National Prevalence of Resistance to Third-Generation Cephalosporins in Escherichia coli Isolates from Layer Flocks in France

ABSTRACTResistance ofEscherichia colito third-generation cephalosporin (3GC) in fecal samples representative of French egg production was studied. The susceptibility to cefotaxime ofE. coliisolates obtained by culture on nonselective media was determined. Twenty-two nonsusceptible isolates were obtained (7.51%; 95% confidence interval, 4.49 to 10.54%), the majority of which came from young birds. Most isolates carried ablaCTX-M-1group gene, and a few carried ablaCMY-2-like gene. Control of 3GC resistance in laying hens is needed.

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Characterization of Third-Generation-Cephalosporin-Resistant Shiga Toxin-Producing Strains of Escherichia coli O157:H7 in Japan

Journal of Clinical Microbiology ◽

10.1128/jcm.01263-15 ◽

2015 ◽

Vol 53 (9) ◽

pp. 3035-3038 ◽

Cited By ~ 5

Author(s):

Ryuji Kawahara ◽

Kazuko Seto ◽

Masumi Taguchi ◽

Chie Nakajima ◽

Yuko Kumeda ◽

...

Keyword(s):

Escherichia Coli ◽

Shiga Toxin ◽

Generation Cephalosporin ◽

Escherichia Coli O157 ◽

Third Generation ◽

Content Type ◽

Resistant Strains ◽

Third Generation Cephalosporins

We isolated Shiga toxin-producingEscherichia coliO157:H7 strains resistant to third-generation cephalosporins. The resistant strains harboredblaCMY-2, a plasmid-mediated AmpC β-lactamase. Genotyping of isolates revealed the possible spread of this problematic bacterium. Results suggested the importance of the investigation and surveillance of enterobacteria with plasmids harboringblaCMY-2.

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Intrathecal Administration of Amikacin for Treatment of Meningitis Secondary to Cephalosporin-Resistant Escherichia Coli

Annals of Pharmacotherapy ◽

10.1177/106002809302700709 ◽

1993 ◽

Vol 27 (7-8) ◽

pp. 870-873 ◽

Cited By ~ 19

Author(s):

Sandra L. Preston ◽

Laurie L. Briceland

Keyword(s):

Escherichia Coli ◽

Bacterial Resistance ◽

Generation Cephalosporin ◽

Intrathecal Administration ◽

Neurosurgical Procedures ◽

Third Generation ◽

E Coli ◽

Efficacious Treatment ◽

Clonic Seizures ◽

Third Generation Cephalosporins

OBJECTIVE: To report a case of gram-negative bacillary meningitis (GNBM) secondary to cephalosporin-resistant Escherichia coli that was treated with intrathecal and intravenous amikacin and intravenous imipenem/cilastatin (I/C). CASE SUMMARY: A patient who had undergone two recent neurosurgical procedures developed GNBM and bacteremia. He was treated empirically with ceftazidime. Both bloodstream and cerebrospinal fluid isolates were identified as E. coli, resistant to third-generation cephalosporins, penicillins, tobramycin, and gentamicin. The patient was subsequently treated with intravenous and intrathecal amikacin plus intravenous I/C He experienced subjective and objective improvement on days 2–4 of antimicrobial therapy; two generalized tonic-clonic seizures occurred on days 7 and 12. Intrathecal amikacin was discontinued after 6 days, and intravenous amikacin and I/C were discontinued after 23 and 27 days, respectively. The patient's mental status did not completely return to premeningitis baseline. DISCUSSION: Third-generation cephalosporins are the treatment of choice for GNBM. In the case reported herein, bacterial resistance to these agents prompted the use of a therapy that has not been well studied and is also considered to be less safe and perhaps less efficacious. Treatment of GNBM with an intrathecally administered aminoglycoside or with intravenous I/C plus an aminoglycoside is reviewed. CONCLUSIONS: Patients with GNBM secondary to third-generation cephalosporin-resistant organisms may require therapies that may be less effective and more toxic. Further study of alternative agents is warranted.

