Multiple Drug Resistance Patterns in Various Phylogenetic Groups of Hospital-Acquired Uropathogenic E. coli Isolated from Cancer Patients

Abstract

Cancer patients are more susceptible to several bacterial infections, particularly urinary tract infections caused by uropathogenic E. coli (UPEC). The objective of this work was detection and the phylogenetic characterization of hospital-acquired isolates of uropathogenic E. coli in cancer patients and the determination of its relation with antibiotic resistance. A total of 110 uropathogenic E. coli responsible for hospital-acquired urinary tract infections in cancer patients were included in this study. A triplex PCR was employed to segregate different isolates into four different phylogenetic groups (A, B1, B2 and D). Drug resistance was evaluated by the disc diffusion method. All of the isolates were multiple drug-resistant (MDR) and 38.18% of all UPEC isolates were extended-spectrum beta-lactamase (ESBL) producers from which 52% were positive for the blaCTX-M gene, 40% for the blaTEM gene, and 17% for the blaSHVgene. Among 42 ESBL-producing uropathogenic E. coli isolates, the majority belonged to phylogenetic group B2 (43%), followed by group D (36%), group A (19%) and group B1 (2%). Our results have shown the emergence of MDR isolates among uropathogenic E. coli with the dominance of phylogenetic group B2. Groups A and B1 were relatively less common. The most effective drug in all phylogenetic groups was imipenem.

Genomic Insights into a Colistin-Resistant Uropathogenic Escherichia coli Strain of O23:H4-ST641 Lineage Harboring mcr-1.1 on a Conjugative IncHI2 Plasmid from Egypt

“…In the present study, six isolates (8.9%) were resistant to colistin. Reports from the Upper Egypt sector revealed a colistin resistance of 32.7%, 20.8% and 23.1% among UPEC isolates in three different governorates [ 11 , 21 ]. After a preliminary screening using disk diffusion method, the MIC of colistin against the 67 tested isolates in the current study was determined by broth microdilution, the recommended method by CLSI 2020.…”

“…None of the isolates harbored the mcr-2 gene. Two mcr-1 -positive clinical E. coli isolates have been identified in Egypt to date; the first one was isolated from a patient with bacteremia while the second was recovered from a cancer patient [ 10 , 11 ]. Nevertheless, reports on mcr-1 -producing E. coli isolates recovered from livestock or food in Egypt were numerous and included those from a diseased cow [ 22 ], healthy broilers [ 23 ], cheese [ 24 ] and beef sausage [ 25 ].…”

“…The irresponsible use of colistin in veterinary practice, especially in the absence of strict legislations has contributed to the global spread of the mcr-1 gene in 10% of animal isolates and in 0.1–2% of human isolates [ 5 ]. Despite ample information on the distribution of mcr-1 gene worldwide, very few studies have investigated the prevalence of this gene in E. coli of human origin in Egypt where two mcr-1 -postive E. coli strains from clinical settings have been reported so far [ 10 , 11 ]. In the present study, we aimed to shed light on the occurrence of colistin resistance among E. coli isolated from patients with UTIs in Alexandria, Egypt and to investigate the underlying mechanisms of this resistance.…”

Comparative Evaluation of qnrA, qnrB, and qnrS Genes in Enterobacteriaceae Ciprofloxacin-Resistant Cases, in Swine Units and a Hospital from Western Romania

“…The qnr genes provide low resistance level to quinolones in Enterobacteriaceae , but the multi-resistance dimension is of great importance, and studies about the resistance of E. coli to ciprofloxacin (CIP) and the specific qnrA , qnrB , and qnrS genes’ detection and expression have been published in the last years [ 20 , 21 , 22 ].…”

Stewardship of Antibiotics for Multidrug-Resistant Gram-Negative Bacteria

“…results of an antimicrobial stewardship project aimed at reducing the incidence of infections due to carbapenem-resistant Klebsiella pneumoniae in a cardiosurgery department [4]. Finally, in their surveillance study, Mahmoud and colleagues highlight the need for effective stewardship intervention in cancer patients with hospital-acquired urinary infections due to ESBL-producing Escherichia coli [5].…”