본문 바로가기
KERD
논문KCI 등재

High Prevalence of blaCTX-M in Fecal Commensal Escherichia coli from Healthy Children

Ruiz Joaquim|Alcedo Katherine|Ochoa Theresa J.|Riveros Maribel
대한감염학회 (The Korean Society Of Infectious Diseases)|2022.03|Infection and Chemotherapy|제54권 제1호|pp. 59-69|DOI 10.3947/ic.2021.0102

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

Escherichia coliExtended-spectrum β-lactamasesAntibiotic-resistanceCommensalHealthy carriers
주제분류내과학

초록

Background: Antibiotic-resistant Escherichia coli can colonize the intestinal tract of healthy children, causing concern when antibiotic resistance is related to the presence of transferable mechanisms, such as extended-spectrum β-lactamases (ESBLs). Materials and methods: Fecal samples from 41 healthy children from two villages of rural Peru were cultured on ceftriaxone-disks. ESBL production was confirmed with double disk synergy. In all ESBL-produced isolates, antibiotic susceptibility to 12 antibacterial agents was established by disk diffusion, while clonal relationships were determined by repetitive extragenic palindromic-polymerase chain reaction (REP-PCR). Presence of ST131 was determined using PCR. Results: Ceftriaxone-resistant microorganisms were recovered from 39 samples belonging to 22 out of 41 children (53.7%). Of these, 80 ceftriaxone-resistant and two ceftriaxone-intermediate E. coli from inside ceftriaxone-halos were confirmed as ESBL-producers. All isolates were multidrug-resistant. In 79/80 (98.8%) ceftriaxone-resistant isolates, the presence of blaCTX-M was detected alone (58 isolates, or together with other β-lactamase (blaTEM, 17 isolates; blaOXA-1-like, 3 isolates; blaTEM + blaOXA-1-like, 1 isolate), while in one isolate no such ESBL was identified. The two ceftriaxone-intermediate isolates recovered from the same sample, carried a blaTEM and blaSHV respectively. Thirty-four different clones were identified, with 4 clones being recovered from different samples from the same child. Twelve clones were disseminated among different children, including 5 clones disseminated between both villages. Two clones, accounting for 3 isolates and both recovered from the same children, belonged to E. coli ST131. Conclusion: This study demonstrates high prevalence of ESBL-carriers among healthy children living in a rural area of Peru, stressing the need for continuous surveillance and search for public health control measures.

Abstract

Background: Antibiotic-resistant Escherichia coli can colonize the intestinal tract of healthy children, causing concern when antibiotic resistance is related to the presence of transferable mechanisms, such as extended-spectrum β-lactamases (ESBLs). Materials and methods: Fecal samples from 41 healthy children from two villages of rural Peru were cultured on ceftriaxone-disks. ESBL production was confirmed with double disk synergy. In all ESBL-produced isolates, antibiotic susceptibility to 12 antibacterial agents was established by disk diffusion, while clonal relationships were determined by repetitive extragenic palindromic-polymerase chain reaction (REP-PCR). Presence of ST131 was determined using PCR. Results: Ceftriaxone-resistant microorganisms were recovered from 39 samples belonging to 22 out of 41 children (53.7%). Of these, 80 ceftriaxone-resistant and two ceftriaxone-intermediate E. coli from inside ceftriaxone-halos were confirmed as ESBL-producers. All isolates were multidrug-resistant. In 79/80 (98.8%) ceftriaxone-resistant isolates, the presence of blaCTX-M was detected alone (58 isolates, or together with other β-lactamase (blaTEM, 17 isolates; blaOXA-1-like, 3 isolates; blaTEM + blaOXA-1-like, 1 isolate), while in one isolate no such ESBL was identified. The two ceftriaxone-intermediate isolates recovered from the same sample, carried a blaTEM and blaSHV respectively. Thirty-four different clones were identified, with 4 clones being recovered from different samples from the same child. Twelve clones were disseminated among different children, including 5 clones disseminated between both villages. Two clones, accounting for 3 isolates and both recovered from the same children, belonged to E. coli ST131. Conclusion: This study demonstrates high prevalence of ESBL-carriers among healthy children living in a rural area of Peru, stressing the need for continuous surveillance and search for public health control measures.

참고문헌 (40)

