Antimicrobial Susceptibility Profile of Extended Spectrum β-Lactamase (ESBL) Producing Escherichia coli from Various Clinical Samples

Background Extended spectrum β-lactamase (ESBL) producing Escherichia coli has tremendously increased worldwide and it is one of the most common causes of morbidity and mortality associated with hospital-acquired infections. This could be attributed to association of multi drug resistance in ESBL producing isolates. The present study was aimed to determine the antimicrobial sensitivity profile of ESBL producing E. coli isolates from various clinical samples. Materials and Methods Clinical samples, which consist of pus, urine, blood, cerebrospinal fluid (CSF), stool, sputum, swabs, and different body fluids, are included in the study. Samples were processed and identified as per routine laboratory protocol. ESBL screening and confirmation along with antimicrobial susceptibility test was done according to the Clinical Laboratory Standards Institute (CLSI) guidelines. Results Out of 180 third generation cephalosporins resistant E. coli, 100 (55.55%) isolates were ESBL producers showing a greater degree of resistance to antibiotics. Conclusion The prevalence of ESBL is increasing day by day in nearly every center of different countries and necessary steps to prevent the spread and emergence of resistance should be taken.

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A One Health Comparative Assessment of Antimicrobial Resistance in Generic and Extended-Spectrum Cephalosporin-Resistant Escherichia coli from Beef Production, Sewage and Clinical Settings

Microorganisms ◽

10.3390/microorganisms8060885 ◽

2020 ◽

Vol 8 (6) ◽

pp. 885 ◽

Cited By ~ 1

Author(s):

Emelia H. Adator ◽

Claudia Narvaez-Bravo ◽

Rahat Zaheer ◽

Shaun R. Cook ◽

Lisa Tymensen ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

One Health ◽

Hot Spot ◽

Municipal Sewage ◽

Multi Drug Resistance ◽

Beef Production ◽

E Coli ◽

Beef Processing ◽

Extended Spectrum

This study aimed to compare antimicrobial resistance (AMR) in extended-spectrum cephalosporin-resistant and generic Escherichia coli from a One Health continuum of the beef production system in Alberta, Canada. A total of 705 extended-spectrum cephalosporin-resistant E. coli (ESCr) were obtained from: cattle feces (CFeces, n = 382), catch basins (CBasins, n = 137), surrounding streams (SStreams, n = 59), beef processing plants (BProcessing, n = 4), municipal sewage (MSewage; n = 98) and human clinical specimens (CHumans, n = 25). Generic isolates (663) included: CFeces (n = 142), CBasins (n = 185), SStreams (n = 81), BProcessing (n = 159) and MSewage (n = 96). All isolates were screened for antimicrobial susceptibility to 9 antimicrobials and two clavulanic acid combinations. In ESCr, oxytetracycline (87.7%), ampicillin (84.4%) and streptomycin (73.8%) resistance phenotypes were the most common, with source influencing AMR prevalence (p < 0.001). In generic E. coli, oxytetracycline (51.1%), streptomycin (22.6%), ampicillin (22.5%) and sulfisoxazole (14.3%) resistance were most common. Overall, 88.8% of ESCr, and 26.7% of generic isolates exhibited multi-drug resistance (MDR). MDR in ESCr was high from all sources: CFeces (97.1%), MSewage (96.9%), CHumans (96%), BProcessing (100%), CBasins (70.5%) and SStreams (61.4%). MDR in generic E. coli was lower with CFeces (45.1%), CBasins (34.6%), SStreams (23.5%), MSewage (13.6%) and BProcessing (10.7%). ESBL phenotypes were confirmed in 24.7% (n = 174) ESCr and 0.6% of generic E. coli. Prevalence of bla genes in ESCr were blaCTXM (30.1%), blaCTXM-1 (21.6%), blaTEM (20%), blaCTXM-9 (7.9%), blaOXA (3.0%), blaCTXM-2 (6.4%), blaSHV (1.4%) and AmpC β-lactamase blaCMY (81.3%). The lower AMR in ESCr from SStreams and BProcessing and higher AMR in CHumans and CFeces likely reflects antimicrobial use in these environments. Although MDR levels were higher in ESCr as compared to generic E. coli, AMR to the same antimicrobials ranked high in both ESCr and generic E. coli sub-populations. This suggests that both sub-populations reflect similar AMR trends and are equally useful for AMR surveillance. Considering that MDR ESCr MSewage isolates were obtained without enrichment, while those from CFeces were obtained with enrichment, MSewage may serve as a hot spot for MDR emergence and dissemination.

