Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams
Background: Uropathogenic Escherichia coli are increasingly becoming resistant to flouroquinolones and to other commonly available antimicrobials. We sought to investigate the genetic basis for fluoroquinolone and extended spectrum beta-lactam (ESBL) resistance in 17 fluoroquinolone-resistant (MIC o...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
The Journal of Infection in Developing Countries
2007-12-01
|
| Series: | Journal of Infection in Developing Countries |
| Subjects: | |
| Online Access: | https://jidc.org/index.php/journal/article/view/361 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849323549811015680 |
|---|---|
| author | Samuel Kariuki Gunturu Revathi John Corkill John Kiiru Joyce Mwituria Nazir Mirza C. Anthony Hart |
| author_facet | Samuel Kariuki Gunturu Revathi John Corkill John Kiiru Joyce Mwituria Nazir Mirza C. Anthony Hart |
| author_sort | Samuel Kariuki |
| collection | DOAJ |
| description | Background: Uropathogenic Escherichia coli are increasingly becoming resistant to flouroquinolones and to other commonly available antimicrobials. We sought to investigate the genetic basis for fluoroquinolone and extended spectrum beta-lactam (ESBL) resistance in 17 fluoroquinolone-resistant (MIC of levofloxacin and ciprofloxacin >32 μg/ml) E. coli isolated from patients with urinary tract infections (UTIs).
Methods: We applied PCR and Pulsed Field Gel Electrophoresis (PFGE) to characterize resistance genes and to determine clonal relatedness of strains, respectively.
Results: Twelve of the 17 E. coli were resistant to multiple drugs, including ampicillin, co-amoxyclav, cefotaxime, ceftriaxone, ceftazidime and gentamicin and nalidixic acid and produced plasmid-mediated CTX-M-15 type ESBLs and CMY-2 AmpC type enzymes. The other 5 E. coli that were non-ESBL-producing were multiply resistant to ampicillin, nitrofurantoin, cefoxitin, nalidixic acid. Resistance to fluoroquinolones resulted from a combination of the presence of qnrA, qnrB, ciprofloxacin acetylating enzyme designated aac(6’)-1b-cr, and mutations in the two amino acid substitutions; 83 Serine (TCG) to Leucine (TTG) and 87 Aspartic acid (GAC) to Asparagine (AAC).
Conclusion: Antibiogram patterns and PFGE of E. coli showed that these were community acquired UTI caused by pockets of clonally-related and some discreet strain types. Plasmid-mediated CTX-M-15 beta-lactamases and CMY-2 AmpC enzymes and fluoroquinolone resistant E. coli are becoming increasingly prevalent in hospitals in Kenya, posing a major challenge in the management of UTIs. |
| format | Article |
| id | doaj-art-8773d4fef80f46daa6bc662cc33da573 |
| institution | Kabale University |
| issn | 1972-2680 |
| language | English |
| publishDate | 2007-12-01 |
| publisher | The Journal of Infection in Developing Countries |
| record_format | Article |
| series | Journal of Infection in Developing Countries |
| spelling | doaj-art-8773d4fef80f46daa6bc662cc33da5732025-08-20T03:48:58ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802007-12-0110310.3855/jidc.361Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactamsSamuel Kariuki0Gunturu Revathi1John Corkill2John Kiiru3Joyce Mwituria4Nazir Mirza5C. Anthony Hart6Centre for Microbiology Research, Kenya Medical Research Institute, PO Box 43640, NairobiDepartment of Pathology, Aga Khan University Hospital, P.O. Box 30270, NairobiDepartment of Medical Microbiology and Genito-Urinary Medicine, University of Liverpool, Liverpool, L69 3GACentre for Microbiology Research, Kenya Medical Research Institute, PO Box 43640, NairobiCentre for Microbiology Research, Kenya Medical Research Institute, PO Box 43640, NairobiThe Nairobi Hospital, PO Box 30026, NairobiDepartment of Medical Microbiology and Genito-Urinary Medicine, University of Liverpool, Liverpool, L69 3GABackground: Uropathogenic Escherichia coli are increasingly becoming resistant to flouroquinolones and to other commonly available antimicrobials. We sought to investigate the genetic basis for fluoroquinolone and extended spectrum beta-lactam (ESBL) resistance in 17 fluoroquinolone-resistant (MIC of levofloxacin and ciprofloxacin >32 μg/ml) E. coli isolated from patients with urinary tract infections (UTIs). Methods: We applied PCR and Pulsed Field Gel Electrophoresis (PFGE) to characterize resistance genes and to determine clonal relatedness of strains, respectively. Results: Twelve of the 17 E. coli were resistant to multiple drugs, including ampicillin, co-amoxyclav, cefotaxime, ceftriaxone, ceftazidime and gentamicin and nalidixic acid and produced plasmid-mediated CTX-M-15 type ESBLs and CMY-2 AmpC type enzymes. The other 5 E. coli that were non-ESBL-producing were multiply resistant to ampicillin, nitrofurantoin, cefoxitin, nalidixic acid. Resistance to fluoroquinolones resulted from a combination of the presence of qnrA, qnrB, ciprofloxacin acetylating enzyme designated aac(6’)-1b-cr, and mutations in the two amino acid substitutions; 83 Serine (TCG) to Leucine (TTG) and 87 Aspartic acid (GAC) to Asparagine (AAC). Conclusion: Antibiogram patterns and PFGE of E. coli showed that these were community acquired UTI caused by pockets of clonally-related and some discreet strain types. Plasmid-mediated CTX-M-15 beta-lactamases and CMY-2 AmpC enzymes and fluoroquinolone resistant E. coli are becoming increasingly prevalent in hospitals in Kenya, posing a major challenge in the management of UTIs.https://jidc.org/index.php/journal/article/view/361Fluoroquinolone-resistantESBL-producing MDR uropathogenic E. coliKenya |
| spellingShingle | Samuel Kariuki Gunturu Revathi John Corkill John Kiiru Joyce Mwituria Nazir Mirza C. Anthony Hart Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams Journal of Infection in Developing Countries Fluoroquinolone-resistant ESBL-producing MDR uropathogenic E. coli Kenya |
| title | Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams |
| title_full | Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams |
| title_fullStr | Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams |
| title_full_unstemmed | Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams |
| title_short | Escherichia coli from community-acquired urinary tract infections resistant to fluoroquinolones and extended-spectrum beta-lactams |
| title_sort | escherichia coli from community acquired urinary tract infections resistant to fluoroquinolones and extended spectrum beta lactams |
| topic | Fluoroquinolone-resistant ESBL-producing MDR uropathogenic E. coli Kenya |
| url | https://jidc.org/index.php/journal/article/view/361 |
| work_keys_str_mv | AT samuelkariuki escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams AT guntururevathi escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams AT johncorkill escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams AT johnkiiru escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams AT joycemwituria escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams AT nazirmirza escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams AT canthonyhart escherichiacolifromcommunityacquiredurinarytractinfectionsresistanttofluoroquinolonesandextendedspectrumbetalactams |