scholarly journals Prevalence, multidrug-resistance and risk factors for AmpC β-lactamases producing Escherichia coli from hospitalized patients

2020 ◽  
Vol 14 (12) ◽  
pp. 1466-1469
Author(s):  
Rosy Bala ◽  
Varsha A Singh ◽  
Nitin Gupta ◽  
Pue Rakshit
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Drug Resistance ◽  
Multidrug Resistance ◽  
Infection Control ◽  
Three Dimensional ◽  
Hospitalized Patients ◽  
Clinical Specimens ◽  
E Coli ◽  
Associated Risk Factors

Introduction: Multi-drug resistance among AmpC β-lactamases producing Escherichia coli isolates is alarming. The study aimed to know the prevalence and presumptive antibiogram of AmpC producing Escherichia coli isolates and to determine the associated risk factors. Methodology: Escherichia coli isolated from various clinical specimens from hospitalized patients during the study period (January 2018- December 2018) were taken for the study. Standard biochemical reactions were used for organism identification. Antibiotic susceptibility testing was done using Kirby-Bauer method as per CLSI guidelines. Cefoxitin resistance was taken as screening tool to detect AmpC producing strains. The phenotypic confirmation was done using modified three-dimensional test. Multiplex PCR was used to detect pAmpC. Results: A total non-duplicate consecutive 470 Escherichia coli were isolated from various clinical specimens of hospitalized patients during the study period. Cefoxitin resistance was observed in 51.9% (244/470). Modified three dimensional test was positive in 115/244 (47.1%) strains. Genotypic characterization of phenotypic positive AmpC strains showed presence of CIT and DHA genes among 33/115 and 19/115 isolates respectively. The overall prevalence of pAmpC producing E. coli was found to be 52/470 (11.1%). Multidrug resistance (MDR) was observed in 42/52 (80.7%) pAmpC strains. Antimicrobial use, prolonged hospitalization and interventions were associated risk factors for AmpC producing isolates. Conclusions: A high prevalence of multidrug resistance among AmpC producing strains suggests plasmid mediated spread of drug resistance in E. coli. Every hospital should formulate and implement infection control policies at-least for the risk group patients to control the dissemination of such microbes as infection prevention is better than infection control.

Cefepime Resistance and Associated Risk Factors among Escherichia coli Strains Isolated from Clinical Specimens

Chemotherapy ◽  
2011 ◽  
Vol 57 (2) ◽  
pp. 134-137 ◽  
Author(s):  
Majid Mansouri ◽  
Rashid Ramazanzadeh ◽  
Parisa Norabadi
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Clinical Specimens ◽  
Associated Risk Factors

scholarly journals Molecular detection and antibiotic resistance pattern of extended-spectrum beta-lactamase producing Escherichia coli in a Tertiary Hospital in Enugu, Nigeria

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Ifeyinwa N. Nwafia ◽  
Martin E. Ohanu ◽  
Samuel O. Ebede ◽  
Uchenna C. Ozumba
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Unit Admission ◽  
Beta Lactamase ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Associated Risk Factors