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Evaluation of extended spectrum beta lactamase enzymes prevalence in clinical isolates of Escherichia coli

Microbiology Research ◽

10.4081/mr.2011.e8 ◽

2011 ◽

Vol 2 (1) ◽

pp. 8

Author(s):

Ronak Bakhtiari ◽

Jalil Fallah Mehrabadi ◽

Hedroosha Molla Agamirzaei ◽

Ailar Sabbaghi ◽

Mohammad Mehdi Soltan Dallal

Keyword(s):

Escherichia Coli ◽

Disk Diffusion ◽

Confirmatory Test ◽

Diffusion Method ◽

Multi Drug Resistance ◽

Beta Lactamase ◽

Disk Diffusion Method ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum

Resistance to b-lactam antibiotics by gramnegative bacteria, especially Escherichia coli (E. coli), is a major public health issue worldwide. The predominant resistance mechanism in gram negative bacteria particularly E. coli is via the production of extended spectrum beta lactamase (ESBLs) enzymes. In recent years, the prevalence of b-lactamase producing organisms is increased and identification of these isolates by using disk diffusion method and no-one else is not satisfactory. So, this investigation focused on evaluating the prevalence of ESBL enzymes by disk diffusion method and confirmatory test (Combined Disk). Five hundred clinical samples were collected and 200 E. coli isolates were detected by standard biochemical tests. To performing initial screening of ESBLs was used from Disk diffusion method on E. coli isolates. A confirmation test (Combined Disk method) was performed on isolates of resistant to cephalosporin's indicators. Up to 70% isolates exhibited the Multi Drug Resistance phenotype. In Disk diffusion method, 128(64%) E. coli isolates which resistant to ceftazidime and cefotaxime while in Combined Disk, among 128 screened isolates, 115 (89.8%) isolates were detected as ESBLs producers. This survey indicate beta lactamase enzymes are playing a significant role in antibiotic resistance and correct detection of them in phenotypic test by using disk diffusion and combined Disk is essential for accurate recognition of ESBLs.

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Incidence and Antimicrobial Susceptibility of Escherichia coli and Klebsiella pneumoniae with Extended-Spectrum β-Lactamases in Community- and Hospital-Associated Intra-Abdominal Infections in Europe: Results of the 2008 Study for Monitoring Antimicrobial Resistance Trends (SMART)

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00265-10 ◽

2010 ◽

Vol 54 (7) ◽

pp. 3043-3046 ◽

Cited By ~ 58

Author(s):

Stephen P. Hawser ◽

Samuel K. Bouchillon ◽

Daryl J. Hoban ◽

Robert E. Badal ◽

Rafael Cantón ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Klebsiella Pneumoniae ◽

Antimicrobial Susceptibility ◽

Beta Lactamase ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Abdominal Infections

ABSTRACT From 2002 to 2008, there was a significant increase in extended-spectrum beta-lactamase (ESBL)-positive Escherichia coli isolates in European intra-abdominal infections, from 4.3% in 2002 to 11.8% in 2008 (P < 0.001), but not for ESBL-positive Klebsiella pneumoniae isolates (16.4% to 17.9% [P > 0.05]). Hospital-associated isolates were more common than community-associated isolates, at 14.0% versus 6.5%, respectively, for E. coli (P < 0.001) and 20.9% versus 5.3%, respectively, for K. pneumoniae (P < 0.01). Carbapenems were consistently the most active drugs tested.

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Analysis of blood stream infections: Antimicrobial susceptibility and associated types of extended spectrum β-lactamases

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v19i6.25 ◽

2020 ◽

Vol 19 (6) ◽

pp. 1285-1293

Author(s):

Lorina I. Badger-Emeka ◽

Zainab Yaseen Al-Jaziri ◽

Naheed Kausar ◽

Nora Ahmad Al-Muhainy ◽

Edric Estrella

Keyword(s):

