(s):

Cristina L. C. Esteves ◽

Bradley D. Jones ◽

Steven Clegg

Keyword(s):

Escherichia Coli ◽

Epithelial Cells ◽

Salmonella Enterica ◽

Biofilm Formation ◽

Salmonella Enterica Serovar Typhimurium ◽

E Coli ◽

Serovar Typhimurium

ABSTRACT Biofilms were formed by inoculations of Salmonella enterica serovar Typhimurium and Escherichia coli on HEp-2 cells. Inoculations of S. enterica serovar Typhimurium and E. coli resulted in the formation of an extensive biofilm of S. enterica serovar Typhimurium. In experiments where an E. coli biofilm was first formed followed by challenge with S. enterica serovar Typhimurium, there was significant biofilm formation by S. enterica serovar Typhimurium. The results of this study indicate that S. enterica serovar Typhimurium can outgrow E. coli in heterologous infections and displace E. coli when it forms a biofilm on HEp-2 cells.

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Chlorpromazine-impregnated catheters as a potential strategy to control biofilm-associated urinary tract infections

Future Microbiology ◽

10.2217/fmb-2019-0092 ◽

2019 ◽

Vol 14 (12) ◽

pp. 1023-1034 ◽

Cited By ~ 3

Author(s):

José JC Sidrim ◽

Bruno R Amando ◽

Francisco IF Gomes ◽

Marilia SMG do Amaral ◽

Paulo CP de Sousa ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

Proteus Mirabilis ◽

Biofilm Formation ◽

Antibiofilm Activity ◽

Potential Strategy ◽

Tract Infections

Aim: This study proposes the impregnation of Foley catheters with chlorpromazine (CPZ) to control biofilm formation by Escherichia coli, Proteus mirabilis and Klebsiella pneumoniae. Materials & methods: The minimum inhibitory concentrations (MICs) for CPZ and the effect of CPZ on biofilm formation were assessed. Afterward, biofilm formation and the effect of ciprofloxacin and meropenem (at MIC) on mature biofilms grown on CPZ-impregnated catheters were evaluated. Results: CPZ MIC range was 39.06–625 mg/l. CPZ significantly reduced (p < 0.05) biofilm formation in vitro and on impregnated catheters. In addition, CPZ-impregnation potentiated the antibiofilm activity of ciprofloxacin and meropenem. Conclusion: These findings bring perspectives for the use of CPZ as an adjuvant for preventing and treating catheter-associated urinary tract infections.

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Effect of Trans-Cinnamaldehyde on preformed biofilm and biofilm formation of Escherichia coli isolated from urine specimens

QJM ◽

10.1093/qjmed/hcab101 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Eman Adel El-Haddad ◽

Soha Abdel Rahman El-Hady ◽

Amira Esmail Abdel Hamid ◽

Hisham Abdel Majeed Fahim

Keyword(s):

Escherichia Coli ◽

Biofilm Formation ◽

Defense Mechanisms ◽

Colorimetric Assay ◽

Biofilm Inhibition ◽

Hospital Acquired Infection ◽

E Coli ◽

Before And After ◽

Tract Infections ◽

Hospital Acquired

Abstract Introduction Bacteria in most environments exist as communities of sessile cells in a selfproduced polymeric matrix known as biofilms. Biofilms are responsible for more than 80% of infections, including urinary tract infections (UTI). UTI is the most common hospital acquired infection, caused mainly by Escherichia coli (E.coli). E. coli can readily form biofilm in such infections, specially in the presence of indwelling urinary catheter. It’s difficult to eradicate bacteria in biofilms, since they are shielded from the host defense mechanisms as phagocytes and antibodies, as well as antibiotics. Searching for alternative or adjuvant substances for prevention and eradication of biofilm associated infections are therefore urgently needed. Aim of the work Studying the efficacy of the trans-cinnamaldehyde (TC) for preventing E. coli biofilm formation. Materials and methods Thirty isolates of E.coli were obtained from urine samples. To test the effect of TC on E.coli biofilm formation and preformed biofilms, microtitre plates (MTP) were inoculated with the isolated E.coli and were treated with different concentrations of TC and incubated at 37° C. A colorimetric assay was used to assess biofilm inhibition and inactivation and optical densities (OD) were compared before and after adding different TC concentrations. Results The mean OD of the isolated E.coli biofilms was 1.3 and significantly decreased when mixed with TC different concentrations. TC had high activity in inhibition of preformed E.coli biofilms, where no biofilm was detected on MTP treated with 1.25% and 1.5% TC. Conclusion TC inhibited the biofilm forming ability of E.coli isolates could fully inactivate formed biofilms, suggesting its possibility to be used as an anti-biofilm agent or adjuvant in preventing and treating UTI caused by biofilm producing E.coli.