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Molecular Epidemiology of Escherichia coli Producing CTX-M and pAmpC β-Lactamases from Dairy Farms Identifies a Dominant Plasmid Encoding CTX-M-32 but No Evidence for Transmission to Humans in the Same Geographical Region

Applied and Environmental Microbiology ◽

10.1128/aem.01842-20 ◽

2020 ◽

Vol 87 (1) ◽

Author(s):

Jacqueline Findlay ◽

Oliver Mounsey ◽

Winnie W. Y. Lee ◽

Nerissa Newbold ◽

Katy Morley ◽

...

Keyword(s):

Escherichia Coli ◽

Geographical Location ◽

Dairy Farms ◽

Generation Cephalosporin ◽

Sequencing Analysis ◽

Third Generation ◽

Content Type ◽

E Coli ◽

Animal Populations ◽

Close Relatives

ABSTRACT Third-generation cephalosporin resistance (3GC-R) in Escherichia coli is a rising problem in human and farmed-animal populations. We conducted whole-genome sequencing analysis of 138 representative 3GC-R isolates previously collected from dairy farms in southwest England and confirmed by PCR to carry acquired 3GC-R genes. This analysis identified blaCTX-M (131 isolates encoding CTX-M-1, -14, -15, -and 32 and the novel variant CTX-M-214), blaCMY-2 (6 isolates), and blaDHA-1 (1 isolate). A highly conserved plasmid was identified in 73 isolates, representing 27 E. coli sequence types. This novel ∼220-kb IncHI2 plasmid carrying blaCTX-M-32 was sequenced to closure and designated pMOO-32. It was found experimentally to be stable in cattle and human transconjugant E. coli even in the absence of selective pressure and was found by multiplex PCR to be present on 26 study farms representing a remarkable range of transmission over 1,500 square kilometers. However, the plasmid was not found among human urinary E. coli isolates we recently characterized from people living in the same geographical location, collected in parallel with farm sampling. There were close relatives of two blaCTX-M plasmids circulating among eight human and two cattle isolates, and a closely related blaCMY-2 plasmid was found in one cattle and one human isolate. However, phylogenetic evidence of recent sharing of 3GC-R strains between farms and humans in the same region was not found. IMPORTANCE Third-generation cephalosporins (3GCs) are critically important antibacterials, and 3GC resistance (3GC-R) threatens human health, particularly in the context of opportunistic pathogens such as Escherichia coli. There is some evidence for zoonotic transmission of 3GC-R E. coli through food, but little work has been done examining possible transmission via interaction of people with the local near-farm environment. We characterized acquired 3GC-R E. coli found on dairy farms in a geographically restricted region of the United Kingdom and compared these with E. coli from people living in the same region, collected in parallel. While there is strong evidence for recent farm-to-farm transmission of 3GC-R strains and plasmids—including one epidemic plasmid that has a remarkable capacity to be transmitted—there was no evidence that 3GC-R E. coli found on study farms had a significant impact on circulating 3GC-R E. coli strains or plasmids in the local human population.

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Impact of Third-Generation-Cephalosporin Administration in Hatcheries on Fecal Escherichia coli Antimicrobial Resistance in Broilers and Layers

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.03106-14 ◽

2014 ◽

Vol 58 (9) ◽

pp. 5428-5434 ◽

Cited By ~ 41

Author(s):

Sandrine Baron ◽

Eric Jouy ◽

Emeline Larvor ◽

Florent Eono ◽

Stéphanie Bougeard ◽

...

Keyword(s):

