Rodrigues Renata Santos, Lima Nucia Cristiane da Silva, Taborda Roger Lafontaine Mesquita, Esquerdo Rosimar Pires, Gama Antonieta Rodrigues, Nogueira Paulo Afonso, Orlandi Patricia Puccinelli, Matos Najla Benevides
Tropical Medicine Research Center, Porto Velho, Rondônia, Brazil.
Oswaldo Cruz Foundation, Rondônia, Porto Velho, Rondônia, Brazil.
J Infect Dev Ctries. 2019 Aug 31;13(8):698-705. doi: 10.3855/jidc.10674.
Enteropathogenic Escherichia coli is an important causative agent of diarrhea in both developed and developing countries.
We assessed the antibiotic resistance profile and the ability of 71 Enteropathogenic Escherichia coli (EPEC) isolates from children in the age group 6 years, or younger, to form biofilm. These children were hospitalized in Cosme and Damião Children Hospital in Porto Velho, Western Brazilian Amazon, between 2010 and 2012, with clinical symptoms of acute gastroenteritis.
The highest frequency of atypical EPEC (aEPEC) isolates reached 83.1% (59/71). Most EPEC isolates presented Localized Adherence Like (LAL) pattern in HEp-2 cells (57.7% - 41/71). Biofilm production was observed in 33.8% (24/71) of EPEC isolates, and it means statistically significant association with shf gene (p = 0.0254). The highest antimicrobial resistance rates and a large number of multiresistant isolates 67.6% (48/71), regarded cefuroxime (CXM), ampicillin (AMP), trimethoprim-sulfamethoxazole (SXT) and tetracycline (TET), respectively, mainly in typical EPEC (tEPEC). Furthermore, 96% (68/71) of EPEC isolates in the present study were resistant to at least one antibiotic, whereas only 3 isolates were sensitive to all the tested drugs.
Based on our findings, there was increased aEPEC identification. EPEC isolates showed high resistance rate; most strains showed multiresistance; thus, they work as warning about the continuous need of surveillance towards antimicrobial use. Besides, the ability of forming biofilm was evidenced by the EPEC isolates. This outcome is worrisome, since it is a natural resistance mechanism of bacteria.
肠致病性大肠杆菌是发达国家和发展中国家腹泻的重要病原体。
我们评估了71株来自6岁及以下儿童的肠致病性大肠杆菌（EPEC）分离株的抗生素耐药谱以及形成生物膜的能力。这些儿童于2010年至2012年期间在巴西西部亚马逊州波多韦柳的科斯梅和达米昂儿童医院住院，患有急性肠胃炎的临床症状。
非典型EPEC（aEPEC）分离株的最高频率达到83.1%（59/71）。大多数EPEC分离株在HEp-2细胞中呈现局部粘附样（LAL）模式（57.7% - 41/71）。在33.8%（24/71）的EPEC分离株中观察到生物膜形成，这意味着与shf基因存在统计学上的显著关联（p = 0.0254）。最高的抗菌耐药率以及大量多重耐药分离株67.6%（48/71），分别针对头孢呋辛（CXM）、氨苄西林（AMP）、甲氧苄啶 - 磺胺甲恶唑（SXT）和四环素（TET），主要见于典型EPEC（tEPEC）。此外，本研究中96%（68/71）的EPEC分离株对至少一种抗生素耐药，而只有3株对所有测试药物敏感。
基于我们的研究结果，aEPEC的鉴定有所增加。EPEC分离株显示出高耐药率；大多数菌株表现出多重耐药；因此，它们警示了持续监测抗菌药物使用的必要性。此外，EPEC分离株证明了形成生物膜的能力。这一结果令人担忧，因为它是细菌的一种天然耐药机制。
