A Case of Bacteremia and Meningitis Associated with Piperacillin-Tazobactam Nonsusceptible, Ceftriaxone Susceptible Escherichia coli during Strongyloides Hyperinfection in an Immunocompromised Host

Strongyloidiasis is an emerging parasitic infection with intriguing epidemiology, presentation, and clinical management. We report a case of hyperinfection syndrome complicated by E. coli bacteremia and meningitis with one of the isolates showing a unique resistance pattern recently being recognized. This report describes the aspect of invasive bacterial infections in strongyloidiasis and highlights the unique susceptibility pattern of the E. coli isolate and the extreme caution required during the antibiotic therapy.

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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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Antimicrobial resistance in fecal Escherichia coli and Salmonella enterica isolates: a two-year prospective study of small poultry flocks in Ontario, Canada

BMC Veterinary Research ◽

10.1186/s12917-019-2187-z ◽

2019 ◽

Vol 15 (1) ◽

Cited By ~ 3

Author(s):

Csaba Varga ◽

Michele T. Guerin ◽

Marina L. Brash ◽

Durda Slavic ◽

Patrick Boerlin ◽

...

Keyword(s):

Escherichia Coli ◽

Multidrug Resistance ◽

Bacterial Infections ◽

Animal Health ◽

Enteric Bacteria ◽

Positive Sample ◽

Resistance Pattern ◽

Resistant Bacteria ◽

E Coli ◽

Game Bird

Abstract Background Although keeping small poultry flocks is increasingly popular in Ontario, information on the antimicrobial susceptibility of enteric bacteria of such flocks is lacking. The current study was conducted on small poultry flocks in Ontario between October 2015 and September 2017, and samples were submitted on a voluntary basis to Ontario’s Animal Health Laboratory. From each submission, a pooled cecal sample was obtained from all the birds of the same species from the same flock and tested for the presence of two common enteric pathogens, E. coli and Salmonella. Three different isolates from each E. coli-positive sample and one isolate from each Salmonella-positive sample were selected and tested for susceptibility to 14 antimicrobials using a broth microdilution technique. Results A total of 433 fecal E. coli isolates (358 chicken, 27 turkey, 24 duck, and 24 game bird) and 5 Salmonella isolates (3 chicken, 1 turkey, and 1 duck) were recovered. One hundred and sixty-seven chicken, 5 turkey, 14 duck, and 15 game bird E. coli isolates were pan-susceptible. For E. coli, a moderate to high proportion of isolates were resistant to tetracycline (43% chicken, 81% turkey, 42% duck, and 38% game bird isolates), streptomycin (29% chicken, 37% turkey, and 33% game bird isolates), sulfonamides (17% chicken, 37% turkey, and 21% duck isolates), and ampicillin (16% chicken and 41% turkey isolates). Multidrug resistance was found in 37% of turkey, 20% of chicken, 13% of duck, and 8% of game bird E. coli isolates. Salmonella isolates were most frequently resistant to streptomycin, tetracycline, and sulfonamides. Resistance to cephalosporins, carbapenems, macrolides, and quinolones was infrequent in both E. coli and Salmonella isolates. Cluster and correlation analyses identified streptomycin-tetracycline-sulfisoxazole-trimethoprim-sulfamethoxazole as the most common resistance pattern in chicken E. coli isolates. Turkey E. coli isolates compared to all the other poultry species had higher odds of resistance to tetracycline and ampicillin, and a higher multidrug resistance rate. Conclusions Escherichia coli isolates were frequently resistant to antimicrobials commonly used to treat poultry bacterial infections, which highlights the necessity of judicious antimicrobial use to limit the emergence of multidrug resistant bacteria.

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Escherichia coli of Ready-to-Eat (RTE) Meats Origin Showed Resistance to Antibiotics Used by Farmers

Antibiotics ◽

10.3390/antibiotics9120869 ◽

2020 ◽

Vol 9 (12) ◽

pp. 869

Author(s):

Abdulai Abass ◽

Frederick Adzitey ◽

Nurul Huda

Keyword(s):

