Relative Fecal Abundance of Extended-Spectrum-β-Lactamase-Producing Escherichia coli Strains and Their Occurrence in Urinary Tract Infections in Women

Ruppé, Étienne; Lixandru, Brânduşa Elena; Cojocaru, Radu; Büke, Çağrı; Paramythiotou, Elisabeth; Angebault, Cécile; Visseaux, Claire; Djuikoue, Cécile Ingrid; Erdem, Esra; Burduniuc, Olga; Mniai, Assiya El; Marcel, Candice; Perrier, Marion; Kesteman, Thomas; Clermont, Olivier; Denamur, Erick; Armand-Lefèvre, Laurence; Andremont, Antoine

doi:10.1128/aac.00238-13

Cited by 108 publications

(81 citation statements)

References 30 publications

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“…Of note, ESBL-RA in patients without antibiotic exposure was similar to that observed in European women [1.1%] [8]. ESBL-RA was not found to be associated with age, pregnancy, antibiotics use …”

Section: Resultsmentioning

confidence: 55%

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Intestinal carriage of Extended Spectrum Beta-Lactamase producing E. coli in women with urinary tract infections, Cameroon

Djuikoue

Woerther

Toukam

et al. 2016

J Infect Dev Ctries

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Introduction: During the last decade, the prevalence of the intestinal carriage of extended spectrum beta-lactamases -producing Escherichia coli (ESBL-E. coli) has continued to increase worldwide in the community, especially in developing countries. Hence, we undertook a study to determine the ESBL-E. coli fecal carriage rate and the associated risk factors in Cameroonian women. Methodology: A total of 86 women suspected of community-acquired urinary tract infections (UTI) were included in 10 health structures from May 2011 to April 2012. After filling a questionnaire, they provided a stool sample that was plated on selective media for ESBL producing bacteria. The identification of strains was obtained with mass spectrometry and the antibiotic susceptibility by disk diffusion in agar media. The ESBL type was determined by PCR. The relative abundance of ESBL-E. coli was measured for positive samples. Eventually, the presence of antibiotics in stool was assessed. Results: The carriage rate of ESBL-E. coli was 57/86 (66.3%). Phenotypic and molecular characterization showed that all ESBL-E. coli strains contained group 1 CTX-M enzymes. Multivariate analysis showed that ESBL-E. coli fecal carriage was associated with the presence of antibiotics in stools (p < 0.05). Although not significant, mean ESBL relative abundance tended to be higher in patients with antibiotic exposure. Conclusions: Our results show that the carriage of ESBL-E. coli fecal carriage in women with UTI suspicion from the Cameroonian community is extremely high and associated with recent antibiotic intake.

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Section: Resultsmentioning

confidence: 55%

“…CFUs were counted in decimal logarithms at the dilution in which 1-100 CFUs grew. ESBLrelative abundance (ESBL-RA) was calculated as the ratio of the ESBL-E. coli counts divided by the total number of Enterobacteriaceae [8]. For women who carried more than one ESBL E. coli, only the ESBL-RA of the dominant clone was considered.…”

Section: Microbiological Analysismentioning

confidence: 99%

Intestinal carriage of Extended Spectrum Beta-Lactamase producing E. coli in women with urinary tract infections, Cameroon

Djuikoue

Woerther

Toukam

et al. 2016

J Infect Dev Ctries

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“…In recent years, extended-spectrum β-lactamases (ESBLs) have increased in type and frequency, such as enterobacteriaceae and carbapenemases, which have resulted in a worldwide dissemination of such extended spectrum β-lactamases producing strains [21]; production of extended spectrum β-lactamases (ESBLs) is currently a matter of increasing global concern [5,22]. Ruppe and Cols identified that the occurrence of UTI caused by ESBL E. coli in women who were not exposed to antibiotics was linked to the relative amount of fecal ESBL E. coli [23].…”

Section: Discussionmentioning

confidence: 99%

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Cerna

Macriz-Romero²,

Santoscoy-Gutierrez³

et al. 2015

Int Arch Med

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Background: Urinary tract infections (UTIs) are a major public health problem worldwide. In Latin America, most UTIs are treated without bacteriological identification. Our aim was to examine resistance rates to commonly prescribed antibiotics, focusing on cases from Jalisco, Mexico; and additionally to conduct a review of the literature to search for resistance patterns in other countries of Latin America. Methods: Results:We obtained 1.206 consecutive samples from outpatient and inpatient facilities, including adult and pediatric subjects. The most frequent isolate in all groups was ESBL-producing E. coli with high resistance rates for ampicillin, TMP-SMX, and ciprofloxacin. In the literature review we found 15 papers related to resistance rates of commonly prescribed antibiotics. Conclusions:The information summarized in this article supports the finding that resistance rates to commonly prescribed antimicrobial agents are increasing worldwide. As such, this study challenges the rationale behind empiric use of antibiotics, emphasizing the need, whenever possible, to perform urine cultures before initiating antimicrobial treatment.

