Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit
Abstract Introduction Escherichia coli (E. coli) causes infections in neonates admitted to neonatal intensive care units (NICUs). Although β-lactam antibiotics are commonly used for neonatal infectious diseases, E. coli has exhibited resistance to them. Therefore, we investigated the resistance of E...
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2025-02-01
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| author | Jian Zhou Jingqian Zhou Min Chen Pan Lü Chunming Jiang |
| author_facet | Jian Zhou Jingqian Zhou Min Chen Pan Lü Chunming Jiang |
| author_sort | Jian Zhou |
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| description | Abstract Introduction Escherichia coli (E. coli) causes infections in neonates admitted to neonatal intensive care units (NICUs). Although β-lactam antibiotics are commonly used for neonatal infectious diseases, E. coli has exhibited resistance to them. Therefore, we investigated the resistance of E. coli strains isolated from a NICU to β-lactam antibiotics. Methods E. coli isolates were collected from patients admitted to a NICU from 2020–2023. The clinical characteristics of the patients were analyzed. The antimicrobial susceptibility was determined using the agar dilution method, and the distribution of β-lactamase genes was analyzed using PCR. Conjugation experiments were conducted to analyze the horizontal transferability of resistance genes on plasmids. Genomic DNA was extracted for whole genome sequencing, construction of plasmid physical maps, locating resistance genes, and analyzing flanking regions and the resistance gene-related sequences. Results Throughout the study period, 110 distinct E. coli strains were collected. Among these, 62 cases presented strains, which were resistant against at least one of seven ß-lactam antibiotics associated with conditions such as ventilator-associated pneumonia (35/62), catheter-associated urinary tract infection (14/62), necrotizing enterocolitis (7/62), skin infection (1/62), and neonatal septicemia (5/62). Resistance of E. coli isolates to seven β-lactam antibiotics ranged from 2.73–56.36%. In 62 strains (56.36%, 62/110), six genotypes (11 sub-genotypes) of 111 β-lactamase genes were identified. Conjugation experiments revealed two transconjugants carrying the bla KPC-2 gene and two carrying the bla OXA-1 gene, exhibiting resistance to carbapenems and other β-lactams. The plasmids of four strains were successfully conjugated and transferred to recipient E. coli C600. PCR of the transconjugant resistance genes revealed that two carried a bla KPC-2 gene with a MIC increased up to 32-fold relative to the recipients, and the other two carried a bla OXA-1 gene with a 32-fold increased MIC. For isolate ECK03 carrying bla KPC-2, bla CTX-M-64, bla CTX-M-65, and bla TEM-1, sequencing results showed that bla KPC-2, bla CTX-M-64, and bla TEM-1 were harbored on a 114-kb pECK03_KPC-2 plasmid, whereas two identical bla CTX-M-64 genes were harbored in E. coli isolate ECF13. Conclusion These findings highlight the existence of E. coli β-lactam resistance within NICU populations, emphasizing the need for continual monitoring of β-lactamase isolates to facilitate effective antibiotic selection. |
| format | Article |
| id | doaj-art-d063aa059a57428f962c612c2a584af1 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-02-01 |
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| spelling | doaj-art-d063aa059a57428f962c612c2a584af12025-02-09T12:54:35ZengBMCBMC Pediatrics1471-24312025-02-0125111010.1186/s12887-025-05389-yPrevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unitJian Zhou0Jingqian Zhou1Min Chen2Pan Lü3Chunming Jiang4Zhejiang University School of MedicineZhejiang University School of MedicineDepartment of Neonatology, The First People’s Hospital of YongkangDepartment of Clinical Laboratory, The First People’s Hospital of YongkangDepartment of Pediatrics, Hangzhou First People’s HospitalAbstract Introduction Escherichia coli (E. coli) causes infections in neonates admitted to neonatal intensive care units (NICUs). Although β-lactam antibiotics are commonly used for neonatal infectious diseases, E. coli has exhibited resistance to them. Therefore, we investigated the resistance of E. coli strains isolated from a NICU to β-lactam antibiotics. Methods E. coli isolates were collected from patients admitted to a NICU from 2020–2023. The clinical characteristics of the patients were analyzed. The antimicrobial susceptibility was determined using the agar dilution method, and the distribution of β-lactamase genes was analyzed using PCR. Conjugation experiments were conducted to analyze the horizontal transferability of resistance genes on plasmids. Genomic DNA was extracted for whole genome sequencing, construction of plasmid physical maps, locating resistance genes, and analyzing flanking regions and the resistance gene-related sequences. Results Throughout the study period, 110 distinct E. coli strains were collected. Among these, 62 cases presented strains, which were resistant against at least one of seven ß-lactam antibiotics associated with conditions such as ventilator-associated pneumonia (35/62), catheter-associated urinary tract infection (14/62), necrotizing enterocolitis (7/62), skin infection (1/62), and neonatal septicemia (5/62). Resistance of E. coli isolates to seven β-lactam antibiotics ranged from 2.73–56.36%. In 62 strains (56.36%, 62/110), six genotypes (11 sub-genotypes) of 111 β-lactamase genes were identified. Conjugation experiments revealed two transconjugants carrying the bla KPC-2 gene and two carrying the bla OXA-1 gene, exhibiting resistance to carbapenems and other β-lactams. The plasmids of four strains were successfully conjugated and transferred to recipient E. coli C600. PCR of the transconjugant resistance genes revealed that two carried a bla KPC-2 gene with a MIC increased up to 32-fold relative to the recipients, and the other two carried a bla OXA-1 gene with a 32-fold increased MIC. For isolate ECK03 carrying bla KPC-2, bla CTX-M-64, bla CTX-M-65, and bla TEM-1, sequencing results showed that bla KPC-2, bla CTX-M-64, and bla TEM-1 were harbored on a 114-kb pECK03_KPC-2 plasmid, whereas two identical bla CTX-M-64 genes were harbored in E. coli isolate ECF13. Conclusion These findings highlight the existence of E. coli β-lactam resistance within NICU populations, emphasizing the need for continual monitoring of β-lactamase isolates to facilitate effective antibiotic selection.https://doi.org/10.1186/s12887-025-05389-yEscherichia coliResistanceAntimicrobial susceptibility testβ-lactamase geneNeonatal ICU |
| spellingShingle | Jian Zhou Jingqian Zhou Min Chen Pan Lü Chunming Jiang Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit BMC Pediatrics Escherichia coli Resistance Antimicrobial susceptibility test β-lactamase gene Neonatal ICU |
| title | Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit |
| title_full | Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit |
| title_fullStr | Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit |
| title_full_unstemmed | Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit |
| title_short | Prevalence of β-lactam antibiotic resistance of Escherichia coli isolated from a neonatal intensive care unit |
| title_sort | prevalence of β lactam antibiotic resistance of escherichia coli isolated from a neonatal intensive care unit |
| topic | Escherichia coli Resistance Antimicrobial susceptibility test β-lactamase gene Neonatal ICU |
| url | https://doi.org/10.1186/s12887-025-05389-y |
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