The occurrence of ESBL-producing Escherichia coli carrying aminoglycoside resistance genes in urinary tract infections in Saudi Arabia

Abstract

BackgroundThe infection and prevalence of extended-spectrum β-lactamases (ESBLs) is a worldwide problem, and the presence of ESBLs varies between countries. In this study, we investigated the occurrence of plasmid-mediated ESBL/AmpC/carbapenemase/aminoglycoside resistance gene expression in Escherichia coli using phenotypic and genotypic techniques.MethodsA total of 58 E. coli isolates were collected from hospitals in the city of Makkah and screened for the production of ESBL/AmpC/carbapenemase/aminoglycoside resistance genes. All samples were subjected to phenotypic and genotypic analyses. The antibiotic susceptibility of the E. coli isolates was determined using the Vitek-2 system and the minimum inhibitory concentration (MIC) assay. Antimicrobial agents tested using the Vitek 2 system and MIC assay included the expanded-spectrum (or third-generation) cephalosporins (e.g., cefoxitin, cefepime, aztreonam, cefotaxime, ceftriaxone, and ceftazidime) and carbapenems (meropenem and imipenem). Reported positive isolates were investigated using genotyping technology (oligonucleotide microarray-based assay and PCR). The genotyping investigation was focused on ESBL variants and the AmpC, carbapenemase and aminoglycoside resistance genes. E. coli was phylogenetically grouped, and the clonality of the isolates was studied using multilocus sequence typing (MLST).ResultsOur E. coli isolates exhibited different levels of resistance to ESBL drugs, including ampicillin (96.61%), cefoxitin (15.25%), ciprofloxacin (79.66%), cefepime (75.58%), aztreonam (89.83%), cefotaxime (76.27%), ceftazidime (81.36%), meropenem (0%) and imipenem (0%). Furthermore, the distribution of ESBL-producing E. coli was consistent with the data obtained using an oligonucleotide microarray-based assay and PCR genotyping against genes associated with β-lactam resistance. ST131 was the dominant sequence type lineage of the isolates and was the most uropathogenic E. coli lineage. The E. coli isolates also carried aminoglycoside resistance genes.ConclusionsThe evolution and prevalence of ESBL-producing E. coli may be rapidly accelerating in Saudi Arabia due to the high visitation seasons (especially to the city of Makkah). The health authority in Saudi Arabia should monitor the level of drug resistance in all general hospitals to reduce the increasing trend of microbial drug resistance and the impact on patient therapy.

Characterization of cefotaxime resistant Escherichia coli isolated from broiler farms in Ecuador

“…The association of ESBL and AmpC phenotypes with increased prevalence of 276 aminoglycoside resistance has been reported [52]. In our study we identified a significant isolates were significantly more resistant to ceftazidime than ESBL isolates.…”

Infectious Diseases and Mass Gatherings

“…Extended spectrum beta-lactamase Enterobacteriaceae are also common among hospitalized pilgrims. During the 2014-2015 Hajj, 47% of pilgrims attending hospitals for urinary tract infections showed blaCTX-M genes in E. coli isolates [59].…”

Comparative study on biological material for molecular diagnosis of Gallid herpesvirus 2

“…However, a discrepancy between phenotypic and genotypic methods was noted, which emphasizes the imperative need of molecular methods to obtain reliable interpretation of antimicrobial resistance profile. The difference observed in detection of resistance may be justified by the lower sensitivity of phenotypic method and the influence of environmental factors on the incidence of resistance (Alyamani et al, 2017). The lack of constant sensitivity of different phenotypic methods has been emphasized by some studies (Ravi et al, 2011).…”