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Ballesteros-Monrreal MG, Mendez-Pfeiffer P, Ortíz B, Bolado-Martínez E, Álvarez-Ainza ML, Enciso-Martínez Y, Arenas-Hernández MMP, Diaz-Murrieta B, Barrios-Villa E, Valencia D. Uropathogenic E. coli and Hybrid Pathotypes in Mexican Women with Urinary Tract Infections: A Comprehensive Molecular and Phenotypic Overview. Curr Issues Mol Biol 2024; 46:5909-5928. [PMID: 38921024 PMCID: PMC11202577 DOI: 10.3390/cimb46060353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 06/07/2024] [Accepted: 06/08/2024] [Indexed: 06/27/2024] Open
Abstract
Uropathogenic Escherichia coli (UPEC) is the main cause of urinary tract infections (UTIs) and carries virulence and resistance factors often found in mobilizable genetic elements, such as plasmids or pathogenicity islands (PAIs). UPEC is part of the extraintestinal pathogenic E. coli (ExPEC), but hybrid strains possessing both diarrheagenic E. coli (DEC) and ExPEC traits, termed "hypervirulent", present a significant health threat. This study assessed the prevalence of UPEC PAIs, ExPEC sequence types (ST), DEC genes, carbapenemase and extended-spectrum β-lactamase (ESBL) phenotypes, resistance genotypes, and plasmids in 40 clinical isolates of UPEC. Results showed that 72.5% of isolates had PAIs, mainly PAI IV536 (53%). ESBL phenotypes were found in 65% of β-lactam-resistant isolates, with 100% of carbapenem-resistant isolates producing carbapenemase. The predominant ESBL gene was blaCTX-M-2 (60%), and the most common resistance gene in fluoroquinolone and aminoglycoside-resistant isolates was aac(6')Ib (93%). Plasmids were present in 57% of isolates, and 70% belonged to the ST131 clonal group. Molecular markers for DEC pathotypes were detected in 20 isolates, with 60% classified as hybrid pathotypes. These findings indicate significant pathogenic potential and the presence of hybrid pathotypes in E. coli UTI clinical isolates in the Mexican population.
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Affiliation(s)
- Manuel G. Ballesteros-Monrreal
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Pablo Mendez-Pfeiffer
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Bryan Ortíz
- Instituto de Investigaciones en Microbiología, Facultad de Ciencias, Universidad Nacional Autónoma de Honduras, Tegucigalpa 11101, Honduras;
| | - Enrique Bolado-Martínez
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Hermosillo CP 83000, Sonora, Mexico; (E.B.-M.); (M.L.Á.-A.)
| | - Maritza Lizeth Álvarez-Ainza
- Departamento de Ciencias Químico-Biológicas, Universidad de Sonora, Hermosillo CP 83000, Sonora, Mexico; (E.B.-M.); (M.L.Á.-A.)
| | - Yessica Enciso-Martínez
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Margarita M. P. Arenas-Hernández
- Posgrado en Microbiología, Centro de Investigación en Ciencias Microbiológicas, Instituto de Ciencias, Benemérita Universidad Autónoma de Puebla, Ciudad Universitaria, Puebla CP 72570, Pue, Mexico
| | - Betsaida Diaz-Murrieta
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Edwin Barrios-Villa
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
| | - Dora Valencia
- Departamento de Ciencias Químico-Biológicas y Agropecuarias, Universidad de Sonora, Caborca CP 83621, Sonora, Mexico; (M.G.B.-M.); (P.M.-P.); (Y.E.-M.); (B.D.-M.)
