The prevalence of genes encoding ESBL among clinical isolates of Escherichia coli in Iran: A systematic review and meta-analysis

Lippia origanoides and Thymus vulgaris Essential Oils Synergize with Ampicillin against Extended-Spectrum Beta-Lactamase-Producing Escherichia coli

(1) Background: Could compounds such as monoterpenes and sesquiterpenes present in essential plant oils inhibit bacterial growth as an alternative to help mitigate bacterial resistance? The purpose of this study is evaluating the in vitro antibacterial effect of Lippia organoides EO (LEO) and Thymus vulgaris EO (TEO), individually and in combination with ampicillin, against extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli strains; (2) Methods: Experimental in vitro design with post-test. The EOs were obtained by hydrodistillation and were analyzed by GC. ESBL-producing E. coli strains used were selected from urine cultures and the blaCTX-M and blaTEM resistance genes were identified by end point PCR. The disk diffusion method was used for the susceptibility tests. The MICs and MBCs were determined by microdilution test. Finally, the interaction effect was observed by checkerboard assay; (3) Results: A 39.9% decrease in the growth of the strain thymol in TEO and 70.4% in carvacrol in LEO was shown, observing inhibition halos of 32 mm for both EOs. MICs of 632 and 892 μg/mL for LEO and 738 and 940 μg/mL for TEO were determined. Finally, it was observed that, at low doses, there is a synergistic effect between TEO + LEO and EOs + ampicillin; (4) Conclusions: The findings demonstrate that TEO and LEO have an inhibitory effect on ESBL-producing E. coli, suggesting that they are candidates for further studies in the formulation of antibiotics to reduce bacterial resistance to traditional antibiotics.

Phylogenetic analysis, biofilm formation, antimicrobial resistance and relationship between these characteristics in Uropathogenic Escherichia coli

BACKGROUND

In the present study, we examine the prevalence of phylogenetic groups, O-serogroups, adhesin genes, antimicrobial resistance, the level of gene expression associated with biofilm formation, and the presence of extended-spectrum beta-lactamase (ESBL) in UPEC strains isolated from both pediatric and adult patients.

METHODS

In this cross-sectional study, 156 UPEC isolates were collected from UTI patients. ESBL-producing isolates were detected using the double-disc synergy (DDS) method, and biofilm formation was assessed through a microplate assay. The presence of O-serogroups, adhesion factors and resistance genes, including ESBLs and PMQR genes, was detected by PCR, and isolates were categorized into phylogenetic groups using multiplex PCR. Additionally, the quantitative real-time PCR method was also used to determine the expression level of genes related to biofilm.

RESULTS

During the study period, 50.6% (79/156) of the samples were obtained from children, and 49.4% (77/156) were from adults. The highest rate of resistance was to NA (91.7%), while FM (10.9%) had the lowest rate of antibiotic resistance. In addition, 67.9% (106/156) of UPEC isolates were ESBL producers. Most of UPEC isolates belonged to phylogenetic group B2 (37.1%). This study revealed that blaCTX-M and qnrS are widely distributed among UPEC isolates. The mean expression levels of fimA genes were significantly higher in non-biofilm producers than in biofilm producers (p < 0.01).

CONCLUSIONS

The high antibiotic resistance rates in this study highlight the significance of local resistance monitoring and investigating underlying mechanisms. Our findings indicate the dominance of phylogroup B2 and group D as the prevailing phylogenetic groups. Consequently, it is imperative to investigate the epidemiological aspects and characterize UPEC isolates across diverse regions and time frames.

Characterization of carbapenem-resistant Escherichia coli and Klebsiella: a role for AmpC-producing isolates

Aim: This study aimed to investigate the role of AmpC enzymes in carbapenem resistance among AmpC/extended-spectrum β-lactamase (ESBL)-producing clinical isolates of Escherichia coli and Klebsiella spp. Methods: Fifty-six bacterial strains that were AmpC producers were examined. The antibiotic susceptibility test was performed by the disk diffusion and E-test. The prevalence of the plasmid carbapenemase was determined using PCR. Results: The resistance to meropenem in the AmpC⁺/ESBL⁺ group was 64%, higher than that reported for the AmpC^-/ESBL⁺ group. Ten isolates of the carbapenem-resistant AmpC producers were negative for carbapenemase-encoding genes. Conclusion: Carbapenem resistance among AmpC-producing isolates with negative results for carbapenemase-encoding genes potentially demonstrates the role of AmpC enzymes among these isolates.