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Escherichia coli DraE Adhesin-Associated Bacterial Internalization by Epithelial Cells Is Promoted Independently by Decay-Accelerating Factor and Carcinoembryonic Antigen-Related Cell Adhesion Molecule Binding and Does Not Require the DraD Invasin

Infection and Immunity ◽

10.1128/iai.00427-08 ◽

2008 ◽

Vol 76 (9) ◽

pp. 3869-3880 ◽

Cited By ~ 29

Author(s):

Natalia Korotkova ◽

Yuliya Yarova-Yarovaya ◽

Veronika Tchesnokova ◽

Nina Yazvenko ◽

Mike A. Carl ◽

...

Keyword(s):

Escherichia Coli ◽

Cell Adhesion ◽

Epithelial Cells ◽

Carcinoembryonic Antigen ◽

Host Cells ◽

Decay Accelerating Factor ◽

E Coli ◽

Related Cell ◽

Bladder Cells ◽

Tract Infections

ABSTRACT The Dr family of Escherichia coli adhesins are virulence factors associated with diarrhea and urinary tract infections. Dr fimbriae are comprised of two subunits. DraE/AfaE represents the major structural, antigenic, and adhesive subunit, which recognizes decay-accelerating factor (DAF) and carcinoembryonic antigen (CEA)-related cell adhesion molecules (CEACAMs) CEA, CEACAM1, CEACAM3, and CEACAM6 as binding receptors. The DraD/AfaD subunit caps fimbriae and has been implicated in the entry of Dr-fimbriated E. coli into host cells. In this study, we demonstrate that DAF or CEACAM receptors independently promote DraE-mediated internalization of E. coli by CHO cell transfectants expressing these receptors. We also found that DraE-positive recombinant bacteria adhere to and are internalized by primary human bladder epithelial cells which express DAF and CEACAMs. DraE-mediated bacterial internalization by bladder cells was inhibited by agents which disrupt lipid rafts, microtubules, and phosphatidylinositol 3-kinase (PI3K) activity. Immunofluorescence confocal microscopic examination of epithelial cells detected considerable recruitment of caveolin, β1 integrin, phosphorylated ezrin, phosphorylated PI3K, and tubulin, but not F-actin, by cell-associated bacteria. Finally, we demonstrate that the DraD subunit, previously implicated as an “invasin,” is not required for β1 integrin recruitment or bacterial internalization.

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Poloxamer 338 Affects Cell Adhesion and Biofilm Formation in Escherichia coli: Potential Applications in the Management of Catheter-Associated Urinary Tract Infections

Pathogens ◽

10.3390/pathogens9110885 ◽

2020 ◽

Vol 9 (11) ◽

pp. 885

Author(s):

Mariarita Stirpe ◽

Benedetta Brugnoli ◽

Gianfranco Donelli ◽

Iolanda Francolini ◽

Claudia Vuotto

Keyword(s):

Escherichia Coli ◽

Cell Adhesion ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Biofilm Formation ◽

Attenuated Total Reflection ◽

Water Contact ◽

E Coli ◽

Static Conditions ◽

Tract Infections

Poloxamers are nontoxic, amphiphilic copolymers used in different formulations. Due to its surfactant properties, Poloxamer 338 (P388) is herein proposed as a strategy to avoid biofilm formation often causing recalcitrant catheter-associated urinary tract infections (CAUTI). The aim is to evaluate the ability of P388 coatings to affect the adhesion of Ec5FSL and Ec9FSL Escherichia coli strains on silicone urinary catheters. Attenuated total reflection infrared spectroscopy, atomic force microscopy, and static water contact angle measurement were employed to characterize the P388-coated silicone catheter in terms of amount of P388 layered, coating thickness, homogeneity, and hydrophilicity. In static conditions, the antifouling power of P388 was defined by comparing the E. coli cells adherent on a hydrophilic P388-adsorbed catheter segment with those on an uncoated one. A P388-coated catheter, having a homogeneous coverage of 35 nm in thickness, reduced of 0.83 log10 and 0.51 log10 the biofilm of Ec5FSL and Ec9FSL, respectively. In dynamic conditions, the percentage of cell adhesion on P388-adsorbed silicone channels was investigated by a microfluidic system, simulating the in vivo conditions of catheterized patients. As a result, both E. coli isolates were undetected. The strong and stable antifouling property against E. coli biofilm lead us to consider P388 as a promising anti-biofilm agent for CAUTIs control.

