Co-Existence of Certain ESBLs, MBLs and Plasmid Mediated Quinolone Resistance Genes among MDR E. coli Isolated from Different Clinical Specimens in Egypt

Abstract

The emergence of multi-drug resistant (MDR) strains and even pan drug resistant (PDR) strains is alarming. In this study, we studied the resistance pattern of E. coli pathogens recovered from patients with different infections in different hospitals in Minia, Egypt and the co-existence of different resistance determinants. E. coli was the most prevalent among patients suffering from urinary tract infections (62%), while they were the least isolated from eye infections (10%). High prevalence of MDR isolates was found (73%) associated with high ESBLs and MBLs production (89.4% and 64.8%, respectively). blaTEM (80%) and blaNDM (43%) were the most frequent ESBL and MBL, respectively. None of the isolates harbored blaKPC and blaOXA-48 carbapenemase like genes. Also, the fluoroquinolone modifying enzyme gene aac-(6′)-Ib-cr was detected in 25.2% of the isolates. More than one gene was found in 81% of the isolates. Azithromycin was one of the most effective antibiotics against MDR E. coli pathogens. The high MAR index of the isolates and the high prevalence of resistance genes, indicates an important public health concern and high-risk communities where antibiotics are abused.

Antimicrobial Resistance and Molecular Characterization of Gene Cassettes from Class 1 Integrons inEscherichia coliStrains

“…Similar findings have been reported by Mfoutou Mapanguy et al and Chen et al 20 , 21 In our investigation, the rate of detection of MDR strains was nearly 80%, which was lower than that found by Lee et al 3 and similar to that found by Masoud et al 22 This may be related to geographical differences or differences in specimen collection.…”

Characterization of virulence determinants and phylogenetic background of multiple and extensively drug resistant Escherichia coli isolated from different clinical sources in Egypt

“…Elevated rates of resistance to several classes of antimicrobial agents pose a serious health problem decreasing the treatment efficiency and limiting treatment options (Monroy-Pérez et al 2020 ). Similar trends were recently reported in Egypt; where, Masoud et al have reported that 73% of E. coli isolates collected from different clinical sources were MDR (Masoud et al 2021 ). On the other hand, Khairy et al have indicated MDR in 55% of E. coli isolated from children with community acquired-diarrhea in Upper Egypt (Khairy et al 2020 ).…”

“…An array of antibiotics could be used for management of E. coli infections in animals and humans. Nevertheless, recent reports have indicated elevated levels of resistance to different classes of antibiotics including β-lactams, fluoroquinolones, tetracyclines and, aminoglycosides among pathogenic E. coli isolates worldwide and in Egypt (Dehkordi et al 2020 , Duan et al 2020 , Flament-Simon et al 2020 , Khairy et al 2020 , and Masoud et al 2021 ). The increased usage of antibiotics in clinical settings has led to the evolution of multidrug resistant (MDR), extensively drug resistant (XDR), and pan-drug resistant (PDR) strains leading to failure of treatment, complications, and increased rates of morbidity and mortality (Parajuli et al 2017 ).…”

Genomic Characterization of International High-Risk Clone ST410 Escherichia coli Co-Harboring ESBL-Encoding Genes and blaNDM-5 on IncFIA/IncFIB/IncFII/IncQ1 Multireplicon Plasmid and Carrying a Chromosome-Borne blaCMY-2 from Egypt

“…During the past years, the worldwide occurrence of these enzymes has multiplied dramatically among clinical isolates of Enterobacteriaceae genera, predominantly Escherichia coli and Klebsiella pneumoniae [ 2 ]. Arising as important etiological agents of many hospital- and community-acquired infections, ESBL-producing E. coli strains constitute a major public health threat since these pathogens usually exhibit a multidrug-resistant (MDR) profile associated with increased cost, mortality rates, longer hospitalization, and poor clinical outcomes [ 2 , 3 ]. Dissemination rates of ESBL-producing E. coli vary greatly around the globe, revealing flat trends of about 15% in Europe and escalating trends increasing from 7.8% in 2010 to 18.3% in 2014 in North America [ 4 ].…”