High prevalence of β-lactam and fluoroquinolone resistance in various phylotypes of Escherichia coli isolates from urinary tract infections in Jiroft city, Iran

BACKGROUND

Urinary tract infection (UTI) is one of the most prevalent infectious diseases with worldwide health threatening. Antimicrobial resistant strains of Escherichia coli (E. coli) are a common cause of UTI which were identified as a treatment challenge. This study aimed to assay the prevalence of common β-lactam resistance genes including bla_TEM, bla_SHV, bla_CTX-M and bla_CMY and phenotypic resistance to commonly used β-lactam and fluoroquinolone antibiotics in UTIs. These factors were evaluated in various phylogenetic groups (phylotypes) of E. coli isolates. Real-time PCR was applied to detect β-lactam resistance genes and conventional PCR was used to determine the phylotypes. Phenotypic resistance against β-lactams (ceftazidime, cefotaxime, aztreonam and ceftriaxone) and fluoroquinolones (ciprofloxacin) were identified by the disc diffusion technique. The ability of extended spectrum β-lactamases (ESBLs) production in E. coli isolates was detected using the combined disc diffusion method.

RESULTS

The prevalence of resistance genes were 89.6% for bla_TEM, 44.3% for bla_CTX-M, 6.6% for bla_SHV and 0.9% for bla_CMY. The two high prevalent phylotypes were B2 (29.2%) and D (17.9%) followed by E (14.1%), F (9.4%), C (6.6%) and 10.3% of isolates were unknown in phylotyping. Disc diffusion results showed high prevalence of antibiotic resistance to cefotaxime (88.6%), aztreonam (83%), ceftireaxon (77.3%), ceftazidime (76.4%) and ciprofloxacin (55.6%). Totally, 52.8% of isolates were found as phenotypical ESBL-producers.

CONCLUSIONS

This study's results confirmed an explosion of antibiotic resistance amongst E. coli isolates from UTI against β-lactams and fluoroquinolones. Findings explain the necessity of deep changes in quantity and quality of drug resistance diagnosis and antibiotic therapy strategies. More studies are suggested to better and confident evaluations.

High heterogeneity of fecal carriage extended-spectrum beta-lactamase-producing E. coli isolated from iranian community and clinical settings

Background

Extended-spectrum beta-lactamase-producing enterobacteria (ESBL-PE) in carriers have become a global health problem. Using molecular typing techniques, including PFGE, could be useful to determine the source of bacterial dissemination. The current study aimed to investigate the intestinal carriage of ESBL-producing E. coli (ESBL-EC) and clonal relatedness among ESBL-EC isolated from hospitalized and outpatient fecal carriers in Iran.

Methods

A total of 120 rectal swabs were collected; 50.8% (61/120) from intensive care unit (ICU) inpatients and 49.2% (59/120) from outpatients. MacConkey agar enriched with cefotaxime was used to screen the ESBL-EC. PCR assays were performed to detect ESBL and carbapenemase genes. Pulse-fields gel electrophoresis (PFGE) was performed to assess clonal relatedness.

Results

Totally, 60.0% (72/120) were carrier for ESBL-EC. The rates of resistance against ceftazidime and cefepime were 90.2% (65/72) and 93.0% (67/72), respectively. The rates of bla_CTX-M-15, bla_TEM, bla_SHV, bla_NDM-1, bla_OXA-48 and bla_IMP was 90.2% (65/72), 50.0% (36/72), 5.5% (4/72), 4.1% (3/72), 4.1% (3/72) and 1.3% (1/72), respectively. Based on a cut-off 80%, 69 ESBL-EC isolates could be categorized in 10 mini-cluster and 47 isolates were considered as singletons.

Discussion

High heterogeneity among isolates from ESBL-EC suggests that this bacterium probably has a different source of dissemination. Screening of carriers in hospitals and communities could help the infection control program in public health.

Supplementary information

The online version contains supplementary material available at 10.1186/s12879-022-07304-7.

Meta-analysis of Escherichia coli O157 prevalence in foods of animal origin in Turkey

The present study aims to analyze the prevalence of E. coli O157 detected in foods of animal origin by meta-analysis. The prevalence of E. coli O157 detected in the different studies was combined to provide a common prevalence estimate, and heterogeneities between studies were investigated. The study material consisted of 49 studies investigating E. coli O157 prevalence in a total of 9600 food samples, including milk and dairy products, red meat and products, poultry meat and products, and cold appetizers between the years 1997-2019 in Turkey. In the meta-analysis, the Der-Simonian-Laird method was used. Meta-analyses were performed using the R 3.6.1. As a result of the meta-analysis, the common prevalence of E. coli O157 was 0.024 (0.018-0.029). As a result of the Egger’s Linear Regression Test, the study samples were found to be biased (t-value=6.092, P<0.001). To determine the source of heterogeneity between studies, sub-group and meta-regression analyses were performed in milk and dairy products, red meat and products, poultry meat and products, and ready-to-eat foods (RTEs). Accordingly, the prevalence of E. coli O157 in milk and dairy products, red meat and products, poultry meat and products, and RTEs was determined as 0.017, 0.031, 0.023, and 0.080 in Turkey, respectively. This study provides a stronger and more accurate estimation of the prevalence of E. coli O157 in foods of animal origin with the meta-analysis by eliminating inconsistencies in the effect of the sampling size of independent prevalence studies. However, in order to obtain accurate prevalence results in practice, it is necessary carefully to select the studies to be included in the analysis, to use the appropriate statistical model, and to interpret the results of the analysis correctly.