Antimicrobial Resistance of &lt;b&gt;&lt;i&gt;Escherichia coli&lt;/i&gt;&lt;/b&gt; Strains Causing Neonatal Sepsis between 1998 and 2008

Guiral, Elisabet; Bosch, Jordi; Vila, Jordi; Soto, Sara M.

doi:10.1159/000337062

Cited by 19 publications

(17 citation statements)

References 47 publications

(33 reference statements)

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“…The phenotypic results of antimicrobial resistance observed in the present study indicated high levels of ampicillin-resistant isolates in the collection, in accordance with those found in E. coli isolates causing neonatal sepsis and in extraintestinal E. coli in general (10). On the other hand, the low rates of resistance to amoxicillin-clavulanic acid and second-and third-generation cephalosporins observed in the present study are in contrast with the increasing appearance of strains carrying extended-spectrum ␤-lactamases (ESBLs) in the last years and causing infections from other sources, suggesting that the implementation of these antimicrobial agents as first-line therapy in these types of infections is correct (11).…”

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confidence: 90%

Antimicrobial Resistance and Virulence Characterization among Escherichia coli Clinical Isolates Causing Severe Obstetric Infections in Pregnant Women

et al. 2015

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dThe virulence markers and the antimicrobial resistance profiles of 78 Escherichia coli isolates causing obstetric infections accompanied by sepsis or not were studied. Adhesion-related virulence factors were the most prevalent markers. Low rates of resistance to the antimicrobial agents used as first-line therapy suggest their correct implementation in stewardship guidelines. Escherichia coli is the enteric Gram-negative bacillus most frequently found in the genital tract of women. Despite its commensal role, this microorganism can become pathogenic, colonizing new environments. Extraintestinal E. coli is the second most prevalent etiologic agent causing obstetric infections (1). E. coli possesses several virulence factor genes (VFG) that enhance vaginal and/or endocervical colonization in pregnant women. This colonization can lead to different infections in obstetric patients, such as intra-amniotic infection (IAI) or endometrial and urinary tract infections (UTIs), sometimes accompanied by sepsis. In addition, these microorganisms can cause neonatal infections, leading to maternal and fetal morbidity and mortality (2, 3). It has been estimated that 15% of pregnant and 12% of nonpregnant women in our hospital present E. coli in the genital tract (4).The treatment of choice for maternal sepsis includes the administration of different antimicrobial agents, depending on the infection focus, being limited by the low number of antimicrobial agents considered to be safe to the fetus (5). In our hospital, the treatment of choice in patients with IAI consists of ceftriaxone, ampicillin-gentamicin, or ampicillin-cefoxitin, while the treatment of endometritis involves the use of ampicillin-gentamicinmetronidazole.Briefly, among the virulence factors involved in UTIs, it is well known that adhesins, fimbriae, and toxins are the most important, as they allow the bacteria to adhere to the uroepithelium and cause tissue damage. However, further knowledge is necessary regarding their prevalences and the roles of other families of virulence factors in the specific field of obstetric infections derived from UTIs.For this purpose, 78 E. coli isolates obtained from pregnant women attending the Hospital Clinic of Barcelona from 1987 to 2010 were included in the study; 56 were isolated from the blood samples of patients with sepsis from a genital or urinary origin, and 22 were isolated from amniotic fluid or placenta samples of patients with nonbacteremic IAI.The resistance profiles were determined using the disk diffusion method. The antimicrobial agents tested are listed in Table 1 and include the first therapeutic options used to treat UTIs and genital infections. The results were interpreted according to CLSI guidelines (6), and the E. coli ATCC 25922 strain was used as the control.The VFG profiles of the isolates were analyzed by PCR using gene-specific primers for the virulence genes coding for the adhesins, toxins, and invasins most prevalent in the uropathogenic E. coli (UPEC) isolates described, from which the isolates ca...