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Identification of Type 3 Fimbriae in Uropathogenic Escherichia coli Reveals a Role in Biofilm Formation

Journal of Bacteriology ◽

10.1128/jb.01523-07 ◽

2007 ◽

Vol 190 (3) ◽

pp. 1054-1063 ◽

Cited By ~ 66

Author(s):

Cheryl-Lynn Y. Ong ◽

Glen C. Ulett ◽

Amanda N. Mabbett ◽

Scott A. Beatson ◽

Richard I. Webb ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Biofilm Formation ◽

Klebsiella Oxytoca ◽

The United States ◽

Conjugative Plasmid ◽

Biofilm Growth ◽

Indwelling Catheters ◽

E Coli ◽

Type 3

ABSTRACT Catheter-associated urinary tract infection (CAUTI) is the most common nosocomial infection in the United States. Uropathogenic Escherichia coli (UPEC), the most common cause of CAUTI, can form biofilms on indwelling catheters. Here, we identify and characterize novel factors that affect biofilm formation by UPEC strains that cause CAUTI. Sixty-five CAUTI UPEC isolates were characterized for phenotypic markers of urovirulence, including agglutination and biofilm formation. One isolate, E. coli MS2027, was uniquely proficient at biofilm growth despite the absence of adhesins known to promote this phenotype. Mini-Tn5 mutagenesis of E. coli MS2027 identified several mutants with altered biofilm growth. Mutants containing insertions in genes involved in O antigen synthesis (rmlC and manB) and capsule synthesis (kpsM) possessed enhanced biofilm phenotypes. Three independent mutants deficient in biofilm growth contained an insertion in a gene locus homologous to the type 3 chaperone-usher class fimbrial genes of Klebsiella pneumoniae. These type 3 fimbrial genes (mrkABCDF), which were located on a conjugative plasmid, were cloned from E. coli MS2027 and could complement the biofilm-deficient transconjugants when reintroduced on a plasmid. Primers targeting the mrkB chaperone-encoding gene revealed its presence in CAUTI strains of Citrobacter koseri, Citrobacter freundii, Klebsiella pneumoniae, and Klebsiella oxytoca. All of these mrkB-positive strains caused type 3 fimbria-specific agglutination of tannic acid-treated red blood cells. This is the first description of type 3 fimbriae in E. coli, C. koseri, and C. freundii. Our data suggest that type 3 fimbriae may contribute to biofilm formation by different gram-negative nosocomial pathogens.

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Apple Flavonoid Phloretin Inhibits Escherichia coli O157:H7 Biofilm Formation and Ameliorates Colon Inflammation in Rats

Infection and Immunity ◽

10.1128/iai.05580-11 ◽

2011 ◽

Vol 79 (12) ◽

pp. 4819-4827 ◽

Cited By ~ 94

Author(s):

Jin-Hyung Lee ◽

Sushil Chandra Regmi ◽

Jung-Ae Kim ◽

Moo Hwan Cho ◽

Hyungdon Yun ◽

...

Keyword(s):

Escherichia Coli ◽

Epithelial Cells ◽

Biofilm Formation ◽

Pathogenic Bacteria ◽

Antimicrobial Agents ◽

Trinitrobenzene Sulfonic Acid ◽

Content Type ◽

E Coli ◽

Colon Inflammation ◽

K 12

ABSTRACTPathogenic biofilms have been associated with persistent infections due to their high resistance to antimicrobial agents, while commensal biofilms often fortify the host's immune system. Hence, controlling biofilm formation of both pathogenic bacteria and commensal bacteria is important in bacterium-related diseases. We investigated the effect of plant flavonoids on biofilm formation of enterohemorrhagicEscherichia coliO157:H7. The antioxidant phloretin, which is abundant in apples, markedly reducedE. coliO157:H7 biofilm formation without affecting the growth of planktonic cells, while phloretin did not harm commensalE. coliK-12 biofilms. Also, phloretin reducedE. coliO157:H7 attachment to human colon epithelial cells. Global transcriptome analyses revealed that phloretin repressed toxin genes (hlyEandstx2), autoinducer-2 importer genes (lsrACDBF), curli genes (csgAandcsgB), and dozens of prophage genes inE. coliO157:H7 biofilm cells. Electron microscopy confirmed that phloretin reduced fimbria production inE. coliO157:H7. Also, phloretin suppressed the tumor necrosis factor alpha-induced inflammatory responsein vitrousing human colonic epithelial cells. Moreover, in the rat model of colitis induced by trinitrobenzene sulfonic acid (TNBS), phloretin significantly ameliorated colon inflammation and body weight loss. Taken together, our results suggest that the antioxidant phloretin also acts as an inhibitor ofE. coliO157:H7 biofilm formation as well as an anti-inflammatory agent in inflammatory bowel diseases without harming beneficial commensalE. colibiofilms.

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