CTX-M-producing Escherichia coli and Klebsiella pneumoniae isolated from community-acquired urinary tract infections in Valledupar, Colombia

Martínez, Pedro; Garzon, Denisse; Máttar, Salim

doi:10.1016/j.bjid.2012.05.001

Cited by 37 publications

(25 citation statements)

References 28 publications

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“…Endemic worldwide resistance to these molecules limits their efficiency in the empirical treatment of UTI. 28,46 Noteworthy was the resistance rate to tetracycline (51.3%) comparable to rates of 53% and 60.8% reported by Ho et al 29 and Martinez et al 41 Tetracycline is used less in human medicine; the high resistance rate may be due to its common use as an animal growth promoter leading to the transmission of resistant bacteria to humans by direct contact and through the food chain. 27 Resistance to sulfamethoxazole-trimethoprim and fluoroquinolones, the most common antibacterial drugs in UTI treatment, was substantial (rates >20%) and no longer allowed their empirical prescription as recommended.…”

Section: Discussionsupporting

confidence: 60%

Antibiotic Resistance, Virulence, and Genetic Background of Community-Acquired Uropathogenic Escherichia coli from Algeria

Yahiaoui

Robin

Bakour

et al. 2015

Microbial Drug Resistance

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The aim of the study was to investigate antibiotic resistance mechanisms, virulence traits, and genetic background of 150 nonrepetitive community-acquired uropathogenic Escherichia coli (CA-UPEC) from Algeria. A rate of 46.7% of isolates was multidrug resistant. bla genes detected were blaTEM (96.8% of amoxicillin-resistant isolates), blaCTX-M-15 (4%), overexpressed blaAmpC (4%), blaSHV-2a, blaTEM-4, blaTEM-31, and blaTEM-35 (0.7%). All tetracycline-resistant isolates (51.3%) had tetA and/or tetB genes. Sulfonamides and trimethoprim resistance genes were sul2 (60.8%), sul1 (45.9%), sul3 (6.7%), dfrA14 (25.4%), dfrA1 (18.2%), dfrA12 (16.3%), and dfrA25 (5.4%). High-level fluoroquinolone resistance (22.7%) was mediated by mutations in gyrA (S83L-D87N) and parC (S80I-E84G/V or S80I) genes. qnrB5, qnrS1, and aac(6')-Ib-cr were rare (5.3%). Class 1 and/or class 2 integrons were detected (40.7%). Isolates belonged to phylogroups B2+D (50%), A+B1 (36%), and F+C+Clade I (13%). Most of D (72.2%) and 38.6% of B2 isolates were multidrug resistant; they belong to 14 different sequence types, including international successful ST131, ST73, and ST69, reported for the first time in the community in Algeria and new ST4494 and ST4529 described in this study. Besides multidrug resistance, B2 and D isolates possessed virulence factors of colonization, invasion, and long-term persistence. The study highlighted multidrug-resistant CA-UPEC with high virulence traits and an epidemic genetic background.

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Section: Discussionsupporting

confidence: 60%

Antibiotic Resistance, Virulence, and Genetic Background of Community-Acquired Uropathogenic Escherichia coli from Algeria

Yahiaoui

Robin

Bakour

et al. 2015

Microbial Drug Resistance

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“…In contrast with Acinetobacter species isolates, both members of the Enterobacteriaceae contained multiple resistance genes in two large plasmids (151 to 198 kb) (Table 1), including bla CTXM-15 , consistent with the previously documented predominance of that extended-spectrum ␤-lactamase (ESBL) in Colombia (11,12). The K. pneumoniae isolate belonged to ST392, previously associated with the dissemination of bla KPC , bla , and other ESBLs (13,14).…”

supporting

confidence: 67%

Initial Assessment of the Molecular Epidemiology of bla _NDM-1 in Colombia

Rojas

Wright

Cadena

et al. 2016

Antimicrob Agents Chemother

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fWe report complete genome sequences of four bla NDM-1 -harboring Gram-negative multidrug-resistant (MDR) isolates from Colombia. The bla NDM-1 genes were located on 193-kb Inc FIA, 178-kb Inc A/C2, and 47-kb (unknown Inc type) plasmids. Multilocus sequence typing (MLST) revealed that these isolates belong to sequence type 10 (ST10) (Escherichia coli), ST392 (Klebsiella pneumoniae), and ST322 and ST464 (Acinetobacter baumannii and Acinetobacter nosocomialis, respectively). Our analysis identified that the Inc A/C2 plasmid in E. coli contained a novel complex transposon (Tn125 and Tn5393 with three copies of bla NDM-1 ) and a recombination "hot spot" for the acquisition of new resistance determinants.A t this time, bla NDM is recognized as a major global health threat. Guatemala and Colombia reported the first cases of bla NDM-1 -harboring isolates in Latin America (1, 2). In both instances, bla NDM-1 was discovered in hospital-acquired, clonally related Klebsiella pneumoniae isolates that were recovered from patients who had not travelled recently. The molecular epidemiology of bla NDM carbapenemases in South America has been investigated only in a limited fashion, and data in Colombia are very scarce. In order to understand the dissemination of bla NDM-1 in Colombia, we performed a genomic analysis of four sentinel isolates, Acinetobacter baumannii, Acinetobacter nosocomialis, Escherichia coli, and K. pneumoniae collected in 2012, shortly after the first reported outbreak (1).