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Antimicrobial Resistance and Virulence Characterization among Escherichia coli Clinical Isolates Causing Severe Obstetric Infections in Pregnant Women

et al. 2015

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“…In E. coli , resistance to other antibiotics, such as carbapenems and aminoglycosides (AGs), has become a concern [17]. These antibiotics are occasionally used to treat severe systemic infections, such as sepsis.…”

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confidence: 99%

High Prevalence of Cross-Resistance to Aminoglycosides in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates

Tsukamoto¹,

Ohkoshi²,

Okubo³

et al. 2013

Chemotherapy

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Background: Multidrug-resistant Escherichia coli, especially a lineage of O25b:H4-ST131, has increased and spread worldwide. The surveillance of cross-resistance of E. coli is necessary. Methods: Cross-resistance to fluoroquinolones (FQs) and aminoglycosides (AGs) was examined in E. coli isolated in Hokkaido Prefecture, Japan, between 2008 and 2009. Results: Gentamicin (GEN) resistance was more common in FQ-resistant isolates (30/112 strains; 26.8%) than in FQ-susceptible isolates (2/100 strains; 2%). The frequency of GEN resistance was similar in two groups of FQ-resistant strains, O25b:H4-ST131 genotype (22/87 strains; 25.3%) and a group of other FQ-resistant genotypes (8/25 strains; 32.0%). The main AG resistance gene was aac(3)-II (87.5% of GEN-resistant strains). The only amikacin-resistant strain which was FQ resistant carried the aac(6')-Ib-cr gene. CTX-M type extended-spectrum β-lactamase (ESBL) genes were also found in FQ-resistant strains at a high frequency. However, the number of strains with both ESBL and AG-modifying enzyme genes was relatively low (8 strains). Conclusion: All FQ-resistant strains, not only O25b:H4-ST131, appeared to preferentially acquire ESBL genes and/or genes encoding AG-modifying enzymes; however, the acquisitions of these genes seemed to occur independently.

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“…12 The percentage of strains resistant to ampicillin and gentamicin is on the rise, cephalosporins being the alternative treatment in these cases. However, the number of strains resistant to cephalosporins is also becoming an increasingly notable problem in developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…However, the number of E. coli strains causing neonatal sepsis resistant to these antibiotics is increasing. 3,12,19,29 The emergence of extended spectrum beta-lactamases (ESBL)-producing E. coli in neonates 1,12,13,23,24 makes epidemiological surveillance for vertical transmission of neonatal sepsis necessary, being of special interest in the cases of newborns from mothers with obstetric risk factors.…”

mentioning

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Characterization of CTX-M-14 and CTX-M-15 ProducingEscherichia coliStrains Causing Neonatal Sepsis

Sáez-López

Guiral

López

et al. 2014

Microbial Drug Resistance

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Neonatal sepsis is a disease affecting newborns £ 1 month of age with clinical symptoms and positive blood cultures. The number of Escherichia coli strains causing neonatal sepsis resistant to the antibiotics used in the treatment is increasing. In this study, two E. coli strains causing sepsis in neonates of mothers infected with an E. coli strain harboring extended spectrum beta-lactamases were characterized. The bla CTX-M-15 and the bla CTX-M-14 genes were found in an IncFIA and nontypeable transferable plasmids, respectively. In addition, these highly virulent strains belonged to ST705 and ST156 clonal groups, respectively. The presence of strains, which are highly virulent and resistant to ampicillin, gentamicin, and cephalosporins, makes a change in empirical treatment necessary as well as an increase in the surveillance of these infections.

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Antimicrobial Resistance of <b><i>Escherichia coli</i></b> Strains Causing Neonatal Sepsis between 1998 and 2008

Cited by 19 publications

References 47 publications

Antimicrobial Resistance and Virulence Characterization among Escherichia coli Clinical Isolates Causing Severe Obstetric Infections in Pregnant Women

Antimicrobial Resistance and Virulence Characterization among Escherichia coli Clinical Isolates Causing Severe Obstetric Infections in Pregnant Women

High Prevalence of Cross-Resistance to Aminoglycosides in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates

Characterization of CTX-M-14 and CTX-M-15 ProducingEscherichia coliStrains Causing Neonatal Sepsis

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