High incidence of multidrug-resistant fecal E. coli producing ESBLs and carried ST131 in Jordanian adults
DOI:
https://doi.org/10.3823/0810Keywords:
Fecal E .coli ST131, Antimicrobial resistance, ESBls, Jordanian AdultsAbstract
Background: Escherichia coli is part of the human intestine normal flora, although it has the potential of causing variety of invasive and diarrheal diseases. It is also a frequent cause of community- and hospital-acquired urinary tract infections. Intestinal E. coli has the potential to develop rapidly multidrug resistant (MDR) and to emerge as extended-spectrum β-lactamases (ESBLs)-producer.
Methods: Over the period of July through November, 2015; 287 stool samples were collected from Jordanian adults who visited the students’ clinic of the University of Jordan. Fecal samples were collected and cultured for isolation of E. coli. The isolates were investigated for antimicrobial susceptibility, and molecular method of polymerase chain reaction (PCR) was performed for the detection genes of ST131 clone, blaCTX-M group I, blaCTX-M-15, blaNDM-1, blaVIM, blaIMP, blaOXA-48, blaKPC and fluoroquinolones resistance (gyrA and parC).
Results: A total of 105/287 E. coli isolates (36.6%) were found to be multi-drug resistant (MDR) to at least 3 classes of antibiotics, of these 45.1% were ESBL-producers. A total of 51 representative MDR isolates indicated the following; 49% were found positive for ST131 clone, 58.8% were resistant for ciprofloxacin, and 41.2% were positive for CTX-M group I and CTX-M-15, respectively. All these MDR isolates were also positive for mutated both gyrA and ParC genes, and only 6 / 51 isolates (11.8%) were positive for each blaNDM-1 and blaKPC. One out of 51 MDR isolates (2%) was positive for blaVIM, and none of these isolates was positive for blaIMP nor blaOXA-48 genes.
Conclusion: This study indicated that a relatively high rates of commensal fecal E. coli isolates from Jordanian adults were MDR, ESBLs-producer and belonging to ST131 clone. Also, high rates of CTX-M-15 and fluoroquinolones resistance were found among MDR E. coli isolates.
References
Antimicrobial resistance global report on surveillance, World Health organization, 2014 (ISBN 978 92 4 156474 8) 20, 1211 Geneva 27, Switzerland,
CantÓn R, Gonzalez-Alba JM, Galan JC. CTX-M enzymes: origin and diffusion. Front Microbiol 2012; 3: 110.
Baroud M, Araj GF, Matar GM. Spread of CTX-M-15 Extended Spectrum β-Lactamases Encoding Genes Among Enterobacteriaceae in the Middle Eastern Region. The IAJAA 2011; 1(1): 4.
Badran EF, Qamar Din AR, Shehabi AA. (2016), Low intestinal colonization of Escherichia coli clone ST131 producing CTX-M-15 in Jordanian infants. J Med Microbiol 2016; 65(2): 137-141.
Tayh G, Ben Sallem R, Ben Yahia H, Gharsa H, Klibi N. et al. First report of extended-spectrum β-lactamases among clinical isolates of Escherichia coli in Gaza Strip, Palestine. J Glob Antimicrob Resist 2016; 6: 17-21.
Abu Salah MA, Badran, EF, Shehabi AA. High incidence of multidrug resistant Escherichia coli producing CTX-M-type ESBLs colonizing the intestine of Jordanian infants. The IAJAA 2013; 3(4): 3.
Al-Agamy MHM, Ashour MSE, Wiegand I. First description of CTX-M β-lactamase-producing clinical Escherichia coli isolates from Egypt. Int J Antimicrob Agents 2006; 27(6): 545-548.
Nordmann P. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. Clin l Microbiol Infect 2012; 18(5): 413-431.
Bush Karen . Bench-to-bedside review: The role of β-lactamases in antibiotic resistant Gram-negative infections. Crit Care 2010;14(3): 224.
Patel G, Bonomo RA. (2013), “Stormy waters aheadâ€: global emergence of carbapenemases. Front Microbiol 2013; 4:8.
Papagiannitsis CC, Studentova V, Jakubu V, Spanelova P, Urbaskova P, et al. High prevalence of ST131 among CTX-M-producing Escherichia coli from community-acquired infections, in the Czech Republic. Microbial Drug Resistance 2015; 21(1): 74-84.
Dahbi G, Mora A, Mamani R, Lopez C, Alonso MP, et al. Molecular epidemiology and virulence of Escherichia coli O16:H5-ST131: comparison with H30 and H30-Rx subclones of O25b: H4-ST131. Int Med Microbiol 2014; 304 (8): 1247-1257.
Wu, YH, Cheng MF, Lai CH, Lin HH, Hung CH, et al. The role of Sequence Type (ST) 131 in adult community-onset non-ESBL-producing Escherichia coli bacteraemia. BMC Infect Dis 2014; 14: 579.
Can F, Azap OK, Seref C, Ispir P,Arslan H, Ergonul O. Emerging Escherichia coli O25b/ ST131 clone predicts treatment failure in urinary tract infections. Clin infect dis 2015; 60(4): 523-527.