Escherichia Coli ◽

Clavulanic Acid ◽

Bacterial Infections ◽

Tertiary Education ◽

Antibiotic Usage ◽

Diffusion Method ◽

Resistance Pattern ◽

Disk Diffusion Method ◽

E Coli ◽

Amoxicillin Clavulanic Acid

Bacterial foodborne infections, including meat-derived infections, are globally associated with diseases and some deaths. Antibiotics are sometimes used to treat bacterial infections. The use of antibiotics by farmers contributes to the development of resistance by foodborne pathogens. This study aimed to investigate the antibiotics used by farmers and the occurrence of antibiotic-resistant Escherichia coli in ready-to-eat (RTE) meat sources. Data was obtained from livestock farmers through the administration of semistructured questionnaires (n = 376) to obtain information on their demographics, knowledge and antibiotic usage. The procedure in the USA Food and Drug Administration (FDA)’s Bacteriological Analytical Manual was used for E. coli detection. Antibiotic resistance test was performed using the disk diffusion method. The findings revealed that most of the farmers were male (74.5%), were aged 30−39 years (28.5%), had tertiary education (30.3%) and had 6−10 years of experience in livestock husbandry. Sheep (65.7%) were the most reared livestock, and antibiotics were mostly used to treat sick animals (36.7%). Tetracycline (27.7%) was the most common antibiotic used by farmers, followed by amoxicillin/clavulanic acid (18.6%) and trimethoprim/sulfamethoxazole (11.7%). Most farmers (56.1%) said they had knowledge of antibiotic usage. The prevalence of E. coli in RTE meats was lowest in pork (6.0%) and highest in chevon (20.0%). E. coli isolates from RTE meats were highly resistant to teicoplanin (96.77%), tetracycline (93.55%), amoxicillin/clavulanic (70.97%), azithromycin (70.97%) and trimethoprim/sulfamethoxazole (58.06%) but was susceptible to chloramphenicol (93.55%), ciprofloxacin (61.29%) and ceftriaxone (58.06%). The multiple antibiotic index ranged from 0.22 to 0.78. Multidrug resistance (93.55%) was high among the E. coli isolates. The resistance pattern AmcAzmTecTeSxt (amoxicillin/clavulanic acid–azithromycin–telcoplanin–tetracycline–trimethoprim/sulfamethoxazole) was the most common. The use of antibiotics by farmers must be well regulated. Sellers of RTE meats also ought to take hygiene practices seriously to keep meat safe and healthy for public consumption.

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Study of Multidrug Resistance Pattern among Escherichia coli isolated from patients with Urinary tract infection

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2016.v9i6.13961 ◽

2016 ◽

Vol 9 (6) ◽

pp. 157

Author(s):

Soniya Goyal ◽

Vikas Beniwal

Keyword(s):

Escherichia Coli ◽

Multidrug Resistance ◽

Urinary Tract ◽

Bacterial Infections ◽

Multidrug Resistant ◽

Resistance Pattern ◽

Male Population ◽

Antimicrobial Drugs ◽

E Coli ◽

Tract Infections

Objective: Urinary tract infections (UTIs) are some of the most common bacterial infections encountered in community and cause of significant morbidity and high medical cost. Escherichia coli is the most common pathogen belongs to Enterobacteriaceae family responsible for majority of UTI infections. Antimicrobial drugs have been routinely prescribed for empirical treatment of UTIs which has led to a dramatic increase in antibiotic resistance pattern of E. coli. The aim of present study was to analyse the multidrug resistance patterns (MDR) of E. coli isolated from UTI patients.Methods: A total of 80 urine samples collected from the patients suspected of having UTI attending Maharishi Markandeshwar Institute of Medical Sciences and Research (MMIMSR), Mullana, Ambala were cultured using standard microbiological techniques. Antibiotic susceptibility testing of E.coli was done by using minimum inhibitory concentration (MIC). MIC of tetracycline, doxycycline, azithromycin, erythromycin, ciprofloxacin, levofloxacin, ampicillin, amoxicillin and amikacin was done by agar dilution method.Results: Of the total 46 isolates contributing 33 females and 13 males were confirmed as E. coli. About 51.34% of the female patients belonged to the age group 21-40 yr and 53.84% of the male population belonged to 41-80 yr were found to be more susceptible to UTI infection. All isolates confirmed as E.coli were found to be multidrug resistant. 80% of the isolates exhibited MICs higher than 1000mg/L against β-lactams. 20% of the E. coli isolates exhibited MICs higher than 1000mg/L against ciprofloxacin, amikacin and erythromycin. 23% and 95% of E. coli isolates exhibited MICs less than 128 mg/L against doxycycline and levofloxacin respectively.Conclusion: The present study revealed the decreased susceptibility of the E.coli to all drugs. E. coli resistance profile to beta lactams, quinolones, macrolides, tetracyclines and aminoglycosides were also found to be quite high in this study emphasizing the need to educate public about appropriate use of antibiotics.NA

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Three-Year Trend in Escherichia coli Antimicrobial Resistance among Children’s Urine Cultures in an Italian Metropolitan Area

Children ◽

10.3390/children8070597 ◽

2021 ◽

Vol 8 (7) ◽

pp. 597

Author(s):

Luca Pierantoni ◽

Laura Andreozzi ◽

Simone Ambretti ◽

Arianna Dondi ◽

Carlotta Biagi ◽

...

