Phylogenetic Origin and Virulence Genotype in Relation to Resistance to Fluoroquinolones and/or Extended‐Spectrum Cephalosporins and Cephamycins among<i>Escherichia coli</i>Isolates from Animals and Humans

Johnson, James R.; Kuskowski, Michael A.; Owens, Krista; Gajewski, Abby; Winokur, Patricia L.

doi:10.1086/377455

Cited by 232 publications

(241 citation statements)

References 42 publications

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“…Phylogroups A and B1 are considered less virulent or even commensal compared to the B2 phylogroup and, to a lesser extent, the D phylogroup [47]. Moreover, A and B1 were described as the most frequently resistant to antibiotics, as shown in our results; indeed, it seems that there is a trade-off between antibiotic resistance, particularly to quinolones (ciprofloxacin), and virulence in E. coli [32].…”

Section: Discussionsupporting

confidence: 67%

Characteristics of ciprofloxacin-resistant Enterobacteriaceae isolates recovered from wastewater of an Algerian hospital

Anssour

Messai

Estepa

et al. 2016

J Infect Dev Ctries

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Introduction: Hospital effluents are a source of environmental pollution by drugs, antibiotic-resistant bacteria, and resistance genes. Quinolones, particularly ciprofloxacin, are commonly detected in these effluents, contributing to the emergence of antimicrobial resistance. The objective of this study was to characterize ciprofloxacin-resistant Enterobacteriaceae in hospital effluents. Methodology: Isolates were selected on Tergitol-7 agar supplemented with ciprofloxacin and genotyped by ERIC-PCR. Antibiotic susceptibility testing was done using the disk diffusion method, and minimum inhibitory concentrations were determined using the agar dilution method. Resistance genes, integrons, phylogenetic groups, and sequence types were identified by PCR and sequencing. Results: A total of 17 ciprofloxacin-resistant isolates were characterized: Escherichia coli, Escherichia vulneris, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter freundii, and Citrobacter koseri/farmeri. Isolates presented concomitant resistance to nalidixic acid, ciprofloxacin, ofloxacin, and pefloxacin. A diversity in mutation patterns in gyrA and parC genes and new amino-acid substitutions in GyrA subunit were observed. Quinolone plasmidic resistance genes qnrB1, qnrB2, qnrB5/19, qnrS1, and aac(6')-Ib-cr were detected. Resistance to other antibiotic classes was observed. Class 1 integrons and resistance genes blaCTX- sul1, sul2, sul3, tetA, tetB, aadA1/2, aadA5, aac(3) II, dfrA1, dfrA5, dfrA7, and dfrA12 were detected. Bacterial tolerance to cadmium, zinc, and mercury was observed with the presence of the merA gene. E. coli isolates belonged to phylogenetic groups A, B1, and D and to sequence types ST405, ST443, ST101, ST10, and ST347. Conclusions: This study highlighted bacterial multidrug resistance linked to ciprofloxacin and, consequently, the risk of bacterial exposure to this antibiotic.

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Section: Discussionsupporting

confidence: 67%

Characteristics of ciprofloxacin-resistant Enterobacteriaceae isolates recovered from wastewater of an Algerian hospital

Anssour

Messai

Estepa

et al. 2016

J Infect Dev Ctries

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“…These results support the hypothesis that although virulence factors and antibiotic resistance may confer increased Þ tness for extraintestinal infections in humans, they may do so via mutually exclusive pathways and in distinct populations. 21 A rise in the number of virulence factors was associated with a decrease in the rate of ESBL production. A robust virulence factor repertoire may be essential for a pathogen to overcome intact host defences, whereas it may be unnecessary in a compromised host, where antibiotic resistance may provide a substantial advantage to the survival of the pathogen.…”

Section: Discussionmentioning

confidence: 99%

Virulence factors and drug resistance in <i>Escherichia coli </i>isolated from extraintestinal infections

Sharma¹,

Bhat²,

Shenoy³

2007

Indian J Med Microbiol

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“…(Johnson & O'Bryan, 2004). The ExPEC (UPEC) status of the E. coli isolates was predicted based on the operational definition of ExPEC: 'presence of ¢2 of the abovementioned VAGs' (Johnson et al, 2003).…”

Section: Methodsmentioning

confidence: 99%

“…Also, Johnson et al (2003) have reported that among human clinical E. coli isolates, FQ and/or AmpC resistance was associated with a significant shift towards the non-B2 phylogenetic lineage as well as a reduced virulence profile. However, there is a paucity of data on the antibiotic-resistance profile, phylogeny and prevalence of specific virulence-associated genes (VAGs) among uropathogenic E. coli (UPEC) from HIV patients.…”

Section: Introductionmentioning

confidence: 99%

Extended-spectrum β-lactamase/AmpC-producing uropathogenic Escherichia coli from HIV patients: do they have a low virulence score?