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Link DT, Viana GGF, Siqueira LP, Ferraz CM, Rodrigues RA, Mathias LA, Cardozo MV, Rossi GAM. Assessing the Microbial Quality of Shrimp ( Xiphonaeus kroyeri) and Mussels ( Perna perna) Illegally Sold in the Vitória Region, Brazil, and Investigating the Antimicrobial Resistance of Escherichia coli Isolates. Antibiotics (Basel) 2024; 13:242. [PMID: 38534677 DOI: 10.3390/antibiotics13030242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 03/01/2024] [Accepted: 03/05/2024] [Indexed: 03/28/2024] Open
Abstract
The consumption of seafood is crucial for food security, but poor hygiene along the food production chain can result in low microbiological quality, posing significant risks for public health and seafood quality. Thus, this study aimed to assess the microbiological quality and antimicrobial sensitivity of E. coli from 69 samples of illegally marketed shrimp and mussels in the Vitória Region, Brazil. These foods exhibited poor microbiological quality due to high counts of mesophilic, psychrotrophic, and enterobacteria microorganisms. While this issue is widespread in this area, shrimp samples displayed higher microbial counts compared to mussels, and fresh mussels had elevated counts of enterobacteria compared to frozen ones. Among the 10 E. coli isolates, none carried the genes blaCTX-M-1, blaCTX-M-2, blaCTX-M-3, blaCTX-M-15, mcr-1, mcr-2, mcr-3, mcr-4, and tet, associated with antibiotic resistance. Phenotypical resistance to tetracycline and fosfomycin was not observed in any isolate, while only 20% demonstrated resistance to ciprofloxacin. Regarding ampicillin and amoxicillin with clavulanic acid, 60% of isolates were resistant, 10% showed intermediate susceptibility, and 30% were sensitive. One isolate was considered simultaneously resistant to β-lactams and quinolones, and none were conserved as ESBL producers. These findings highlight the inherent risks to local public health that arise from consuming improperly prepared seafood in this area.
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Affiliation(s)
- Daniella Tosta Link
- Department of Veterinary Medicine, University of Vila Velha (UVV), Vila Velha 29102-920, ES, Brazil
| | | | - Lívia Pasolini Siqueira
- Department of Veterinary Medicine, University of Vila Velha (UVV), Vila Velha 29102-920, ES, Brazil
| | - Carolina Magri Ferraz
- Department of Veterinary Medicine, University of Vila Velha (UVV), Vila Velha 29102-920, ES, Brazil
| | - Romário Alves Rodrigues
- Department of Pathology, Reproduction and One Health, São Paulo State University (UNESP), Jaboticabal 14884-900, SP, Brazil
| | - Luis Antonio Mathias
- Department of Pathology, Reproduction and One Health, São Paulo State University (UNESP), Jaboticabal 14884-900, SP, Brazil
| | - Marita Vedovelli Cardozo
- Microorganism Physiology Laboratory, Department of Biomedical Science and Health, Universidade do Estado de Minas Gerais (UEMG), Passos 37900-004, MG, Brazil
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Pitout JDD, Peirano G, Matsumura Y, DeVinney R, Chen L. Escherichia coli sequence type 410 with carbapenemases: a paradigm shift within E. coli toward multidrug resistance. Antimicrob Agents Chemother 2024; 68:e0133923. [PMID: 38193668 PMCID: PMC10869336 DOI: 10.1128/aac.01339-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024] Open
Abstract
Escherichia coli sequence type ST410 is an emerging carbapenemase-producing multidrug-resistant (MDR) high-risk One-Health clone with the potential to significantly increase carbapenem resistance among E. coli. ST410 belongs to two clades (ST410-A and ST410-B) and three subclades (ST410-B1, ST410-B2, and ST410-B3). After a fimH switch between clades ST410-A and ST410-B1, ST410-B2 and ST410-B3 subclades showed a stepwise progression toward developing MDR. (i) ST410-B2 initially acquired fluoroquinolone resistance (via homologous recombination) in the 1980s. (ii) ST410-B2 then obtained CMY-2, CTX-M-15, and OXA-181 genes on different plasmid platforms during the 1990s. (iii) This was followed by the chromosomal integration of blaCMY-2, fstl YRIN insertion, and ompC/ompF mutations during the 2000s to create the ST410-B3 subclade. (iv) An IncF plasmid "replacement" scenario happened when ST410-B2 transformed into ST410-B3: F36:31:A4:B1 plasmids were replaced by F1:A1:B49 plasmids (both containing blaCTX-M-15) followed by blaNDM-5 incorporation during the 2010s. User-friendly cost-effective methods for the rapid identification of ST410 isolates and clades are needed because limited data are available about the frequencies and global distribution of ST410 clades. Basic mechanistic, evolutionary, surveillance, and clinical studies are urgently required to investigate the success of ST410 (including the ability to acquire successive MDR determinants). Such information will aid with management and prevention strategies to curb the spread of carbapenem-resistant E. coli. The medical community can ill afford to ignore the spread of a global E. coli clone with the potential to end the carbapenem era.
