Fecal carriage of ESBL-producing <em>Escherichia coli</em> in Egyptian patients admitted to the Medical Research Institute hospital, Alexandria University

Abstract

Commensal ESBL-producing E. coli represent a reservoir for resistance genes therefore, their detection is crucial to restrain the spread of beta-lactam resistance. Hence, the aim of the present study was phenotypic and genotypic characterization of commensal ESBL-producing E. coli obtained from the stool of patients at the time of admission and at the time of discharge from the Medical Research Institute hospital. A total of 70 E. coli isolates were collected from 35 patients and were categorized into Group A (samples obtained on admission) and Group B (samples obtained at the time of discharge). Phenotypically, 30 isolates were ESBL producers (40% of E. coli isolates collected on admission and 45.7% of the strains obtained at the time of discharge were ESBL producers). Most of them harbored one to three plasmids with sizes ranging from one kbp to ten kbp. Upon genotypic investigation, bla CTX-M was the most detected gene in 80% of ESBL strains, followed by bla TEM in 53.3% and the least detected was bla SHV in only 13.3%. By comparing group A and group B, ten patients were found to carry commensal ESBL-producing E. coli , in two patients these isolates carried ESBL genes that were identical on admission and on discharge. However, in eight patients, these isolates carried different ESBL genes, which were newly harbored during hospital stay. The high abundance of MDR commensal E. coli 48.57% together with the presence of 42.86% ESBL-producing commensal E. coli among our isolates represents an alarming threat, as they are frequently associated with the increased risk of infection, higher costs and longer hospital stay.

ESBL Producing Escherichia coli in Faecal Sludge Treatment Plants: An Invisible Threat to Public Health in Rohingya Camps, Cox's Bazar, Bangladesh

“…The increased ratio of multidrug-resistant E. coli among ESBL positive isolates suggests that resistance to other antibiotic classes is being co-selected. Similarly, previous studies reported MDR organisms in faecal and sewage sludge samples ( 41 , 65 , 66 , 68 , 70 ). The most frequently used antibiotics in Bangladesh are cephalosporins and penicillins ( 92 ), which explains the reason for the isolates being resistant to cephalosporins and penicillins.…”

“…In our study, ESBL producing E. coli was recovered from 78% (42/54) of the inlet and 69% (37/54) of the outlet samples. Previously, ESBL producing E. coli were recovered from faecal samples ( 41 , 65 – 68 ) and sewage sludge ( 69 , 70 ). Recovery of ESBL E. coli from the samples manifested a real probability of bacterial circulation within the FSTPs and might also escape to the surrounding environment and eventually contaminate the surface water and groundwater.…”

Genomic Analysis of ESBL-Producing E. coli in Wildlife from North-Eastern Germany

“…In a recent study of commensal E. coli from human fecal samples, ElBaradei et al found high abundances of ESBL carriers or even multidrug resistance. This is alarming, since these strains are associated with an increased risk of infection [ 42 ]. Similar E. coli clones belonging to the commensal phylogroup A were increasingly reported in association with ESBL production [ 43 ].…”

Molecular detection of extended-spectrum β-lactamase-producing Escherichia coli from bat caves on Lombok Island

“…Escherichia coli is generally used as an indicator of antibiotic resistance because it can easily transfer antibiotic-resistance genes to other bacterial strains in the Enterobacteriaceae family, especially through plasmid mediation ( Radhouani et al ., 2012 ). Feces have been identified as a major reservoir of E. coli that harbor extended-spectrum beta-lactamase (ESBL) genes such as bla CTX-M , bla TEM , and bla SHV ( ElBaradei et al ., 2020 ).…”