Adam A Mwakyoma, Benson R Kidenya, Caroline A Minja, Martha F Mushi, Alison Sandeman, Wilber Sabiti, Mathew T G Holden, Stephen E Mshana
{"title":"坦桑尼亚疑似尿路感染患者尿液、粪便、动物和环境中分离的产超广谱β-内酰胺酶大肠杆菌对环丙沙星和庆大霉素的等位基因分布和表型耐药性","authors":"Adam A Mwakyoma, Benson R Kidenya, Caroline A Minja, Martha F Mushi, Alison Sandeman, Wilber Sabiti, Mathew T G Holden, Stephen E Mshana","doi":"10.3389/frabi.2023.1164016","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Additional antimicrobial resistance to extended-spectrum β-lactamase (ESBL)-producing <i>E. coli</i> exhausts treatment options. We investigated allele distribution and resistance to ciprofloxacin and gentamicin among ESBL-producing <i>E. coli</i> isolates from the urine, stool, animals, and environments of presumptive urinary tract infection (UTI) patients, in order to gain a crucial insight toward devising prevention and control measures and treatment guidelines.</p><p><strong>Methods: </strong>Archived ESBL-producing <i>E. coli</i> isolates from the urine, stool, animals, and surrounding environments of presumptive UTI patients were retrieved. Antimicrobial susceptibility profiles for ciprofloxacin and gentamicin were done followed by multiplex Polymerase chain reaction (PCR) for <i>bla<sub>CTX-M</sub></i> , <i>bla<sub>TEM</sub></i> , and <i>bla<sub>SHV</sub></i> , to determine ESBL allele distribution. Data were analyzed using STATA version 17.</p><p><strong>Results: </strong>A total of 472 confirmed ESBL-producing <i>E. coli</i> isolates from Mwanza 243 (51.5%), Kilimanjaro 143 (30.3%), and Mbeya 86 (18.2%) were analyzed. Of these, 75 (15.9%) were from urine, 199 (42.2%) from stool, 58 (12.3%) from rectal/cloaca swabs of animals, and 140 (29.7%) from surrounding environments. Out of the 472 ESBL-producing <i>E. coli</i>, 98.9% (467) had at least one ESBL allele. The most frequent allele was <i>bla<sub>CTX-M</sub></i> , which was detected in 88.1% (416/472) of isolates, followed by the <i>bla<sub>TEM</sub></i> allele, which was detected in 51.5% (243/472) of isolates. A total of 40.7% (192/472) of isolates harbored dual <i>bla<sub>CTX-M</sub></i> + <i>bla<sub>TEM</sub></i> alleles and only 0.2% (1/472) of isolates had dual <i>bla<sub>CTX-M</sub></i> + <i>bla<sub>SHV</sub></i> alleles, whereas 2.3% (11/472) of isolates had a combination of all three alleles (<i>bla<sub>CTX-M</sub></i> + <i>bla<sub>TEM</sub></i> + <i>bla<sub>SHV</sub></i> ). None of the isolates harbored a combination of <i>bla<sub>TEM</sub></i> + <i>bla<sub>SHV</sub></i> only. Resistance to ciprofloxacin and gentamicin was observed in 70.8% (334/472) and 46.0% (217/472) of isolates, respectively. There was a significant difference in the distribution of resistance to ciprofloxacin as well as gentamicin among ESBL-producing <i>E. coli</i> isolated from various sources (<i>p</i>-value < 0.001 and 0.002, respectively).</p><p><strong>Conclusion: </strong>Almost all ESBL-producing <i>E. coli</i> isolates carry <i>bla<sub>CTX-M</sub></i> , <i>bla<sub>TEM</sub></i> , and <i>bla<sub>SHV</sub></i> either alone or in combination, with the most common allele being <i>bla<sub>CTX-M.</sub></i> The resistance to ciprofloxacin and gentamicin, which are frontline antibiotics for UTIs among ESBL-producing <i>E. coli</i>, is high. This implies the need to continually revise the local guidelines used for optimal empirical therapy for UTIs, and for continual research and surveillance using one health approach.</p>","PeriodicalId":73065,"journal":{"name":"Frontiers in antibiotics","volume":" ","pages":"1164016"},"PeriodicalIF":0.0000,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732152/pdf/","citationCount":"0","resultStr":"{\"title\":\"Allele distribution and phenotypic resistance to ciprofloxacin and gentamicin among extended-spectrum β-lactamase-producing <i>Escherichia coli</i> isolated from the urine, stool, animals, and environments of patients with presumptive urinary tract infection in Tanzania.\",\"authors\":\"Adam A Mwakyoma, Benson R Kidenya, Caroline A Minja, Martha F Mushi, Alison Sandeman, Wilber Sabiti, Mathew T G Holden, Stephen E Mshana\",\"doi\":\"10.3389/frabi.2023.1164016\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Additional antimicrobial resistance to extended-spectrum β-lactamase (ESBL)-producing <i>E. coli</i> exhausts treatment options. We investigated allele distribution and resistance to ciprofloxacin and gentamicin among ESBL-producing <i>E. coli</i> isolates from the urine, stool, animals, and environments of presumptive urinary tract infection (UTI) patients, in order to gain a crucial insight toward devising prevention and control measures and treatment guidelines.</p><p><strong>Methods: </strong>Archived ESBL-producing <i>E. coli</i> isolates from the urine, stool, animals, and surrounding environments of presumptive UTI patients were retrieved. Antimicrobial susceptibility profiles for ciprofloxacin and gentamicin were done followed by multiplex Polymerase chain reaction (PCR) for <i>bla<sub>CTX-M</sub></i> , <i>bla<sub>TEM</sub></i> , and <i>bla<sub>SHV</sub></i> , to determine ESBL allele distribution. Data were analyzed using STATA version 17.