High incidence of multidrug-resistant fecal E. coli producing ESBLs and carried ST131 in Jordanian adults

Background: Escherichia coli  is part of the human intestine normal flora, although it has the potential of causing variety of invasive and diarrheal diseases. It is also a frequent cause of community- and hospital-acquired urinary tract infections. Intestinal E. coli has the potential to develop rapidly multidrug resistant (MDR) and to emerge as extended-spectrum β-lactamases (ESBLs)-producer.    Methods: Over the period of July through November, 2015; 287 stool samples were collected from Jordanian adults who visited the students’ clinic of the University of Jordan. Fecal samples were collected and cultured for isolation of E. coli. The isolates were investigated for antimicrobial susceptibility, and molecular method of polymerase chain reaction (PCR) was performed for the detection genes of ST131 clone, blaCTX-M group I, blaCTX-M-15, blaNDM-1, blaVIM, blaIMP, blaOXA-48, blaKPC and fluoroquinolones resistance (gyrA and parC). Results: A total of 105/287 E. coli isolates (36.6%) were found to be multi-drug resistant (MDR) to at least 3 classes of antibiotics, of these 45.1% were ESBL-producers. A total of 51 representative MDR isolates indicated the following; 49% were found positive for ST131 clone, 58.8% were resistant for ciprofloxacin, and 41.2% were positive for CTX-M group I and CTX-M-15, respectively. All these MDR isolates were also positive for mutated both gyrA and ParC genes, and only 6 / 51 isolates (11.8%) were positive for each blaNDM-1 and blaKPC.  One out of 51 MDR isolates (2%) was positive for blaVIM, and none of these isolates was positive for blaIMP nor blaOXA-48 genes. Conclusion: This study indicated that a relatively high rates of commensal fecal E. coli isolates from Jordanian adults were MDR, ESBLs-producer and belonging to ST131 clone.  Also, high rates of CTX-M-15 and fluoroquinolones resistance were found among MDR E. coli isolates.