scholarly journals The Clinical and Molecular Epidemiology of CTX-M-9 Group Producing Enterobacteriaceae infections in children

2018 ◽  
Author(s):  
Latania K. Logan ◽  
Rachel L. Medernach ◽  
T. Nicholas Domitrovic ◽  
Jared R. Rispens ◽  
Andrea M. Hujer ◽  
...  
Keyword(s):  
Dna Analysis ◽  
Multivariable Analysis ◽  
Antibiotic Use ◽  
Resistant Bacteria ◽  
Unexpected Finding ◽  
Control Analysis ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

AbstractBackgroundThe pandemic of extended-spectrum-beta-lactamase (ESBL)-producing-Enterobacteriaceae (Ent) is strongly linked to the dissemination of CTX-M-type-ESBL-Ent. We sought to define the epidemiology of infections in children due to an emerging resistance type, CTX-M-9-group-producing-Ent (CTX-M-9-grp-Ent).MethodsA multi-centered case-control analysis of Chicago children with CTX-M-9-grp-Ent infections was performed. Cases were defined as children possessing extended-spectrum-cephalosporin-resistant (ESC-R) infections. PCR and DNA analysis assessed beta-lactamase (bla) genes, multi-locus sequence types (MLST) and phylogenetic grouping of E. coli. Controls were children with ESC-susceptible (ESC-S)-Ent infections matched 3:1 by age, source, and hospital. The clinical-epidemiologic predictors of CTX-M-9-grp-Ent infection were assessed.ResultsOf 356 ESC-R-Ent isolates from children (median age 4.1 years), CTX-M-9-group was the solely detected bla gene in 44(12.4%). The predominant species was E. coli (91%) of virulent phylogroups D(60%) and B2(40%). MLST revealed multiple strain types. On multivariable analysis, CTX-M-9-grp-Ent occurred more often in E. coli (OR 7.0), children of non-black-white-Hispanic race (OR 6.5), and outpatients (OR 4.5) which was a very unexpected finding for infections due to antibiotic-resistant bacteria. Residents of South Chicago were 6.7 times more likely to have CTX-M-9-grp-Ent infections than those in the reference region (West), while residence in Northwestern Chicago was associated with an 81% decreased risk. Other demographic, comorbidity, invasive-device, and antibiotic use differences were not found.ConclusionsCTX-M-9-grp-Ent infection is strikingly associated with patient residence and is occurring in children without traditional in-patient exposure risk factors. This suggests that among children, the community environment may be a key contributor in the spread of these resistant pathogens.

scholarly journals Extended-Spectrum Beta-Lactamase-Producing Escherichia coli Meningitis and Cerebral Abscess in a Neonate: Therapeutic Challenge

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Surasak Puvabanditsin ◽  
Marianne Jacob ◽  
Maaz Jalil ◽  
Samhita Bhattarai ◽  
Qaiser Patel ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Agents ◽  
Cerebral Abscess ◽  
Term Neonate ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Therapeutic Challenge ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

We report a case of a 12-day-old term neonate with extended-spectrum beta-lactamase (ESBL) producing Escherichia coli (E. coli) meningitis and cerebral abscess. The patient received a 7-day course of antibiotics just few days prior to the infection. The incidence of infections from ESBL-producing E. coli is increasingly emerging. Antimicrobial agents must be vigilantly utilized to prevent the new highly resistant bacteria.

scholarly journals Extended-spectrum beta-lactamase and ampicillin Class C beta lactamase-producing Escherichia coli from food animals: A review

2019 ◽  
pp. 65-75 ◽  
Author(s):  
Asinamai Athliamai Bitrus ◽  
Peter Anjili Mshelia ◽  
Iliya Dauda Kwoji ◽  
Mohammed Dauda Goni ◽  
Saleh Mohammed Jajere
Keyword(s):  
Public Health ◽  
Escherichia Coli ◽  
Health Concern ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Care Providers ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Class C

