Research article

Fecal carriage of ESBL-producing Escherichia coli in Egyptian patients admitted to the Medical Research Institute hospital, Alexandria University

  • Received: 25 July 2020 Accepted: 29 October 2020 Published: 03 November 2020
  • Commensal ESBL-producing E. coli represent a reservoir for resistance genes therefore, their detection is crucial to restrain the spread of beta-lactam resistance. Hence, the aim of the present study was phenotypic and genotypic characterization of commensal ESBL-producing E. coli obtained from the stool of patients at the time of admission and at the time of discharge from the Medical Research Institute hospital. A total of 70 E. coli isolates were collected from 35 patients and were categorized into Group A (samples obtained on admission) and Group B (samples obtained at the time of discharge). Phenotypically, 30 isolates were ESBL producers (40% of E. coli isolates collected on admission and 45.7% of the strains obtained at the time of discharge were ESBL producers). Most of them harbored one to three plasmids with sizes ranging from one kbp to ten kbp. Upon genotypic investigation, blaCTX-M was the most detected gene in 80% of ESBL strains, followed by blaTEM in 53.3% and the least detected was blaSHV in only 13.3%. By comparing group A and group B, ten patients were found to carry commensal ESBL-producing E. coli, in two patients these isolates carried ESBL genes that were identical on admission and on discharge. However, in eight patients, these isolates carried different ESBL genes, which were newly harbored during hospital stay. The high abundance of MDR commensal E. coli 48.57% together with the presence of 42.86% ESBL-producing commensal E. coli among our isolates represents an alarming threat, as they are frequently associated with the increased risk of infection, higher costs and longer hospital stay.

    Citation: Amira ElBaradei, Dalia Ali Maharem, Ola Kader, Mustafa Kareem Ghareeb, Iman S. Naga. Fecal carriage of ESBL-producing Escherichia coli in Egyptian patients admitted to the Medical Research Institute hospital, Alexandria University[J]. AIMS Microbiology, 2020, 6(4): 422-433. doi: 10.3934/microbiol.2020025

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  • Commensal ESBL-producing E. coli represent a reservoir for resistance genes therefore, their detection is crucial to restrain the spread of beta-lactam resistance. Hence, the aim of the present study was phenotypic and genotypic characterization of commensal ESBL-producing E. coli obtained from the stool of patients at the time of admission and at the time of discharge from the Medical Research Institute hospital. A total of 70 E. coli isolates were collected from 35 patients and were categorized into Group A (samples obtained on admission) and Group B (samples obtained at the time of discharge). Phenotypically, 30 isolates were ESBL producers (40% of E. coli isolates collected on admission and 45.7% of the strains obtained at the time of discharge were ESBL producers). Most of them harbored one to three plasmids with sizes ranging from one kbp to ten kbp. Upon genotypic investigation, blaCTX-M was the most detected gene in 80% of ESBL strains, followed by blaTEM in 53.3% and the least detected was blaSHV in only 13.3%. By comparing group A and group B, ten patients were found to carry commensal ESBL-producing E. coli, in two patients these isolates carried ESBL genes that were identical on admission and on discharge. However, in eight patients, these isolates carried different ESBL genes, which were newly harbored during hospital stay. The high abundance of MDR commensal E. coli 48.57% together with the presence of 42.86% ESBL-producing commensal E. coli among our isolates represents an alarming threat, as they are frequently associated with the increased risk of infection, higher costs and longer hospital stay.


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    This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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    The authors declare no conflict of interest.