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Affiliation(s)
- Johann D. D. Pitout
- Cummings School of Medicine, Calcary, Alberta, Canada
- University of Calgary, Alberta Precision Laboratories, Calgary, Alberta, Canada
- University of Pretoria, Pretoria, Gauteng, South Africa
| | - Gisele Peirano
- Cummings School of Medicine, Calcary, Alberta, Canada
- University of Calgary, Alberta Precision Laboratories, Calgary, Alberta, Canada
| | - Yasufumi Matsumura
- Kyoto University Graduate School of Medicine, Pretoria, Gauteng, South Africa
| | | | - Liang Chen
- Meridian Health Center for Discovery and Innovation, Kyoto, Japan
- Hackensack Meridian School of Medicine at Seton Hall University, Nutley, New Jersey, USA
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Reolom RP, Klafke A. Resistência antimicrobiana em uroculturas de moradores das Zonas Norte e Nordeste de Porto Alegre. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introdução: Infecção urinária é motivo comum de consulta na Atenção Primária, requerendo tratamento empírico. Para a seleção do antimicrobiano, é necessário conhecer o perfil de resistência dos uropatógenos na comunidade. Objetivo: Analisar o perfil de resistência antimicrobiana em uroculturas realizadas em pacientes da Atenção Primária à Saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição, de julho de 2017 a junho de 2019. Métodos: Estudo transversal, observacional e descritivo com uroculturas de pacientes ambulatoriais das Unidades de Saúde do Serviço de Saúde Comunitária do Grupo Hospitalar Conceição, nas Zonas Norte e Nordeste de Porto Alegre, de julho de 2017 a junho de 2019. Os dados das uroculturas foram fornecidos pelo laboratório do Grupo Hospitalar e analisados por meio das proporções, por sexo, micro-organismo e resistência antimicrobiana. Resultados: Encontraram-se 2.000 uroculturas positivas no período, principalmente por Escherichia coli (75,50%), Klebsiella pneumoniae (7,80%), Staphylococcus saprophyticus (4,95%), Enterococcus specie (3,35%) e Proteus mirabilis (2,85%). Entre os antibióticos orais testados, a maior resistência foi para ampicilina (48,95%), seguida por sulfametoxazol+trimetoprima (25,85%), norfloxacino (18,05%), ciprofloxacino (18,00%), amoxicilina+clavulanato (11,05%) e nitrofurantoína (8,60%). Considerando-se apenas E. coli, as resistências foram 47,75% para ampicilina, 29,74% para sulfametoxazol+trimetoprima, 19,74% para norfloxacino e ciprofloxacino, 8,08% para amoxicilina+clavulanato e 1,99% para nitrofurantoína. Conclusões: O perfil de resistência antimicrobiana nas Zonas Norte e Nordeste de Porto Alegre sugere que sejam utilizados para tratamento empírico de infecção do trato urinário nessa localidade nitrofurantoína ou amoxicilina+clavulanato.
