Characterization of Genomic Diversity among Carbapenem-Resistant Escherichia coli Clinical Isolates and Antibacterial Efficacy of Silver Nanoparticles from Pakistan

Abstract

The emergence of carbapenem-resistant Escherichia coli (E. coli) is considered an important threat to public health resulting in resistance accumulation due to antibiotics misuse and selection pressure. This warrants periodic efforts to investigate and develop strategies for infection control. A total of 184 carbapenem-resistant clinical strains of E. coli were characterized for resistance pattern, resistance genes, plasmids, sequence types and in vitro efficacy of silver nanoparticles (AgNPs). Carbapenem resistance was prevalent in E. coli isolated from female patients (64.7%), urine samples (40.8%) and surgical wards (32.1%). Polymyxin-B showed higher susceptibility. ESBLs and carbapenemases were produced in 179 and 119 isolates, respectively. Carbapenemase-encoding genes were observed among 104 strains with blaNDM-1 (45.1%), blaOXA-48 (27%), blaNDM-7 (3.8%), blaNDM-1/blaOXA-48 (15.4%), blaNDM-7/blaOXA-48 (2.9%), blaOXA-48/blaVIM (3.8%) and blaNDM-1/blaVIM (2%). ESBL resistance genes were detected in 147 isolates, namely blaSHV (24.9%), blaCTX-M (17.7%), blaTEM (4.8%), blaSHV/blaCTX-M (29.2%), blaSHV/blaTEM (15%) and blaCTX-M/blaTEM (8.8%). ST405 (44.4%) and ST131 (29.2%) were more frequent sequence types with ST101 (9.7%), ST10 (9.7%) and ST648 (7%). The replicon types IncFII, IncFIIK, IncA/C, IncN and IncL/M were detected. The combination of MEM/AgNPs remained effective against carbapenemase-positive E. coli. We reported genetically diverse E. coli strains coharboring carbapenemases/ESBLs from Pakistan. Moreover, this study highlights the enhanced antibacterial activity of MEM/AgNPs and may be used to manage bacterial infections.

Estimation, Evaluation and Characterization of Carbapenem Resistance Burden from a Tertiary Care Hospital, Pakistan

“…as main producer species. Other reports from Pakistan supplement our findings that K. pneumoniae and E. coli were major contributors of the total carbapenemase production among Enterobacterales [ 15 , 17 , 40 , 44 , 57 , 90 , 91 ]. Another study observed a high proportion of carbapenemase production among Citrobacter spp.…”

“…The key contributing carbapenemases involved in the expansion of CPE in the study population are bla NDM-1 and bla OXA-48 , confirming the existing data from Pakistan [ 14 , 15 , 17 , 40 , 45 , 57 , 90 , 91 , 92 ]. We observed a considerable increase in the prevalence of KPC-producing K. pneumoniae (15.4%).…”

“…(18.5%). E. coli and K. pneumoniae were considered the prime reason for CRE as evidenced by a number of other studies; E. coli (86.0–38.24%) [ 17 , 45 , 51 , 56 ] and K. pneumoniae (60.0–31.62%) [ 15 , 45 , 56 , 57 ]). We observed that CR is significantly associated with K. pneumoniae ( p = 0.008) and Proteus spp.…”

“…Clinically relevant core carbapenemases include KPC, NDM, OXA48, VIM and IMP [ 13 ]. Notably, carbapenem hydrolyzing enzymes reported among Enterobacterales from Pakistan include bla KPC2 / bla NDM-1 [ 14 ], bla NDM-1 / bla OXA-48 [ 15 ], bla KPC2 [ 16 ], bla NDM-7 , bla VIM and bla IMP [ 17 , 18 ].…”

Diversity of Bacterial Clones and Plasmids of NDM-1 Producing Escherichia coli Clinical Isolates in Central Greece

“…Recently, several reports have demonstrated the dissemination of bla NDM encoding gene among E. coli isolated from patients in various geographical locations [ 7 ]. The heterogenicity of the genetic environment of bla NDM encoding gene, combined with its location on plasmids of different incompatibility groups (Inc) has led to the emergence of diverse CREC clones worldwide [ 8 , 9 ].…”