Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela

Abstract

Introduction: The treatment of urinary tract infections has become more challenging due to the increasing frequency of multidrug-resistant Escherichia coli in human populations.Objective: To characterize multidrug-resistant E. coli isolates causing community-acquired urinary tract infections in Cumaná, Venezuela, and associate possible risk factors for infection by extended-spectrum beta-lactamases (ESBL)-producing isolates.Materials and methods: We included all the patients with urinary tract infections attending the urology outpatient consultation and emergency unit in the Hospital de Cumaná, Estado Sucre, Venezuela, from January through June, 2014. blaTEM, blaSHV and blaCTX-M genes detection was carried out by PCR.Results: We found a high prevalence of multidrug-resistant E. coli (25.2%) with 20.4% of the isolates producing ESBL. The ESBL-producing isolates showed a high frequency (66.7%) of simultaneous resistance to trimethoprim-sulphamethoxazole, fluoroquinolones and aminoglycosides compared to non-producing isolates (2.4%). Of the resistant isolates, 65.4% carried the blaTEM gene, 34.6% the blaCTX-M and 23.1% the blaSHV. The blaCTX-M genes detected belonged to the CTX-M-1 and CTX-M-2 groups. Plasmid transfer was demonstrated by in vitro conjugation in 17 of the 26 ESBL-producing isolates. All three genes detected were transferred to the transconjugants. Age over 60 years, complicated urinary tract infections and previous use of a catheter predisposed patients to infection by ESBL-producing E. coli.Conclusions: The high frequency of multidrug-resistant ESBL-producing isolates should alert the regional health authorities to take measures to reduce the risk of outbreaks caused by these types of bacteria in the community.

Evaluation of the Prevalence of blaSHV, blaTEM, and blaCTX Genes in Escherichia coli Isolated From Urinary Tract Infections

“…The genes encoding ESBLs are located on the bacterial chromosome or plasmid (13). The bla SHV , bla TEM , and bla CTX-M types are regarded as the most common ESBLs (14). The UPEC strains contain bla SHV and bla TEM genes which cause resistance to betalactam antibiotics and the bacterium also possesses a bla CTX-M gene that hydrolyzes cefotaxime and ceftazidime (15).…”

Clinical Epidemiology Characteristics and Antibiotic Resistance Associated with Urinary Tract Infections Caused by E. coli

“…When comparing the current study and the study carried out by Shaki [ 28 ] in Southern Israel, ampicillin and cotrimoxazole had the highest rate of E. coli resistance. Similarly, in numerous studies throughout the world, such as Guzman's (96.1%), Alanazi's (82.76%), and others, the proportion of E. coli resistant to ampicillin is high [ 10 , 12 , 28 ]. Our results also indicate that the resistance rate to E. coli of cefotaxime increased from 38.8% in 2011–2013 to 66.7% in 2018–2020.…”

Molecular characterization of beta-lactamase genes produced by community-acquired uropathogenic Escherichia coli in Nouna

“…The design, the small number of samples obtained and the lack of information about the patients does not allow any considerations regarding risk factors for acquiring an infection of community origin with ESBLproducing pathogens. However, investigating these and other aspects regarding the provenience of the strains and their resistance genes, along with the surveillance of asymptomatic carriers is crucial for the development of prevention and infection control efforts, for instance of the growing number of community-onset bloodstream infections caused by ESBL-producing bacteria, which has the potential to become similar to that of community-acquired methicillin-resistant Staphylococcus aureus [4,27,29].…”