Community-acquired CTX-M-15-type ESBL-producing Escherichia coli meningitis: a case report and literature review

Elaldı, Nazif; Gözel, Mustafa Gökhan; Kolayli, Fetiye; Engin, Aynur; Çelik, Cem; Bakıcı, Mustafa Zahir; Vahaboğlu, Haluk

doi:10.3855/jidc.2820

Cited by 13 publications

(15 citation statements)

References 18 publications

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“…In addition to the presence of bla TEM and bla SHV genes, this study identified bla CTX-M-2 , bla CTX-M-15 , and bla CTX-M-14 genes among the E. coli strains that caused meningitis. Cases of meningitis caused by ESBL-producing E. coli strains have been also been reported from Turkey, France, Algeria, Thailand, Germany, and Brazil (23,33).…”

Section: Discussionmentioning

confidence: 99%

“…Serotypes of E. coli that have been isolated from cases of meningitis include O18:K1, O45:K1, O1:K1, and O83:K1 (14,19,21,22). The sequence types isolated from cases of meningitis include ST95, ST62, ST131, and ST69 (14,19,20,(22)(23)(24). When combinations of typing methods and more discriminant typing methods are used, isolates that have caused meningitis can be separated from isolates from other sources (15,16).…”

mentioning

confidence: 99%

“…There are recent reports of meningitis caused by E. coli strains that are resistant to third-generation cephalosporins and produce extended-spectrum beta-lactamases (ESBL) (23,25). The spread of E. coli strains that are resistant to broader-spectrum cephalosporin antibiotics is problematic because these antibiotics are recommended for the treatment of meningitis caused by E. coli (11,12).…”

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confidence: 99%

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Distribution of Strain Type and Antimicrobial Susceptibility of Escherichia coli Isolates Causing Meningitis in a Large Urban Setting in Brazil

et al. 2014

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The clinical management of meningitis caused by Escherichia coli is greatly complicated when the organism becomes resistant to broad-spectrum antibiotics. We sought to characterize the antimicrobial susceptibilities, sequence types (ST), and presence of known drug resistance genes of E. coli isolates that caused meningitis between 1996 and 2011 in Salvador, Brazil. We then compared these findings to those for E. coli isolates from community-acquired urinary tract infections (UTI) that occurred during the same time period and in the same city. We found that 19% of E. coli isolates from cases of meningitis and less than 1% of isolates from UTI were resistant to third-generation cephalosporins. The sequence types of E. coli isolates from cases of meningitis included ST131, ST69, ST405, and ST62, which were also found among isolates from UTI. Additionally, among the E. coli isolates that were resistant to third-generation cephalosporins, we found genes that encode the extended-spectrum beta-lactamases CTX-M-2, CTX-M-14, and CTX-M-15. These observations demonstrate that compared to E. coli strains isolated from cases of community-acquired UTI, those isolated from cases of meningitis are more resistant to third-generation cephalosporins, even though the same sequence types are shared between the two forms of extraintestinal infections.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Distribution of Strain Type and Antimicrobial Susceptibility of Escherichia coli Isolates Causing Meningitis in a Large Urban Setting in Brazil

et al. 2014

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“…In the last decades, worldwide, Enterobacteriaceae producing ESBLs of the CTX-M type have shown a rapid and alarming dissemination and have been recognized as the most prevalent causative agents of hospital- and community-acquired infections [3-5]. The CTX-M- β lactamases, of which there are now over 150 different types detected in very distant regions such as Europe, the Near and Far East, South America, North America, and more recently in Africa are responsible for the recent huge increment in ESBLs throughout the world [3,6-10]. With the wide distribution of these enzymes worldwide, it seems that there are predominant enzymes in each region (3).…”

Section: Introductionmentioning

confidence: 99%

Fecal carriage of extended-spectrum β-lactamases and AmpC-producing Escherichia coli in a Libyan community

