Multi-drug Resistance, β-Lactamases Production, and Coexistence of bla_NDM-1 and mcr-1 in Escherichia coli Clinical Isolates From a Referral Hospital in Kathmandu, Nepal

Abstract

The ability of pathogenic Escherichia coli to produce carbapenemase enzymes is a characteristic that allows them to resist various antibiotics, including last-resort antibiotics like colistin and carbapenem. Our objectives were to identify rapidly developing antibiotic resistance (AR), assess β-lactamases production, and detect mcr-1 and blaNDM-1 genes in the isolates. A prospective cross-sectional study was carried out in a referral hospital located in Kathmandu from November 2019 to December 2020 using standard laboratory and molecular protocols. Among 77 total E. coli isolates, 64 (83.1%) of them were categorized as MDR. Phenotypically 13 (20.3%) colistin-resistant, 30 (46.9%) ESBL and 8 (12.5%) AmpC producers, and 5 (7.8%) ESBL/AmpC co-producers were distributed among MDR- E. coli. Minimum inhibitory concentrations (MIC) against the majority of MDR isolates were exhibited at 1 g/L. Of these 77 E. coli isolates, 24 (31.2%) were carbapenem-resistant. Among these carbapenem-resistant bacteria, 11 (45.9%) isolates were reported to be colistin-resistant, while 15 (62.5%) and 2 (8.3%) were MBL and KPC producers, respectively. Out of 15 MBL producers, 6 (40%) harbored blaNDM-1, and 8 (61.5%) out of 13 colistin-resistant pathogens possessed mcr-1. The resistance by colistin- and carbapenem were statistically associated ( P < .001). However, only 2 (18.2%) of the co-resistant bacteria were found to have both genes. Our study revealed the highly prevalent MDR and the carbapenem-resistant E. coli and emphasized that the pathogens possess a wide range of capabilities to synthesize β-lactamases. These findings could assist to expand the understanding of AR in terms of enzyme production.

A comprehensive computational study to explore promising natural bioactive compounds targeting glycosyltransferase MurG in Escherichia coli for potential drug development

“…Diarrhoeagenic Escherichia coli ( E. coli ) pathotypes, particularly enteroaggregative E. coli , are one of the major food pollutants in gastrointestinal infections worldwide 1 , 2 . Causing more than half a million deaths and 1.7 billion morbidities of children under five yearly, thus representing an awful global health issue 3 , 4 . Indeed, the existence of E. coli has commonly been described in all countries worldwide 3 , 5 .…”

“…Causing more than half a million deaths and 1.7 billion morbidities of children under five yearly, thus representing an awful global health issue 3 , 4 . Indeed, the existence of E. coli has commonly been described in all countries worldwide 3 , 5 . And antimicrobial misuse is responsible for a frightening upsurge in bacterial resistance 6 – 8 .…”

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

“…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. 12 The production of extended beta-lactamases (ESBL), metallo beta-lactamases (MBL) and AmpC enzyme combined with a colistin resistance in gram-negative bacteria has a great threat to economic burden of these infections. For effective treatment against MDR uropathogenic gram negative bacteria it is important that proper and continuous surveillance of antimicrobial resistance pattern with ESBL, MBL, AmpC and colistin resistance should be done in Pakistan.…”

“… 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. 12 …”