Login Register Cart 0
Generic placeholder image

Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Clonal Relatedness, Phylotyping and Antimicrobial Susceptibility of Extended- spectrum-beta-lactamase Producing Uropathogenic Escherichia coli Isolates from Outpatients and Inpatients

Author(s): Negar Azimzadeh, Abdollah Derakhshandeh, Mohammad Motamedifar* and Zahra Naziri

Volume 20, Issue 5, 2020

Page: [659 - 666] Pages: 8

DOI: 10.2174/1871526519666190715152118

Price: $65

Abstract

Objectives: Antibiotic resistance, phylogenetic groups and Pulsed-Field Gel Electrophoresis (PFGE) patterns were evaluated in urinary tract infection (UTI) Escherichia coli (E. coli) isolates from outpatients and inpatients.

Methods: In this study, antibiotic resistance to E. coli isolated from non-hospitalized and hospitalized patients (153 outpatients and 147 inpatients ) was evaluated in Shiraz County, Iran. Phylogenetic groups and Pulse Field Gel Electrophoresis (PFGE) patterns of 143 ESBLs-producing E. coli were also assessed.

Results: The prevalence of ESBL-producing E. coli was shown to be 46.4% and 49% in the outpatient and inpatient UTI E. coli isolates, respectively. Most ESBL-producers were detected on patients hospitalized in clinical surgery units (66.7%) and intensive care units (62.5%). Phylogenetic group D was the dominant group in both the outpatient and inpatient isolates (67.6% and 61.1%, respectively) and also in internal, clinical surgery and ICU units. PFGE results showed more relatedness (>80% similarity) among inpatient isolates. PFGE analysis of 49 ESBL-producing inpatient E.coli in hospital units revealed 17 different pulsotypes, consisting of 11 clones and 6 single patterns. There were no clonal patterns in outpatient isolates, and similarity among the outpatient isolates and also between inpatient and outpatient isolates was less than 80% (75% and 66%, respectively).

Conclusion: The results showed extreme genomic diversity among the ESBL-producing E. coli isolates in terms of the community and multiclonal dissemination of ESBL-producing E. coli isolated from hospital units.

Keywords: PFGE, ESBLs, inpatients, outpatients, Escherichia coli, urinary tract infections