Escherichia Coli ◽

Antimicrobial Susceptibility ◽

Blood Stream ◽

Susceptibility Test ◽

Automated System ◽

Antimicrobial Susceptibility Test ◽

Isolation And Identification ◽

Blood Stream Infections ◽

E Coli ◽

Extended Spectrum

Purpose: To investigate the antimicrobial susceptibility and extended spectrum β-lactamase (ESBL) production by clinical isolates of Escherichia coli (ESBL-EC) and Klebsiella species (ESBL-KP) associated with blood stream infections (BSIs).Methods: Bacteria isolation and identification were carried out using basic bacteriological and biochemical techniques. Antimicrobial susceptibility test was performed according to the guidelines of the Clinical Laboratory Standard Institute (CLSI). Vitek 2 Compact automated system was used toconfirm the identifications (ID) and antimicrobial susceptibility test (AST). The ESBL produced by E. coli and K. pneumoniae isolates were phenotypically characterised using Modified Double Disc Synergy Test (MDDST), as recommended by CLSI.Results: All (100 %) isolates were sensitive to imipenem and meropenem, while susceptibility to other antibiotics varied. ESBL genotypes, viz, blaTEM, blaSHV and blaCTX were encountered in the BSIs. For ESBL-EC, TEM, SHV and CTX producers accounted for 33, 16.67 and 58.3 %, respectively, while 75, 91.7 and 100 % of ESBL-KP were TEM, SHV and CTX producers, respectively. In ESBL-KP, 67 % coexisted with all three genotypes (blaTEM, blaSHV, and blaCTX, while 8.3 % of ESBL-EC coexisted with the three encoding genes (CTX, SHV and TEM).Conclusion: ESBL E. coli and K. pneumoniae associated with BSI have been identified as TEM, SHV and CXT producers, with more ESBL-KP coexisting with all three than ESBL-EC. Keywords: β-Lactamases, Genes, Klebsiella pneumoniae, Escherichia coli

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Impact of Antibiotic Usage on Extended-Spectrum ß-Lactamase Producing Escherichia Coli Prevalence: A Time-Series Analysis of Tertiary Hospital Implementing Stewardship Program

10.21203/rs.3.rs-151498/v1 ◽

2021 ◽

Author(s):

Jeong Yeon Kim ◽

Yun Jin Yum ◽

Hyung Joon Joo ◽

Hyonggin An ◽

Jong Hun Kim ◽

...

Keyword(s):

Escherichia Coli ◽

Time Series ◽

Antimicrobial Resistance ◽

Time Series Analysis ◽

Antimicrobial Stewardship ◽

Antibiotic Usage ◽

E Coli ◽

Series Analysis ◽

Extended Spectrum ◽

Hospital Acquired

Abstract An increase in antibiotic usage is considered to attribute to the emergence of antimicrobial resistance. Although experts are counting on the antimicrobial stewardship programs to reduce antibiotic usage, their effect remains uncertain. In this study, we aimed to evaluate the impact of antibiotic usage and forecast the prevalence of hospital-acquired extended spectrum β-lactamase (ESBL) - producing Escherichia coli (E. coli) using time-series analysis. Antimicrobial culture information of E. coli was obtained using a text processing technique that helped extract free-text electronic health records from standardized data. The antimicrobial use density (AUD) of antibiotics of interest was used to estimate the quarterly antibiotic usage. Transfer function model was applied to forecast relationship between antibiotic usage and ESBL-producing E. coli. Of the 1,938 hospital-acquired isolates, 831 isolates (42.9%) were ESBL-producing E. coli. Both the proportion of ESBL-producing E. coli and AUD increased over time. The transfer model predicted that ciprofloxacin AUD is related to the proportion of ESBL-producing E. coli two quarters later. In conclusion, excessive use of antibiotics was shown to affect the prevalence of resistant organisms in the future. Therefore, the control of antibiotics with antimicrobial stewardship programs should be considered to restrict antimicrobial resistance.

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Antimicrobial resistance, diarrheagenic and avian pathogenic virulence genes in Escherichia coli from poultry feed and the ingredients

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/1678-4162-10355 ◽

2019 ◽

Vol 71 (6) ◽

pp. 1968-1976 ◽

Cited By ~ 1

Author(s):

J.M. Rossato ◽

B.G. Brito ◽

R.K.T. Kobayashi ◽

V.L. Koga ◽

J.J.P. Sarmiento ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Susceptibility Gene ◽

