High incidence of multidrug resistant Escherichia coli producing CTX-M-type ESBLs colonizing the intestine of Jordanian infants
Keywords:ESBL, E.coli, Class I integrons, Jordanian Infants
Background. This prospective study investigated major characteristics of E.coli colonizing the intestine of out-patient and in-patient infants, especially their association with CTX-M-type Â extended spectrumÂ Î²-Lactamases (ESBLs), integrons andÂ fluoroquinolone resistance genes (gyrAandparC) .
Method. A total of 288 stool samples were collected from infants aged less than 1 year which were admitted at the pediatric department, Jordan University Hospital, Amman. The E.coli isolates were investigated using antimicrobial susceptibility tests and PCR for detection of CTX-M genes and integrons . Â
Results. A total of 170 (59%) infants were colonized with E.coli, including 73 (42.9%) females and 97 (57.1%) males.Â A significant difference was observed between gender and age groups according to the presence or absence of E.coli (P= 0.001). Multidrug resistant (MDR) accounted for 52 (30.6%) of the isolates and all were ESBL producers. The detection rate of CTX-M genes among Â MDR E.coli isolates was 49 (94.2%), CTX-M group 1 accounted for Â 41 (87.8%) of theÂ isolates and 30(73.2%) were CTX-M-15 producers.Â Only Class I integron was detected in 20/52 (38.5%) of Â MDRÂ E. coli isolates, and resistance to fluoroquinolones accounted for 45/52(86.5%) of these isolates . A total of 33/52 (63.5%) of MDR E.coli isolates were resistant to Â potential Quinolone resistance genes (parC) and (gyrA) in association with CTX-M group.Conclusion. This study demonstrates that formula-fed infants, vaginal delivery and old age of infants were higher and significant associated with colonization of E .coli. High incidence of CTX-MÂ ESBL-producing E. coli was found in association withÂ fluoroquinolones-resistance and Class I integrons colonizing the intestine of Jordanian infants
Gopi P. and Bonomo RA. Stormy waters ahead: global emergence of carbapenemases. Front Microbiol 2013; 4:1-17.
CantÃ³n R, AkÃ³va M., Carmeli Y, Giske CG, Glupczynski Y, Gniadkowski M, et al. Rapid evolution and spread of carbapenemases among Enterobacteriaceae in Europe. Clin Microbiol Infect 2012;18:413â€“431.
Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis J 2011; 17: 1791â€“1798.
Baroud M, Araj GF, Matar GM. Spread of CTX-M-15 Extended Spectrum Î²-lactamases Encoding Genes Among Enterobacteriaceae in the Middle Eastern Region. Int Arb J Antimicrob Agents 2011; 1: 1-6.
Hawkey PM. The growing burden of antimicrobial resistance. J Antimicrob Chemother 2008; 62: 1-9.
Clinical Laboratory and Standards Institute (CLSI,2012), Method for dilution antimicrobial susceptibitytests for bacteria that grow aerobically. CLSI, Villanova, PA, USA.
Mirzaee M., Owlia P., and Mansouri S. Distribution of CTX-M Î²-lactamase Genes Among Escherichia coli Strains Isolated from Patients in Iran. Lab Med 2009;40:724-727.
Leflon-Guibout V, Jurand C, Bonacorsi S, Espinasse F, Guelfi MC, et al. Emergence and spread of three clonally related virulent isolates of CTX-M-15-producing Escherichia coli with variable resistance to aminoglycosides and tetracycline in a French geriatric hospital. Antimicrob Agents Chemother 2004;48:3736-42.
Dillon B, Thomas L, Mohmand G, Zelynski A, Iredell J. Multiplex PCR for screening of integrons in bacterial lysates. J Microbiol Method 2005; 62: 221â€“ 232.
