Duran-Bedolla Josefina, Téllez-Sosa Juan, González-Villoria Ana María, Barrios-Camacho Humberto
Instituto Nacional de Salud Pública (INSP), Centro de Investigación Sobre Enfermedades Infecciosas (CISEI), Departamento de Diagnóstico Epidemiológico. Cuernavaca, Morelos, México.
División de Estudios de Posgrado. Universidad de la Sierra Sur, Oaxaca, México.
J Infect Dev Ctries. 2024 Dec 30;18(12):1861-1866. doi: 10.3855/jidc.18854.
Escherichia coli has emerged as an important pathogen in urinary tract infections (UTIs) due to the rapid acquisition of antibiotic resistance genes. This enhances the ability of E. coli to colonize and creates therapeutic challenges within the healthcare system. This study aimed to identify the extended spectrum beta-lactamase (ESBL) and O25b-ST131 pandemic clones in E. coli isolated from two hospitals in Mexico.
Bacterial identification and antibiotic susceptibility tests were conducted using the VITEK 2 system. The ESBL and plasmid-mediated quinolone resistance (PMQR) genes were identified by polymerase chain reaction (PCR). E. coli genotyping was carried out by the phylogenetic group analysis and O25b-ST131 identification.
A total of 103 unique E. coli clinical isolates were analyzed from a pool of 1,002 strains; 75% obtained from UTIs and vaginal secretions. Multi-resistant antibiotic profiles were observed. Notably, the presence of the aac(6`)lb-cr and qnr genes was associated with 100% ciprofloxacin resistance, when ESBL was present. Additionally, the B2 phylogenetic group was identified, with 23% of isolates belonging to the O25b-ST131 clone.
Our research revealed a 10% prevalence of ESBL, in contrast to global prevalence rates. The resistance profiles suggest that the effectiveness of these commonly used antibiotics in treating E. coli-associated UTIs or vaginal infections has decreased significantly. Excessive use of antimicrobial agents contributes to the regional variation. Our results underscore the importance of monitoring the molecular epidemiology, antibiotic resistance, and transmission dynamics of the O25b-ST131 E. coli clone.
由于抗生素耐药基因的快速获得，大肠杆菌已成为尿路感染（UTI）中的一种重要病原体。这增强了大肠杆菌的定植能力，并在医疗系统中带来了治疗挑战。本研究旨在鉴定从墨西哥两家医院分离出的大肠杆菌中的超广谱β-内酰胺酶（ESBL）和O25b-ST131大流行克隆株。
使用VITEK 2系统进行细菌鉴定和抗生素敏感性试验。通过聚合酶链反应（PCR）鉴定ESBL和质粒介导的喹诺酮耐药（PMQR）基因。通过系统发育组分析和O25b-ST131鉴定进行大肠杆菌基因分型。
从1002株菌株中总共分析了103株独特的大肠杆菌临床分离株；75%来自尿路感染和阴道分泌物。观察到多重耐药的抗生素谱。值得注意的是，当存在ESBL时，aac(6`)lb-cr和qnr基因的存在与100%的环丙沙星耐药相关。此外，鉴定出了B2系统发育组，23%的分离株属于O25b-ST131克隆株。
我们的研究显示ESBL的流行率为10%，与全球流行率不同。耐药谱表明这些常用抗生素在治疗大肠杆菌相关的尿路感染或阴道感染中的有效性已显著降低。抗菌剂的过度使用导致了区域差异。我们的结果强调了监测O25b-ST131大肠杆菌克隆株的分子流行病学、抗生素耐药性和传播动态的重要性。
