喀麦隆滨海地区拉昆蒂尼医院高血压患者中引起肠道感染的致泻性大肠杆菌抗生素耐药性 bla、bla、bla 和 bla 基因的检测

Detection of bla, bla, bla, and bla genes of antibiotic resistance in diarrheagenic E. coli causing enteric infection in hypertensive patients at Laquintinie Hospital, Littoral Region of Cameroon.

作者信息

Tsobeng Ornella Djiolieu, Mbaveng Armelle T, Kengne Michael F, Dadjo Ballue S T, Fonjou Delano G T, Kuete Victor

机构信息

Department of Biochemistry, Faculty of Science, University of Dschang, Dschang, Cameroon.

出版信息

J Infect Public Health. 2025 Jan;18(1):102617. doi: 10.1016/j.jiph.2024.102617. Epub 2024 Dec 5.

DOI:10.1016/j.jiph.2024.102617

PMID:39662159

Abstract

BACKGROUND

Pathogenic Escherichia coli is one of the most common causes of acute watery diarrhea among children and adults in the developing world. The severity of infection by this bacterium is a product of many factors, including virulence properties and antimicrobial resistance. This study aimed to determine the distribution of different virulence genes of E. coli isolates in hypertensive and non-hypertensive patients and their association with some selected beta-lactam resistance genes.

METHODS

At the Douala Laquintinie Hospital, 518 fecal samples were collected from both hypertensive and non-hypertensive patients with enteric infections. E. coli was isolated on eosin-methylene blue agar (EMB) and identified by the Api 20 E Galery. The virulence genes and extended-spectrum β-lactamase-producing (ESBL) E. coli genes were detected by simplex polymerase chain reaction (PCR), while antimicrobial susceptibility was tested by the Kirby-Bauer agar disc diffusion method.

RESULTS

The prevalence of enteric infection due to diarrheagenic E. coli (n = 204) was found to be 39.38 % in the general population (n = 518). There were 55 enterovirulent E. coli isolates identified. According to hypertension (HTN), enteropathogenic E. coli (EPEC) isolates were more isolated in hypertensive patients (77.78 %) than in non-hypertensive patients (22.22 %), while enteroaggregative E. coli (EAEC) were the most frequent in non-hypertensive patients (58.33 %). EPEC, EAEC, enterotoxigenic E. coli (ETEC), and Shiga toxin-producing E. coli (STEC) isolates showed higher rates of resistance to amoxicillin (AMO) (90.48 %; 100.00 %; 100.00 %; 100.00 % vs 83.33 %; 85.71 %; 75.00 %; 50.00 %) and SXT (71.43 %; 80.00 %; 75.00 %; 75.00 % vs 0.00 %; 28.57 %; 50.00 %; 25.00 %) in hypertensive patients compared to non-hypertensive patients. The prevalence of ESBL-producing (ESBL-P) E. coli was 87.27 %. The resistance genes bla (64.71 % vs 52.38 %) and bla (23.53 % vs 9.52 %) were more frequently detected in hypertensive patients than in non-hypertensive patients. The high resistance to AMO was correlated with the presence of the bla gene (OR: 5.52; 95 % CI: 0.61-49.39; p = 0.093).

CONCLUSION

This study reveals the high burden of the typical EPEC, EAEC, and ESBL-P E. coli and confirmed the high occurrence of bla and bla among ESBL-producing E. coli in hypertensive patients. The study suggests that measures need to be taken to reduce the harmfulness of enterovirulent E. coli and the resistance of enterovirulent E. coli in hypertensive patients.

摘要

背景

致病性大肠杆菌是发展中国家儿童和成人急性水样腹泻最常见的病因之一。这种细菌感染的严重程度受多种因素影响，包括毒力特性和抗菌药物耐药性。本研究旨在确定大肠杆菌分离株中不同毒力基因在高血压患者和非高血压患者中的分布情况及其与某些选定β-内酰胺耐药基因的关联。

方法

在杜阿拉拉昆蒂尼医院，从患有肠道感染的高血压患者和非高血压患者中收集了518份粪便样本。在伊红美蓝琼脂（EMB）上分离大肠杆菌，并通过Api 20 E鉴定。通过单重聚合酶链反应（PCR）检测毒力基因和产超广谱β-内酰胺酶（ESBL）的大肠杆菌基因，同时采用 Kirby-Bauer 琼脂纸片扩散法检测抗菌药物敏感性。

结果

在普通人群（n = 518）中，致泻性大肠杆菌（n = 204）引起的肠道感染患病率为39.38%。共鉴定出55株肠毒性大肠杆菌分离株。根据高血压情况（HTN），肠致病性大肠杆菌（EPEC）分离株在高血压患者中分离率更高（77.78%），高于非高血压患者（22.22%），而肠聚集性大肠杆菌（EAEC）在非高血压患者中最为常见（58.33%）。与非高血压患者相比，EPEC、EAEC、产肠毒素大肠杆菌（ETEC）和产志贺毒素大肠杆菌（STEC）分离株对阿莫西林（AMO）（90.48%；100.00%；100.00%；100.00% 对 83.33%；85.71%；75.00%；50.00%）和复方新诺明（SXT）（71.43%；80.00%；75.00%；75.00% 对 0.00%；28.57%；50.00%；25.00%）的耐药率更高。产ESBL的大肠杆菌（ESBL-P）患病率为87.27%。与非高血压患者相比，高血压患者中耐药基因bla（64.71% 对 52.38%）和bla（23.53% 对 9.52%）的检出频率更高。对AMO的高耐药性与bla基因的存在相关（比值比：5.52；95% 置信区间：0.61 - 49.39；p = 0.093）。