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Ramos CP, Kamei CYI, Viegas FM, de Melo Barbieri J, Cunha JLR, Hounmanou YMG, Coura FM, Santana JA, Lobato FCF, Bojesen AM, Silva ROS. Fecal Shedding of Multidrug Resistant Escherichia coli Isolates in Dogs Fed with Raw Meat-Based Diets in Brazil. Antibiotics (Basel) 2022; 11:antibiotics11040534. [PMID: 35453285 PMCID: PMC9029118 DOI: 10.3390/antibiotics11040534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022] Open
Abstract
The practice of feeding dogs raw meat-based diets (RMBDs) is growing in several countries, and the risks associated with the ingestion of pathogenic and antimicrobial-resistant Escherichia coli in dogs fed these diets are largely unknown. We characterized E. coli strains isolated from dogs fed either an RMBD or a conventional dry feed, according to the phylogroup, virulence genes, and antimicrobial susceptibility profiles of the bacteria. Two hundred and sixteen E. coli strains were isolated. Dogs fed RMBDs shed E. coli strains from the phylogroup E more frequently and were positive for the E. coli heat-stable enterotoxin 1-encoding gene. Isolates from RMBD-fed dogs were also frequently positive for multidrug-resistant E. coli isolates including extended-spectrum beta-lactamase (ESBL) producers. Whole-genome sequencing of seven ESBL-producing E. coli strains revealed that they predominantly harbored blaCTX-M-55, and two strains were also positive for the colistin-resistant gene mcr-1. These results suggest that feeding an RMBD can affect the dog’s microbiota, change the frequency of certain phylogroups, and increase the shedding of diarrheagenic E. coli. Also, feeding an RMBD seemed to be linked with the fecal shedding of multidrug-resistant E. coli, including the spread of strains harboring mobilizable colistin resistance and ESBL genes. This finding is of concern for both animal and human health.
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Affiliation(s)
- Carolina Pantuzza Ramos
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - Carolina Yumi Iceri Kamei
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - Flávia Mello Viegas
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - Jonata de Melo Barbieri
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - João Luís Reis Cunha
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - Yaovi Mahuton Gildas Hounmanou
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Copenhagen, Denmark; (Y.M.G.H.); (A.M.B.)
| | - Fernanda Morcatti Coura
- Departamento de Ciências Agrárias, Instituto Federal de Minas Gerais (IFMG), Bambuí 38900-000, Brazil;
| | - Jordana Almeida Santana
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - Francisco Carlos Faria Lobato
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
| | - Anders Miki Bojesen
- Department of Veterinary and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, 1870 Copenhagen, Denmark; (Y.M.G.H.); (A.M.B.)
| | - Rodrigo Otávio Silveira Silva
- Departamento de Medicina Veterinária Preventiva, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte 30123-970, Brazil; (C.P.R.); (C.Y.I.K.); (F.M.V.); (J.d.M.B.); (J.L.R.C.); (J.A.S.); (F.C.F.L.)
- Correspondence:
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Lima WG, Batista Filho FL, Lima IP, Simião DC, Brito JCM, da Cruz Nizer WS, Cardoso VN, Fernandes SOA. Antibacterial, anti-biofilm, and anti-adhesive activities of melittin, a honeybee venom-derived peptide, against quinolone-resistant uropathogenic Escherichia coli (UPEC). Nat Prod Res 2022; 36:6381-6388. [PMID: 35073796 DOI: 10.1080/14786419.2022.2032047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Here, we demonstrated the in vitro and in vivo antibacterial and anti-biofilm activities of melittin, a peptide derived from honeybee venom, against uropathogenic Escherichia coli (UPEC) resistant to quinolones. The minimum inhibitory concentration (MIC) of melittin varied from 0.5 to 8 μM. The bactericidal effect was considered rapid and potent (ranging from 3.0 to 6.0 h after incubation) against a quinolone-resistant and Extended Spectrum Beta-lactamase (ESBL)-producing UPEC strain. Prior exposure to melittin did not reduce the MIC of the quinolones tested, but it decreased the MIC of ceftizoxime by 8-fold due to its ability to form pores in the membrane. Furthermore, melittin disrupted mature biofilms (39.58% at 32 μM) and inhibited the adhesion of this uropathogen to the surfaces of urethral catheter. These results show that melittin is a promising molecule that can be incorporated into invasive urethral medical devices to prevent urinary infections caused by multidrug-resistant UPECs.