Padmavathy

Krishnan

Rajasekaran

2013

Journal of Medical Microbiology

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Extended-spectrum b-lactamase (ESBL) production and quinolone resistance are often associated in enterobacteria. Prior exposure to 3G cephalosporins/quinolones accelerates the risk of resistance to both these groups of antibiotics. Hence, information on the antimicrobial resistance pattern of uropathogenic Escherichia coli (UPEC) isolates is important to better formulate the guidelines for the empirical therapy of urinary tract infection in the context of HIV/ AIDS. The aim of this study was to determine the incidence of ESBL/AmpC and fluoroquinolone (FQ) resistance among urinary E. coli isolates and to establish the association of extraintestinal virulence and phylogenetic distribution with antibiotic resistance and host immunocompromisation. Accordingly, 118 urinary Escherichia coli isolates from HIV (n576) and non-HIV antenatal patients (n542) from Chennai, South India, were analysed for the presence of five virulence-associated genes (VAGs): pap, sfa/foc, afa/dra, iutA and kpsMII. Compared with the susceptible HIV isolates, the majority of the ESBL + AmpC + FQ R isolates harboured iutA (66.7 %) and pap (40 %). The FQ-resistant HIV isolates were significantly enriched for iutA (67.8 %) and kpsMII (47.5 %) and qualified as UPEC (54.2 %), while a majority of the FQ-susceptible isolates from the non-HIV patients were found to harbour pap (48.4 %), sfa/foc (41.9 %) and kpsMII (48.4 %) and were classified as UPEC (40.5 %). We conclude that antibiotic-resistant (ESBL + AmpC + and/or FQ R ) phylogroup D isolates with limited virulence are competent enough to establish infections in HIV patients, while among non-HIV patients, an array of virulence factors is essential for E. coli to overcome host defences irrespective of antibiotic resistance. INTRODUCTIONThe liberal use of quinolones and b-lactams has triggered bacterial resistance worldwide. Urinary Escherichia coli are increasingly reported to exhibit resistance to the conventional front-line antibiotic ciprofloxacin (Lüthje & Brauner, 2010). The recent EAU (European Association of Urology) guidelines (2011; see http://www.uroweb.org/guidelines/ online-guidelines/) recommend the use of Group 3a/b cephalosporins (cefotaxime, ceftazidime, cefoperazone) for the treatment of complicated urinary tract infections and urosepsis (Grabe et al., 2011). However, emergence of b-lactam resistance mediated by extended-spectrum blactamases (ESBLs) and group 1 AmpC cephalosporinases (especially plasmid-mediated AmpC b-lactamasesPMACBLs) is a major global problem (Winokur et al., 2001;Lampri et al., 2012). ESBL/AmpC-producing organisms are of paramount concern as they limit therapeutic options, cause treatment failures and increase the cost/ duration of hospitalization (Odeh et al., 2002). Emerging resistance in E. coli is frequently due to the irrational use of antibiotics and is associated with high mortality rates. Hence, rapid detection of such strains is a prerequisite to limit their dissemination and for the selection of appropriate antimicrobial therapy, which is frequentl...

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Phylogenetic Origin and Virulence Genotype in Relation to Resistance to Fluoroquinolones and/or Extended‐Spectrum Cephalosporins and Cephamycins amongEscherichia coliIsolates from Animals and Humans

Cited by 232 publications

References 42 publications

Characteristics of ciprofloxacin-resistant Enterobacteriaceae isolates recovered from wastewater of an Algerian hospital

Characteristics of ciprofloxacin-resistant Enterobacteriaceae isolates recovered from wastewater of an Algerian hospital

Virulence factors and drug resistance in <i>Escherichia coli </i>isolated from extraintestinal infections

Extended-spectrum β-lactamase/AmpC-producing uropathogenic Escherichia coli from HIV patients: do they have a low virulence score?

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