Abstract Background The use of antibiotic agents in the treatment of infectious diseases has greatly contributed to the decrease in morbidity and mortality, but these great advances in treatment are being undermined by the rapidly increasing antimicrobial resistant organisms. Extended-spectrum beta-lactamases are enzymes hydrolyzing the beta lactam antibiotics, including third generation cephalosporins and monobactams but not cephamycins and carbapenems. They pose a serious global health threat and have become a challenge for health care providers. The aim of this research was to assess the prevalence of extended-spectrum beta-lactamase producing Escherichia coli in University of Nigeria Teaching Hospital Ituku-Ozalla Enugu and to detect the risk factors for acquisition of the resistant organism. To proffer advice on antibiotic stewardship in clinical practice and public health interventions, to curb the spread of the resistant organisms in the hospital. Results Out of the 200 E. coli isolates, 70 (35.00%) were confirmed positive for extended-spectrum beta-lactamase production. Fifty-three (75.7%) were from hospital acquired infections. All the isolates were resistant to ampicillin, tetracycline and chloramphenicol while 68 (97.14%) of the 70 isolates were susceptible to imipenem. BlaTEM, blaSHV and blaTEM were detected in 66 (94%) of the 70 isolates. The ESBL bla genes detected were blaCTX-M (n = 26; 37.14%), blaTEM (n = 7; 10.00%), blaSHV (n = 2; 2.86%), blaCTX-M/TEM (n = 7; 10.0%), blaCTX-M/SHV (n = 14; 20.0%) and blaCTX-M/TEM/SHV (n = 10; 14.29%). The three bla genes were not detected in 4 (5.71%) of the isolates. Recent surgery, previous antibiotic and intensive care unit admission were the associated risk factors to infections caused by extended-spectrum beta-lactamase producing E. coli. Conclusion There is a high rate of infections caused by extended-spectrum beta-lactamase producing E. coli. Recent surgery, previous antibiotic and intensive care unit admission were associated risk factors.

scholarly journals Prevalence of Diarrhoeagenic Escherichia Coli and Associated Risk Factors in Dug Wells in Ile-Ife, Southwestern Nigeria

2021 ◽  
Author(s):  
Babatunde Odetoyin ◽  
Olawumi Ogundipe ◽  
Adebola Onanuga
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Drinking Water ◽  
Diversity Index ◽  
Shannon Diversity Index ◽  
Southwestern Nigeria ◽  
E Coli ◽  
Shannon Diversity ◽  
Dug Wells ◽  
Associated Risk Factors

Abstract BackgroundDiarrhoeagenic Escherichia coli (DEC) strains are common bacterial causes of morbidity and mortality in young children. Waterborne DEC could pose a potential health risk to humans through domestic use of contaminated water. However, epidemiological studies on DEC strains in drinking water are scarce in Nigeria. This study determined the prevalence, diversity and factors associated with the presence of DEC in dug wells in Ile-Ife, southwestern Nigeria.MethodsWe assessed 143 wells for safety by coliform count using the multiple tube technique. A standardized questionnaire was used to obtain relevant information about the wells and their owners. Contaminating isolates were identified as E. coli by amplifying their 16S rRNA gene. Five DEC pathotypes comprising enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC) enteroinvasive E. coli (EIEC), enteropathogenic E. coli (EPEC) and Shiga-toxin producing E. coli (STEC) were detected using two sets of multiplex PCR assays. Isolates diversity was determined by (GTG)5 Repetitive element palindromic PCR and Shannon diversity index. Multivariate logistic regression analysis was used to identify associated risk factors. Results Fifty-eight (40.6%) wells were contaminated by diarrhoeagenic E. coli. Wells with dirty platforms, damaged by erosion and sited near septic tanks significantly harboured DEC (p<0.05). There was a preponderance of STEC among the isolates with nine isolates carrying multiple diarrhoeagenic genes and 10 (17.2%) wells contaminated by multiple DEC strains. The (GTG)5-PCR fingerprinting assigned all DEC strains into six clades, with an overall Shannon diversity index of 18.87. A diverse profile was obtained among and between the isolates recovered from different sources.ConclusionsThe presence of DEC strains in drinking water highlights the risk to human health associated with the use of untreated water. There was a high degree of genetic diversity among the isolates implying multiple sources of contamination. There is a need for periodic sanitation and inspection of wells for cracks to prevent seepages and possible outbreaks of waterborne diseases.

scholarly journals Multidrug resistance and high prevalence of class 1 integrons in Escherichia coli isolated from waters and vegetables in Nsukka and Enugu, Nigeria

2020 ◽  
Author(s):  
Chinyere B. Chigor ◽  
Ini-Abasi I. Ibangha ◽  
Nkechinyere O. Nweze ◽  
Chizoba A. Ozochi ◽  
Valentino C. Onuora ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Drug Resistance ◽  
Multidrug Resistance ◽  
Treatment Plant ◽  
Treated Wastewater ◽  
Multi Drug Resistance ◽  
E Coli ◽  
Class 1 Integrons ◽  
High Prevalence ◽  
Class 1