Poultry Feed ◽

Diffusion Method ◽

Multi Drug Resistance ◽

E Coli ◽

Phylogenetic Classification ◽

Mar Index

ABSTRACT Diarrheagenic (DEC) and avian pathogenic Escherichia coli (APEC) are associated with intestinal and extra-intestinal infections (ExPEC), respectively. We aimed to analyze the antimicrobial susceptibility, gene encoding virulence factors associated to DEC and APEC, and phylogenetic classification in E. coli isolated from 320 samples of feed and ingredients. Antimicrobial susceptibility was performed using the disk diffusion method and Multiple Antibiotic Resistance (MAR) Index and Multi-Drug Resistance (MDR) were calculated. Phylogenetic classification was performed on samples harboring DEC and/or APEC virulence-associated genes. A total of 110 E. coli strains were isolated in 15% (49/320) of the evaluated inputs (n=13 vegetable meal; n=33 animal meal, n=3 feed). In general, the isolates showed the highest rates of antimicrobial resistance to sulfonamide and cefazolin and 18% (20/110) were multi-drug resistant. MAR index of feed samples was the highest (0.467). Six and five strains had APEC and DEC virulence-associated genes, respectively, and belonging to phylogenetic groups A and B1. These findings point to the need for strict microbiological control during the production process of these foods.

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Prevalence of Multidrug Resistance and Extended-Spectrum β-Lactamase Carriage of Clinical Uropathogenic Escherichia coli Isolates in Riyadh, Saudi Arabia

International Journal of Microbiology ◽

10.1155/2018/3026851 ◽

2018 ◽

Vol 2018 ◽

pp. 1-9 ◽

Cited By ~ 14

Author(s):

Abdulaziz Alqasim ◽

Ahmad Abu Jaffal ◽

Abdullah A. Alyousef

Keyword(s):

Escherichia Coli ◽

Multidrug Resistance ◽

Antimicrobial Susceptibility ◽

Empirical Therapy ◽

E Coli ◽

Extended Spectrum ◽

High Prevalence ◽

Tertiary Healthcare ◽

Polymerase Chain ◽

Synergy Test

The prevalence of extended-spectrum β-lactamase-producing Escherichia coli (ESBL-producing E. coli) has recently increased worldwide. This study aims at determining the antimicrobial susceptibility patterns of a collection of clinical E. coli urine isolates and evaluating the ESBL carriage of these isolates at phenotypic and genotypic levels. A total of 100 E. coli urine isolates were collected at a tertiary healthcare centre in Riyadh from January 2018 to March 2018. Antimicrobial susceptibility testing was carried out for all isolates. ESBL production was characterized at phenotypic and genotypic levels using double-disc synergy test and polymerase chain reaction, respectively. Detection of different ESBL variants was performed using DNA sequencing. Of 100 E. coli isolates, 67 were associated with multidrug resistance (MDR) phenotype. All isolates showed variable resistance levels to all antibiotics used here expect to imipenem, where they were all imipenem-sensitive. 33 out of 100 E. coli isolates were positive for ESBLs by phenotypic and genotypic methods. Among all ESBL-positive E. coli isolates, the CTX-M was the most prevalent ESBL type (31/33 isolates; 93.94%). CTX-M-15 variant was detected in all isolates associated with CTX-M carriage. Multiple ESBL gene carriage was detected in 15/33 isolates (45.45%), where 11 (33.33%) isolates produced two different ESBL types while 4 isolates (12.12%) associated with carrying three different ESBL types. Our study documented the high antimicrobial resistance of ESBL-producing E. coli to many front-line antibiotics currently used to treat UTI patients, and this implies the need to continuously revise the local guidelines used for optimal empirical therapy for UTI patients. It also showed the high prevalence of ESBL carriage in E. coli urine isolates, with CTX-M-15 being the most predominant CTX-M variant.

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Molecular Characteristics of Travel-Related Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates from the Calgary Health Region

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00061-09 ◽

2009 ◽

Vol 53 (6) ◽

pp. 2539-2543 ◽

Cited By ~ 53

Author(s):

Johann D. D. Pitout ◽

Lorraine Campbell ◽

Deirdre L. Church ◽

Daniel B. Gregson ◽

Kevin B. Laupland

Keyword(s):