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Affiliation(s)
- William Gustavo Lima
- Laboratório de Radioisótopos, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Francisco Leandro Batista Filho
- Laboratório de Radioisótopos, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Iasmin Pinheiro Lima
- Laboratório de Radioisótopos, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Daniela Carolina Simião
- Laboratório de Radioisótopos, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | - Valbert Nascimento Cardoso
- Laboratório de Radioisótopos, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Simone Odília Antunes Fernandes
- Laboratório de Radioisótopos, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Cho HH. Analysis of Sequence Type and Fluoroquinolone Resistance in Ciprofloxacin-Resistant Escherichia coli. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2021. [DOI: 10.15324/kjcls.2021.53.3.217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hye Hyun Cho
- Departments of Biomedical Laboratory Science, Daejeon Institute of Science and Technology, Daejeon, Korea
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Virulence Genes Profile and Antimicrobial Susceptibility of Community-Acquired Bacterial Urinary Tract Infections in a Brazilian Hospital. Curr Microbiol 2021; 78:3913-3923. [PMID: 34522976 DOI: 10.1007/s00284-021-02650-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 08/30/2021] [Indexed: 10/20/2022]
Abstract
Urinary tract infections (UTI) are one of the most common diseases worldwide and Escherichia coli is the most common causative bacteria. Empirical treatment is challenging due to antimicrobial or multidrug-resistance. The aims of this study were to determine the uropathogens and their antimicrobial susceptibility profile, as well as to identify the phylogroups and virulence genes of E. coli strains, associated with community-acquired UTI in outpatients admitted at a Brazilian Hospital in southeast Brazil. In total, 47 bacterial strains were isolated from 47 patients, 44 women and 2 men (no gender record from one patient). The age of the patients whose urine culture were positive varied from 0 (less than one month) to 104 years. Most of the isolates were E. coli (41/47), followed by Klebsiella pneumoniae (2/47), Klebsiella variicola/Klebsiella aerogenes (1/47), Pseudomonas aeruginosa (1/47), Proteus mirabilis (1/47), and Citrobacter koseri (1/47). Most E. coli strains were classified as phylogroup B2 (15/41 = 36.59%) and B1 (12/41 = 29.27%) and the most common virulence genes among E. coli strains were fimH (31/41 = 75.61%), iutA (21/41 = 51.22%), and tratT (16/41 = 39.02%). Among the E. coli strains, 59% were multidrug-resistance and strains that were ampicillin, sulfamethoxazole/trimethoprim, or tetracycline-resistant exhibited more chance to be multidrug-resistance, with an odds ratio of 100.00 [95% confidence interval (CI) 9.44-1059.26], 22.50 (95% CI 3.95-128.30), and 12.83 (95% CI 2.68-61.45), respectively. Our results showed that E. coli was the main etiological agent identified and demonstrated high frequency of multidrug-resistance and virulence factors in bacterial strains isolated from UTIs.
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Genome profiling of fluoroquinolone-resistant uropathogenic Escherichia coli isolates from Brazil. Braz J Microbiol 2021; 52:1067-1075. [PMID: 34105110 DOI: 10.1007/s42770-021-00513-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 04/27/2021] [Indexed: 10/21/2022] Open
Abstract
Urinary tract infections (UTIs) are a major public health concern in both community and hospital settings worldwide. Uropathogenic Escherichia coli (UPEC) is the main causative agent of UTI and increasingly associated with antibiotic resistance. Herein, we report the draft genome sequence of 9 fluoroquinolone-resistant UPEC isolates from Brazil and examine selected major phenotypic features, such as antimicrobial resistance profile, phylogroup, serotype, sequence type (ST), virulence genes, and resistance marks. Besides the quinolone resistance, beta-lactams, ESBL production, aminoglycosides, and tetracycline resistance were observed. High prevalence of 20 virulence genes was detected in all isolates, such as those encoding type 1 fimbriae, acid tolerance system, and hemolysin E, particularly within E. coli B2 phylogroup, as ST131 and ST1193 strains, among other genomic analyses as genomic islands, resistance plasmids, and integron identification.
