ESBL-Producing Escherichia coli Isolated from Children with Acute Diarrhea – Antimicrobial Susceptibility, Adherence Patterns and Phylogenetic Background
Journal Title: Advances in Clinical and Experimental Medicine - Year 2012, Vol 21, Issue 2
Abstract
[b]Background. [/b]Escherichia coli remains the principal bacterial pathogen in childhood diarrhea and constitutes an important public health problem, especially in developing countries. Diarrheagenic E. coli strains often display resistance to β-lactams due to the production of extended-spectrum β-lactamases (ESBLs). [b]Objectives.[/b] A total of thirty ESBL-producing E. coli strains colonizing the gastrointestinal tracts of children with acute diarrhea were studied in order to determine their antimicrobial susceptibility, adherence patterns to the HEp-2 cell line and phylogenetic background. [b]Material and Methods.[/b] ESBL production was detected by the double disk synergy test (DDST). The minimal inhibitory concentrations (MICs) of antibacterial drugs were determined by an agar dilution technique on Mueller-Hinton agar. The presence of blaTEM, blaSHV and blaCTX-M determinants in the strains studied was ascertained by polymerase chain reaction (PCR). [b]Results.[/b] The strains displayed the resistance pattern typical of ESBL producers. The majority of them (23 out of 30) were found to produce CTX-M-type ESBLs conferring a high level of resistance to oxyimino-β-lactams, especially to cefotaxime and ceftriaxone. In many cases, the strains exhibited resistance to non-β-lactam antimicrobials, such as gentamicin, amikacin, co-trimoxazole and tetracycline. On the other hand, these strains were uniformly susceptible to carbapenems, to oxyimino-β-lactams combined with clavulanic acid and to tigecycline. The E. coli strains were distributed among the four main phylogenetic groups: A, B1, B2 and D. The in vitro adhesion assay revealed that all but two of the strains adhered to the HEp-2 epithelial cell line. Aggregative and diffuse adherence patterns were found to be the most prevalent. [b]Conclusions.[/b] CTX-M-type enzymes were the most prevalent ESBLs among the strains studied. As many as 40% of the diarrheagenic E. coli isolates were found to belong to phylogenetic group D, which usually comprises E. coli strains associated with extraintestinal infections. The effectiveness of tigecycline against ESBL-producing E. coli strains was similar to that of imipenem and meropenem.
Authors and Affiliations
Roman Franiczek, Beata Sobieszczańska, Michał Turniak, Urszula Kasprzykowska, Barbara Krzyżanowska, Katarzyna Jermakow, Grażyna Mokracka-Latajka
Keywords
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