Escherichia Coli ◽

Genetic Relatedness ◽

Indian Subcontinent ◽

Molecular Characteristics ◽

E Coli ◽

Health Region ◽

Calgary Health Region ◽

Extended Spectrum ◽

Hospital Acquired ◽

M 14

ABSTRACT Extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli has recently emerged as a major risk factor for community-acquired, travel-related infections in the Calgary Health Region. Molecular characterization was done on isolates associated with infections in returning travelers using isoelectric focusing, PCR, and sequencing for bla CTX-Ms, bla TEMs, bla SHVs, bla OXAs, and plasmid-mediated quinolone resistance determinants. Genetic relatedness was determined with pulsed-field gel electrophoresis using XbaI and multilocus sequence typing (MLST). A total of 105 residents were identified; 6/105 (6%) presented with hospital-acquired infections, 9/105 (9%) with health care-associated community-onset infections, and 90/105 (86%) with community-acquired infections. Seventy-seven of 105 (73%) of the ESBL-producing E. coli isolates were positive for bla CTX-M genes; 55 (58%) produced CTX-M-15, 13 (14%) CTX-M-14, six (6%) CTX-M-24, one (1%) CTX-M-2, one (1%) CTX-M-3, and one (1%) CTX-M-27, while 10 (10%) produced TEM-52, three (3%) TEM-26, 11 (11%) SHV-2, and four (4%) produced SHV-12. Thirty-one (30%) of the ESBL-producing E. coli isolates were positive for aac(6′)-Ib-cr, and one (1%) was positive for qnrS. The majority of the ESBL-producing isolates (n = 95 [90%]) were recovered from urine samples, and 83 (87%) were resistant to ciprofloxacin. The isolation of CTX-M-15 producers belonging to clone ST131 was associated with travel to the Indian subcontinent (India, Pakistan), Africa, the Middle East, and Europe, while clonally unrelated strains of CTX-M-14 and -24 were associated with travel to Asia. Our study suggested that clone ST131 coproducing CTX-M-15, OXA-1, TEM-1, and AAC(6′)-Ib-cr and clonally unrelated CTX-M-14 producers have emerged as important causes of community-acquired, travel-related infections.

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Extended-Spectrum-β-Lactamase-Producing Escherichia coli Strains Isolated from Farm Animals from 1999 to 2002: Report from the Japanese Veterinary Antimicrobial Resistance Monitoring Program

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.49.8.3533-3537.2005 ◽

2005 ◽

Vol 49 (8) ◽

pp. 3533-3537 ◽

Cited By ~ 114

Author(s):

Akemi Kojima ◽

Yoshikazu Ishii ◽

Kanako Ishihara ◽

Hidetake Esaki ◽

Tetsuo Asai ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antimicrobial Susceptibility ◽

Promoter Region ◽

Monitoring Program ◽

Farm Animals ◽

Resistance Monitoring ◽

E Coli ◽

Extended Spectrum ◽

Nationwide Surveillance

ABSTRACT A nationwide surveillance for antimicrobial susceptibility in Escherichia coli strains isolated from food-producing animals in Japan was conducted from 1999 to 2002. Eighteen cefazolin-resistant E. coli strains were isolated from broilers. Six were CTX-M-type producing, and eight were CMY-2 producing, while eight had mutations at the ampC promoter region.

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Impact of antibiotic usage on extended-spectrum β-lactamase producing Escherichia coli prevalence

Scientific Reports ◽

10.1038/s41598-021-91332-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jeong Yeon Kim ◽

Yunjin Yum ◽

Hyung Joon Joo ◽

Hyonggin An ◽

Young Kyung Yoon ◽

...

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Antimicrobial Stewardship ◽

Antibiotic Usage ◽

Transfer Model ◽

Free Text ◽

E Coli ◽

Extended Spectrum ◽

Hospital Acquired ◽

The Impact

AbstractAn increase in antibiotic usage is considered to contribute to the emergence of antimicrobial resistance. Although experts are counting on the antimicrobial stewardship programs to reduce antibiotic usage, their effect remains uncertain. In this study, we aimed to evaluate the impact of antibiotic usage and forecast the prevalence of hospital-acquired extended spectrum β-lactamase (ESBL)—producing Escherichia coli (E. coli) using time-series analysis. Antimicrobial culture information of E. coli was obtained using a text processing technique that helped extract free-text electronic health records from standardized data. The antimicrobial use density (AUD) of antibiotics of interest was used to estimate the quarterly antibiotic usage. Transfer function model was applied to forecast relationship between antibiotic usage and ESBL-producing E. coli. Of the 1938 hospital-acquired isolates, 831 isolates (42.9%) were ESBL-producing E. coli. Both the proportion of ESBL-producing E. coli and AUD increased over time. The transfer model predicted that ciprofloxacin AUD is related to the proportion of ESBL-producing E. coli two quarters later. In conclusion, excessive use of antibiotics was shown to affect the prevalence of resistant organisms in the future. Therefore, the control of antibiotics with antimicrobial stewardship programs should be considered to restrict antimicrobial resistance.

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