Non-carbapenem antimicrobial therapy in young infant with urinary tract infections caused by community-acquired extended-spectrum β-lactamase-producing Escherichia coli

Urinary Tract Infections among Febrile Infants in Qatar: Extended-Spectrum-Beta-Lactamase (ESBL)-Producing Versus Non-ESBL Organisms

BACKGROUND

The escalating prevalence of ESBL-producing Enterobacteriaceae in Qatar's pediatric population, especially in community-onset febrile urinary tract infections (FUTIs), necessitates a comprehensive investigation into this concerning trend.

RESULTS

Over the course of one year, a total of 459 infants were diagnosed and subsequently treated for UTIs. Cases primarily occurred in infants aged over 60 days, predominantly non-Qatari females born from term pregnancies. Notably, E. coli and K. pneumoniae were the most frequently identified organisms, accounting for 79.7% and 9.8% in the ESBL group and 57.2% and 18.7% in the non-ESBL group, respectively. Interestingly, hydronephrosis emerged as the most prevalent urological anomaly detected in both ESBL (n = 10) and other organism (n = 19) groups.

METHODS

In this retrospective cohort study conducted in Qatar, we meticulously evaluated the prevalence of pediatric FUTIs. Our study focused on febrile infants aged less than 1 year, excluding those with urine samples not obtained through a catheter.

CONCLUSIONS

E. coli and K. pneumoniae prevailed as the predominant causative agents in febrile children in Qatar, with hydronephrosis being identified as the most common urological anomaly. Moreover, our findings suggested that gentamicin served as a viable non-carbapenem option for hospitalized ESBL cases, while oral nitrofurantoin showed considerable promise for uncomplicated ESBL UTIs.

Characterization of Primary Action Mode of Eight Essential Oils and Evaluation of Their Antibacterial Effect against Extended-Spectrum β-Lactamase (ESBL)-Producing Escherichia coli Inoculated in Turkey Meat

The current study aims to evaluate the antimicrobial activity of eight essential oils (EOs) against multidrug-resistant Escherichia coli strains, producing extended-spectrum β-lactamase (ESBL) enzymes and isolated from foods. Disc-diffusion assay showed that the inhibition diameters generated by EOs varied significantly among the tested EOs and strains. In fact, EOs extracted from Thymus capitaus, Eucalyptus camaldulensis, Trachyspermum ammi and Mentha pulegium exerted an important antimicrobial effect against tested strains, with the diameters of inhibition zones varied between 20 and 27 mm. Moreover, minimal inhibition and bactericidal concentration (MIC and MBC) values demonstrated that T. capitatus EOs generate the most important inhibitory effect against E. coli strains, with MIC values ranging from 0.02 to 0.78%. Concerning the mode of action of T. capitatus EO, the obtained data showed that treatment with this EO at its MIC reduced the viability of E. coli strains, their tolerance to NaCl and promoted the loss of 260-nm-absorbing material. In addition, in the presence of T. capitatus EO, cells became disproportionately sensitive to subsequent autolysis. Moreover, the inhibitory effect of T. capitatus was evaluated against two E. coli strains, experimentally inoculated (10⁵ CFU/g) in minced turkey meat, in the presence of two different concentrations of EO (MIC and 2 × MIC), and stored for 15 days. In both samples, EO exerted a bacteriostatic effect in the presence of concentrations equal to MIC. Interestingly, at 2 × CMI concentration, the bactericidal activity was pronounced after 15 days of storage. Our results highlighted that the use of essential oils, specially of T. capitatus, to inhibit or prevent the growth of extended-spectrum β-lactamase (ESBL)-producing E. coli in food, may be a promising alternative to chemicals.

Antibacterial and antibiofilm activity of Lagotis brachystachya extract against extended-spectrum β-lactamases-producing Escherichia coli from broiler chickens

Lagotis brachystachya Maxim (L. brachystachya) is an herb widely used in traditional Tibetan medicine. In the present study, the antibacterial activity of L. brachystachya extract to extended-spectrum-lactamases (ESBLs)-producing E. coli was determined by Kirby-Bauer disc diffusion, minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) methods as well as time-kill curve assay. Meanwhile, the biofilm inhibition and eradication effects of L. brachystachya extract on the ESBLs-producing E. coli were evaluated by crystal violet staining, and further confirmed by confocal laser scanning microscope (CLSM) and scanning electron microscopy (SEM). The results indicated that L. brachystachya extract exhibited moderate antibacterial activity, with diameter of inhibition zones varying from 15.4 to 20.3 mm, and the MIC and MBC values were 6.25 to 25 mg/mL and 12.5 to 100 mg/mL, respectively. Time-kill curve showed that 4 × MIC level of L. brachystachya extract concentration of was able to kill 99.9% of ESBLs-producing E. coli after 16 h treatment. The biofilm inhibition rate and eradication rate for the ESBLs-producing E. coli were 35.66 to 79.91% and 22.18 to 56.21% at MIC level of extract concentration, respectively. CLSM images showed that the biofilm became thinner as the ESBLs-producing E. coli isolate exposed to L. brachystachya extract with a concentration-dependent manner from 1/4 × MIC to MIC compared with the control isolate. SEM images indicated that L. brachystachya extract at 1/2 × MIC and MIC levels could evidently inhibit the biofilm formation or eradicate the mature biofilms. The effect of L. brachystachya highlights its potential of antibacterial and antibiofilm activities against the ESBLs-producing E. coli.