Decreased antibiotic susceptibility of Enterobacteriaceae causing community-acquired urinary tract infections in French Amazonia

Baizet, Claire; Ouar-Epelboin, S.; Walter, Gaëlle; Mosnier, Émilie; Moreau, Brigitte; Djossou, Félix; Epelboin, Loïc

doi:10.1016/j.medmal.2018.09.009

Cited by 9 publications

(12 citation statements)

References 14 publications

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“…Nationally, rates ranging from 4.5 to 12.2% have been reported [24,32]. Other foreign countries have reported rates ranging from 8.2 to 34.7% [33,34]. These studies excluded the strict hospital affiliation of these strains.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic resistance in uropathogenic enterobacteria

et al. 2021

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Multidrug-resistant Enterobacteriaceae are a major public health threat worldwide. These germs are the most redoubtable because they are producers of beta-lactamases and possess other mechanisms of resistance to many antibiotics. The objective of this work is to identify isolated strains of Enterobacteriaceae and to study their antibiotic resistance profiles, thus contributing to the surveillance of antibioresistance. This is a retrospective study over a period of three years (2018-2020) including urine samples taken in the region of Rabat-Salé-Zaire and examined at the laboratory of Epidemic Diseases in National Institute of Hygiene of Rabat. Enterobacteriaceae were the most frequent germs with a predominance of Escherichia coli (68%) followed by Klebsiella pneumoniae (23%). Extended-spectrum beta-lactamase-producing Enterobacteriaceae accounted for 10.5%. The highest resistance was observed with amoxicillin, followed by ticarcillin, cefalotin, trimethoprim/sulfamethoxazole, amoxicillin+clavulanic acid, nalidixic acid and finally ciprofloxacin and norfloxacin. The aminoglycosides and the 2nd and 3rd cephalosporins were the most active molecules. The sensitivity of imipenem and ertapenem was 100%. This study shows the worrying appearance of resistance to the usual antibiotics in uropathogenic enterobacteria. Rational prescription of antibiotics and monitoring of the evolution of bacterial resistance are necessary in each region.

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Section: Discussionmentioning

confidence: 99%

Antibiotic resistance in uropathogenic enterobacteria

et al. 2021

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“…E. coli and K. pneumoniae are two of the most common pathogens associated with high morbidity and mortality among Gram-negative bacilli, especially in UTI [18]. The etiologies of UTI were diverse according to regions and countries, and dependent on the severity of complications; E. coli was the most common, followed by K. pneumonia [671920]. Baizet et al reported that E. coli was the most common pathogen in cystitis, pyelonephritis in females, and upper UTI in male.…”

Section: Discussionmentioning

confidence: 99%

“…Baizet et al reported that E. coli was the most common pathogen in cystitis, pyelonephritis in females, and upper UTI in male. K. pneumoniae was the second most common pathogen in pyelonephritis in females and upper UTI in males [19]. Comparisons of clinical characteristics between E. coli and K. pneumoniae had been presented in many reports [1921]; however, comparative studies regarding the differences in antimicrobial resistance rates and predisposing factors between the two strains were rare.…”

Section: Discussionmentioning

confidence: 99%

“…K. pneumoniae was the second most common pathogen in pyelonephritis in females and upper UTI in males [19]. Comparisons of clinical characteristics between E. coli and K. pneumoniae had been presented in many reports [1921]; however, comparative studies regarding the differences in antimicrobial resistance rates and predisposing factors between the two strains were rare. In this study, we compared clinical characteristics, treatment outcomes, and determined the antimicrobial susceptibility profiles of UTI between E. coli and K. pneumoniae .…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Escherichia coli and Klebsiella pneumoniae Acute Pyelonephritis in Korean Patients