Escherichia Coli ◽

Generation Cephalosporin ◽

Third Generation ◽

Macconkey Agar ◽

Content Type ◽

E Coli ◽

Resistant Strains ◽

The Impact ◽

Selection Of

ABSTRACTWe investigated the impact of the hatchery practice of administering third-generation cephalosporin (3GC) on the selection and persistence of 3GC-resistantEscherichia coliin poultry. We studied 15 3GC-treated (TB) and 15 non-3GC-treated (NTB) broiler flocks and 12 3GC-treated (TL) and 10 non-3GC-treated (NTL) future layer flocks. Fecal samples from each flock were sampled before arrival on the farm (day 0), on day 2, on day 7, and then twice more.E. coliisolates were isolated on MacConkey agar without antibiotics and screened for 3GC resistance, and any 3GC-resistantE. coliisolates were further analyzed. 3GC-resistantE. coliisolates were found in all 3GC-treated flocks on at least one sampling date. The percentages of 3GC-resistantE. coliisolates were significantly higher in TB (41.5%) than in NTB (19.5%) flocks and in TL (49.5%) than in NTL (24.5%) flocks. In the day 2 samples, more than 80% of theE. colistrains isolated were 3GC resistant. 3GC-resistantE. colistrains were still detected at the end of the follow-up period in 6 out of 27 3GC-treated and 5 out of 25 non-3GC-treated flocks. Many 3GC-resistantE. colistrains were resistant to tetracycline, and there were significant differences in the percentages of resistance to sulfamethoxazole-trimethoprim, streptomycin, or gentamicin between treated and nontreated flocks.blaCTX-MandblaCMY-2were the most frequently detected genes. These results clearly demonstrated that 3GC-resistant strains are introduced early in flocks and that the use of 3GC in hatcheries promotes the selection of 3GC-resistantE. coli. Measures must be implemented to avoid the spread and selection of 3GC-resistant strains.

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Occurrence of Antimicrobial-Resistant Escherichia coli and Salmonella enterica in the Beef Cattle Production and Processing Continuum

Applied and Environmental Microbiology ◽

10.1128/aem.03079-14 ◽

2014 ◽

Vol 81 (2) ◽

pp. 713-725 ◽

Cited By ~ 44

Author(s):

John W. Schmidt ◽

Getahun E. Agga ◽

Joseph M. Bosilevac ◽

Dayna M. Brichta-Harhay ◽

Steven D. Shackelford ◽

...

Keyword(s):

Escherichia Coli ◽

Salmonella Enterica ◽

Generation Cephalosporin ◽

Resistant Bacteria ◽

Processing Plant ◽

Cattle Production ◽

Content Type ◽

E Coli ◽

Beef Processing ◽

Tract Infections

ABSTRACTSpecific concerns have been raised that third-generation cephalosporin-resistant (3GCr)Escherichia coli, trimethoprim-sulfamethoxazole-resistant (COTr)E. coli, 3GCrSalmonella enterica, and nalidixic acid-resistant (NALr)S. entericamay be present in cattle production environments, persist through beef processing, and contaminate final products. The prevalences and concentrations of these organisms were determined in feces and hides (at feedlot and processing plant), pre-evisceration carcasses, and final carcasses from three lots of fed cattle (n= 184). The prevalences and concentrations were further determined for strip loins from 103 of the carcasses. 3GCrSalmonellawas detected on 7.6% of hides during processing and was not detected on the final carcasses or strip loins. NALrS. entericawas detected on only one hide. 3GCrE. coliand COTrE. coliwere detected on 100.0% of hides during processing. Concentrations of 3GCrE. coliand COTrE. colion hides were correlated with pre-evisceration carcass contamination. 3GCrE. coliand COTrE. coliwere each detected on only 0.5% of final carcasses and were not detected on strip loins. Five hundred and 42 isolates were screened for extraintestinal pathogenicE. coli(ExPEC) virulence-associated markers. Only two COTrE. coliisolates from hides were ExPEC, indicating that fed cattle products are not a significant source of ExPEC causing human urinary tract infections. The very low prevalences of these organisms on final carcasses and their absence on strip loins demonstrate that current sanitary dressing procedures and processing interventions are effective against antimicrobial-resistant bacteria.

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Outbreak of CTX-M-15-Producing Enterotoxigenic Escherichia coli O159:H20 in the Republic of Korea in 2016

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00339-17 ◽

2017 ◽

Vol 61 (9) ◽

Cited By ~ 3

Author(s):

Jin Seok Kim ◽

Jungsun Park ◽

Eunkyung Shin ◽

Soojin Kim ◽

Sung Suck Oh ◽

...

Keyword(s):

Escherichia Coli ◽

High School ◽

Food Samples ◽

Enterotoxigenic Escherichia Coli ◽

Republic Of Korea ◽

Third Generation ◽

Content Type ◽

The Republic ◽

Third Generation Cephalosporins

ABSTRACT We investigated an outbreak of enterotoxigenic Escherichia coli (ETEC) O159:H20 associated with the consumption of a tossed-noodle dish in a high school in 2016. Thirty-three ETEC strains isolated from clinical and food samples were genetically indistinguishable. The outbreak strains were resistant to third-generation cephalosporins and harbored a bla CTX-M-15 gene on a 97-kb self-transferable IncK plasmid. This is the first outbreak caused by CTX-M-15-producing ETEC strains.