Keyword(s):

Escherichia Coli ◽

Metropolitan Area ◽

Bacterial Infections ◽

Asymptomatic Bacteriuria ◽

Multidrug Resistant ◽

Resistance Rate ◽

First Line ◽

E Coli ◽

First Line Therapy ◽

Tract Infections

Urinary tract infections (UTIs) are among the most common bacterial infections in children, and Escherichia coli is the main pathogen responsible. Several guidelines, including the recently updated Italian guidelines, recommend amoxicillin-clavulanic acid (AMC) as a first-line antibiotic therapy in children with febrile UTIs. Given the current increasing rates of antibiotic resistance worldwide, this study aimed to investigate the three-year trend in the resistance rate of E. coli isolated from pediatric urine cultures (UCs) in a metropolitan area of northern Italy. We conducted a retrospective review of E. coli-positive, non-repetitive UCs collected in children aged from 1 month to 14 years, regardless of a diagnosis of UTI, catheter colonization, urine contamination, or asymptomatic bacteriuria. During the study period, the rate of resistance to AMC significantly increased from 17.6% to 40.2% (p < 0.001). Ciprofloxacin doubled its resistance rate from 9.1% to 16.3% (p = 0.007). The prevalence of multidrug-resistant E. coli rose from 3.9% to 9.2% (p = 0.015). The rate of resistance to other considered antibiotics remained stable, as did the prevalence of extended spectrum beta-lactamases and extensively resistant E. coli among isolates. These findings call into question the use of AMC as a first-line therapy for pediatric UTIs in our population, despite the indications of recent Italian guidelines.

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Mechanistic insights into synergy between nalidixic acid and tetracycline against clinical isolates of Acinetobacter baumannii and Escherichia coli

Communications Biology ◽

10.1038/s42003-021-02074-5 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Amit Gaurav ◽

Varsha Gupta ◽

Sandeep K. Shrivastava ◽

Ranjana Pathania

Keyword(s):

Escherichia Coli ◽

Acinetobacter Baumannii ◽

Nalidixic Acid ◽

Bacterial Infections ◽

Clinical Isolates ◽

Hospital Environment ◽

Infection Model ◽

Drug Resistant ◽

E Coli

AbstractThe increasing prevalence of antimicrobial resistance has become a global health problem. Acinetobacter baumannii is an important nosocomial pathogen due to its capacity to persist in the hospital environment. It has a high mortality rate and few treatment options. Antibiotic combinations can help to fight multi-drug resistant (MDR) bacterial infections, but they are rarely used in the clinics and mostly unexplored. The interaction between bacteriostatic and bactericidal antibiotics are mostly reported as antagonism based on the results obtained in the susceptible model laboratory strain Escherichia coli. However, in the present study, we report a synergistic interaction between nalidixic acid and tetracycline against clinical multi-drug resistant A. baumannii and E. coli. Here we provide mechanistic insight into this dichotomy. The synergistic combination was studied by checkerboard assay and time-kill curve analysis. We also elucidate the mechanism behind this synergy using several techniques such as fluorescence spectroscopy, flow cytometry, fluorescence microscopy, morphometric analysis, and real-time polymerase chain reaction. Nalidixic acid and tetracycline combination displayed synergy against most of the MDR clinical isolates of A. baumannii and E. coli but not against susceptible isolates. Finally, we demonstrate that this combination is also effective in vivo in an A. baumannii/Caenorhabditis elegans infection model (p < 0.001)

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Alteration of the phagocytosis and antimicrobial defense of Octodonta nipae (Coleoptera: Chrysomelidae) pupae to Escherichia coli following parasitism by Tetrastichus brontispae (Hymenoptera: Eulophidae)

Bulletin of Entomological Research ◽

10.1017/s0007485318000780 ◽

2018 ◽

Vol 109 (2) ◽

pp. 248-256

Author(s):

E. Meng ◽

J. Li ◽

B. Tang ◽

Y. Hu ◽

T. Qiao ◽

...

