High Carriage of Extended-Spectrum, Beta Lactamase-Producing, and Colistin-Resistant Enterobacteriaceae in Tibetan Outpatients with Diarrhea

Abstract

Antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs) have been detected in human-impacted habitats, especially in densely populated cities. The Qinghai–Tibet Plateau is located far from the heavily populated regions of China, and Tibetan residents have distinct dietary habits and gut microbes. Antibiotic-resistance monitoring in the Tibetan population is rare. Here, we collected stool samples from Tibetan outpatients with diarrhea. From 59 samples, 48 antibiotic-resistant Enterobacteriaceae isolates were obtained, including 19 extended-spectrum beta lactamase (ESBL)-producing isolates from 16 patients and 29 polymyxin-resistant isolates from 22 patients. Either ESBL or mcr genes were found in 17 Escherichia coli isolates, approximately 58.8% of which were multidrug-resistant, and ten incompatible plasmid types were found. The gene blaCTX-M was a common genotype in the ESBL-producing E. coli isolates. Four E. coli isolates contained mcr-1. The same mcr-1-carrying plasmid was found in distinct E. coli isolates obtained from the same sample, thus confirming horizontal transmission of mcr-1 between bacteria. Genomic clustering of E. coli isolates obtained from Lhasa, with strains from other regions providing evidence of clone spreading. Our results reveal a strong presence of ARB and ARGs in Tibetan outpatients with diarrhea, implying that ARB and ARGs should be monitored in the Tibetan population.

Extended-spectrum β-lactamase- producing gram-negative bacterial infections in severely ill COVID-19 patients admitted in a national referral hospital, Kenya

“…Klebsiella pneumoniae (30.6%) was the predominant ESBL producer among GNB isolates from severely ill COVID-19 patients. Even though data on ESBL-producing bacteria in COVID-19 patients is limited, in the general population, E. coli and K. pneumoniae [ 31 – 34 ] seems to be the most common ESBL producers. Our finding may infer similarity in ESBL-producing bacteria profiles among COVID-19 and non-COVID patients.…”

“…Emeraud et al documented a nosocomial outbreak of ESBL producing K. pneumoniae carrying CTX-M-15 in a French intensive care unit dedicated to COVID-19 during the first wave of the pandemic [ 37 ], however, information on ESBL gene carriage among ESBL producing GNB that cause infections in COVID-19 patients is limited. Before the year 2000, SHV- and TEM–type enzymes were the most predominant ESBLs worldwide [ 38 ] but have since been outnumbered by CTX-M ESBLs in non-COVID19 patients [ 39 , 40 , 11 , 34 ]. Therefore, our findings suggest a similar ESBL gene carriage among bacterial isolates from COVID-19 patients and the general population.…”

Extended-spectrum β-lactamase- producing gram-negative bacterial infections in severely ill COVID-19 patients admitted in a national referral hospital, Kenya

“…French intensive care unit dedicated to COVID-19 during the rst wave of the pandemic [36], however, information on ESBL gene carriage among ESBL producing GNB that cause infections in COVID-19 patients is limited. Before the year 2000, SHV-and TEM-type enzymes were the most predominant ESBLs worldwide[37] but have since been outnumbered by CTX-M ESBLs in non-COVID19 patients [38][39] [10][33]. Therefore, our ndings suggest a similar ESBL gene carriage among bacterial isolates from COVID-19 patients and the general population.…”

“…Klebsiella pneumoniae (30.6%) was the predominant ESBL producer among GNB isolates from severely ill COVID-19 patients. Even though data on ESBL-producing bacteria in COVID-19 patients is limited, in the general population, E. coli and K. pneumoniae[30] [31] [32][33] seems to be the most common ESBL producers.…”

Phenotypic identification of different β-Lactamases in intrinsic and acquired colistin resistant uropathogenic gram negative bacteria

“…8 Treating Multi drug resistant bacteria, colistin was used as a last line of antibiotic for gram negative bacteria. 9 After the detection of mcr genes on plasmid of gram-negative bacteria disclosed that colistin resistance can be horizontally transferred. 10,11 ESBL, MBL, AmpC producing gram negative bacteria with mcr genes harboring by Enterobacteriaceae have been discovered all over the world, putting people at risk of having no effective antibacterial treatments.…”