Ahmed

Ali

Kamel

et al. 2014

Ann Clin Microbiol Antimicrob

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BackgroundExtended-spectrum β-lactamases (ESBLs), including the AmpC type, are important mechanisms of resistance among Enterobacteriaeceae. CTX-M type extended-spectrum β- lactamases, of which there are now over 90 variants, are distributed globally, yet appear to vary in regional distribution. AmpC β-lactamases hydrolyze third generation cephalosporins, but are resistant to inhibition by clavulanate or other β-lactamase inhibitors in vitro. Fecal carriage and rates of colonization by bacteria harboring these resistance mechanisms have been reported in patients with community-acquired infections and in healthy members of their households. Expression of these ESBLs compromises the efficacy of current antibacterial therapies, potentially increasing the seriousness of hospital- and community-acquired Escherichia coli (E. coli) infections.To investigate the occurrence of ESBL-producing E. coli in human fecal flora isolated from two pediatric populations residing in the Libyan cities Zleiten and Abou El Khoms. Isolates were further studied to characterize genes encoding β-lactam resistance, and establish genetic relationships.MethodsAntibiotic resistance profiles of phenotypically characterized E. coli isolates recovered from the stools of 243 Libyan children during two surveillance periods in 2001 and 2007 were determined by the disk diffusion method. ESBL-screening was performed using the cephalosporin/clavulanate double synergy disc method, and the AmpC-phenotype was confirmed by the aminophenyl-boronic acid test. ESBL genes were molecularly characterized. Phylogenetic group and multilocus sequence typing (MLST) were determined for ESBL-producing isolates and PFGE was performed to compare banding profiles of some dominant strains.ResultsESBLs were identified in 13.4% (18/134) of E. coli isolates, and nine isolates (6.7%) demonstrated AmpC activity; all 18 isolates contained a CTX-M gene. Three CTX-M gene families (CTX-M-1, n = 9; CTX-M-15, n = 8 and CTX-M-3, n = 1) were distributed in diverse E. coli backgrounds (phylogenetic group D, 39%; B2, 28%; B1, 22% and A, 11%). MLST analysis revealed 14 sequence type (ST) with six new sequence types. The gene encoding the CMY-2 enzyme was detected in five AmpC-positive E. coli.ConclusionsThese results identified heterogeneous clones of CTX-M-producing E. coli in the fecal isolates, indicating that the intestinal tract acts as a reservoir for ESBL-producing organisms, and a trafficker of antibiotic resistance genes.

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“…El perfil de multirresistencia a antibióticos que expresan estas cepas productoras de BLEE, ocasiona un problema terapéutico importante, tanto en el ámbito hospitalario como en el comunitario (11,14). Las BLEE han emergido como el principal problema en pacientes hospitalizados y en la comunidad, y son las principales responsables de infecciones de las vías urinarias, septicemia, neumonía adquirida en el hospital, abscesos intraabdominales, e infecciones del sistema nervioso central y las relacionadas con dispositivos médicos, entre otras (15)(16)(17)(18)(19)(20).…”

Section: Materiales Y Métodosunclassified

Caracterización fenotípica de bacilos Gram negativos con betalactamasas de espectro extendido y carbapenemasas

Gutierrez¹,

Caycedo²,

Orduz³

et al. 2015

Revista Investig. Salud Univ. Boyacá

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Introducción: La resistencia bacteriana de los bacilos Gram negativos tiene un importante impacto económico y social en salud pública. Ha incrementado la morbilidad y la mortalidad en los últimos años, conllevando incremento de costos en salud; es un hecho significativo que orienta la implementación de acciones de prevención y estudio, mediante la identificación de los perfiles regionales como estrategia de vigilancia y contención de la resistencia. Objetivo: Caracterizar fenotípicamente la resistencia en cepas de bacilos Gram negativos aislados de infecciones, en un centro hospitalario de segundo nivel en el departamento de Boyacá, Colombia. Métodos: Se hizo un estudio descriptivo de corte transversal. La identificación bacteriana y las pruebas de sensibilidad se determinaron mediante el método automatizado VITEK®. Los fenotipos de resistencia a β-lactamasas de espectro extendido y carbapenemasas, se confirmaron siguiendo la metodología del Clinical and Laboratory Standards Institute (CLSI). Resultados: Se procesaron 458 cultivos durante cuatro meses, de los cuales 298 fueron negativos y 160 mostraron aislamientos bacterianos positivos; 127 eran procedentes de urocultivo. El patógeno prevalente fue Escherichia coli. De las cepas de estudio, se confirmó el fenotipo β-lactamasa en 11 aislamientos y uno para el fenotipo β-lactamasa/carbapenemasa. Conclusiones: Los hallazgos del presente estudio evidencian que E. coli es el microorganismo predominante a partir de los aislamientos que presentan un fenotipo multirresistente. La identificación de este tipo de cepas bacterianas, que son una amenaza en el ambiente hospitalario y el comunitario, amerita un cambio en las estrategias de contención de la multirresistencia; igualmente, los resultados identifican el panorama epidemiológico regional. Palabras clave: farmacorresistencia bacteriana, infecciones bacterianas, betalactamasas, salud pública.

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Community-acquired CTX-M-15-type ESBL-producing Escherichia coli meningitis: a case report and literature review

Cited by 13 publications

References 18 publications

Distribution of Strain Type and Antimicrobial Susceptibility of Escherichia coli Isolates Causing Meningitis in a Large Urban Setting in Brazil

Distribution of Strain Type and Antimicrobial Susceptibility of Escherichia coli Isolates Causing Meningitis in a Large Urban Setting in Brazil

Fecal carriage of extended-spectrum β-lactamases and AmpC-producing Escherichia coli in a Libyan community

Caracterización fenotípica de bacilos Gram negativos con betalactamasas de espectro extendido y carbapenemasas

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