Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK

Abstract

Globally, cephalosporin therapy failure is a serious problem for infection control. One causative agent of cephalosporin-resistant infections is multidrug-resistant (MDR) E. coli producing extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases. We evaluated the occurrence of ESBL/pAmpC genetic determinants in phenotypically MDR E. coli isolated from clinical samples of blood, faeces, ear effusion, urine and sputum from a UK hospital. Phenotypic resistance profiling for 18 antibiotics (from seven classes) showed that 32/35 isolates were MDR, with resistance to 4–16 of the tested antibiotics. Of the isolates, 97.1% showed resistance to ampicillin, 71.4% showed resistance to co-amoxiclav, cefotaxime, ceftazidime and ceftiofur, and 68.5% showed resistance to cefquinome. blaCTX-M, blaTEM and blaOXA-1 genes were detected in 23, 13 and 12 strains, respectively, and Intl1 was detected in 17 isolates. The most common subtypes among the definite sequence types were CTX-M-15 (40%) and TEM-1 (75%). No E. coli isolates carried pAmpC genes. Significant correlations were seen between CTX-M carriage and cefotaxime, ceftiofur, aztreonam, ceftazidime and cefquinome resistance; between blaCTX-M, blaTEM and blaOXA-1 carriage and ciprofloxacin resistance; and between Intl1 carriage and trimethoprim/sulfamethoxazole resistance. Thus, MDR phenotypes may be conferred by a relatively small number of genes. The level and pattern of antibiotic resistance highlight the need for better antibiotic therapy guidelines, including reduced use and improved surveillance.

Multidrug-Resistant Extended-Spectrum Beta-Lactamase (ESBL)-Producing Escherichia coli in a Dairy Herd: Distribution and Antimicrobial Resistance Profiles

“…ESBL E. coli often carries multiple resistance genes for other antimicrobial drugs than β-lactams, leading to MDR [ 22 ]. All the isolates obtained in our study, from the calves, their equipment, and the farm environment, were MDR.…”

Retrospective analysis of pediatric sepsis and the burden of antimicrobial resistance in Duhok, Kurdistan Region of Iraq

“…Various studies observed that bacteria isolated from blood displayed a high level of resistance, not only to commonly used antibiotics but also to broad-spectrum antibiotics ( Saleem et al, 2013 ; Ibrahim et al, 2023 ). To effectively control infections, the prolonged use of broad-spectrum antibiotics can lead to a resurgence of multidrug-resistant organisms; therefore, they should be used sparingly.…”

Monitoring fluoroquinolone resistance among ESBL-positive and ESBL-negative Escherichia coli strains isolated from urinary tract infections: An alert for empirical treatment

“…First, empirically prescribed antimicrobials that reach a percentage of resistance above 20% in the community run a high risk of therapeutic failure, recommending caution with their usage. Second, a significant increase in the appearance of ESBL-producing strains has been reported worldwide, including in North America and South/Latin America [16][17][18][19][20] .…”