Phenotypic and Genotypic Characterization of ESBL-, AmpC-, and Carbapenemase-Producing Klebsiella pneumoniae and High-Risk Escherichia coli CC131, with the First Report of ST1193 as a Causative Agent of Urinary Tract Infections in Human Patients in Algeria.

IF 4.3 2区医学 Q1 INFECTIOUS DISEASES

Antibiotics-Basel Pub Date : 2025-05-09 DOI:10.3390/antibiotics14050485

Hajer Ziadi, Fadela Chougrani, Abderrahim Cheriguene, Leticia Carballeira, Vanesa García, Azucena Mora

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引用次数: 0

Abstract

Background: High-risk Escherichia coli clones, such as sequence type (ST)131 and ST1193, along with multidrug-resistant (MDR) Klebsiella pneumoniae, are globally recognized for their significant role in urinary tract infections (UTIs). This study aimed to provide an overview of the virulence factors, clonal diversity, and antibiotic resistance profiles of extended-spectrum cephalosporin (ESC)-E. coli and K. pneumoniae causing UTIs in humans in the Tebessa region of Algeria.

Methods: Forty E. coli and 17 K. pneumoniae isolates exhibiting ESC-resistance were recovered (July 2022-January 2024) from urine samples of patients at three healthcare facilities to be phenotypically and genotypically characterized. Whole genome sequencing (WGS) was performed on the ST1193 clone.

Results: Among K. pneumoniae isolates, all except one harbored CTX-M-15, with a single isolate carrying bla_CTX-M-194. Additionally, two K. pneumoniae isolates co-harboring bla_CTX-M-15 and bla_NDM exhibited phenotypic and genotypic hypervirulence traits. Fluoroquinolone resistance (FQR) was detected in 94.1% of K. pneumoniae isolates. The E. coli isolates carried diverse ESC-resistance genes, including CTX-M-15 (87.5%), CTX-M-27 (5%), CTX-M-1, CMY-59, and CMY-166 (2.5% each). Co-carriage of bla_ESC and bla_OXA-48 was identified in three E. coli isolates, while 62.5% exhibited FQR. Phylogenetic analysis revealed that 52.5% of E. coli belonged to phylogroup B2, including the high-risk clonal complex (CC)131 CH40-30 (17 isolates) and ST1193 (one isolate). In silico analysis of the ST1193 genome determined O75:H5-B2 (CH14-64), and the carriage of IncI1-I(Alpha) and IncF [F-:A1:B10] plasmids. Notably, core genome single-nucleotide polymorphism (SNP) analysis demonstrated high similarity between the Algerian ST1193 isolate and a previously annotated genome from a hospital in Northwest Spain.

Conclusions: This study highlights the spread and genetic diversity of E. coli CC131 CH40-30 and hypervirulent K. pneumoniae clones in Algeria. It represents the first report of a CTX-M-15-carrying E. coli ST1193 in the region. The findings emphasize the urgent need for antibiotic optimization programs and enhanced surveillance to curb the dissemination of high-risk clones that pose an increasing public health threat in Algeria. A simplified method based on virulence traits for E. coli and K. pneumoniae is proposed here for antimicrobial resistance (AMR) monitoring.

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产ESBL-、AmpC-和碳青霉烯酶的肺炎克雷伯菌和高风险大肠埃希菌CC131的表型和基因型特征，以及阿尔及利亚人类尿路感染病原菌ST1193的首次报道。

背景：高风险大肠杆菌克隆，如序列型（ST）131和ST1193，以及多药耐药（MDR）肺炎克雷伯菌，因其在尿路感染（uti）中的重要作用而被全球公认。本研究旨在综述广谱头孢菌素(ESC)-E的毒力因子、克隆多样性和耐药性。大肠杆菌和肺炎克雷伯菌在阿尔及利亚泰贝萨地区引起人类尿路感染。方法：从三家医疗机构的患者尿液样本中（2022年7月至2024年1月）回收40株大肠杆菌和17株肺炎克雷伯菌，表现出esc耐药性，并对其进行表型和基因表型表征。对ST1193克隆进行全基因组测序（WGS）。结果：肺炎克雷伯菌分离株除1株外均携带CTX-M-15, 1株携带blaCTX-M-194。另外，两个携带blaCTX-M-15和blaNDM的肺炎克雷伯菌分离株表现出表型和基因型高毒力特征。94.1%的肺炎克雷伯菌对氟喹诺酮类药物耐药。大肠杆菌分离株携带多种esc耐药基因，包括CTX-M-15（87.5%）、CTX-M-27（5%）、CTX-M-1、CMY-59和CMY-166（2.5%）。在3株大肠杆菌中发现blaESC和blaOXA-48共携带，62.5%表现出FQR。系统发育分析显示，52.5%的大肠杆菌属于B2系统群，包括高危克隆复合体（CC）131 CH40-30（17株）和ST1193（1株）。通过对ST1193基因组的计算机分析，确定了O75:H5-B2 (CH14-64)，以及inc1 - i （Alpha）和IncF [F-:A1:B10]质粒的携带。值得注意的是，核心基因组单核苷酸多态性（SNP）分析表明，阿尔及利亚ST1193分离物与先前来自西班牙西北部一家医院的注释基因组之间具有高度相似性。结论：本研究强调了大肠杆菌CC131 CH40-30和高毒力肺炎克雷伯菌克隆在阿尔及利亚的传播和遗传多样性。这是该地区首次报告的携带ST1193大肠杆菌的ctx - m -15。研究结果强调迫切需要抗生素优化规划和加强监测，以遏制高风险克隆的传播，这些克隆在阿尔及利亚构成越来越大的公共卫生威胁。本文提出了一种基于大肠杆菌和肺炎克雷伯菌毒力特征的抗生素耐药性监测方法。

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来源期刊

Antibiotics-Basel Pharmacology, Toxicology and Pharmaceutics-General Pharmacology, Toxicology and Pharmaceutics

CiteScore

7.30

自引率

14.60%

发文量

1547

审稿时长

11 weeks

期刊介绍： Antibiotics (ISSN 2079-6382) is an open access, peer reviewed journal on all aspects of antibiotics. Antibiotics is a multi-disciplinary journal encompassing the general fields of biochemistry, chemistry, genetics, microbiology and pharmacology. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on the length of papers.