[1]
Cao, X.; Cavaco, L.M.; Lv, Y.; Li, Y.; Zheng, B.; Wang, P.; Hasman, H.; Liu, Y.; Aarestrup, F.M. Molecular characterization and antimicrobial susceptibility testing of Escherichia coli isolates from patients with urinary tract infections in 20 Chinese hospitals. J. Clin. Microbiol., 2011, 49(7), 2496-2501.
[http://dx.doi.org/10.1128/JCM.02503-10] [PMID: 21525216]
[2]
Zowawi, H.M.; Harris, P.N.; Roberts, M.J.; Tambyah, P.A.; Schembri, M.A.; Pezzani, M.D.; Williamson, D.A.; Paterson, D.L. The emerging threat of multidrug-resistant Gram-negative bacteria in urology. Nat. Rev. Urol., 2015, 12(10), 570-584.
[http://dx.doi.org/10.1038/nrurol.2015.199] [PMID: 26334085]
[3]
Rodríguez-Baño, J.; Navarro, M.D.; Romero, L.; Muniain, M.A.; Perea, E.J.; Pérez-Cano, R.; Hernández, J.R.; Pascual, A. Clinical and molecular epidemiology of extended-spectrum β-lactamase-producing Escherichia coli as a cause of nosocomial infection or colonization: implications for control. Clin. Infect. Dis., 2006, 42(1), 37-45.
[http://dx.doi.org/10.1086/498519] [PMID: 16323089]
[4]
Smet, A.; Martel, A.; Persoons, D.; Dewulf, J.; Heyndrickx, M.; Claeys, G.; Lontie, M.; Van Meensel, B.; Herman, L.; Haesebrouck, F.; Butaye, P. Characterization of extended-spectrum β-lactamases produced by Escherichia coli isolated from hospitalized and nonhospitalized patients: emergence of CTX-M-15-producing strains causing urinary tract infections. Microb. Drug Resist., 2010, 16(2), 129-134.
[http://dx.doi.org/10.1089/mdr.2009.0132] [PMID: 20370505]
[5]
Mittal, S.; Sharma, M.; Chaudhary, U. Study of virulence factors of uropathogenic Escherichia coli and its antibiotic susceptibility pattern. Indian J. Pathol. Microbiol., 2014, 57(1), 61-64.
[http://dx.doi.org/10.4103/0377-4929.130899] [PMID: 24739833]
[6]
Lee, J.H.; Subhadra, B.; Son, Y.J.; Kim, D.H.; Park, H.S.; Kim, J.M.; Koo, S.H.; Oh, M.H.; Kim, H.J.; Choi, C.H. Phylogenetic group distributions, virulence factors and antimicrobial resistance properties of uropathogenic Escherichia coli strains isolated from patients with urinary tract infections in South Korea. Lett. Appl. Microbiol., 2016, 62(1), 84-90.
[http://dx.doi.org/10.1111/lam.12517] [PMID: 26518617]
[7]
Karami, N.; Wold, A.E.; Adlerberth, I. Antibiotic resistance is linked to carriage of papC and iutA virulence genes and phylogenetic group D background in commensal and uropathogenic Escherichia coli from infants and young children. Eur. J. Clin. Microbiol. Infect. Dis., 2017, 36(4), 721-729.
[http://dx.doi.org/10.1007/s10096-016-2854-y] [PMID: 27924435]
[8]
Koshesh, M.; Mansouri, S.; Hashemizadeh, Z.; Kalantar-Neyestanaki, D. Identification of extended-spectrum β-lactamase genes and ampc-β-lactamase in clinical isolates of Escherichia coli recovered from patients with urinary tract infections in Kerman Iran. Pediatr. Infect. Dis. J., 2017.5e37968
[9]
Morgand, M.; Vimont, S.; Bleibtreu, A.; Boyd, A.; Thien, H.V.; Zahar, J.R.; Denamur, E.; Arlet, G. Extended-spectrum beta-lactamase-producing Escherichia coli infections in children: are community-acquired strains different from nosocomial strains? Int. J. Med. Microbiol., 2014, 304(8), 970-976.
[http://dx.doi.org/10.1016/j.ijmm.2014.06.003] [PMID: 25023074]
[10]
Fasugba, O.; Mitchell, B.G.; Mnatzaganian, G.; Das, A.; Collignon, P.; Gardner, A. Five-year antimicrobial resistance patterns of urinary Escherichia coli at an Australian tertiary hospital: time series analyses of prevalence data. PLoS One, 2016, 11(10)e0164306
[http://dx.doi.org/10.1371/journal.pone.0164306] [PMID: 27711250]