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“…Recently, it has been shown that a high relative abundance (RA) of ESBL E. coli in the feces increases the risk of urinary tract infection (UTI) by ESBL E. coli (3). Additionally, a high ESBL E. coli RA has been associated with longer fecal carriage time, increasing the numbers of excreted E. coli in the environment and the potential risk of dissemination of these resistant strains (4).…”

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confidence: 99%

“…Although controversial, several works have suggested that the RA of various E. coli clones present in the feces plays a key role in the pathogenesis of UTIs, probably because the dominant E. coli clone would have the maximum likelihood to colonize the urinary tract (14). Subsequently, a high RA of ESBL E. coli in the feces increases the risk of UTI by ESBL E. coli (3). Similarly, during bacterial translocation from the gut leading to bacteremia, the translocating bacteria, including E. coli, have been found to be mostly the dominant gut colonizer (15).…”

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confidence: 99%

Prospective Cohort Study of the Relative Abundance of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli in the Gut of Patients Admitted to Hospitals

Lastours

Jacquier

d’Humières

et al. 2016

Antimicrob Agents Chemother

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A total of 458 patients were prospectively included at hospital admission and screened for extended-spectrum-beta-lactamaseproducing (ESBL) Escherichia coli carriage in 2007 and in 2010 to 2012. A 4-fold increase in ESBL carriage (3% to 12%), a 5-fold increase in numbers of community patients among ESBL carriers, and a higher number of multiple ESBL strains was found in the 2010 to 2012 period. ESBL E. coli represented the dominant E. coli strain (relative abundance, >50%) in 10/32 (31%) of ESBL carriers. This represents a major threat in terms of infectious risk and dissemination.T he epidemiology of Escherichia coli infections has recently been profoundly modified with the global emergence of strains resistant to third-generation cephalosporins (3GC), specifically, strains producing extended-spectrum ␤-lactamases (ESBL), in both hospitals and the community (1). CTX-M-type ESBLs, which have spread in a polyclonal manner on all continents, constitute a major public health concern worldwide (1).Gut colonization is the first step toward infections by E. coli (2). Recently, it has been shown that a high relative abundance (RA) of ESBL E. coli in the feces increases the risk of urinary tract infection (UTI) by ESBL E. coli (3). Additionally, a high ESBL E. coli RA has been associated with longer fecal carriage time, increasing the numbers of excreted E. coli in the environment and the potential risk of dissemination of these resistant strains (4). However, most studies focusing on ESBL fecal carriage have described the presence or absence of ESBL E. coli in the gut but have lacked quantitative data. Moreover, whether the ESBL populations are dominant was not specified. Here, we characterized and determined the prevalence, bacterial load, and diversity of ESBL E. coli in the gut of patients at hospital admission at two different time periods and determined factors associated with high relative abundance of ESBL carriage.We used samples collected in two previous prospective clinical trials (5, 6) (https://clinicaltrials.gov/ct2/show/NCT00520715 and https://clinicaltrials.gov/ct2/show/NCT01209247). In both works, clinical data (age, sex, Charlson comorbidity index, hospitalization ward, history of immunosuppression, previous hospitalization in the last 12 months, previous antibiotic exposure in the last 3 months, and antibiotic class) as well as a rectal swab had been collected from patients at admission in the same two tertiarycare hospitals from the Paris region in France (5, 6). The first collection period (P1) was between May and November 2007, and the second period (P2) was between October 2010 and July 2012. Both studies were approved by the local institutional review board (IRB 00008522), and patients gave informed consent (5, 6). Rectal swabs were discharged in 1 ml of brain heart infusion (BHI) broth with glycerol and stored at Ϫ80°C in duplicates (5, 6). After thawing, 50 l was plated on Drigalski agar plates (Pasteur Diagnostics, Paris, France), one containing no antibiotics and one containing 1 g/ml cefotax...

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Relative Fecal Abundance of Extended-Spectrum-β-Lactamase-Producing Escherichia coli Strains and Their Occurrence in Urinary Tract Infections in Women

Cited by 108 publications

References 30 publications

Intestinal carriage of Extended Spectrum Beta-Lactamase producing E. coli in women with urinary tract infections, Cameroon

Intestinal carriage of Extended Spectrum Beta-Lactamase producing E. coli in women with urinary tract infections, Cameroon

High Microbiological Spectrum Resistance Rates in urine isolates from Jalisco, Mexico. A retrospective study and literature review

Prospective Cohort Study of the Relative Abundance of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli in the Gut of Patients Admitted to Hospitals

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