Antimicrobial resistance has gained global notoriety due to its public health concern, the emergence of multiple drug-resistant bacteria, and lack of new antimicrobials. Extended-spectrum beta-lactamase (ESBL)/ampicillin Class C (AmpC)- producing Escherichia coli and other zoonotic pathogens can be transmitted to humans from animals either through the food chain, direct contact or contamination of shared environments. There is a surge in the rate of resistance to medically important antibiotics such as carbapenem, ESBL, aminoglycosides, and fluoroquinolones among bacteria of zoonotic importance. Factors that may facilitate the occurrence, persistence and dissemination of ESBL/AmpC-Producing E. coli in humans and animal includes; 1). o ral administration of antimicrobials to humans primarily (by physician and health care providers) and secondarily to animals, 2). importation of parent stock and day-old chickens, 3). farm management practice and lack of water acidification in poultry, 4). contamination of feed, water and environment, 5). contamination of plants with feces of animals. Understanding these key factors will help reduce the level of resistance, thereby boosting the therapeutic effectiveness of antimicrobial agents in the treatment of animal and human infections. This review highlights the occurrence, risk factors, and public health importance of ESBL/AmpC-beta-lactamase producing E. coli isolated from livestock.

scholarly journals Carriage of Extended-Spectrum-Beta-Lactamase- and AmpC Beta-Lactamase-Producing Escherichia coli Strains from Humans and Pets in the Same Households

2020 ◽  
Vol 86 (24) ◽  
Author(s):  
Leah J. Toombs-Ruane ◽  
Jackie Benschop ◽  
Nigel P. French ◽  
Patrick J. Biggs ◽  
Anne C. Midwinter ◽  
...  
Keyword(s):  
Index Case ◽  
Companion Animals ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Content Type ◽  
Beta Lactamases ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Tract Infections

ABSTRACT Extended-spectrum-beta-lactamase (ESBL)- or AmpC beta-lactamase (ACBL)-producing Escherichia coli bacteria are the most common cause of community-acquired multidrug-resistant urinary tract infections (UTIs) in New Zealand. The carriage of antimicrobial-resistant bacteria has been found in both people and pets from the same household; thus, the home environment may be a place where antimicrobial-resistant bacteria are shared between humans and pets. In this study, we sought to determine whether members (pets and people) of the households of human index cases with a UTI caused by an ESBL- or ACBL-producing E. coli strain also carried an ESBL- or ACBL-producing Enterobacteriaceae strain and, if so, whether it was a clonal match to the index case clinical strain. Index cases with a community-acquired UTI were recruited based on antimicrobial susceptibility testing of urine isolates. Fecal samples were collected from 18 non-index case people and 36 pets across 27 households. Eleven of the 27 households screened had non-index case household members (8/18 people and 5/36 animals) positive for ESBL- and/or ACBL-producing E. coli strains. Whole-genome sequence analysis of 125 E. coli isolates (including the clinical urine isolates) from these 11 households showed that within seven households, the same strain of ESBL-/ACBL-producing E. coli was cultured from both the index case and another person (5/11 households) or pet dog (2/11 households). These results suggest that transmission within the household may contribute to the community spread of ESBL- or ACBL-producing E. coli. IMPORTANCE Enterobacteriaceae that produce extended-spectrum beta-lactamases (ESBLs) and AmpC beta-lactamases (ACBLs) are important pathogens and can cause community-acquired illnesses, such as urinary tract infections (UTIs). Fecal carriage of these resistant bacteria by companion animals may pose a risk for transmission to humans. Our work evaluated the sharing of ESBL- and ACBL-producing E. coli isolates between humans and companion animals. We found that in some households, dogs carried the same strain of ESBL-producing E. coli as the household member with a UTI. This suggests that transmission events between humans and animals (or vice versa) are likely occurring within the home environment and, therefore, the community as a whole. This is significant from a health perspective, when considering measures to minimize community transmission, and highlights that in order to manage community spread, we need to consider interventions at the household level.

scholarly journals Antibiogram of Extended Spectrum Beta-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae isolated from Hospital Samples

