Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016

Autor: Sanjaya K. Shrestha, Prativa Pandey, Katie R. Margulieux, Kamonporn Poramathikul, Sirigade Ruekit, Oralak Serichantalergs, Panida Nobthai, Brett E. Swierczewski, Apichai Srijan, Ladaporn Bodhidatta
Jazyk: angličtina
Rok vydání: 2018
Předmět:
0301 basic medicine
Microbiology (medical)
Diarrhea
medicine.medical_specialty
Virulence Factors
030231 tropical medicine
030106 microbiology
Population
Prevalence
Virulence
Drug resistance
medicine.disease_cause
beta-Lactamases
lcsh:Infectious and parasitic diseases
Microbiology
03 medical and health sciences
0302 clinical medicine
Medical microbiology
Antibiotic resistance
Nepal
Enterotoxigenic Escherichia coli
Drug Resistance
Multiple
Bacterial
medicine
lcsh:RC109-216
Pharmacology (medical)
education
Escherichia coli Infections
education.field_of_study
business.industry
ETEC
Research
Escherichia coli Proteins
Public Health
Environmental and Occupational Health
biochemical phenomena
metabolism
and nutrition
bacterial infections and mycoses
Anti-Bacterial Agents
Infectious Diseases
ESBL
medicine.symptom
business
Zdroj: Antimicrobial Resistance and Infection Control
Antimicrobial Resistance and Infection Control, Vol 7, Iss 1, Pp 1-7 (2018)
ISSN: 2047-2994
Popis: Background Multidrug-resistant (MDR) Gram-negative bacterial species are an increasingly dangerous public health threat, and are now endemic in many areas of South Asia. However, there are a lack of comprehensive data from many countries in this region determining historic and current MDR prevalence. Enterotoxigenic Escherichia coli (ETEC) is a leading cause of both acute infant diarrhea and traveler’s diarrhea in Nepal. The MDR prevalence and associated resistance mechanisms of ETEC isolates responsible for enteric infections in Nepal are largely unknown. Methods A total of 265 ETEC isolates were obtained from acute diarrheal samples (263/265) or patient control samples (2/265) at traveler’s clinics or regional hospitals in Nepal from 2001 to 2016. Isolates were screened for antibiotic resistance, to include extended spectrum beta-lactamase (ESBL) production, via the Microscan Automated Microbiology System. ETEC virulence factors, specifically enterotoxins and colonization factors (CFs), were detected using multiplex PCR, and prevalence in the total isolate population was compared to ESBL-positive isolates. ESBL-positive isolates were assessed using multiplex PCR for genetic markers potentially responsible for observed resistance. Results A total of 118/265 (44.5%) ETEC isolates demonstrated resistance to ≥2 antibiotics. ESBL-positive phenotypes were detected in 40/265 isolates, with isolates from 2008, 2013, 2014, and 2016 demonstrating ESBL prevalence rates of 1.5, 34.5, 31.2, and 35.0% respectively. No difference was observed in overall enterotoxin characterization between the total ETEC and ESBL-positive populations. The CFs CS2 (13.6%), CS3 (25.3%), CS6 (30.2%), and CS21 (62.6%) were the most prevalent in the total ETEC population. The ESBL-positive ETEC isolates exhibited a higher association trend with the CFs CS2 (37.5%), CS3 (35%), CS6 (42.5%), and CS21 (67.5%). The primary ESBL gene identified was bla CTX-M-15 (80%), followed by bla SHV-12 (20%) and bla CTX-M-14 (2.5%). The beta-lactamase genes bla TEM-1 (40%) and bla CMY-2 (2.5%) were also identified. It was determined that 42.5% of the ESBL-positive isolates carried multiple resistance genes. Conclusion Over 30% of ETEC isolates collected post-2013 and evaluated in this study demonstrated ESBL resistance. Persistent surveillance and characterization of enteric ETEC isolates are vital for tracking the community presence of MDR bacterial species in order to recommend effective treatment strategies and help mitigate the spread of resistant pathogens.
Databáze: OpenAIRE
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