Emergence of Carbapenem-Resistant Uropathogenic Escherichia coli (ST405 and ST167) Strains Carrying blaCTX-M-15, blaNDM-5 and Diverse Virulence Factors in Hospitalized Patients.

IF 3.3 3区 医学 Q2 MICROBIOLOGY Pathogens Pub Date : 2024-11-05 DOI:10.3390/pathogens13110964
Fatima Mujahid, Muhammad Hidayat Rasool, Muhammad Shafiq, Bilal Aslam, Mohsin Khurshid
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Abstract

Background: Urinary tract infections (UTIs) are common infectious diseases in hospital settings, and they are frequently caused by uropathogenic Escherichia coli (UPEC). The emergence of carbapenem-resistant (Carb-R) E. coli strains poses a significant threat due to their multidrug resistance and virulence. This study aims to characterize the antimicrobial resistance and virulence profiles of Carb-R UPEC strains isolated from hospitalized patients.

Methods: A total of 1100 urine samples were collected from patients in Lahore and Faisalabad, Pakistan, between May 2023 and April 2024. The samples were processed to isolate and identify E. coli using standard microbiological techniques and VITEK®2, followed by amplification of the uidA gene. Antimicrobial susceptibility was evaluated using the Kirby-Bauer disc diffusion method and broth microdilution. Resistance and virulence genes were detected through PCR and DNA sequencing, and sequence typing was performed using MLST.

Results: Among the 118 Carb-R UPEC isolates, resistance was most frequently observed against sulfamethoxazole-trimethoprim (96.6%) and doxycycline (96.6%). All of the isolates remained sensitive to colistin and tigecycline. Sequence types ST405 (35.6%) and ST167 (21.2%) were predominant and carried the blaCTX-M-15 and blaNDM-5 genes. The distribution of virulence genes and a variety of antimicrobial resistance genes (ARGs), conferring resistance to aminoglycosides, fluoroquinolones, tetracyclines, and sulfonamides, were observed as specifically linked to certain sequence types.

Conclusions: This study provides insights into the molecular epidemiology of carbapenem-resistant Uropathogenic E. coli (Carb-R UPEC) strains and highlights the presence of globally high-risk E. coli clones exhibiting extensive drug resistance phenotypes in Pakistani hospitals. The findings underscore the urgent need for enhanced surveillance and stringent antibiotic stewardship to manage the spread of these highly resistant and virulent strains within hospital settings.

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住院患者中出现携带 blaCTX-M-15、blaNDM-5 和多种毒力因子的耐碳青霉烯类尿路致病性大肠埃希菌(ST405 和 ST167)菌株。
背景:尿路感染(UTI)是医院环境中常见的传染病,通常由尿路致病性大肠杆菌(UPEC)引起。耐碳青霉烯类(Carb-R)大肠杆菌菌株的出现因其耐多药和毒力强而构成了重大威胁。本研究旨在分析从住院患者中分离出的 Carb-R UPEC 菌株的抗菌药耐药性和毒力特征:方法:2023 年 5 月至 2024 年 4 月期间,从巴基斯坦拉合尔和费萨拉巴德的患者身上共收集了 1100 份尿液样本。采用标准微生物学技术和 VITEK®2 对样本进行处理,以分离和鉴定大肠杆菌,然后扩增 uidA 基因。采用柯比鲍尔盘扩散法和肉汤微量稀释法评估抗菌药敏感性。通过 PCR 和 DNA 测序检测耐药性和毒力基因,并使用 MLST 进行序列分型:结果:在 118 个 Carb-R UPEC 分离物中,对磺胺甲噁唑-三甲氧苄啶(96.6%)和强力霉素(96.6%)的耐药性最常见。所有分离物对可乐定和替加环素仍然敏感。序列类型以 ST405(35.6%)和 ST167(21.2%)为主,携带 blaCTX-M-15 和 blaNDM-5 基因。据观察,毒力基因和各种抗菌药耐药基因(ARGs)的分布与某些序列类型特别相关,这些基因可产生对氨基糖苷类、氟喹诺酮类、四环素类和磺胺类药物的耐药性:本研究深入揭示了耐碳青霉烯类药物尿路致病性大肠杆菌(Carb-R UPEC)菌株的分子流行病学,并强调了巴基斯坦医院中存在着表现出广泛耐药表型的全球高风险大肠杆菌克隆。研究结果突出表明,迫切需要加强监测和严格的抗生素管理,以控制这些高耐药性和高毒性菌株在医院环境中的传播。
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来源期刊
Pathogens
Pathogens Medicine-Immunology and Allergy
CiteScore
6.40
自引率
8.10%
发文量
1285
审稿时长
17.75 days
期刊介绍: Pathogens (ISSN 2076-0817) publishes reviews, regular research papers and short notes on all aspects of pathogens and pathogen-host interactions. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodical details must be provided for research articles.
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