AbstractIn spite of treated wastewater presenting itself as an attractive alternative to scarce quality water in the developing countries, the associated contamination of fresh produce by irrigation waters leading to outbreak of foodborne illnesses is on the rise. Horizontal transfer of integrons play important role in the spread and maintenance of antimicrobial resistance among strains of Escherichia coli. This study assessed the effluents from the University of Nigeria, Nsukka Wastewater Treatment Plant (UNN-WWTP) as well as vegetables irrigated with the effluent, and vegetables sold in selected markets from Nsukka and Enugu cities for the presence of E. coli and determined the prevalence integrons in multidrug-resistant isolates. Isolation of E. coli was done using eosin methylene blue agar and isolates subjected to Gram staining for identification of presumptive colonies. Confirmation of E. coli was achieved by polymerase chain reaction (PCR) technique, targeting beta-glucuronidase (uidA). Resistance to antibiotics was determined using the Bauer-Kirby disk diffusion assay and the Clinical and Laboratory Standard Institute criteria. Integrons were detected by multiplex PCR using primers specific for class 1 and 2 integrons. A total of 178 E. coli isolates were obtained from WWTP effluent (41), and vegetables from greenhouse (46), farms (55) and market (36). Multi-drug resistance was detected in all the isolates, ranging from five-drug resistance in a single isolate to 16-drug resistance patterns in two different isolates. Of the total isolates, class 1 integrons were abundantly detected in 175 (98.3%) and class 2 in 5 (2.8%). All the class 2 integrons were found in isolates that were positive for class 1. The high detection of E. coli in the studied effluent and vegetables pose potential public health hazards heightened by observed multidrug resistance in all the isolates and the high prevalence of class 1 integron. It is concluded that the vegetable samples are significant reservoirs for potentially pathogenic E. coli. Therefore, vegetable irrigation farming with unsafe water should be discontinued, while appropriate improvement strategies to ensure compliance should be facilitated without further delay.

scholarly journals Risk Factors for Recovery of Ampicillin-Sulbactam-Resistant Escherichia coli in Hospitalized Patients

2000 ◽  
Vol 44 (4) ◽  
pp. 1004-1009 ◽  
Author(s):  
Keith S. Kaye ◽  
Anthony D. Harris ◽  
Howard Gold ◽  
Yehuda Carmeli
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Drug Exposure ◽  
Multivariate Analyses ◽  
Statistical Significance ◽  
Hospitalized Patients ◽  
E Coli ◽  
Factors Associated ◽  
Time Period ◽  
Independent Risk Factors

ABSTRACT Ampicillin-sulbactam resistance in Escherichia coli is an emerging problem. This study determined risk factors for the recovery of ampicillin-sulbactam-resistant E. coli in hospitalized patients. A case-control design was used to compare two groups of case patients with control patients. The first group of case patients consisted of patients from whom nosocomially acquired ampicillin-sulbactam-resistant E. coli strains were isolated, and the second group of case patients consisted of patients from whom ampicillin-sulbactam-susceptible E. coli strains were isolated. Control patients were a random selection among 5% of all patients admitted during the same time period. Risk factors analyzed included antimicrobial drug exposure, comorbid conditions, and demographics. Univariate and multivariate analyses were performed. Ampicillin-sulbactam-resistant E. coli strains were isolated from 175 patients, and ampicillin-sulbactam-susceptibleE. coli strains were isolated from 577 patients. Nine hundred thirty-four control patients were selected. Exposure to penicillin antibiotics as a class and to ampicillin and ampicillin-sulbactam individually were the only significant, independent risk factors associated with the isolation of ampicillin-sulbactam-resistant E. coli (odds ratio [OR] = 2.32 [P < 0.001], OR = 3.04 [P = 0.02], and OR = 1.72 [P= 0.04], respectively), but they were not associated with the isolation of ampicillin-sulbactam-susceptible E. coli. Interestingly, exposure to piperacillin-tazobactam tended to protect against the isolation of E. coli strains resistant to ampicillin-sulbactam, but this did not reach statistical significance (OR = 0.13; P = 0.11).