1970 ◽  
Vol 4 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Iraj Alipourfard ◽  
Nilufar Yeasmin Nili
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Diffusion Method ◽  
Resistant Bacteria ◽  
Molecular Characteristics ◽  
Significant Implication ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

Extended spectrum beta-lactmase (ESBL) producing organisms create a major problem for clinical therapeutics. The frequency of ESBL producing strains among clinical isolates has been steadily increasing over the past few years resulting in limitation of the therapeutic options. These resistant bacteria are emerging world wide as a threat to human health in both the community and hospital settings. -lactamase production by several organisms is the most important mechanism of resistance to beta-lactam antibiotics, such as penicillins and cephalosporins. This study was done to determine the susceptibility of different antimicrobials to ESBL producing Escherichia coli and Klebsiella pneumoniae isolated from wound swabs, blood, urine, fluid, tracheal aspirates and sputum in Shahid Bahonar Hospital of Tehran from July, 2007 to June, 2008. A total of 115 ESBLproducing isolates were obtained from outdoor and indoor patients. Out of 115 isolates, 60% were E. coli and 40% were K. pneumoniae. All ESBL-producing isolates were confirmed using the Clinical and Laboratory Standards Institute (CLSI)-approved double-disk diffusion method. 29.6% of these isolates were collected from medical wards and 24.3% were collected from outdoor. Urine (70.4%) was the main source of ESBL-producing isolates from all patients, followed by blood (16.5%). All isolates were susceptible to both imipenem and meropenem. Of all isolates, 93.9% were susceptible to amikacin. The cephalosporins (1-4 generations) were almost 100% resistant. For Nitrofurantoin, 57.4% were sensitive. High rate resistance (74.8%) was observed to all quinolones tested. Aztreonam, Ampicillin, Co-amoxyclav and Ampicillin/Sulbactam were 100% resistant. This study shows that the frequency of ESBL producing strains of E. coli and K. pneumoniae is high in both hospital and community levels and it has a significant implication for patients’ management. Advance drug resistance surveillance and molecular characteristics of ESBL isolates is necessary to guide the appropriate and judicious antibiotic use. Key words: Extended spectrum beta-lactamase (ESBL), Drug sensitivity, Escherichia coli, Klebseilla pneumoniae DOI: http://dx.doi.org/10.3329/bjmm.v4i1.8467 BJMM 2011; 4(1): 32-36  

scholarly journals The prevalence of extended spectrum bêta-lactamase-producing Escherichia coli isolated in wastewater in relation to patients hospitalized in the city of Meknes in Morocco

2021 ◽  
Vol 319 ◽  
pp. 02014
Author(s):  
Khadija Ouarrak ◽  
Abdelkader Chahlaoui ◽  
Hajar El Omari ◽  
Imane Taha ◽  
Rachid Sammoudi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Animal Health ◽  
Hospitalized Patients ◽  
Fecal Coliforms ◽  
Resistant Bacteria ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
The City

The present study was conducted to better understand the specific contingency of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) isolated from urban waters of Wadi Ouislane of the city of Meknes, compared to isolates from patients hospitalized in the resuscitation department at Mohamed V Hospital in Meknes, Morocco. These antibiotic-resistant bacteria have become ubiquitous in effluents, creating increasing concern about their potential impact on human and animal health and the environment. We took four samples of wastewater representative of a day, effluents of the wadi Ouislane. They were analyzed for indicator germs of fecal pollution, namely total coliforms (TC) and fecal coliforms (FC). Bacteria were enumerated by the dilution-filtration technique and by incorporation in solid medium in supercooling. However, four bacteriological samples, taken for clinical purposes from hospitalized patients, were performed at the medical analysis laboratory of Mohamed V Hospital in Meknes. Analysis of our results showed that ESBL-producing E. coli bacteria isolated from our effluents had the same antibiotic resistance profiles as those from hospitalized patients. Urban wastewater discharges into the environment contribute to the dissemination of extended-spectrum beta-lactamase-producing Escherichia coli that may pose health risks to the population.

