Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK

Ibrahim, Delveen R.; Dodd, Christine E. R.; Stekel, Dov J.; Meshioye, Remilekun T.; Diggle, Mathew; Lister, Michelle; Hobman, Jon L.

Abstract

Globally, cephalosporin therapy failure is a serious problem for infection control. One causative agent of cephalosporin-resistant infections is multidrug-resistant (MDR) E. coli producing extended-spectrum β-lactamases (ESBLs) and/or plasmid-encoded AmpC (pAmpC) β-lactamases. We evaluated the occurrence of ESBL/pAmpC genetic determinants in phenotypically MDR E. coli isolated from clinical samples of blood, faeces, ear effusion, urine and sputum from a UK hospital. Phenotypic resistance profiling for 18 antibiotics (from seven classes) showed that 32/35 isolates were MDR, with resistance to 4–16 of the tested antibiotics. Of the isolates, 97.1% showed resistance to ampicillin, 71.4% showed resistance to co-amoxiclav, cefotaxime, ceftazidime and ceftiofur, and 68.5% showed resistance to cefquinome. blaCTX-M, blaTEM and blaOXA-1 genes were detected in 23, 13 and 12 strains, respectively, and Intl1 was detected in 17 isolates. The most common subtypes among the definite sequence types were CTX-M-15 (40%) and TEM-1 (75%). No E. coli isolates carried pAmpC genes. Significant correlations were seen between CTX-M carriage and cefotaxime, ceftiofur, aztreonam, ceftazidime and cefquinome resistance; between blaCTX-M, blaTEM and blaOXA-1 carriage and ciprofloxacin resistance; and between Intl1 carriage and trimethoprim/sulfamethoxazole resistance. Thus, MDR phenotypes may be conferred by a relatively small number of genes. The level and pattern of antibiotic resistance highlight the need for better antibiotic therapy guidelines, including reduced use and improved surveillance.

Citation

Ibrahim, D. R., Dodd, C. E. R., Stekel, D. J., Meshioye, R. T., Diggle, M., Lister, M., & Hobman, J. L. (2023). Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK. Antibiotics, 12(1), Article 169. https://doi.org/10.3390/antibiotics12010169

• Journal Article Type: Article
• Acceptance Date: Jan 11, 2023
• Online Publication Date: Jan 13, 2023
• Publication Date: Jan 13, 2023
• Deposit Date: Mar 17, 2023
• Publicly Available Date: Mar 21, 2023
• Journal: Antibiotics
• Electronic ISSN: 2079-6382
• Publisher: MDPI AG
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 1
• Article Number: 169
• DOI: https://doi.org/10.3390/antibiotics12010169
• Keywords: Escherichia coli; multidrug-resistant; cephalosporin-resistant; ESBL
• Public URL: https://nottingham-repository.worktribe.com/output/15940023
• Publisher URL: https://www.mdpi.com/2079-6382/12/1/169