scholarly journals 1438. Prevalence and Risk Factors for Extended Spectrum Betalactamases Among Hospitalized Patients with Community Acquired Pyelonephritis in Colombia

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S801-S801
Author(s):  
Mariana Franco Rodríguez ◽  
Jorge Cortes
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Logistic Regression ◽  
Hospitalized Patients ◽  
Adult Patients ◽  
Charlson Score ◽  
Esbl Production ◽  
E Coli ◽  
Extended Spectrum ◽  
Tract Infections

Abstract Background Urinary tract infections (UTI) are the most frequent bacterial infection in hospitalized patients. Extented spectrum betalactamases (ESBL) producing bacteria causing UTI have become more prevalent. Escherichia coli (E. coli) is the most frequent ESBL producing bacteria isolated in UTI. This drug resistant organisms are associated with poorer outcomes for patients. In low income countries, approaching to and treating ESBL E. coli, represent a major challenge for health care centers. Methods A retrospective cohort of adult patients with community acquired pyelonephritis caused by Escherichia coli was identified in a tertiary hospital in Colombia. Susceptibility was performed with Vitek (BioMerieux, France); extended spectrum beta lactamase (ESBL) production was defined phenotypically. Inclusion criteria were adult patients hospitalized with a positive urine culture for E. coli. Demographic and clinical characteristics were searched in electronic records. Risk factors associated with ESBL production were identified by using a multivariate logistic regression analysis. Results During 7 years 817 patients with pyelonephritis caused by E. coli were identified. 79 (9.7%) of them were caused by ESBL producers. Women were 66% and 408 (74.8% of them) had menopause. Mean age was 64.2 years (standard deviation of 19.1). Of the cohort, 481 (561.1%) had at least some comorbidity and was frequent to find diabetes (18.5%), immunosuppression due to oncologic disease or medications (18.4%), urolithiasis or previous surgical procedures (17%). After logistic regression, risk factors identified to predict ESBL production, were: being a man (aOR 5.4, 2.1-18.2), a woman with menopause (aOR 2.9, 1.3 -9.9), and the Charlson score (aOR 0.83, 0.73 – 0.96). Previous antibiotic use was not related to ESBL infection. Conclusion In this relatively large cohort of patients with pyelonephritis caused by E. coli, ESBL production risk factors were not clearly identified other than sex and menopause. Curiously, Charlson score predicted a lower risk of resistance. Other factors (food consumptions and others) might be driving the resistance in the community in E. coli. Disclosures Jorge Cortes, MD, Pfizer (Research Grant or Support)

scholarly journals Prevalence, Antimicrobial Susceptibility Pattern and Associated Risk Factors for Salmonella Species and Escherichia Coli from Raw Meat at butchery houses in Mekelle, Tigray, Northern Ethiopia

2020 ◽  
Author(s):  
HAFTAY Abraha TADESSE ◽  
Atsebaha Gebrekidan Kahsay ◽  
Dawit Gebreegziabiher Hagos
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Antimicrobial Susceptibility ◽  
Bacterial Contamination ◽  
Diffusion Method ◽  
Northern Ethiopia ◽  
Raw Meat ◽  
E Coli ◽  
Associated Risk Factors ◽  
Susceptibility Patterns

