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

Abstract

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.

Virulence factors, prevalence and potential transmission of extraintestinal pathogenic Escherichia coli isolated from different sources: recent reports

“…Based on the obtained results, it has been found that the prevalence of ExPEC is much lower among egg-source isolates than in the group of chicken-source E. coli isolates (4.7% and 21% respectively). Many methods have been applied to identify the ExPEC strains with the zoonotic potential, including strains able to cause one or more diseases in the animal models of sepsis, meningitis or UTI [5, 22, 71, 72]. This confirms the results of other studies which have proven that E. coli isolates from the feces of healthy Danish broiler chickens were virulent in the UTI mouse model [73].…”

Comprehensive Molecular Characterization of Escherichia coli Isolates from Urine Samples of Hospitalized Patients in Rio de Janeiro, Brazil

“…In our study, 49.53% of the isolates were identified as UPEC and 9.34% were classified as ExPEC (non-UPEC) based on predictive virulence genes score. The other 41.13% could not be typed as ExPEC using this method, indicating that the predictive virulence genes score is not always sufficient for classification of ExPEC as has also been reported before (Berman et al, 2014 ). In general, ExPEC can be classified into five phylogenetic groups, i.e., A, B (subgroups B1 and B2), D, E, and F, and the majority of the isolates in our study belonged to phylogenetic groups B2 and D. Indeed, other studies, as the ones from Iran and China, show that human pathogenic ExPEC predominantly belong to these two groups (Kazemnia et al, 2014 ; Tong et al, 2014 ), that are also considered to be more virulent and more associated with infections than, e.g., phylogenetic groups A and B1 (Lee et al, 2016 ).…”

Virulence potential of commensal multidrug resistant Escherichia coli isolated from poultry in Brazil

“…ie/dbs/Ecoli). The ST93 was also found in poultry (APEC) and in humans (ExPEC) causing infections (Berman et al 2014;Chen et al 2013;Dierikx et al 2013;Maluta et al 2014). The ST354 was reported in Brazil in 2005 and 2009 associated to human infections caused by ExPEC in two different regions of the country (http://mlst.ucc.ie/dbs/ Ecoli).…”