Banerjee R, Johnston B, Lohse C, Porter SB, Clabots C, et al. Escherichia coli Sequence Type 131 Is a Dominant, Antimicrobial-Resistant Clonal Group Associated with Healthcare and Elderly Hosts. Infect Control Hosp Epidemiol 2013; 34(4): 361-369.
Clermont O, Dhanji H, Upton M, Gibreel T, Fox A, et al. Rapid detection of the O25b-ST131 clone of Escherichia coli encompassing the CTX-M-15-producing strains. J Antimicrob Chemother 2009; 64(2): 274-277.
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fifth Informational Supplement. CLSI document M100-S25 (ISBN 1-56238-989-0 [Print]; ISBN 1-56238-990-4 [Electronic]). Clinical and Laboratory Standards Institute, 950 West Valley Road, Suite 2500, Wayne, Pennsylvania 19087 USA, 2015.
Leflon-Guibout V, Jurand C, Bonacorsi S, Espinasse F, Guelfi MC, et al. Emergence and Spread of Three Clonally Related Virulent Isolates of CTX-M-15-Producing Escherichia coli with Variable Resistance to Aminoglycosides and Tetracycline in a French Geriatric Hospital. Antimicrob Agents Chemother 2004; 48(10): 3736-3742.
Pillai DR, Melano R, Rawte P, Lo S, Tijet N, et al. Klebsiella pneumoniae Carbapenemase, Canada. Emerg Infect Dis 2009; 15(5): 827-829.
Pitout JDD, Gregson DB, Poirel L, McClure J-A, Le P, et al. Detection of Pseudomonas aeruginosa Producing Metallo-β-Lactamases in a Large Centralized Laboratory. J Clin Microbiol 2005;43(7): 3129-3135.
Bonnin RA, Naas T, Poirel L, Nordmann P. Phenotypic Biochemical, and Molecular Techniques for Detection of Metallo-β-Lactamase NDM in Acinetobacter baumanii. J Clin Microbiol 2012;50(4): 1419-1421.
Poirel L, Heritier C, Tolun V, Nordmann P. Emergence of Oxacillinase- Mediated Resistance to Imipenem in Klebsiella pneumonia. Antimicrob Agents Chemother 2004;48(1): 15-22.
Pitout JD. Extraintestinal pathogenic Escherichia coli: a combination of virulence with antibiotic resistance. Front Microbiol 2012; 2: 9
Ahmed SF, Ali MMM, Mohamed ZK, Moussa TA, Klena JD. Fecal carriage of extended-spectrum β-lactamases and AmpC-producing Escherichia coli in a Libyan community. Ann Clin Microbiol Antimicrob 2014; 13: 22.
Ben Sallem R, Ben Slama K, Astepa V, Jouini A, Gharsa H, et al. Prevalence and characterization of extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli isolates in healthy volunteers in Tunisia. Eur J Clin Microbiol Infect Dis 2012; 31(7): 1511-1516.
Hayajneh WA, Hajj A, Hulliel F, Sarkis DK, Irani-Hakimeh N, et al. Susceptibility trends and molecular characterization of Gram-negative bacilli associated with urinary tract and intra-abdominal infections in Jordan and Lebanon: SMART 2011-2013. Int J Infect Dis 2015; 35: 56-61.
Shahlol AM, Abukhres OM, Taher IA. Prevalence and Characterization of Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Brack-AlShati, Fezza, Libya. EC Microbiology 2015; 1.1: 23-32.
Adwan K, Jarrar N, Abu-Hijleh A, Adwan G , Awwad E. Molecular characterization of Escherichia coli isolates from patients with urinary tract infections in Palestine. J Med Microbiol 2014; 63: 229-234.
Nicolas-Chanoine MH, Gruson C, Bialek-Davenet S, Bertrand X, Thomas-Jean F. et al. 10-Fold increase (2006-11) in the rate of healthy subjects with extended-spectrum β-Lactamase-producing Escherichia coli faecal carriage in a Parisian check-up centre. J Antimicrobi Chemother 2013; 68(3): 562-568.
Johnson J, Johnston B, Clabots C, Kuskowski M, Castanheira M. Escherichia coli sequence type ST131 as the major cause of serious multidrug-resistant E. coli infections in the United States. Clin Infect Dis 2010; 51(3): 286-294.
Ho PL, Chu YP, Wu L, Chow KH, Law PY, et al. High Prevalence of Escherichia coli sequence type 131 among antimicrobial-resistant E. coli isolate from geriatric patients. J Med Microbiol 2015; 64(Pt 3): 243-247.
Han JH, Johnston B, Nachamkim I, Tolomero P, Bilker WB, et al. Clinical and molecular epidemiology of Escherichia coli sequence type 131 among hospitalized patients colonized intestinally with fluoroquinolone-resistant E.coli. Antimicrob Agents Chemother 2014; 58(11): 7003-7006.
Gomi R, Matsuda T, Matsumura Y, Yamamoto M, Tanaka M, et al. Occurrence of Clinically Important Lineages, Including the Sequence Type 131 C1-M27 Subclone, among Extended-Spectrum-β-Lactamase-ProducingEscherichia coli in Wastewater. Antimicrob Agents Chemother 2017; 61: 9 e00564-17
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