Molecular characterization of Extended-spectrum β lactamase- producing E. coli recovered from community-acquired urinary tract infections in Upper Egypt

Abstract

Treatment of community urinary tract infections (UTIs) caused by extended-spectrum β lactamase (ESBL)- producing Escherichia coli (E. coli) is more expensive than treating ESBL-negative opposites. Evaluation of the prevalence of ESBL-production among urinary E. coli isolates is crucial due to its great impact on the choice of proper antimicrobials. Accordingly, the aim of this work was to detect and characterize ESBL-producing E. coli isolated from outpatients with signs of UTIs in Upper Egypt. Urinary E. coli isolates were identified by 16S rRNA and their ESBL-production was confirmed by Modified Double Disc Synergy Test (MDDST) and ESBL- CHROMagar media. Isolates were then subjected to Polymerase Chain Reaction (PCR) for new Clermont phylogrouping, ESBL genes detection and CTX-M typing. The study enrolled 583 patients with clinically diagnosed UTIs. Uropathogens were found in 400 urine samples (68.6%) out of which 134 E. coli isolates were identified. Among the examined uropathogenic E. coli (UPEC), 80 (59.7%) were recognized as ESBL-producers. Greater than half of the ESBL-producers were multi-drug resistant (MDR) (62%). All of them were susceptible to meropenem. Most of the E. coli isolates were distributed in 4 phylogenetic groups: B2 = 42 (52.5%), F = 17 (21.25%) and Clade I or II = 10 (12.5%). The predominant gene types were TEM 60 (75%) and CTX-M gene 45 (56.25%). The CTX-M-1 group was the most prevalent (62.2%), including the CTX-M-15 enzyme, followed by the CTX-M-2 group, CTX-M-8 group and CTX-M-9 group. In conclusion, the results present alarming evidence of a serious spread of ESBL genes in Egypt, especially the epidemiological CTX-M 15, with the potential for the dissemination of MDR UPEC strains in the community.

Multidrug Resistant <em>Escherichia</em><em> coli</em> Harboring Extended-spectrum β-lactamase-encoding Genes Isolated from Clinically-healthy Pigs

“…In addition, one ESBL-producing E. coli isolate is susceptible to ampicillin (Table 3) and this isolate was negative to all ESBL genes tested in this study. This phenomenon agrees with previous studies that were conducted in ESBL-producing E. coli from various clinical samples [26][27][28][29]. However, it is still unclear about genetics underlying ESBL production in this ampicillin-resistant ESBL producing strain.…”

Prevalence and drug-resistance profile of plasmid-borne extended spectrum beta-lactamase (ESBLs) resistance genes in multidrug resistant Escherichia coli from HIV-1 positive individuals in Jos, Nigeria

“…This difference may be attributed to the use of molecular technique in our study as against phenotypic detection in theirs, since the latter is known to be less sensitive compared to the former. Our result is very similar to the 33 and 33.5% earlier reported from Saudi Arabia and Egypt by Abdulaziz et al (2018) and Hassuna et al (2020), respectively. Previous workers (Saravanan et al, 2018;Abdulaziz et al, 2018;Hassuna et al, 2020), have also reported higher prevalence of bla-CTX gene in the middle-East and Africa, but our study showed the bla-TEM gene dominating over the bla-CTX gene with the bla-SHV being completely absent.…”

“…Available literature has demonstrated a risen prevalence of multidrug resistant ESBL-producing E. coli globally (Hassuna et al, 2020;Abdulaziz et al, 2018;Falgenhauer et al, 2019). Our study is predicated on the paucity of data from the West African sub-region on ESBLs resistant genes in HIV-infected individuals.…”

Occurrence and Characteristics of Extended-Spectrum β-Lactamase-Producing <em>Escherichia coli</em> from Dairy Cattle, Milk and Farm Environment in Peninsular Malaysia

“…Escherichia coli producing narrow and extended spectrum beta-lactamases (ESBL) are continuously becoming a public health problem worldwide [3,4]. ESBL are plasmid-mediated βlactamase enzyme recognized for their remarkable ability to hydrolyse, penicillin, 3 rd and 4 th generation cephalosporins and monobactams except for carbapenem and cephamycin [5]. These enzymes emerged from blaTEM-1, blaTEM-2, and blaSHV a narrow-spectrum parent.…”

“…Recently, blaCTX-M, a new class of ESBL genes appeared have gained global traction, because of the burden it placed on environment health. Amino acid sequence analysis of CTX-M variant grouped these enzymes into five distinct clusters including CTX-M-1, CTX-M-2, CTX-M-8, CTX-M-9, and CTX-M-25 [4,5]. The success of the genes in the ecosystem may likely be associated with the spread of bacterial strains carrying ESBL genes and horizontal transfer of these genes on transmissible plasmids [6][7][8].…”