Keyword(s):

Escherichia Coli ◽

Immune Response ◽

Immune Responses ◽

Mrna Expression ◽

Bactericidal Activity ◽

Bacterial Infections ◽

Expression Level ◽

Primary Immune Response ◽

Mrna Expression Level ◽

E Coli

AbstractAlthough parasites and microbial pathogens are both detrimental to insects, little information is currently available on the mechanism involved in how parasitized hosts balance their immune responses to defend against microbial infections. We addressed this in the present study by comparing the immune response between unparasitized and parasitized pupae of the chrysomelid beetle, Octodonta nipae (Maulik), to Escherichia coli invasion. In an in vivo survival assay, a markedly reduced number of E. coli colony-forming units per microliter was detected in parasitized pupae at 12 and 24 h post-parasitism, together with decreased phagocytosis and enhanced bactericidal activity at 12 h post-parasitism. The effects that parasitism had on the mRNA expression level of selected antimicrobial peptides (AMPs) of O. nipae pupae showed that nearly all transcripts of AMPs examined were highly upregulated during the early and late parasitism stages except defensin 2B, whose mRNA expression level was downregulated at 24 h post-parasitism. Further elucidation on the main maternal fluids responsible for alteration of the primary immune response against E. coli showed that ovarian fluid increased phagocytosis at 48 h post-injection. These results indicated that the enhanced degradation of E. coli in parasitized pupae resulted mainly from the elevated bactericidal activity without observing the increased transcripts of target AMPs. This study contributes to a better understanding of the mechanisms involved in the immune responses of a parasitized host to bacterial infections.

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Multi-omic surveillance of Escherichia coli and Klebsiella spp. in hospital sink drains and patients

10.1101/2020.02.19.952366 ◽

2020 ◽

Author(s):

B Constantinides ◽

KK Chau ◽

TP Quan ◽

G Rodger ◽

M Andersson ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Resistance Genes ◽

Bacterial Infections ◽

Wide Spectrum ◽

Klebsiella Oxytoca ◽

Clinical Disease ◽

E Coli ◽

Antimicrobial Resistance Genes ◽

Wide Range

ABSTRACTEscherichia coli and Klebsiella spp. are important human pathogens that cause a wide spectrum of clinical disease. In healthcare settings, sinks and other wastewater sites have been shown to be reservoirs of antimicrobial-resistant E. coli and Klebsiella spp., particularly in the context of outbreaks of resistant strains amongst patients. Without focusing exclusively on resistance markers or a clinical outbreak, we demonstrate that many hospital sink drains are abundantly and persistently colonised with diverse populations of E. coli, Klebsiella pneumoniae and Klebsiella oxytoca, including both antimicrobial-resistant and susceptible strains. Using whole genome sequencing (WGS) of 439 isolates, we show that environmental bacterial populations are largely structured by ward and sink, with only a handful of lineages, such as E. coli ST635, being widely distributed, suggesting different prevailing ecologies which may vary as a result of different inputs and selection pressures. WGS of 46 contemporaneous patient isolates identified one (2%; 95% CI 0.05-11%) E. coli urine infection-associated isolate with high similarity to a prior sink isolate, suggesting that sinks may contribute to up to 10% of infections caused by these organisms in patients on the ward over the same timeframe. Using metagenomics from 20 sink-timepoints, we show that sinks also harbour many clinically relevant antimicrobial resistance genes including blaCTX-M, blaSHV and mcr, and may act as niches for the exchange and amplification of these genes. Our study reinforces the potential role of sinks in contributing to Enterobacterales infection and antimicrobial resistance in hospital patients, something that could be amenable to intervention.IMPORTANCEEscherichia coli and Klebsiella spp. cause a wide range of bacterial infections, including bloodstream, urine and lung infections. Previous studies have shown that sink drains in hospitals may be part of transmission chains in outbreaks of antimicrobial-resistant E. coli and Klebsiella spp., leading to colonisation and clinical disease in patients. We show that even in non-outbreak settings, contamination of sink drains by these bacteria is common across hospital wards, and that many antimicrobial resistance genes can be found and potentially exchanged in these sink drain sites. Our findings demonstrate that the colonisation of handwashing sink drains by these bacteria in hospitals is likely contributing to some infections in patients, and that additional work is needed to further quantify this risk, and to consider appropriate mitigating interventions.

