High incidence of multidrug-resistant fecal E. coli producing ESBLs and carried ST131 in Jordanian adults

Abstract

Background: Escherichia coli is part of the normal human intestinal microflora, although it has the potential of causing a variety of invasive and diarrheal diseases. It is also a frequent cause of community-and hospital-acquired urinary tract infections. Intestinal E. coli has the potential to rapidly develop multidrug resistant (MDR) and to emerge as extended-spectrum β-lactamases (ESBLs)-producer. Methods:Over the period of July through November, 2015; 287 stool samples were collected from Jordanian adults who visited the students' clinic of the University of Jordan. Fecal samples were collected and cultured for isolation of E. coli. The isolates were investigated for antimicrobial susceptibility, and molecular method of polymerase chain reaction (PCR) was performed for the detection genes of ST131 clone, blaVIM, blaIMP, blaKPC and fluoroquinolones resistance (gyrA and parC).Results: A total of 105/287 E. coli isolates (36.6%) were found to be MDR to at least 3 classes of antibiotics, of these 45.1% were ESBLproducers. A total of 51 representative MDR isolates indicated the following; 49% were found positive for ST131 clone, 58.8% were resistant for ciprofloxacin, and 41.2% were positive for CTX-M group I and CTX-M-15, respectively. All these MDR isolates were also positive for mutated both gyrA and parC genes, and only 6/51 isolates (11.8%) were positive for each blaNDM-1 and blaKPC. One out of 51 MDR isolates (2%) was positive for blaVIM, and none of these isolates was positive for blaIMP nor blaOXA-48 genes. IntroductionThe increased incidence of ESBLs, that make Gramnegative bacteria frequently resistant to penicillins, cephalosporins and aztreonam by hydrolyzing them, is becoming a global health problem [1].Class of CTX-M type enzymes are the most prevalent extended-spectrum β-lactamases (ESBLs) worldwide including Arab Middle East countries [2,3]. Among the CTX-M type enzymes, CTX-M-15 has been frequently found in Arab countries over the last decade [3][4][5][6][7].Carbapenems are part of the last line of defense against serious or invasive infections caused by extremely drug-resistant Gram-negative pathogens producing ESBLs [8][9].Prior to the last decade, carbapenem resistance in Enterobacteriaceae was rare. However, Klebsiella pneumonia carbapenemase (KPC), New Delhi metallo-β-lactamase-1 (NDM-1), and recently oxacillinase-48 (OXA-48) have been reported in Enterobacteriaceae isolates [10].E. coli species are currently classified into four main phylogenetic groups (A, B1, B2, and D), where A and B1 groups are mainly commensal strains, whereas extraintestinal pathogenic strains are mostly part of B2 and D groups. The clone that belong to the B2 phylogenetic subgroup I, characterized by the multilocus sequence type (MLST) 131 and exhibits a specific O25 type (O25b) [11].This new discovered ST131 clone has been recently isolated from a diverse range of infections caused in community and hospitalized patients across the world, and it has been found as ESBL CTX-M-15-producer with a high virulenc...

Epidemiological Features of Clostridium difficile Colonizing the Intestine of Jordanian Infants

“…These findings are also much related to those of other European studies [ 15 , 23 , 24 ]. It is also important to mention here that fecal E. coli isolates from Jordan infant and adults were highly resistant to ciprofloxacin, and it is well known that Jordan physicians are extensively using fluoroquinolones in treatment of urinary and respiratory tract infections [ 25 – 27 ].…”

Detection Probiotic's DNA of Lactobacillus paracasei in Healthy Human Faeces

“…It is well established that antibiotic administration has adverse effects on gut flora by reducing the abundance and diversity of beneficial commensal microbiota [22]. Antibiotics consumption may also increase the presence of resistant bacterial strains in the intestinal flora of human and animal over the time [22][23][24]. In addition, usage of antibiotics, prebiotics and probiotics can modify the gut microbiota of humans and domestic animals [25].…”