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Prevalence of fluoroquinolone-resistant and broad-spectrum cephalosporin-resistant community-acquired urinary tract infections in Rio de Janeiro: Impact of genotypes ST69 and ST131. INFECTION GENETICS AND EVOLUTION 2020; 85:104452. [DOI: 10.1016/j.meegid.2020.104452] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/25/2020] [Accepted: 06/29/2020] [Indexed: 12/11/2022]
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Campos ACDC, Andrade NL, Couto N, Mutters NT, de Vos M, Rosa ACDP, Damasco PV, Lo Ten Foe JR, Friedrich AW, Chlebowicz-Flissikowska MA, Rossen JWA. Characterization of fosfomycin heteroresistance among multidrug-resistant Escherichia coli isolates from hospitalized patients in Rio de Janeiro, Brazil. J Glob Antimicrob Resist 2020; 22:584-593. [PMID: 32389792 DOI: 10.1016/j.jgar.2020.04.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 03/06/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Urinary tract infections (UTIs) caused by multidrug-resistant Escherichia coli have become a major medical concern. Old antibiotics such as fosfomycin have become an alternative therapeutic option due to their effectiveness and, as a result, fosfomycin is now used as a first-line drug for the treatment of UTIs in many countries. Despite low resistance rates, fosfomycin heteroresistance, defined as a phenomenon where subpopulations of bacteria are resistant to high antibiotic concentrations whereas most of the bacteria are susceptible, is an underestimated problem. METHODS The frequency of heteroresistance in E. coli isolated from hospitalized patients in Brazil and its effect on susceptibility of E. coli in biofilms was studied and the isolates were molecularly characterized to reveal the mechanisms behind their fosfomycin heteroresistance using whole-genome sequencing. RESULTS A higher frequency of fosfomycin heteroresistance compared with other studies was found. In biofilms, most heteroresistant isolates were less sensitive to fosfomycin than control isolates and showed overexpression of metabolic genes thereby increasing their survival rate. Molecular characterization showed that some resistant subpopulations derived from heteroresistant isolates had a defect in their fosfomycin uptake system caused by mutations in transporter and regulatory genes, whereas others overexpressed the murA gene. None to minor effects on bacterial fitness were observed. Oxidative stress protection, virulence and metabolic genes were differentially expressed in resistant subpopulations and heteroresistant isolates. CONCLUSION Frequent detection of heteroresistance in UTIs may play a role in the failure of antibiotic treatments and should therefore be more carefully diagnosed.
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Affiliation(s)
- Ana Carolina da C Campos
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Departamento de Microbiologia, Inmunologia e Parasitologia, Boulevard 28 de Setembro, 77 - Vila Isabel, RJ-20551-030, Rio de Janeiro, Brazil; University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Nathália L Andrade
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Departamento de Microbiologia, Inmunologia e Parasitologia, Boulevard 28 de Setembro, 77 - Vila Isabel, RJ-20551-030, Rio de Janeiro, Brazil
| | - Natacha Couto
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Nico T Mutters
- Heidelberg University Hospital, Center for Infectious Diseases, Medical Microbiology and Hygiene, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - Marjon de Vos
- University of Groningen, Institute for Evolutionary Life Sciences, Linnaeusborg 5(th) floor, Nijenborgh 7, 9747 AG, Groningen, The Netherlands
| | - Ana Cláudia de P Rosa
- Universidade do Estado do Rio de Janeiro, Faculdade de Ciências Médicas, Departamento de Microbiologia, Inmunologia e Parasitologia, Boulevard 28 de Setembro, 77 - Vila Isabel, RJ-20551-030, Rio de Janeiro, Brazil
| | - Paulo V Damasco
- Universidade do Estado do Rio de Janeiro, Departamento de Doenças Infecciosas e Parasitárias, Boulevard 28 de Setembro, 77 - Vila Isabel, RJ-20551-030, Rio de Janeiro, Brazil; Universidade Federal do Estado do Rio de Janeiro, Departamento de Doenças Infecciosas e Parasitárias, R. Voluntários da Pátria, 107 - Botafogo, RJ- 22270-000, Rio de Janeiro, Brazil
| | - Jerome R Lo Ten Foe
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Alex W Friedrich
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - Monika A Chlebowicz-Flissikowska
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| | - John W A Rossen
- University of Groningen, University Medical Center Groningen, Department of Medical Microbiology and Infection Prevention, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