scholarly journals Community origins and regional differences highlight risk of plasmid-mediated fluoroquinolone resistant Enterobacteriaceae infections in children

2018 ◽  
Author(s):  
Latania K. Logan ◽  
Rachel L. Medernach ◽  
Jared R. Rispens ◽  
Steven H. Marshall ◽  
Andrea M. Hujer ◽  
...  
Keyword(s):  
Dna Analysis ◽  
Strong Association ◽  
Multivariable Analysis ◽  
Gene Mutations ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Multidrug Resistant ◽  
Control Analysis ◽  
E Coli ◽  
Enterobacteriaceae Infections

AbstractBackground:Fluoroquinolones (FQs) are uncommonly prescribed in children, yet pediatric multidrug-resistant (MDR)-Enterobacteriaceae (Ent) infections often reveal FQ resistance (FQR). We sought to define the molecular epidemiology of FQR and MDR-Ent in children.Methods:A case-control analysis of children with MDR-Ent infections at 3 Chicago hospitals was performed. Cases were children with third-generation-cephalosporin-resistant (3GCR) and/or carbapenem-resistant (CR)-Ent infections. PCR and DNA analysis assessed bla and plasmid-mediated FQR (PMFQR) genes. Controls were children with 3GC and carbapenem susceptible-Ent infections matched by age, source and hospital. We assessed clinical-epidemiologic predictors of PMFQR Ent infection.Results:Of 169 3GCR and/or CR Ent isolates from children (median age 4.8 years), 85 were FQR; 56 (66%) contained PMFQR genes. The predominant organism was E. coli and most common bla gene blaCTX-M-1 group. In FQR isolates, PMFQR gene mutations included aac6’1b-cr, oqxA/B, qepA, and qnrA/B/D/S in 83%, 15%, 13% and 11% of isolates, respectively. FQR E. coli was often associated with phylogroup B2, ST43/ST131. On multivariable analysis, PMFQR Ent infections occurred mostly in outpatients (OR 33.1) of non-black-white-Hispanic race (OR 6.5). Residents of Southwest Chicago were >5 times more likely to have PMFQR-Ent infections than those in the reference region, while residence in Central Chicago was associated with a 97% decreased risk. Other demographic, comorbidity, invasive-device, antibiotic use, or healthcare differences were not found.Conclusions:The strong association of infection with MDROs showing FQR with patient residence rather than with traditional risk factors suggests that the community environment is a major contributor to spread of these pathogens in children.

scholarly journals Competition between Escherichia coli Populations with and without Plasmids Carrying a Gene Encoding Extended-Spectrum Beta-Lactamase in the Broiler Chicken Gut

2019 ◽  
Vol 85 (17) ◽  
Author(s):  
Egil A. J. Fischer ◽  
Cindy M. Dierikx ◽  
Alieda van Essen-Zandbergen ◽  
Dik Mevius ◽  
Arjan Stegeman ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Competitive Exclusion ◽  
Antibiotic Use ◽  
Beta Lactamase ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Plasmid Carriage