Abstract Background: Salmonella species and Escherichia coli (E. coli) are important foodborne pathogens affecting humans and animals. They are among the most important causes of infection that are associated with the consumption of contaminated food. This study was aimed to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors for Salmonella species and E. coli in raw meat from butchery houses of Mekelle, Northern Ethiopia.MethodA cross-sectional study was conducted from January to December 2019. Socio-demographic data and risk factors were collected using a predesigned questionnaire. Meat samples were collected aseptically from the butchery houses and transported using icebox to Mekelle University, College of Veterinary Sciences for the isolation and identification of Salmonella species and E. coli. Antimicrobial susceptibility patterns were determined using Kirby disc diffusion method. Data obtained were cleaned and entered into Statistical Package for the Social Sciences version 22 and logistic regression models with odds ratio were calculated. P-value < 0.05 was considered as statistically significant.ResultsA total of 153 out of 384 (39.8%) of the meat specimens were found to be contaminated. The contamination of Salmonella species and E. coli were 15.6% (n=60) and 20.8%) (n=80), respectively. Mixed contamination (Salmonella species and E. coli) was observed in 13 (3.4 %) of the analyzed. Poor washing hands regularly (AOR = 8.37; 95% CI: 2.75-25.50) and not using gloves during meat handling (AOR=11. 28; 95% CI: (4.69‑27.10) were associated with an overall bacterial contamination About 95.5% of the tested isolates were sensitive to chloramphenicol and norfloxacin while the resistance of amoxyclav_amoxicillin and erythromycin were both isolated bacteria species. The overall multidrug resistance pattern for Salmonella and E. coli were 51.4% (n=19) and 31.8% (14), respectively.ConclusionOf the 153 (153/384) contaminated raw meat, 60 (15.6%) and 80 (20.8%) were contaminated by Salmonella species and E. coli, respectively. Poor handwashing practice and not using glove during meat handling showed significant association with bacterial contamination. Multidrug-resistant showed in Salmonella species and E. coli were 19 (51.4%) and 14 (31.8%), respectively.

scholarly journals Escherichia coli Harboring a Natural IncF Conjugative F Plasmid Develops Complex Mature Biofilms by Stimulating Synthesis of Colanic Acid and Curli

2008 ◽  
Vol 190 (22) ◽  
pp. 7479-7490 ◽  
Author(s):  
Thithiwat May ◽  
Satoshi Okabe
Keyword(s):  
Escherichia Coli ◽  
Biofilm Formation ◽  
Three Dimensional ◽  
F Plasmid ◽  
Form Complex ◽  
Global Regulators ◽  
E Coli ◽  
Colanic Acid ◽  
Regulatory Systems ◽  
Initial Deposition

ABSTRACT It has been shown that Escherichia coli harboring the derepressed IncFI and IncFII conjugative F plasmids form complex mature biofilms by using their F-pilus connections, whereas a plasmid-free strain forms only patchy biofilms. Therefore, in this study we investigated the contribution of a natural IncF conjugative F plasmid to the formation of E. coli biofilms. Unlike the presence of a derepressed F plasmid, the presence of a natural IncF F plasmid promoted biofilm formation by generating the cell-to-cell mating F pili between pairs of F+ cells (approximately two to four pili per cell) and by stimulating the formation of colanic acid and curli meshwork. Formation of colanic acid and curli was required after the initial deposition of F-pilus connections to generate a three-dimensional mushroom-type biofilm. In addition, we demonstrated that the conjugative factor of F plasmid, rather than a pilus synthesis function, was involved in curli production during biofilm formation, which promoted cell-surface interactions. Curli played an important role in the maturation process. Microarray experiments were performed to identify the genes involved in curli biosynthesis and regulation. The results suggested that a natural F plasmid was more likely an external activator that indirectly promoted curli production via bacterial regulatory systems (the EnvZ/OmpR two-component regulators and the RpoS and HN-S global regulators). These data provided new insights into the role of a natural F plasmid during the development of E. coli biofilms.

scholarly journals Impact of Extended-Spectrum β-Lactamase Production on Treatment Outcomes of Acute Pyelonephritis Caused by Escherichia coli in Patients without Health Care-Associated Risk Factors

2015 ◽  
Vol 59 (4) ◽  
pp. 1962-1968 ◽  
Author(s):  
Sun Hee Park ◽  
Su-Mi Choi ◽  
Dong-Gun Lee ◽  
Sung-Yeon Cho ◽  
Hyo-Jin Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Health Care ◽  
Treatment Outcomes ◽  
Acute Pyelonephritis ◽  
Esbl Production ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
The Impact