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Clinical and Economic Impact of Third-Generation Cephalosporin-Resistant Infection or Colonization Caused by Escherichia coli and Klebsiella pneumoniae: A Multicenter Study in China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249285 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9285

Author(s):

Xuemei Zhen ◽

Cecilia Stålsby Lundborg ◽

Xueshan Sun ◽

Xiaoqian Hu ◽

Hengjin Dong

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Hospital Mortality ◽

Multicenter Study ◽

Generation Cephalosporin ◽

Total Hospital Cost ◽

Third Generation ◽

E Coli ◽

Significant Difference ◽

The Impact

Quantifying economic and clinical outcomes for interventions could help to reduce third-generation cephalosporin resistance and Escherichia coli or Klebsiella pneumoniae. We aimed to compare the differences in clinical and economic burden between third-generation cephalosporin-resistant E. coli (3GCREC) and third-generation cephalosporin-susceptible E. coli (3GCSEC) cases, and between third-generation cephalosporin-resistant K. pneumoniae (3GCRKP) and third-generation cephalosporin-susceptible K. pneumoniae (3GCSKP) cases. A retrospective and multicenter study was conducted. We collected data from electronic medical records for patients who had clinical samples positive for E. coli or K. pneumoniae isolates during 2013 and 2015. Propensity score matching (PSM) was conducted to minimize the impact of potential confounding variables, including age, sex, insurance, number of diagnoses, Charlson comorbidity index, admission to intensive care unit, surgery, and comorbidities. We also repeated the PSM including length of stay (LOS) before culture. The main indicators included economic costs, LOS and hospital mortality. The proportions of 3GCREC and 3GCRKP in the sampled hospitals were 44.3% and 32.5%, respectively. In the two PSM methods, 1804 pairs and 1521 pairs were generated, and 1815 pairs and 1617 pairs were obtained, respectively. Compared with susceptible cases, those with 3GCREC and 3GCRKP were associated with significantly increased total hospital cost and excess LOS. Inpatients with 3GCRKP were significantly associated with higher hospital mortality compared with 3GCSKP cases, however, there was no significant difference between 3GCREC and 3GCSEC cases. Cost reduction and outcome improvement could be achieved through a preventative approach in terms of both antimicrobial stewardship and preventing the transmission of organisms.

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Comparative Genomic Analysis of Third-Generation-Cephalosporin-Resistant Escherichia coli Harboring the blaCMY-2-Positive IncI1 Group, IncB/O/K/Z, and IncC Plasmids Isolated from Healthy Broilers in Japan

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02385-19 ◽

2020 ◽

Vol 64 (7) ◽

Cited By ~ 2

Author(s):

Takahiro Shirakawa ◽

Tsuyoshi Sekizuka ◽

Makoto Kuroda ◽

Satowa Suzuki ◽

Manao Ozawa ◽

...

Keyword(s):