    [1] Wang CH, Hsieh YH, Powers ZM, et al. (2020) Defeating antibiotic-resistant bacteria: exploring alternative therapies for a post-antibiotic era. Int J Mol Sci 21: 1061. doi: 10.3390/ijms21031061
    [2] Draenert R, Seybold U, Grutzner E, et al. (2015) Novel antibiotics: are we still in the pre-post-antibiotic era? Infection 43: 145-151. doi: 10.1007/s15010-015-0749-y
    [3] Pandit R, Awal B, Shrestha SS, et al. (2020) Extended-Spectrum beta-Lactamase (ESBL) genotypes among multidrug-resistant uropathogenic Escherichia coli clinical isolates from a teaching hospital of Nepal. Interdiscip Perspect Infect Dis 2020: 6525826. doi: 10.1155/2020/6525826
    [4] Aires-de-Sousa M, Lopes E, Goncalves ML, et al. (2020) Intestinal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae at admission in a Portuguese hospital. Eur J Clin Microbiol Infect Dis 39: 783-790. doi: 10.1007/s10096-019-03798-3
    [5] Goncalves D, Cecilio P, Ferreira H (2016) Nursing homes and long-term care facilities: Reservoirs of CTX-M-15-producing Escherichia coli O25b-ST131 in Portugal. J Glob Antimicrob Resist 7: 69-71. doi: 10.1016/j.jgar.2016.08.001
    [6] Valverde A, Coque TM, Sanchez-Moreno MP, et al. (2004) Dramatic increase in prevalence of fecal carriage of extended-spectrum beta-lactamase-producing Enterobacteriaceae during nonoutbreak situations in Spain. J Clin Microbiol 42: 4769-4775. doi: 10.1128/JCM.42.10.4769-4775.2004
    [7] Baljin B, Baldan G, Chimeddorj B, et al. (2016) Faecal carriage of gram-negative multidrug-resistant bacteria among patients hospitalized in two centres in Ulaanbaatar, Mongolia. PLoS One 11: e0168146. doi: 10.1371/journal.pone.0168146
    [8] Cornejo-Juarez P, Suarez-Cuenca JA, Volkow-Fernandez P, et al. (2016) Fecal ESBL Escherichia coli carriage as a risk factor for bacteremia in patients with hematological malignancies. Support Care Cancer 24: 253-259. doi: 10.1007/s00520-015-2772-z
    [9] Clinical and Laboratory Standards Institute (2018) Performance Standards for Antimicrobial Susceptibility Testing, 28th ed. CLSI supplement M100. Clinical and Laboratory Standards Institute .
    [10] Japoni A, Alborzi A, Kalani M, et al. (2006) Susceptibility patterns and cross-resistance of antibiotics against Pseudomonas aeruginosa isolated from burn patients in the South of Iran. Burns 32: 343-347. doi: 10.1016/j.burns.2005.10.017
    [11] Yang JL, Wang MS, Cheng AC, et al. (2008) A simple and rapid method for extracting bacterial DNA from intestinal microflora for ERIC-PCR detection. World J Gastroenterol 14: 2872-2876. doi: 10.3748/wjg.14.2872
    [12] Paterson DL, Hujer KM, Hujer AM, et al. (2003) Extended-spectrum beta-lactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and widespread prevalence of SHV- and CTX-M-type beta-lactamases. Antimicrob Agents Chemother 47: 3554-3560. doi: 10.1128/AAC.47.11.3554-3560.2003
    [13] Grobner S, Linke D, Schutz W, et al. (2009) Emergence of carbapenem-non-susceptible extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates at the university hospital of Tubingen, Germany. J Med Microbiol 58: 912-922. doi: 10.1099/jmm.0.005850-0
    [14] Grimm V, Ezaki S, Susa M, et al. (2004) Use of DNA microarrays for rapid genotyping of TEM beta-lactamases that confer resistance. J Clin Microbiol 42: 3766-3774. doi: 10.1128/JCM.42.8.3766-3774.2004
    [15] Zhang S, Cahalan MD (2007) Purifying plasmid DNA from bacterial colonies using the QIAGEN Miniprep Kit. J Vis Exp 6: 247.
    [16] Pitout JD, Laupland KB (2008) Extended-spectrum beta-lactamase-producing Enterobacteriaceae: an emerging public-health concern. Lancet Infect Dis 8: 159-166. doi: 10.1016/S1473-3099(08)70041-0
    [17] Freeman JT, McBride SJ, Nisbet MS, et al. (2012) Bloodstream infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae at a tertiary care hospital in New Zealand: risk factors and outcomes. Int J Infect Dis 16: e371-374. doi: 10.1016/j.ijid.2012.01.008
    [18] Wielders CCH, Van Duijkeren E, Van Den Bunt G, et al. (2020) Seasonality in carriage of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in the general population: a pooled analysis of nationwide cross-sectional studies. Epidemiol Infect 148: e68. doi: 10.1017/S0950268820000539
    [19] Magiorakos AP, Srinivasan A, Carey RB, et al. (2012) Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect 18: 268-281. doi: 10.1111/j.1469-0691.2011.03570.x
    [20] Huang IF, Lee WY, Wang JL, et al. (2018) Fecal carriage of multidrug-resistant Escherichia coli by community children in southern Taiwan. BMC Gastroenterol 18: 86. doi: 10.1186/s12876-018-0807-x
    [21] Islam MA, Amin MB, Roy S, et al. (2019) Fecal colonization with multidrug-resistant E. coli among healthy infants in Rural Bangladesh. Front Microbiol 10: 640. doi: 10.3389/fmicb.2019.00640
    [22] Hagel S, Makarewicz O, Hartung A, et al. (2019) ESBL colonization and acquisition in a hospital population: The molecular epidemiology and transmission of resistance genes. PLoS One 14: e0208505. doi: 10.1371/journal.pone.0208505
    [23] Janvier F, Merens A, Delaune D, et al. (2011) Fecal carriage of third-generation cephalosporins-resistant Enterobacteriaceae in asymptomatic young adults: evolution between 1999 and 2009. Pathol Biol (Paris) 59: 97-101. doi: 10.1016/j.patbio.2010.07.012
    [24] Abdallah HM, Alnaiemi N, Reuland EA, et al. (2017) Fecal carriage of extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae in Egyptian patients with community-onset gastrointestinal complaints: a hospital -based cross-sectional study. Antimicrob Resist Infect Control 6: 62. doi: 10.1186/s13756-017-0219-7
    [25] Sunde M, Simonsen GS, Slettemeas JS, et al. (2015) Integron, plasmid and host strain characteristics of Escherichia coli from humans and food included in the Norwegian Antimicrobial Resistance Monitoring Programs. PLoS One 10: e0128797. doi: 10.1371/journal.pone.0128797
    [26] Sharma J, Ray P, Sharma M (2010) Plasmid profile of ESBL producing Gram-negative bacteria and correlation with susceptibility to beta-lactam drugs. Indian J Pathol and Microbiol 53: 83-86. doi: 10.4103/0377-4929.59190
    [27] Wu PC, Wang JL, Hsueh PR, et al. (2019) Prevalence and risk factors for colonization by extended-spectrum beta-lactamase-producing or ST 131 Escherichia coli among asymptomatic adults in community settings in Southern Taiwan. Infect Drug Resist 12: 1063-1071. doi: 10.2147/IDR.S201086
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