Nowrouzian F, Hesselmar B, Saalman R, Strannegard IL, Ã…berg N, Wold AE, et al. Escherichia coli in Infantsâ€™ Intestinal Microflora: Colonization Rate, Strain Turnover, and Virulence Gene Carriage. Pediatric Res 2009; 54: 8-14.
Garcia PG, Silva VL, Diniz CG. Occurrence and antimicrobial drug susceptibility patterns of commensal and diarrheagenic Escherichia coli in fecal microbiota from children with and without acute diarrhea. J Microbiol 2011; 49:46-52.
Penders J, Thijs C, Vink C, Stelma FF, Snijders B, Kummeling I, et al. Factors Influencing the Composition of the Intestinal Microbiota in Early Infancy. Pediatrics 2006;118:511-521.
Adlerberth I, Wold AE. Establishment of the gut microbiota in Western infants. Acta Pediat 2009; 98:229-38.
Rossolini GM, Andrea MM, Mugnaioli C. The spread of CTX-M-type extended-spectrum b-lactamases. Clin Microbiol Infect 2008;50:2700â€“2706.
Livermore DM. Current Epidemiology and Growing Resistance of Gram-Negative Pathogens. Korean J Intern Med. 2012;27:128-142.
Al-Dweik M, Shehabi A. Common antimicrobial resistance phenotypes and genotypes of fecal Escherichia coli isolates from a single family over a six month period. Microbial Drug Resist 2009;15:103-107.
Shehabi AA, Haider AA, Fayyad MK. Frequency of antimicrobial resistance markers among Pseudomonas aeruginosa and Escherichia coli isolates from municipal sewage effluent water and patients in Jordan. Int Arb J Antimicrob Agents 2011; 1: 1-4.
Morosini MI, GarcÄ±a-Castillo M, Coque TM., Valverde A, Novais A, Loza E, et al. Antibiotic Coresistance in Extended-Spectrum-ï¢Lactamase-Producing Enterobacteriaceae and In Vitro Activity of Tigecycline. Antimicrob Agents Chemother 2006; 50:2695â€“2699.
Nasser U. and Sundsford A. The CTX-M conundrum: dissemination of plasmids and Escherichia coli clones. Microbial Drug Resist 2011; 17: 83-97.
Jacoby GA, Walsh KE, Mills DM, Walker VJ, Oh H, Robicsek A, et al. QnrB, Another Plasmid-Mediated Gene for Quinolone Resistance. Antimicrob Agents Chemother 2006; 50:1178-1182.
Chong Y, Ito Y and Kamimura T . Genetic evolution and clinical impact in extended-spectrum Î²-lactamase-producing Escherichia coli and Klebsiella pneumonia. Infect Gen Evolut J 2011; 11:1499â€“1504.
Shehabi AA, Odeh JF Fayyad M. Characterization of antimicrobial resistance
and class 1 integrons found in Escherichia coli isolates from Jordanian Human
Stools and Drinking Water Sources. J Chemother 2006;18: 468-472,
Mazel D. Integrons: agents of bacterial evolution. Nature Reviews Microbiol 2006;4: 608â€“620.
Salem MM, Muharram M, Alhosiny IM. Distribution of Classes 1and 2 Integrons among Multi Drug Resistant E. coli Isolated from Hospitalized Patients with Urinary Tract Infection in Cairo, Egypt. Australian J Basic Appl Scien 2010; 4:398-407.
Harajly M., Khairallah MT, Corkill JE, Araj GF, Matar GM. Frequency of conjugative transfer of plasmid-encoded ISEcp1 - blaCTX-M-15 and aac(6â€™)-lb-cr genes in Enterobacteriaceae at a tertiary care center in Lebanon - role of transferases. An Clin Microbiol Antimicrob 2010; 9(19):1-7.
Anvarinejad M, Farshad S, Alborzi A, Ranjbar R, Giammanco GM, and Japoni A. Integron and genotype patterns of quinolones-resistant uropathogenic Escherichia coli. Af J Microbiol Res 2011; 5: 3765-3770.
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