Escherichia coli Isolated from Urinary Tract Infections of Lebanese Patients between 2005 and 2012: Epidemiology and Profiles of Resistance

Abstract

The early treatment of urinary tract infections (UTIs) is directly related to decrease in morbidity, which makes the empirical treatment of great importance. Recently, beta lactamases of several types have emerged as significant mechanisms of resistance in Gram-negative bacilli, especially Escherichia coli. Our aim was to study the urinary E. coli isolated from Lebanese patients and to characterize their mechanisms of resistance. The study analyzed data between 2005 and 2012 of UTIs caused by E. coli. The mechanisms of resistance were characterized by phenotypic and genotypic methods and the pulsed-field gel electrophoresis (PFGE) was used to determine the different bacterial clusters. As expected, the highest incidence was observed with E. coli (60.53–73.98%) followed by K. pneumoniae (5.32–8.33%). ICU isolates were constantly associated with the lowest rates of susceptibility to extended-spectrum cephalosporins, ciprofloxacin, as well as most of the tested antibiotics. A 100% occurrence of CTX-M in extended-spectrum β-lactamase (ESBL)-producing isolates was recorded, followed by TEM, SHV, and OXA. In addition, 15.9% harbored 4 different ESBL enzymes and only 13 isolates (14.8%) harbored only one enzyme (CTX-M). Over the years, the simultaneous susceptibility of E. coli to ceftazidime and ciprofloxacin decreased from 62.5% in 2006 to 48.7% in 2012. PFGE results demonstrated that 10 clusters were 32 generated, denoting diversity among detected isolates. Understanding the epidemiology of resistance is 33 instrumental for the implementation of recommendations for the management of antimicrobials, infection 34 control measures, as well as active surveillance and antimicrobial stewardship.

Antibiotic Resistance and Virulence Phenotypes of Recent Bacterial Strains Isolated from Urinary Tract Infections in Elderly Patients with Prostatic Disease

“…(8.2%). The results are in accordance with previous studies that identified the presence of the same species in 50–60% of these infections [19,20,21,22]. Other enterobacterial species such as Proteus spp., Enterobacter spp., Serratia marcescens , and Morganella morganii were recorded, as also revealed by other studies [23].…”

Phenotypic and Genotypic Characterization of ESBL-Producing Escherichia coli and Klebsiella pneumonia isolates from Patient’s Urine specimens

“…A study performed by Kateregga et al 2015, also reported that E. coli was the most common ESBL-producers (53.9 %) isolated from urine samples, followed by K. pneumoniae (28.7 %) [22]. The predominance of E. coli isolates from urine samples was in concordance with a study done in Lebanon by Daoud et al, 2015, which has compared between two periods of 2005 and 2012, and stated that ESBL-producing E. coli was isolated in 60.53% and 73.98%, while K. pneumoniae was isolated in 5.32% and 8.33 %, respectively [23].…”

Molecular characterization of extended spectrum beta-lactamase among clinical multidrug resistant <i>Escherichia Coli</i> in two hospitals of Niamey, Niger

“…The difference would be due to the sampling from different hospitals and from different geographic locations, whereas in our study, samples were collected only from two hospital setting. This study revealed that, out of the 37 E coli producing ESBL isolated from urine samples, the percentage of bla TEM was 73.0% followed by bla CTX-M (35.1%) and bla OXA-1 (8.1% (34). The genetic diversity of bla genes in isolates, suggested that resistance genes can easily move from one specie to another with the possibility of easy interspecies transfer.…”