[11]
Saperston, K.N.; Shapiro, D.J.; Hersh, A.L.; Copp, H.L. A comparison of inpatient versus outpatient resistance patterns of pediatric urinary tract infection. J. Urol., 2014, 191(5)(Suppl.), 1608-1613.
[http://dx.doi.org/10.1016/j.juro.2013.10.064] [PMID: 24679887]
[12]
Tada, D.G.; Gandhi, P.J.; Patel, K.N. A study on antibiotic related resistance in UTI patients: a comparison between community acquired and hospital acquired E. coli. Natl. J. Community Med., 2012, 3, 255-258.
[13]
Toval, F.; Köhler, C.D.; Vogel, U.; Wagenlehner, F.; Mellmann, A.; Fruth, A.; Schmidt, M.A.; Karch, H.; Bielaszewska, M.; Dobrindt, U. Characterization of Escherichia coli isolates from hospital inpatients or outpatients with urinary tract infection. J. Clin. Microbiol., 2014, 52(2), 407-418.
[http://dx.doi.org/10.1128/JCM.02069-13] [PMID: 24478469]
[14]
Wollheim, C.; Guerra, I.M.F.; Conte, V.D.; Hoffman, S.P.; Schreiner, F.J.; Delamare, A.P.L.; Barth, A.L.; Echeverrigaray, S.; Costa, S.O. Nosocomial and community infections due to class A extended-spectrum β-lactamase (ESBLA)-producing Escherichia coli and Klebsiella spp. in southern Brazil. Braz. J. Infect. Dis., 2011, 15(2), 138-143.
[PMID: 21503400]
[15]
Goering, R.V. Pulsed field gel electrophoresis: a review of application and interpretation in the molecular epidemiology of infectious disease. Infect. Genet. Evol., 2010, 10(7), 866-875.
[http://dx.doi.org/10.1016/j.meegid.2010.07.023] [PMID: 20692376]
[16]
Clinical and Laboratory Standards Institute. Performance standards for antibiotic susceptibility testing: twenty-nine informational sup-plement. CLSI; NCCLS: Wayne, Pennsylvania, 2019.
[17]
Turnidge, J.D. Susceptibility test methods: general considerations.Manual of Clinical Microbiology, 11th ed; Jorgensen, J.H.; Pfaller, M.A; Carroll, K.C.; Funke, G.; Landry, M.L.; Richter, S.S., Eds.; ASM press, 2015.
[http://dx.doi.org/10.1128/9781555817381.ch70]
[18]
Clermont, O.; Bonacorsi, S.; Bingen, E. Rapid and simple determination of the Escherichia coli phylogenetic group. Appl. Environ. Microbiol., 2000, 66(10), 4555-4558.
[http://dx.doi.org/10.1128/AEM.66.10.4555-4558.2000] [PMID: 11010916]
[19]
Centers for Disease Control and Prevention. 2013.http://www.cdc.gov/pulsenet/PDF/ecoli-shigella-salmonella-pfgeprotocol-08c.pdf
[20]
Harrington, R.D.; Hooton, T.M. Urinary tract infection risk factors and gender. J. Gend. Specif. Med., 2000, 3(8), 27-34.
[PMID: 11253265]
[21]
Linhares, I.; Raposo, T.; Rodrigues, A.; Almeida, A. Frequency and antimicrobial resistance patterns of bacteria implicated in community urinary tract infections: a ten-year surveillance study (2000-2009). BMC Infect. Dis., 2013, 13, 19-32.
[http://dx.doi.org/10.1186/1471-2334-13-19] [PMID: 23327474]
[22]
Edlin, R.S.; Shapiro, D.J.; Hersh, A.L.; Copp, H.L. Antibiotic resistance patterns of outpatient pediatric urinary tract infections. J. Urol., 2013, 190(1), 222-227.
[http://dx.doi.org/10.1016/j.juro.2013.01.069] [PMID: 23369720]
[23]
Zhanel, G.G.; Hisanaga, T.L.; Laing, N.M.; DeCorby, M.R.; Nichol, K.A.; Palatnik, L.P.; Johnson, J.; Noreddin, A.; Harding, G.K.; Nicolle, L.E.; Hoban, D.J. Antibiotic resistance in outpatient urinary isolates: final results from the North American Urinary Tract Infection Collaborative Alliance (NAUTICA). Int. J. Antimicrob. Agents, 2005, 26(5), 380-388.
[http://dx.doi.org/10.1016/j.ijantimicag.2005.08.003] [PMID: 16243229]
[24]