ABSTRACTExtended-spectrum β-lactamase-producingEscherichia coli(ESBL-EC) is increasingly identified as a cause of acute pyelonephritis (APN) among patients without recent health care contact, i.e., community-associated APN. This case-control study compared 75 cases of community-associated ESBL-EC APN (CA-ESBL) to 225 controls of community-associated non-ESBL-EC APN (CA-non-ESBL) to identify the risk factors for ESBL-EC acquisition and investigate the impact of ESBL on the treatment outcomes of community-associated APN (CA-APN) caused byE. coliat a Korean hospital during 2007 to 2013. The baseline characteristics were similar between the cases and controls; the risk factors for ESBL-EC were age (>55 years), antibiotic use within the previous year, and diabetes with recurrent APN. The severity of illness did not differ between CA-ESBL and CA-non-ESBL (Acute Physiology and Chronic Health Evaluation [APACHE] II scores [mean ± standard deviation], 7.7 ± 5.9 versus 6.4 ± 5.3;P= 0.071). The proportions of clinical (odds ratio [OR], 1.76; 95% confidence interval [CI], 0.57 to 5.38;P= 0.323) and microbiological (OR, 1.16; 95% CI, 0.51 to 2.65;P= 0.730) cures were similar, although the CA-ESBL APN patients were less likely to receive appropriate antibiotics within 48 h. A multivariable Cox proportional hazards analysis of the prognostic factors for CA-APN caused byE. colishowed that ESBL production was not a significant factor for clinical (hazard ratio [HR], 0.39; 95% CI, 0.12 to 1.30;P= 0.126) or microbiological (HR, 0.49; 95% CI, 0.21 to 1.12;P= 0.091) failure. The estimates did not change after incorporating weights calculated using propensity scores for acquiring ESBL-EC. Therefore, ESBL production did not negatively affect treatment outcomes among patients with community-associatedE. coliAPN.

scholarly journals Integron Expression in Multidrug-Resistant Escherichia coli Isolated from House Flies within the Hospital

2018 ◽  
Vol 16 (5) ◽  
pp. 319-327
Author(s):  
Atchariya YOSBOONRUANG ◽  
Anong KIDDEE ◽  
Chatsuda BOONDUANG ◽  
Phannarai PIBALPAKDEE
Keyword(s):  
Escherichia Coli ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Hospital Environment ◽  
Sequencing Analysis ◽  
Class 1 Integron ◽  
House Flies ◽  
E Coli ◽  
Class 1 Integrons ◽  
Class 1

Escherichia coli is a serious cause of a variety of hospital-acquired infections and commonly contributes to the environment by house flies. Integrons, particularly class 1 integrons, are the genetic elements that play an important role in the horizontal transfer of antimicrobial resistance mechanism. This mechanism is commonly found in Enterobacteriaceae, especially E. coli. In this study, we aim to investigate the occurrence and antimicrobial resistance patterns of E. coli isolated from the house flies in Phayao hospital and to determine the gene expression of class 1 integrons in those isolates of E. coli. Totally, 70 isolates of E. coli were isolated from 60 house flies collected from the hospital. Fifty-seven of the isolates (81.43 %) were multidrug resistance (MDR) and highly resistant to b-lactams, tetracyclines, and sulfonamides. Of 57 isolates of MDR-E. coli, 20 isolates (35 %) were found to carry class 1 integron genes. Fifteen patterns of antimicrobial resistance occurred in the isolates of integron-positive E. coli. Most integron-positive E. coli isolates were resistant to 7 antimicrobials. Two isolates of these bacteria (10 %) were able to resist 13 out of 14 tested antimicrobials. Using PCR and sequencing analysis, an investigation showed that dfrA17-aadA5, dfrA12-aadA2 gene cassette was the most prevalent cassette (n = 10; 50 %) among the integron-positive E. coli isolates. Our results indicated that the presences of multidrug resistance and class 1 integrons were common in E. coli isolated from the houseflies in hospital. Therefore, screening for integron-positive E. coli from the hospital environment might be necessary for prevention of nosocomial infections.

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