Escherichia Coli ◽

Phylogenetic Analysis ◽

Gene Clustering ◽

Comparative Genomic ◽

Third Generation ◽

Chromosomal Dna ◽

In Ovo ◽

Content Type ◽

E Coli ◽

Network Analyses

ABSTRACT The off-label use of third-generation cephalosporins (3GCs) during in ovo vaccination or vaccination of newly hatched chicks has been a common practice worldwide. CMY-2-producing Escherichia coli strains have been disseminated in broiler chicken production. The objective of this study was to determine the epidemiological linkage of blaCMY-2-positive plasmids among broilers both within and outside Japan, because the grandparent stock and parent stock were imported into Japan. We examined the whole-genome sequences of 132 3GC-resistant E. coli isolates collected from healthy broilers during 2002 to 2014. The predominant 3GC resistance gene was blaCMY-2, which was detected in the plasmids of 87 (65.9%) isolates. The main plasmid replicon types were IncI1-Iγ (n = 21; 24.1%), IncI (n = 12; 13.8%), IncB/O/K/Z (n = 28; 32.2%), and IncC (n = 22; 25.3%). Those plasmids were subjected to gene clustering, network analyses, and plasmid multilocus sequence typing (pMLST). The chromosomal DNA of isolates was subjected to MLST and single-nucleotide variant (SNV)-based phylogenetic analysis. MLST and SNV-based phylogenetic analysis revealed high diversity of E. coli isolates. The sequence type 429 (ST429) cluster harboring blaCMY-2-positive IncB/O/K/Z was closely related to isolates from broilers in Germany harboring blaCMY-2-positive IncB/O/K/Z. pST55-IncI, pST12-IncI1-Iγ, and pST3-IncC were prevalent in western Japan. pST12-IncI1-Iγ and pST3-IncC were closely related to plasmids detected in E. coli isolates from chickens in North America, whereas 26 IncB/O/K/Z types were related to those in Europe. These data will be useful to reveal the whole picture of transmission of CMY-2-producing bacteria inside and outside Japan.

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Impact of restriction of third generation cephalosporins on the burden of third generation cephalosporin resistant K. pneumoniae and E. coli in an ICU

Intensive Care Medicine ◽

10.1007/s00134-008-1355-6 ◽

2008 ◽

Vol 35 (5) ◽

pp. 862-870 ◽

Cited By ~ 20

Author(s):

Elisabeth Meyer ◽

Matthias Lapatschek ◽

Andreas Bechtold ◽

Gerhard Schwarzkopf ◽

Petra Gastmeier ◽

...

Keyword(s):

Generation Cephalosporin ◽

Third Generation ◽

E Coli ◽

Third Generation Cephalosporins

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Role of Ceftiofur in Selection and Dissemination of blaCMY-2-Mediated Cephalosporin Resistance in Salmonella enterica and Commensal Escherichia coli Isolates from Cattle

Applied and Environmental Microbiology ◽

10.1128/aem.02435-08 ◽

2009 ◽

Vol 75 (11) ◽

pp. 3648-3655 ◽

Cited By ~ 56

Author(s):

Joshua B. Daniels ◽

Douglas R. Call ◽

Dale Hancock ◽

William M. Sischo ◽

Katherine Baker ◽

...

Keyword(s):

Escherichia Coli ◽

The United States ◽

Generation Cephalosporin ◽

Plasmid Transfer ◽

Third Generation ◽

Antimicrobial Drugs ◽

E Coli ◽

History Of ◽

Cephalosporin Resistance

ABSTRACT Third-generation cephalosporin resistance of Salmonella and commensal Escherichia coli isolates from cattle in the United States is predominantly conferred by the cephamycinase CMY-2, which inactivates β-lactam antimicrobial drugs used to treat a wide variety of infections, including pediatric salmonellosis. The emergence and dissemination of bla CMY-2 --bearing plasmids followed and may in part be the result of selection pressure imposed by the widespread utilization of ceftiofur, a third-generation veterinary cephalosporin. This study assessed the potential effects of ceftiofur on bla CMY-2 transfer and dissemination by (i) an in vivo experimental study in which calves were inoculated with competent bla CMY-2-bearing plasmid donors and susceptible recipients and then subjected to ceftiofur selection and (ii) an observational study to determine whether ceftiofur use in dairy herds is associated with the occurrence and frequency of cephalosporin resistance in Salmonella and commensal E. coli. The first study revealed bla CMY-2 plasmid transfer in both ceftiofur-treated and untreated calves but detected no enhancement of plasmid transfer associated with ceftiofur treatment. The second study detected no association (P = 0.22) between ceftiofur use and either the occurrence of ceftiofur-resistant salmonellosis or the frequency of cephalosporin resistance in commensal E. coli. However, herds with a history of salmonellosis (including both ceftiofur-resistant and ceftiofur-susceptible Salmonella isolates) used more ceftiofur than herds with no history of salmonellosis (P = 0.03) These findings fail to support a major role for ceftiofur use in the maintenance and dissemination of bla CMY-2-bearing plasmid mediated cephalosporin resistance in commensal E. coli and in pathogenic Salmonella in these dairy cattle populations.

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