Prevalence of <i>Escherichia coli</i> Resistant to Beta-Lactam Antibiotics among Patients with Chronic Obstructive Pulmonary Disease and Urinary Tract Infection

Abstract

Urinary tract infection (UTI), which is typically caused by Escherichia coli (E. coli), is an insufficiently recognized co-morbidity among patients with chronic obstructive pulmonary disease (COPD). Adequate treatment can be complicated by resistance of the causative pathogen to beta-lactam antibiotics, which often produce beta-lactamase enzymes that destroy the antibiotic. The beta-lactamase family of enzymes is extremely diverse, including different types of enzyme and mutant forms. In this study, we analyzed 580 patients with COPD (236 females and 344 males) and thus found 218 patients with co-morbid UTIs, including 58 patients with UTI caused by E. coli (38 females and 20 males). We also investigated cases of uncomplicated symptomatic and asymptomatic UTI caused by E. coli and the presence of resistance to beta-lactam antibiotics among those patients. The E. coli strains resistant to beta-lactam antibiotics were selected for their ability to grow on selective media, before DNA microarrays were applied for specific identification of three beta-lactamase gene types (i.e., TEM, SHV and CTX-M). Overall, 83% of E. coli strains responsible for UTIs in COPD patients carried extended-spectrum beta-lactamase genes. The most prevalent were those producing CTX-M, with CTX-M-15 being predominant. The rare CTX-M-27 and TEM-15 genes were also detected in two samples. Three samples contained several extended-spectrum beta-lactamase genes simultaneously (CTX-M-15 or CTX-M-14 plus SHV-5 or TEM-15). This high prevalence of resistant E. coli strains necessitates rational antibiotic selection when treating UTI to prevent COPD exacerbations. Additionally, antibiotic therapy should be aligned with and adapted to existing and potential COPD co-morbidities.

Multidrug Resistance Profiles and Resistance Mechanisms to β-Lactams and Fluoroquinolones in Bacterial Isolates from Hospital Wastewater in Bangladesh

“…Beta-lactam resistance is generally caused by enzymes that break down the antibiotic’s beta-lactam ring, rendering it ineffective against bacteria. Genes for these enzymes, such as bla TEM , bla SHV1 , bla CTX-M1 , bla NDM , bla VIM1 , etc., have been identified in several Gram-negative bacterial species, with particularly higher prevalence observed in Escherichia coli [ 8 , 9 ].…”

Molecular characterization of Carbapenem resistant Escherichia coli recovered from a tertiary hospital in Lebanon

“…Escherichia coli are one of the most common members of the family Enterobacteriaceae and often exist as commensal in the gastrointestinal tract of humans and animals. However, they can also colonize, infect and cause both hospital- and community-acquired infections leading to serious clinical disorders at both intra- and extraintestinal sites such as urinary tract infections, septicemia, neonatal meningitis and bacteremia [ 1 – 3 ]. Over the past decade, there has been a worldwide increase in extended-spectrum β-lactamase (ESBL) producing and carbapenem resistant E .…”

Utilização de aminoglicosídeos como estratégia terapêutica para combater infecções causadas por enterobactérias produtoras de β-lactamases de espectro estendido

“…O tratamento de infecções do trato urinário (ITU), normalmente causadas pela E. coli, pode ser complicado devido à resistência dessa bactéria aos antibióticos β-lactâmicos, uma vez que no estudo realizado por Nikolić et al (2018), os autores identificaram em pacientes internados em ITUs e portadores de doença pulmonar obstrutiva crônica (DPOC) cepas de E. coli expressando os genes TEM, SHV e CTX-M, isto é, genes que codificam enzimas β-lactamases. Devido a esses achados, a seleção de antibióticos para o tratamento dessas infecções torna-se mais restrito, principalmente em pacientes com DPOC.…”