Antimicrobial Resistance and Molecular Characterization of Extended-Spectrum β-Lactamases ofEscherichia coliandKlebsiellaspp. Isolates from Urinary Tract Infections in Southern Brazil

Abstract

The objective of this study was to evaluate the frequency of different extended-spectrum β-lactamases (ESBL) as well as to associate these ESBL with antimicrobial (ATM) resistance in Escherichia coli and Klebsiella spp. isolates from outpatients and inpatients with urinary tract infections. The study included 435 consecutive nonduplicate clinical isolates, including 362 E. coli isolates, 62 Klebsiella pneumoniae isolates, and 11 K. oxytoca isolates. Isolates were obtained from patients who were treated in a University Hospital between August 2012 and July 2013. Three multiplex PCR were performed to identify the ESBL groups. A total of 48 (11%) ESBL-producing isolates were found. The risk for the ESBL presence was significantly higher in males (26.4%) than females (8%), from hospital-acquired infections (29.1%) than community-acquired infections (7.0%) and in Klebsiella spp. (27.4%) than in E. coli (7.7%). ESBL-producing isolates presented a significantly higher percentage of resistance in 21 of the 23 ATMs analyzed. The CTX-M-1 group was the most predominant ESBL identified. The bla gene was found in 56% of the total ESBL producers from community and in 42.4% from hospital origins; it was followed in frequency by the bla, also found in both environments. Klebsiella spp. presented the largest variety of β-lactamase enzyme combinations and a higher level of resistance to cefotaxime. These findings contribute to better knowledge of the epidemiology of ESBL enzymes and are alarming for the reduced therapeutic options available for the risk groups identified in the studied populations.

Multidrug-resistant Klebsiella pneumoniae: a retrospective study in Manaus, Brazil

“…1. Similar results were described by Pereira et al (2019) who evaluated E. coli (362 strains) and Klebsiella spp. (73 strains) isolated from urinary tract infections in southern Brazil, which demonstrated high percentage of resistance in 91.3% (n = 21/23) antimicrobials analysed: ampicillin (AMP), ampicillin-sulbactam (APS), piperacillin-tazobactam (PIT), amoxicillin-clavulanate (AMC), cefazolin (CFZ), cefotaxime (CTX), ceftazidime (CAZ), ceftriaxone (CRO), cefuroxime (CRX), cefepime (CPM), cefoxitin (CFO), aztreonam (ATM), ertapenem (ERT), meropenem (MPM), imipenem (IPM), amikacin (AMI), tobramycin (TOB), nitrofurantoin (NIT), sulfamethoxazole (SUT), tetracycline (TET), ciprofloxacin (CIP), levofloxacin (LEV).…”

The Prevalence of VIM, IMP, and NDM-1 Metallo-beta-Lactamase Genes in Clinical Isolates of Klebsiella pneumoniae in Qom Province, Iran

“…Our results showed that 48 strains are resistant to imipenem, meropenem, and ertapenem in which 15.6% was positive for IMP, 2.42% for VIM, and 1.92% positive for NDM-1 gene. Some studies showed that, with respect to the relative increase in resistance, ciprofloxacin and its derivatives such as quinolone, Amikacin such as aminoglycoside, and Imipenem such as beta-lactam have been the most effective antibiotics for the treatment of Pseudomonas infections [22][23][24]. In our study, the most effective aminoglycoside, quinolone, and beta-lactam were tobramycin, ciprofloxacin, and imipenem, respectively.…”

Panorama of Bacterial Infections Caused by Epidemic Resistant Strains

“…In India, the most prevalent MRSA is SCC mec type III, corresponding to 58% of the isolates [ 20 ]. In Brazil, 65.4% of MRSA are type II, 37% type I, and 15.4% type IV [ 27 , 28 ], and in the United States 29.9% are type II and 30.9% are type IV [ 29 ].…”

“…In North America, ESBL-producing Enterobacterales have been more prevalent in the US, in which a study conducted between 2013 and 2017 with 1.112.312 enterobacterial isolates from 411 US hospitals found that about 12.05% were producers ESBL [ 65 ], with the CTX-M class being the most widespread in that country [ 97 ]. In Brazil, a study conducted with 435 isolates of enterobacteria from the southeast region of the country, showed that 48 isolates (11%) were ESBL producers, with the bla CTX-M-1 and bla CTX-M-8/25 genes being the most found in samples, as well as combinations of CTX-M, TEM, SHV and OXA [ 28 ].…”