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Frequency and antimicrobial susceptibility pattern of hospital isolates of Escherichia coli and Klebsiella pneumoniae in urine samples

Acta Medica Saliniana ◽

10.5457/ams.v49i0.527 ◽

2019 ◽

Vol 49 ◽

Author(s):

Ivana Jukić ◽

Danijel Topić ◽

El-Jesah Đulić ◽

Amela Dedeić- Ljubović

Keyword(s):

Escherichia Coli ◽

Antimicrobial Susceptibility ◽

Public Health Problem ◽

Urine Samples ◽

Distribution Analysis ◽

Susceptibility Pattern ◽

E Coli ◽

Antimicrobial Susceptibility Pattern ◽

Urinary Infections ◽

Tract Infections

Objectives/Aim: Urinary tract infections (UTI) are a serious public health problem and caused by many pathogens, most often by Escherichia coli and Klebsiella pneumoniae.Aim of this study was to show the frequency and antimicrobial susceptibility pattern of E. coli and K. pneumoniae in hospital isolates, following the GLASS methodology.Methods: This is a retrospective study that was conducted in the Laboratory for Urinary Infections OU Clinical Microbiology CCUS in the period from January till December 2018.A total of 13760 urine samples were processed, using standard laboratory methods, in which significant bacteriuria was detected in 3218 (23.4%) of specimens.Results: Out of the total number of positive samples, E. coli was isolated in 1166 (36.2%) and K. pneumoniae at 341 (10.6%) patients. The presence of E. coli and K. pneumoniae isolates is dominant in females (1103/73.2%) and age group 60 and older (812/54.7%). Out of the total E. coli isolates, the ESBL strain was presented with 79 (6.8%) and K. pneumoniae with 145 (42.5%). The proportion of carbapenemase (CPE) produced by K. pneumoniae isolates was 8 (2.4%). The ESBL strain distribution analysis on clinics showed the highest prevalence of both isolates at the Clinic for Nephrology: K. pneumoniae 26/17,9%; E. coli: 12/15.4%. Isolated E. coli showed the highest resistance to ampicillin 673/1166 (57,7%), trimethoprim-sulfamethoxazole 454/1166 (38.9%) and ciprofloxacin 253/970 (26.1%), while K. pneumoniae to ciprofloxacin and trimethoprim-sulfamethoxazole with 151/285 (53.0%) and 164/341 (48.1%), respectively.Conclusions: Our study has shown that the most common cause of urinary infections in hospital settings are E. coli and K. pneumoniae. Data analysis showed that the presence of ESBL isolates was significantly higher in K. pneumoniae than E. coli. CPE isolates of K. pneumoniae were also detected.

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Antimicrobial resistance pattern of extended-spectrum β-lactamase-producing Escherichia coli isolated from fecal samples of piglets and pig farm workers of selected organized farms of India

Veterinary World ◽

10.14202/vetworld.2020.360-363 ◽

2020 ◽

Vol 13 (2) ◽

pp. 360-363

Author(s):

Shikha Tamta ◽

Obli Rajendran Vinodh Kumar ◽

Shiv Varan Singh ◽

Bommenahalli Siddaramiah Pruthvishree ◽

Ravichandran Karthikeyan ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Susceptibility Testing ◽

Farm Workers ◽

Resistance Pattern ◽

Antibiotic Susceptibility Testing ◽

M Gene ◽

Fecal Samples ◽

E Coli ◽

Pig Farm

Background and Aim: Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli are gradually increasing worldwide and carry a serious public threat. This study aimed to determine the antimicrobial resistance pattern of ESBL-producing E. coli isolated from fecal samples of piglets and pig farm workers. Materials and Methods: Fecal samples from <3-month-old piglets (n=156) and farm workers (n=21) were processed for the isolation of ESBL-producing E. coli in MacConkey agar added with 1 μg/mL of cefotaxime. E. coli (piglets=124; farm workers=21) were tested for ESBL production by combined disk method and ESBL E-strip test. Each of the ESBL-positive isolate was subjected to antibiotic susceptibility testing. The ESBL-producing E. coli were further processed for genotypic confirmation to CTX-M gene. Results: A total of 55 (44.4%, 55/124) and nine (42.9%, 9/21) ESBL-producing E. coli were isolated from piglets and farm workers, respectively. Antibiotic susceptibility testing of the ESBL-positive E. coli isolates from piglets and farm workers showed 100% resistance to ceftazidime, cefotaxime, cefotaxime/clavulanic acid, ceftazidime/clavulanic acid, and cefpodoxime. A proportion of 100% (55/55) and 88.9% (8/9) ESBL-positive E. coli were multidrug resistance (MDR) in piglets and farm workers, respectively. On genotypic screening of the ESBL E. coli isolated from piglets (n=55), 15 were positive for the blaCTX-M gene and of the nine ESBL E. coli from farm workers, none were positive for the blaCTX-M gene. Conclusion: Although there was no significant difference in isolation of ESBL-producing E. coli between piglets and farm workers, the ESBL-positive E. coli from piglets showed relatively higher MDR than farm workers.

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