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“…Este porcentaje es mayor a lo publicado previamente en Estados Unidos, donde se encontró una prevalencia del 1,66% 45 , y a lo descrito previamente en Colombia en el año 2013, con una prevalencia del 2,4% 17 . Sin embargo, en otro estudio nacional basado en reportes de laboratorio se encontró una prevalencia semejante a la nuestra, con el 6,8% de los aislamientos correspondientes al grupo CTX-M-1 48 .…”

Section: Discussionunclassified

Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia

Blanco

Maya

Correa

et al. 2016

Enfermedades Infecciosas y Microbiología Clínica

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RESUMEN Introducción Las infecciones del tracto urinario (ITU) son frecuentes en la comunidad. Sin embargo, la información de aislamientos resistentes en este contexto es limitada en Latinoamérica. Este estudio tiene como objetivo determinar la prevalencia y los factores de riesgo asociados con ITU de inicio en la comunidad (ITU-IC) causadas por Escherichia coli productor de betalactamasas de espectro extendido (BLEE) en Colombia. Materiales y métodos Entre agosto y diciembre de 2011 se realizó un estudio de casos y controles en 3 instituciones de salud de tercer nivel en Colombia. Se invitó a participar a todos los pacientes admitidos a urgencias con diagnóstico probable de ITU-IC, y se les pidió una muestra de orina. En los aislamien-tos de E. coli se realizaron pruebas confirmatorias para BLEE, susceptibilidad antibiótica, caracterización molecular (PCR en tiempo real para genes bla, repetitive element palindromic PCR [rep-PCR], multilocus sequence typing [MLST] y factores de virulencia por PCR). Se obtuvo información clínica y epidemiológica, y posteriormente se realizó el análisis estadístico. Resultados De los 2.124 pacientes seleccionados, 629 tuvieron un urocultivo positivo, en 431 de estos se aisló E. coli, 54 fueron positivos para BLEE y 29 correspondieron a CTX-M-15. La mayoría de los aislamientos de E. coli productor de BLEE fueron sensibles a ertapenem, fosfomicina y amikacina. La ITU complicada se asoció fuertemente con infecciones por E. coli productor de BLEE (OR = 3,89; IC 95%: 1,10–13,89; p = 0,03). E. coli productor de CTX-M-15 mostró 10 electroferotipos diferentes; de estos, el 65% correspondieron al ST131. La mayoría de estos aislamientos tuvieron 8 de los 9 factores de virulencia analizados. Discusión E. coli portador del gen blaCTX-M-15 asociado al ST131 sigue siendo frecuente en Colombia. La presencia de ITU-IC complicada aumenta el riesgo de tener E. coli productor de BLEE, lo cual debe tenerse en cuenta para ofrecer una terapia empírica adecuada.

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CTX-M-producing Escherichia coli and Klebsiella pneumoniae isolated from community-acquired urinary tract infections in Valledupar, Colombia

Abstract: CTX-M ESBL in uropathogens isolated from the community is cause for concern due to the enormous potential for multidrug resistance from strains that produce these enzymes, which could lead to failure of empirically-administered therapies and development of complicated UTIs.

Cited by 37 publications

References 28 publications

Antibiotic Resistance, Virulence, and Genetic Background of Community-Acquired Uropathogenic Escherichia coli from Algeria

Antibiotic Resistance, Virulence, and Genetic Background of Community-Acquired Uropathogenic Escherichia coli from Algeria

Initial Assessment of the Molecular Epidemiology of bla _NDM-1 in Colombia

Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia

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CTX-M-producing Escherichia coli and Klebsiella pneumoniae isolated from community-acquired urinary tract infections in Valledupar, Colombia

Abstract: CTX-M ESBL in uropathogens isolated from the community is cause for concern due to the enormous potential for multidrug resistance from strains that produce these enzymes, which could lead to failure of empirically-administered therapies and development of complicated UTIs.

Cited by 37 publications

References 28 publications

Antibiotic Resistance, Virulence, and Genetic Background of Community-Acquired Uropathogenic Escherichia coli from Algeria

Antibiotic Resistance, Virulence, and Genetic Background of Community-Acquired Uropathogenic Escherichia coli from Algeria

Initial Assessment of the Molecular Epidemiology of bla NDM-1 in Colombia

Prevalencia y factores de riesgo para infecciones del tracto urinario de inicio en la comunidad causadas por Escherichia coli productor de betalactamasas de espectro extendido en Colombia

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Initial Assessment of the Molecular Epidemiology of bla _NDM-1 in Colombia