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Xiang Y, Li F, Dong N, Tian S, Zhang H, Du X, Zhou X, Xu X, Yang H, Xie J, Yang C, Liu H, Qiu S, Song H, Sun Y. Investigation of a Salmonellosis Outbreak Caused by Multidrug Resistant Salmonella Typhimurium in China. Front Microbiol 2020; 11:801. [PMID: 32411120 PMCID: PMC7200987 DOI: 10.3389/fmicb.2020.00801] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/03/2020] [Indexed: 01/05/2023] Open
Abstract
The rapid emergence of multidrug resistant Salmonella is a global public-health concern as outbreaks in recent years have mostly been caused by multidrug resistant strains. Here, we evaluated an outbreak in China caused by multidrug resistant Salmonella enterica serovar Typhimurium (S. Typhimurium) by employing an epidemiological and laboratory investigation using conventional methods and whole genome sequencing (WGS). Eleven of the 12 people who participated in a banquet showed gastrointestinal symptoms, and 8S. Typhimurium strains were recovered. Isolated outbreak strains showed multidrug resistance (MDR), and decreased susceptibility to ciprofloxacin, a first-line drug recommended by WHO for clinical treatment of intestinal infections. Antimicrobial resistance (AMR) gene analysis indicated that the MDR phenotype of these outbreak strains may be due to the presence of a number of AMR genes, including the blaOXA-1 and blaTEM-1 β-lactamase genes, which are often plasmid-borne and easily transferred. Further virulence gene analysis indicated that these outbreak strains also carried a large number of virulence genes, including 2 types of Salmonella pathogenicity islands (SPI-1 and SPI-2) and many adhesion-related virulence genes. Cluster analysis based on pulse-field gel electrophoresis data and phylogenetic analysis based on WGS revealed that the outbreak clone was closely related to and thus probably derived from local strains. This outbreak caused by multidrug resistant S. Typhimurium highlights the need for government improved strategies for the prevention and control of Salmonella infections.
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Affiliation(s)
- Ying Xiang
- Academy of Military Medical Sciences, Beijing, China.,Chinese PLA Center for Disease Control and Prevention, Beijing, China.,Center for Disease Control and Prevention of Southern Theatre Command, Guangzhou, China
| | - Fuxiang Li
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Nian Dong
- Xingcheng Special Service Recuperation Center of PLA Strategic Support Force, Huludao, China
| | - Sai Tian
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Haoran Zhang
- Academy of Military Medical Sciences, Beijing, China
| | - Xinying Du
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Xuan Zhou
- Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Xuebin Xu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Hongxia Yang
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Jing Xie
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Chaojie Yang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hongbo Liu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Shaofu Qiu
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Hongbin Song
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Yansong Sun
- Academy of Military Medical Sciences, Beijing, China
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Kot B. Antibiotic Resistance Among Uropathogenic Escherichia coli. Pol J Microbiol 2019; 68:403-415. [PMID: 31880885 PMCID: PMC7260639 DOI: 10.33073/pjm-2019-048] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 09/09/2019] [Accepted: 09/24/2019] [Indexed: 12/31/2022] Open
Abstract
Urinary tract infections (UTIs) belong to the most common community-acquired and nosocomial infections. A main etiological factor of UTIs is uropathogenic Escherichia coli (UPEC). This review describes the current state of knowledge on the resistance of UPEC to antibiotics recommended for the treatment of UTIs based on the available literature data. Nitrofurantoin and fosfomycin are recommended as first-line therapy in the treatment of uncomplicated cystitis, and the resistance to these antimicrobial agents remains low between UPEC. Recently, in many countries, the increasing resistance is observed to trimethoprim-sulfamethoxazole, which is widely used as the first-line antimicrobial in the treatment of uncomplicated UTIs. In European countries, the resistance of UPEC to this antimicrobial agent ranges from 14.6% to 60%. The widespread use of fluoroquinolones (FQs), especially ciprofloxacin, in the outpatients is the cause of a continuous increase in resistance to these drugs. The resistance of UPEC to FQs is significantly higher in developing countries (55.5–85.5%) than in developed countries (5.1–32.0%). Amoxicillin-clavulanic acid is recommended as first line-therapy for pyelonephritis or complicated UTI. Resistance rates of UPEC to amoxicillin-clavulanic acid are regionally variable. In European countries the level of resistance to this antimicrobial ranges from 5.3% (Germany) to 37.6% (France). Increasing rates of UPEC resistance to antimicrobials indicate that careful monitoring of their use for UTI treatment is necessary.
