Epidemiological characteristics of uropatogenic isolates of Escherichia coli in hospitals

Abstract

The aim of the study was to evaluate the genetic affinity of uropathogenic E. coli cultures (UPEC) and to identify the major types of extended spectrum beta-lactamases (ESBL) found among nosocomial isolates. A molecular typing of UPEC (n=93) isolated from patients with urinary tract infections (UTI) who were hospitalised in nine medical facilities (MO) in Perm was performed. It was found that 69.89% of the cultures had individual RAPD/ERIC profiles, the remaining 30.10% were distributed among 13 genome groups. Most frequently blaCTX-M-1 was detected individually or in combination with other beta-lactamase genes (n=23, 79.31% of ESBL phenotype-positive isolates), genes were detected in seventeen cases (58.62%) blaTEM and/or blaOXA, the blaCMY fragment was found in only three isolates (10.34%), blaSHV was missing in this isolates. It was shown that in two thirds of the cases the pathogens of the infection process are representatives of the endogenous intestinal microbiota of the patients, in other cases an exogenous infection occurs. The proportion of “circulating” (possibly hospital) isolates in the spectrum of UTI increased in the series: therapy departments - surgery departments - intensive care units. In addition, in multidisciplinary hospitals there are conditions for cross-infections of patients, but the epidemiological chains of episodes of UTI are short and concise. It has been shown that the probability of infection with E. coli producing CTX-M or OXA enzymes is significantly higher in the intensive care unit than in surgery or therapy departments. The data obtained complement the understanding of the epidemiology of UTI caused by E. coli and can be used as an aid in the planning and implementation of methods for the prevention and control of nosocomial UTI.

Characterization of multiple resistance genes of Escherichia coli strains isolated from food and clinical samples

“…Kluytmans et al (2013) reported the presence of bla CTX-M in 34, bla TEM in 9, and bla SHV in 1 of 44 ESBL-producing E. coli isolates obtained from humans (23). Similarly, another study stated that the bla CTX-M gene was found in 79.31% of isolates from patients with UTI, followed by bla TEM and bla OXA in 58.62%, while bla SHV was not observed in any of the samples (24).…”

“…They play the role of the primary causative factor of UTIs, which is one of the common nosocomial and community-acquired infections. Empirical antibiotic applications in the treatment of infection have triggered the development of MDR in pathogenic and commensal E. coli, including UPECs (24).…”

Uropathogenic Escherichia coli (UPEC)-Associated Urinary Tract Infections: The Molecular Basis for Challenges to Effective Treatment

“…Trimethoprim mgrB [214] dfrA1, dfrA5, dfrA7, dfrA12, dfrA17 [226] dfrA8, dfrA14, dfr2d, dfrA3, dfrA9, dfrA10, dfrA24, dfrA26 [227] acrAB-tolC [213] Sulfamethoxazole sul1, sul2, sul3 [228] Fluoroquinolones gryA, gyrB, parC [217] qnrA, qnrB, qnrC, qnrS, qnrD, qnrE, qnrVC [219] aac(6 )-Ib-cr [223] acrB, [218] qepA, oqxAB [219] β-lactams mrdA [164] ampC [92] bla CTX-M , bla TEM , bla SHV [163], bla OXA , bla CMY [229] pAmpC [91] acrAB-tolC, acrAD-tolC [165] Table 3 shows resistant determinants of note for each antibiotic/antibiotic class stemming from either chromosomal gene mutation/deletion, antibiotic inactivation due to an enzymatic mechanism, or by efflux.…”

Molecular Factors and Mechanisms Driving Multidrug Resistance in Uropathogenic Escherichia coli—An Update

“…Similar findings were reported by Kuznetsova et al who noticed that bla OXA genes are present in 58.6% of ESBL phenotype-positive isolates. However, the most common β-lactamases belonged to the BlaCTX-M group (79.3%) [ 57 ]. Importantly, the B2 phylogroup is characterized as the most virulent type and, as mentioned before, together with the D phylogroup is responsible for the majority of UTIs [ 56 ].…”