ABSTRACT Extended-spectrum-beta-lactamase (ESBL)/AmpC-producing Escherichia coli strains are widely found in E. coli isolates from broiler feces, largely due to the presence of the blaCTX-M-1 gene on IncI1 plasmids. Plasmid carriage is theorized to cause fitness loss and thus should decrease under conditions of reduced antibiotic use. However, in vitro studies showed plasmid carriage to increase in the absence of antimicrobials, due to plasmid conjugation. We investigated whether this translates to increased levels of plasmid in the gastrointestinal tracts of chickens, where conjugation rates may be different and subtle differences in growth rates may have a larger impact on colonization. Eight groups of five chickens were orally inoculated at 4 days of age with a 0.5-ml volume containing 106 CFU/ml E. coli cells, of which 0%, 0.1%, 10%, or 100% carried the IncI1 plasmid with the gene blaCTX-M-1. At 13 time points during 41 days, fecal samples were taken from each chicken. E. coli strains with and without plasmids were quantified. Trends in E. coli subpopulations were analyzed using generalized linear mixed models, and population dynamics were studied by fitting to a mechanistic model. Trends in E. coli subpopulations were different between groups rather than between individual chickens, suggesting substantial levels of E. coli exchange between chickens in a group. The IncI1 plasmid carrying blaCTX-M-1 was transferred with conjugation coefficients at levels higher than those observed in vitro. Across groups, the plasmids disappeared or were established independently of the initial fraction of plasmid-carrying E. coli, but no major increase occurred as observed in vitro. Differences in growth rates were observed, but competitive exclusion of plasmid-carrying variants was counteracted by conjugation. IMPORTANCE Bacteria that produce extended-spectrum beta-lactamases are resistant to an important class of antimicrobials in human and veterinary medicine. Reduction in antibiotic use is expected to decrease the prevalence of resistance. However, resistance genes often lie on plasmids which can be copied and transferred to other bacteria by conjugation, so in vitro resistance was observed to increase in the absence of antimicrobials. We sought to determine whether this also occurs in the chicken gut and if competitive exclusion by similar E. coli variants without the resistance occurred. We studied the excretion of E. coli carrying IncI1 plasmids with the blaCTX-M-1 resistance gene in small groups of broiler chickens, after inoculating the chickens with E. coli suspensions containing different fractions of plasmid-carrying cells. Our results showed little variation between chickens within groups but large differences between groups that were independent of the ratio of variants with and without the plasmid and with persistence or extinction of the plasmid. However, there was no major plasmid increase as observed in vitro. We conclude that in vivo studies with sufficient independent replications are important for intervention studies on plasmid-mediated antimicrobial resistance.

scholarly journals Multidrug-Resistant, Including Extended-Spectrum Beta Lactamase-Producing and Quinolone-Resistant, Escherichia coli Isolated from Poultry and Domestic Pigs in Dar es Salaam, Tanzania

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 406
Author(s):  
Zuhura I. Kimera ◽  
Fauster X. Mgaya ◽  
Gerald Misinzo ◽  
Stephen E. Mshana ◽  
Nyambura Moremi ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistant ◽  
Antibiotics Resistance ◽  
Beta Lactamase ◽  
Domestic Pigs ◽  
Extended Spectrum Beta Lactamase ◽  
Phenotypic Profile ◽  
E Coli ◽  
Extended Spectrum ◽  
Esbl Producers

We determined the phenotypic profile of multidrug-resistant (MDR) Escherichia coli isolated from 698 samples (390 and 308 from poultry and domestic pigs, respectively). In total, 562 Enterobacteria were isolated. About 80.5% of the isolates were E. coli. Occurrence of E. coli was significantly higher among domestic pigs (73.1%) than in poultry (60.5%) (p = 0.000). In both poultry and domestic pigs, E. coli isolates were highly resistant to tetracycline (63.5%), nalidixic acid (53.7%), ampicillin (52.3%), and trimethoprim/sulfamethoxazole (50.9%). About 51.6%, 65.3%, and 53.7% of E. coli were MDR, extended-spectrum beta lactamase-producing enterobacteriaceae (ESBL-PE), and quinolone-resistant, respectively. A total of 68% of the extended-spectrum beta lactamase (ESBL) producers were also resistant to quinolones. For all tested antibiotics, resistance was significantly higher in ESBL-producing and quinolone-resistant isolates than the non-ESBL producers and non-quinolone-resistant E. coli. Eight isolates were resistant to eight classes of antimicrobials. We compared phenotypic with genotypic results of 20 MDR E. coli isolates, ESBL producers, and quinolone-resistant strains and found 80% harbored blaCTX-M, 15% aac(6)-lb-cr, 10% qnrB, and 5% qepA. None harbored TEM, SHV, qnrA, qnrS, qnrC, or qnrD. The observed pattern and level of resistance render this portfolio of antibiotics ineffective for their intended use.

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