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Affiliation(s)
- Barbara Kot
- Department of Microbiology, Faculty of Natural Sciences, Siedlce University of Natural Sciences and Humanities , Siedlce , Poland
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Vilela FP, Falcão JP, Campioni F. Analysis of Resistance Gene Prevalence in Whole-Genome Sequenced Enterobacteriales from Brazil. Microb Drug Resist 2019; 26:594-604. [PMID: 31746671 DOI: 10.1089/mdr.2019.0370] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Enterobacteriales is an order of bacteria responsible for community and hospital-acquired infections related to high rates of antimicrobial resistance and increased treatment costs, morbidity, and mortality globally. The aims of this study were to analyze the frequency of the resistance genes detected and distribution over the years and sources of isolation in sequenced Enterobacteriales strains isolated in Brazil and available at the Pathogen Detection website. The presence of resistance genes was analyzed in 1,507 whole-genome sequenced strains of 19 Enterobacteriales species. A total of 58.0% of the strains presented resistance genes to at least one antimicrobial class and 684 strains presented a multidrug-resistant (MDR) profile. Resistance genes to 14 classes of antimicrobials were detected. Aminoglycosides presented the most prevalent and diverse resistance genes, while the sulfonamide resistance gene, sul2, was the most prevalent among the strains studied. The presence of resistance genes from 14 different antimicrobial classes, the high levels of MDR strains, and the detection of genes related to clinical and veterinary-used drugs reinforce the necessity of more efficient control measures. Moreover, it warns for the necessity of the rational use of antimicrobials in veterinary and clinical situations in Brazil, since contaminated food may act as a vehicle for human infections.
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Affiliation(s)
- Felipe Pinheiro Vilela
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, Brazil
| | - Juliana Pfrimer Falcão
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, Brazil
| | - Fábio Campioni
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto-USP, Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Ribeirão Preto, Brazil
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Molecular characterisation of multidrug-resistant Klebsiella pneumoniae belonging to CC258 isolated from outpatients with urinary tract infection in Brazil. J Glob Antimicrob Resist 2019; 18:74-79. [DOI: 10.1016/j.jgar.2019.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 01/13/2019] [Accepted: 01/17/2019] [Indexed: 12/17/2022] Open
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Abstract
Extraintestinal pathogenic Escherichia coli (ExPEC) strains are responsible for a majority of human extraintestinal infections globally, resulting in enormous direct medical and social costs. ExPEC strains are comprised of many lineages, but only a subset is responsible for the vast majority of infections. Few systematic surveillance systems exist for ExPEC. To address this gap, we systematically reviewed and meta-analyzed 217 studies (1995 to 2018) that performed multilocus sequence typing or whole-genome sequencing to genotype E. coli recovered from extraintestinal infections or the gut. Twenty major ExPEC sequence types (STs) accounted for 85% of E. coli isolates from the included studies. ST131 was the most common ST from 2000 onwards, covering all geographic regions. Antimicrobial resistance-based isolate study inclusion criteria likely led to an overestimation and underestimation of some lineages. European and North American studies showed similar distributions of ExPEC STs, but Asian and African studies diverged. Epidemiology and population dynamics of ExPEC are complex; summary proportion for some STs varied over time (e.g., ST95), while other STs were constant (e.g., ST10). Persistence, adaptation, and predominance in the intestinal reservoir may drive ExPEC success. Systematic, unbiased tracking of predominant ExPEC lineages will direct research toward better treatment and prevention strategies for extraintestinal infections.
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