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Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK
Delveen R Ibrahim1,2, Christine E R Dodd2, Dov J Stekel2,3
1Department of Biology, School of Science, The University of Duhok, Duhok 42001, Iraq.
Antibiotics (Basel, Switzerland)
|January 21, 2023
Summary
Multidrug-resistant E. coli infections are a growing threat due to resistance genes like blaCTX-M. Understanding these genetic determinants is crucial for developing effective antibiotic therapy guidelines and improving surveillance.
Area of Science:
- Microbiology
- Genetics
- Infectious Diseases
Background:
- Cephalosporin therapy failure is a significant global challenge in infection control.
- Multidrug-resistant (MDR) Escherichia coli (E. coli) producing extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases are key contributors to resistance.
- Investigating the genetic basis of MDR E. coli is essential for understanding and combating antibiotic resistance.
Purpose of the Study:
- To determine the prevalence of ESBL/pAmpC genetic determinants in phenotypically MDR E. coli from clinical samples in a UK hospital.
- To correlate specific resistance genes with observed antibiotic resistance patterns.
- To inform the development of improved antibiotic stewardship and surveillance strategies.
Main Methods:
- Phenotypic resistance profiling of 35 MDR E. coli isolates against 18 antibiotics across seven classes.
- Molecular detection of ESBL, pAmpC, and integrase genes (blaCTX-M, blaTEM, blaOXA-1, Intl1).
- Sequence typing to identify specific gene subtypes, such as CTX-M-15 and TEM-1.
Main Results:
- 32 out of 35 isolates (91.4%) were confirmed as MDR, exhibiting resistance to 4-16 antibiotics.
- blaCTX-M, blaTEM, and blaOXA-1 genes were detected in 23, 13, and 12 isolates, respectively. Intl1 was found in 17 isolates.
- Significant correlations were observed between specific genes (e.g., blaCTX-M, Intl1) and resistance to various antibiotic classes, including cephalosporins, fluoroquinolones, and trimethoprim/sulfamethoxazole. No pAmpC genes were identified.
Conclusions:
- A limited set of genes, particularly blaCTX-M, blaTEM, and blaOXA-1, can confer MDR phenotypes in E. coli.
- The identified resistance patterns underscore the urgent need for enhanced antibiotic therapy guidelines, reduced antibiotic usage, and improved surveillance.
- Targeted molecular detection of key resistance genes can aid in understanding and managing MDR E. coli infections.
