Identification of metallo-β-lactamases and AmpC production among Escherichia coli strains isolated from hemodialysis patients with urinary tract infection

Abstract

Background This study aimed to identify metallo-β-lactamases (MBLs) and AmpC β-lactamases-producing Escherichia coli isolates obtained from hemodialysis (HD) patients with urinary tract infections (UTI). Methods and results A total of 257 HD patients with UTI were included in this study, from which 47 E. coli isolates were collected. Antibiotic susceptibility was tested by disc diffusion method. MBLs and AmpC production were phenotypically detected by imipenem-ethylenediaminetetracetate and cefoxitin/boronic acid assays, respectively. The presence of MBLs and AmpC genes was examined by polymerase chain reaction (PCR). Fosfomycin and ampicillin were the most and the least effective antibiotics against E. coli isolates, respectively. Moreover, 61.7% (29/47) of E. coli isolates were multidrug-resistant with seven different antibiotypes. Antibiotype V (AMP–CIP–IMP–MEM–CPD–CRO–CTX–GEN–LEV–SXT–TOB) was the most prevalent profile. Besides, 24 (51.1%) isolates were simultaneously resistant to imipenem and meropenem. Phenotypic assay showed MBL production in 16 (66.7%) of the 24 carbapenem-resistant E. coli isolates. The distribution of MBL genes in carbapenem-resistant E. coli was as follows: bla IMP 18 (72%), bla VIM 7 (28%), and bla NDM 1 (4%). AmpC was detected in 61.7% (29/47) of the isolates using the phenotypic method. The presence of AmpC genes was confirmed by PCR in only 26 of 29 (86.7%) AmpC producers. The frequencies of bla DHA-1 , bla ACC , and bla CMY-2 were 6 (20.7%), 11 (37.9%), and 21 (72.4%), respectively. Conclusions The emergence of MBL and AmpC coproducing E. coli isolates calls for an urgent surveillance program for timely diagnosis and screening of these genes in our healthcare systems.

Prevalence of β-lactamase enzyme producing uropathogenic E.coli isolates amongst diabetic and non-diabetic patients

“…These enzymes are not inhibited β -lactamase inhibitor such as clavulanate, tazobactam and sulbactam. AmpC production among the study isolates were similar with previous studies reports that 29/47 (61.7%) cefoxitin resistant UPEC were phenotypically positive for AmpC β -lactamase [36] and15% of community acquired UPEC produced AmpC β-lactamase [37].…”

“…Plasmid-mediated AmpC β-lactamase production in bacteria usually associated with multidrug resistance due to the co-existence of resistance genes encoding other antimicrobial agents on the same plasmid [9]. Distribution of AmpCencoding genes were correlated with the previous study reports were 26/29 (86.7%) UPEC isolates were AmpC producers with the prevalence of blaDHA, blaACC and blaCMY2 were 6/26 (20.7%), 11/26 (37.9%) and 21/26 (72.4%) respectively [36].…”

Antibiotic Resistance in Bacteria—A Review

“…Expression of this type of β-lactamase is usually inducible, but in the case Of E. coli it takes place constitutively at a very low level and does not confer β-lactam resistance to wild strains [ 110 ]. Chromosomally encoded AmpC β-lactamases are identified among E. coli strains from both humans [ 111 ] and animals [ 112 ].…”

Co-Production of NDM-1 and OXA-10 β-Lactamase in Citrobacter braakii Strain Causing Urinary Tract Infection

“…New Delhi Metallo-β-lactamase 1 (NDM-1) is an Ambler class B β-lactamase that spreads across different Enterobacteriaceae species, including C. braakii. [12][13][14][15][16][17] This work reports a carbapenem-resistant C. braakii strain causing urinary tract infection, which showed extensive resistance to most tested antibiotics. Nanopore and Illumina sequencing revealed the co-existence of bla NDM-1 -carrying and bl aOXA-10 -carrying plasmids in the isolate.…”