McGregor, J.C.; Elman, M.R.; Bearden, D.T.; Smith, D.H. Sex- and age-specific trends in antibiotic resistance patterns of Escherichia coli urinary isolates from outpatients. BMC Fam. Pract., 2013, 14, 25-49.
[http://dx.doi.org/10.1186/1471-2296-14-25] [PMID: 23433241]
[25]
Afsharian, F.; Askari, E.; Kalamatizade, E.; Ghabouli-Shahroodi, M.; Naderi-Nasab, M. The Frequency of Extended Spectrum Beta Lactamase (ESBL) in Escherichia coli and Klebsiella pneumoniae: A Report from Mashhad, Iran. J. Med. Microbiol., 2015, 2, 12-19.
[26]
Navidinia, M.; Peerayeh, S.N.; Fallah, F.; Bakhshi, B.; Sajadinia, R.S. Phylogenetic grouping and pathotypic comparison of urine and fecal Escherichia coli isolates from children with urinary tract infection. Braz. J. Microbiol., 2014, 45(2), 509-514.
[http://dx.doi.org/10.1590/S1517-83822014000200019] [PMID: 25242935]
[27]
Miao, Z.; Li, S.; Wang, L.; Song, W.; Zhou, Y. Antimicrobial resistance and molecular epidemiology of ESBL-producing Escherichia coli isolated from outpatients in town hospitals of Shandong Province, China. Front. Microbiol., 2017, 8, 63.
[http://dx.doi.org/10.3389/fmicb.2017.00063] [PMID: 28174570]
[28]
Senbayrak, S.; Boz, E.S.; Cevan, S.; Inan, A.; Engin, D.O.; Dosoglu, N. Antibiotic resistance trends and the ESBL prevalence of Escherichia coli and Klebsiella spp urinary isolates in In-and Outpatients in a tertiary care hospital in Istanbul, 2004-2012. Jundishapur J. Microbiol., 2017.10e13098
[http://dx.doi.org/10.5812/jjm.13098]
[29]
Al-Mayahie, S.; Al Kuriashy, J.J. Distribution of ESBLs among Escherichia coli isolates from outpatients with recurrent UTIs and their antimicrobial resistance. J. Infect. Dev. Ctries., 2016, 10(6), 575-583.
[http://dx.doi.org/10.3855/jidc.6661] [PMID: 27367005]
[30]
Burke, L.; Humphreys, H.; Fitzgerald-Hughes, D. The revolving door between hospital and community: extended-spectrum beta-lactamase-producing Escherichia coli in Dublin. J. Hosp. Infect., 2012, 81(3), 192-198.
[http://dx.doi.org/10.1016/j.jhin.2012.04.021] [PMID: 22658893]
[31]
Iranpour, D.; Hassanpour, M.; Ansari, H.; Tajbakhsh, S.; Khamisipour, G.; Najafi, A. Phylogenetic groups of Escherichia coli strains from patients with urinary tract infection in Iran based on the new Clermont phylotyping method. BioMed Res. Int., 2015.2015846219
[http://dx.doi.org/10.1155/2015/846219] [PMID: 25692147]
[32]
Overdevest, I.T.M.A.; Bergmans, A.M.C.; Verweij, J.J.; Vissers, J.; Bax, N.; Snelders, E.; Kluytmans, J.A. Prevalence of phylogroups and O25/ST131 in susceptible and extended-spectrum β-lactamase-producing Escherichia coli isolates, the Netherlands. Clin. Microbiol. Infect., 2015, 21(6), 570.e1-570.e4.
[http://dx.doi.org/10.1016/j.cmi.2015.02.020] [PMID: 25749563]
[33]
Zhao, R.; Shi, J.; Shen, Y.; Li, Y.; Han, Q.; Zhang, X.; Gu, G.; Xu, J.L. i Y.; Han, Q.; Zhang, X., Phylogenetic distribution of virulence genes among ESBL-producing uropathogenic Escherichia coli isolated from long-term hospitalized patients. J. Clin. Diagn. Res., 2015, 9(7), DC01-DC04.
[PMID: 26393125]
[34]
Anvarinejad, M.; Farshad, S.; Alborzi, A.; Ranjbar, R.; Giammanco, G.M.; Japoni, A. Integron and genotype patterns of quinolones-resistant uropathogenic Escherichia coli. Afr. J. Microbiol. Res., 2011, 5, 3736-3770.
[http://dx.doi.org/10.5897/AJMR11.673]
[35]
Mohajeri, P.; Darfarin, G.; Farahani, A. Genotyping of ESBL producing Uropathogenic Escherichia coli in west of Iran. Int. J. Microbiol., 2014.2014276941
[http://dx.doi.org/10.1155/2014/276941] [PMID: 24839441]

Rights & Permissions Print Cite
Article Metrics
10
© 2024 Bentham Science Publishers | Privacy Policy