et al. 2019

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Background Escherichia coli and Klebsiella pneumoniae are two of the most common causes of urinary tract infection. The purpose of this study was to compare clinical characteristics and antimicrobial susceptibility of acute pyelonephritis (APN) between E. coli and K. pneumoniae . Materials and Methods We retrospectively reviewed medical records of patients with APN due to E. coli and K. pneumoniae between February 2014 and October 2017. Results A total 329 patients were enrolled; 258 cases of E. coli and 71 cases of K. pneumoniae . Among them, 219 cases were categorized into community-onset APN; 194 cases of E. coli and 25 cases of K. pneumoniae , and 110 patients were categorized into healthcare-associated APN; 64 cases of E. coli and 46 cases of K. pneumoniae . Catheter-associated APN was more frequently observed in K. pneumoniae in both community-onset and healthcare-associated APN. Neurogenic bladder, obstructive uropathy, urinary tract stone, bacteremia, and severe APN were more related to E. coli in healthcare-associated APN. In multivariate analysis, urinary catheter was more associated with K. pneumoniae (odds ratio [OR] 9.643, 95% confidence intervals [CI] 4.919-18.904, P = 0.001) and neurogenic bladder was more associated with E. coli (OR 3.765, 95% CI 1.112-12.772, P = 0.033). Extended-spectrum β-lactamase (ESBL) production was observed in 29.0% of E. coli in community-onset APN. Among ESBL, antimicrobial susceptibility of piperacillin/tazobactam was significantly higher in E. coli and ciprofloxacin was significantly higher in K. pneumoniae . Conclusion K. pneumoniae were more associated with urinary catheter while E. coli tended to be more associated with urogenital problems. ESBL positivity showed no significance in healthcare-associated APN. In community-onset APN, ESBL producing E. coli was more observed than K. pneumoniae .

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“…In recent years there has been a rapid increase in bacterial resistance in Brazil and worldwide, the occurrence of this phenomenon in regions such as the Brazilian Amazon is still poorly known, but they are already observed in populations in northern South America in hospital cases and in localized outbreaks [1,2]. The production of Extended Spectrum Β-Lactamase (ESBLs) is an important mechanism of resistance in Enterobacteria.…”

Section: Introductionmentioning

confidence: 99%

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2021

GMR

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In recent years there has been a rapid increase in bacterial resistance in Brazil and worldwide. Among the mechanisms described, Extended-Spectrum ß-Lactamases (ESBL) are of great importance. The continuous assessment of bacterial resistance have fundamental importance in preventing the occurrence of outbreaks and the spread of resistance, especially in the Amazon due to the relative isolation of cities and difficulties in epidemiological surveillance in the region. In the present work we approach the use of phenotypic and genotypic characterization in Enterobacterial isolates by determining the resistance profile to β-lactam antimicrobials by antibiogram and the search for blaCTX-M, blaTEM, blaSHV genes associated with β-lactam resistance. Thus, 88 samples from outpatients from 14 regions in northern Brazil, belonging to the Brazilian Amazon, were analyzed from 2012 to 2014. Of these, Salmonella Typhi (57/64.77%), Salmonella spp. (26/29.54%), Shigella flexneri (2/2.27%), Shigella dysenterie (1/1.14%), Shigella sonnei (1/1.14%) and diarrhogenic Escherichia coli (1/1.14%). As for the resistance profile, only Escherichia coli showed resistance to first, second, third and fourth generation penicillins and cephalosporins and the aztreonam monobactamide, the other isolates did not show resistance profile according to the Clinical and Laboratory Standards (CLSI) standards. The evaluation of the blaCTX-M, blaTEM and blaSHV genes showed positive results only for the blaCTX-M gene in the Escherichia coli sample, with no amplifications being observed in the other analyzed samples. Although resistance was observed in only one sample, the data suggest the circulation of β-lactam resistance genes in Enterobacteria and, therefore, we suggest that continuous resistance evaluation can prevent the spread of β-lactamase-producing Enterobacteria, evidencing the importance of continuous monitoring and efficient strategies to reduce the spread of these agents by preventing outbreaks by resistant strains.

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Decreased antibiotic susceptibility of Enterobacteriaceae causing community-acquired urinary tract infections in French Amazonia

Cited by 9 publications

References 14 publications

Antibiotic resistance in uropathogenic enterobacteria

Antibiotic resistance in uropathogenic enterobacteria

Comparison of Escherichia coli and Klebsiella pneumoniae Acute Pyelonephritis in Korean Patients

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