</p><p><strong>Results: </strong>A total of 472 confirmed ESBL-producing <i>E. coli</i> isolates from Mwanza 243 (51.5%), Kilimanjaro 143 (30.3%), and Mbeya 86 (18.2%) were analyzed. Of these, 75 (15.9%) were from urine, 199 (42.2%) from stool, 58 (12.3%) from rectal/cloaca swabs of animals, and 140 (29.7%) from surrounding environments. Out of the 472 ESBL-producing <i>E. coli</i>, 98.9% (467) had at least one ESBL allele. The most frequent allele was <i>bla<sub>CTX-M</sub></i> , which was detected in 88.1% (416/472) of isolates, followed by the <i>bla<sub>TEM</sub></i> allele, which was detected in 51.5% (243/472) of isolates. A total of 40.7% (192/472) of isolates harbored dual <i>bla<sub>CTX-M</sub></i> + <i>bla<sub>TEM</sub></i> alleles and only 0.2% (1/472) of isolates had dual <i>bla<sub>CTX-M</sub></i> + <i>bla<sub>SHV</sub></i> alleles, whereas 2.3% (11/472) of isolates had a combination of all three alleles (<i>bla<sub>CTX-M</sub></i> + <i>bla<sub>TEM</sub></i> + <i>bla<sub>SHV</sub></i> ). None of the isolates harbored a combination of <i>bla<sub>TEM</sub></i> + <i>bla<sub>SHV</sub></i> only. Resistance to ciprofloxacin and gentamicin was observed in 70.8% (334/472) and 46.0% (217/472) of isolates, respectively. There was a significant difference in the distribution of resistance to ciprofloxacin as well as gentamicin among ESBL-producing <i>E. coli</i> isolated from various sources (<i>p</i>-value < 0.001 and 0.002, respectively).</p><p><strong>Conclusion: </strong>Almost all ESBL-producing <i>E. coli</i> isolates carry <i>bla<sub>CTX-M</sub></i> , <i>bla<sub>TEM</sub></i> , and <i>bla<sub>SHV</sub></i> either alone or in combination, with the most common allele being <i>bla<sub>CTX-M.</sub></i> The resistance to ciprofloxacin and gentamicin, which are frontline antibiotics for UTIs among ESBL-producing <i>E. coli</i>, is high. This implies the need to continually revise the local guidelines used for optimal empirical therapy for UTIs, and for continual research and surveillance using one health approach.</p>\",\"PeriodicalId\":73065,\"journal\":{\"name\":\"Frontiers in antibiotics\",\"volume\":\" \",\"pages\":\"1164016\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732152/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in antibiotics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/frabi.2023.1164016\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in antibiotics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/frabi.2023.1164016","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
Allele distribution and phenotypic resistance to ciprofloxacin and gentamicin among extended-spectrum β-lactamase-producing Escherichia coli isolated from the urine, stool, animals, and environments of patients with presumptive urinary tract infection in Tanzania.
Background: Additional antimicrobial resistance to extended-spectrum β-lactamase (ESBL)-producing E. coli exhausts treatment options. We investigated allele distribution and resistance to ciprofloxacin and gentamicin among ESBL-producing E. coli isolates from the urine, stool, animals, and environments of presumptive urinary tract infection (UTI) patients, in order to gain a crucial insight toward devising prevention and control measures and treatment guidelines.
Methods: Archived ESBL-producing E. coli isolates from the urine, stool, animals, and surrounding environments of presumptive UTI patients were retrieved. Antimicrobial susceptibility profiles for ciprofloxacin and gentamicin were done followed by multiplex Polymerase chain reaction (PCR) for blaCTX-M , blaTEM , and blaSHV , to determine ESBL allele distribution. Data were analyzed using STATA version 17.
Results: A total of 472 confirmed ESBL-producing E. coli isolates from Mwanza 243 (51.5%), Kilimanjaro 143 (30.3%), and Mbeya 86 (18.2%) were analyzed. Of these, 75 (15.9%) were from urine, 199 (42.2%) from stool, 58 (12.3%) from rectal/cloaca swabs of animals, and 140 (29.7%) from surrounding environments. Out of the 472 ESBL-producing E. coli, 98.9% (467) had at least one ESBL allele. The most frequent allele was blaCTX-M , which was detected in 88.1% (416/472) of isolates, followed by the blaTEM allele, which was detected in 51.5% (243/472) of isolates. A total of 40.7% (192/472) of isolates harbored dual blaCTX-M + blaTEM alleles and only 0.2% (1/472) of isolates had dual blaCTX-M + blaSHV alleles, whereas 2.3% (11/472) of isolates had a combination of all three alleles (blaCTX-M + blaTEM + blaSHV ). None of the isolates harbored a combination of blaTEM + blaSHV only. Resistance to ciprofloxacin and gentamicin was observed in 70.8% (334/472) and 46.0% (217/472) of isolates, respectively. There was a significant difference in the distribution of resistance to ciprofloxacin as well as gentamicin among ESBL-producing E. coli isolated from various sources (p-value < 0.001 and 0.002, respectively).
Conclusion: Almost all ESBL-producing E. coli isolates carry blaCTX-M , blaTEM , and blaSHV either alone or in combination, with the most common allele being blaCTX-M. The resistance to ciprofloxacin and gentamicin, which are frontline antibiotics for UTIs among ESBL-producing E. coli, is high. This implies the need to continually revise the local guidelines used for optimal empirical therapy for UTIs, and for continual research and surveillance using one health approach.
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