  1. Bartoloni A, "Multidrug-resistant commensal Escherichia coli in children, Peru and Bolivia", Emerg Infect Dis, 12, pp.907~913 (2006)
  2. García C, "Antimicrobial drug resistance in Peru", Emerg Infect Dis, 18, pp.520~521 (2012)
  3. Palma N, "Virulence factors profiles and ESBL production in Escherichia coli causing bacteremia in Peruvian children", Diagn Microbiol Infect Dis, 86, pp.70~75 (2016)
  4. Pons MJ, "Analysis of quinolone-resistance in commensal and diarrheagenic Escherichia coli isolates from infants in Lima, Peru", Trans R Soc Trop Med Hyg, 108, pp.22~28 (2014)
  5. Pashang R, "Widespread detection of antibiotic-resistant bacteria from natural aquatic environments in southern Ontario", Can J Microbiol, 65, pp.322~331 (2019)
  6. Gebeyehu E, "Inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration, Northwest Ethiopia", PLoS One, 10, pp.e0138179~ (2015)
  7. Mathai E, "Antimicrobial resistance surveillance among commensal Escherichia coli in rural and urban areas in Southern India", Trop Med Int Health, 13, pp.41~45 (2008)
  8. Singh AK, "Prevalence of antibiotic resistance in commensal Escherichia coli among the children in rural hill communities of Northeast India", PLoS One, 13, pp.e0199179~ (2018)
  9. Bajaj P, "Escherichia coli β-lactamases : What really matters", Front Microbiol, 7, pp.417~ (2016)
  10. Fernández-Reyes M, "High rate of fecal carriage of extended-spectrum-β-lactamase-producing Escherichia coli in healthy children in Gipuzkoa, northern Spain", Antimicrob Agents Chemother, 58, pp.1822~1824 (2014)
  11. Hijazi SM, "Prevalence and characterization of extended-spectrum beta-lactamases producing Enterobacteriaceae in healthy children and associated risk factors", Ann Clin Microbiol Antimicrob, 15, pp.3~ (2016)
  12. Bäckhed F, "Defining a healthy human gut microbiome : current concepts, future directions, and clinical applications", Cell Host Microbe, 12, pp.611~622 (2012)
  13. Casals-Pascual C, "Intestinal microbiota and antibiotic resistance : Perspectives and solutions", Hum Microbiome J, 9, pp.11~15 (2018)
  14. Pons MJ, "Characterisation of extended-spectrum β-lactamases among Klebsiella pneumoniae isolates causing bacteraemia and urinary tract infection in Mozambique", J Glob Antimicrob Resist, 3, pp.19~25 (2015)
  15. Ruiz J, "Transferable mechanisms of quinolone resistance from 1998 onward", Clin Microbiol Rev, 32, pp.e00007~19 (2019)
  16. Bush K, "Past and present perspectives on β-lactamases", Antimicrob Agents Chemother, 62, pp.e01076~18 (2018)
  17. Peirano G, "Extended-spectrum β-lactamase-producing Enterobacteriaceae : Update on molecular epidemiology and treatment options", Drugs, 79, pp.1529~1541 (2019)
  18. Woerther PL, "Trends in human fecal carriage of extended-spectrum β-lactamases in the community : toward the globalization of CTX-M", Clin Microbiol Rev, 26, pp.744~758 (2013)
  19. Pallecchi L, "Detection of CTX-M-type beta-lactamase genes in fecal Escherichia coli isolates from healthy children in Bolivia and Peru", Antimicrob Agents Chemother, 48, pp.4556~4561 (2004)
  20. Pallecchi L, "Rapid dissemination and diversity of CTX-M extended-spectrum beta-lactamase genes in commensal Escherichia coli isolates from healthy children from low-resource settings in Latin America", Antimicrob Agents Chemother, 51, pp.2720~2725 (2007)
  21. Bartoloni A, "Evaluation of a rapid screening method for detection of antimicrobial resistance in the commensal microbiota of the gut", Trans R Soc Trop Med Hyg, 100, pp.119~125 (2006)
  22. Mac Faddin JF, "Pruebas bioquímicas para la identificación de bacterias de importancia clínica" (2003), Editorial Panamericana Médica
  23. Walk ST, "Cryptic lineages of the genus Escherichia", Appl Environ Microbiol, 75, pp.6534~6544 (2009)
  24. Clinical Laboratory Standards Institute(CLSI), "Performance standards for antimicrobial susceptibility testing. 26th ed. Supplement M100" (2016), CLSI
  25. Lezameta L, "Comparison of four phenotypic methods to detect extended-spectrum betalactamases", Rev Peru Med Exp Salud Publica, 27, pp.345~351 (2010)
  26. Palma N, "Resistance to quinolones, cephalosporins and macrolides in Escherichia coli causing bacteraemia in Peruvian children", J Glob Antimicrob Resist, 11, pp.28~33 (2017)
  27. Riveros M, "Molecular and phenotypic characterization of diarrheagenic Escherichia coli strains isolated from bacteremic children", Am J Trop Med Hyg, 97, pp.1329~1336 (2017)
  28. Heras J, "GelJ--a tool for analyzing DNA fingerprint gel images", BMC Bioinformatics, 16, pp.270~ (2015)
  29. Matsumura Y, "Rapid identification of different Escherichia coli sequence type 131clades", Antimicrob Agents Chemother, 61, pp.e00179~17 (2017)
  30. Yábar MN, "Multiresistance and factors associated with the presence of extended-spectrum beta-lactamases in Escherichia coli strains isolated from urine culture", Rev Peru Med Exp Salud Publica, 34, pp.660~665 (2017)
  31. Gutiérrez-Gutiérrez B, "Current options for the treatment of infections due to extendedspectrum beta-lactamase-producing Enterobacteriaceae in different groups of patients", Clin Microbiol Infect, 25, pp.932~942 (2019)
  32. Pons MJ, "Current trends in epidemiology and antimicrobial resistance in intensive care units", J Emerg Crit Care Med, 3, pp.5~ (2019)
  33. García C, "Molecular characterization of extendedspectrum β-lactamase-producer Klebsiella pneumoniae isolates causing neonatal sepsis in Peru", Am J Trop Med Hyg, 94, pp.285~288 (2016)
  34. García C, "Molecular characterization of extendedspectrum β-lactamase-producer Klebsiella pneumoniae Isolates Causing Neonatal Sepsis in Peru", Am J Trop Med Hyg, 94, pp.285~288 (2016)
  35. Horna G, "High frequency of the exoU+", exoS+ genotype associated with multidrug-resistant"high-risk clones"of Pseudomonas aeruginosa clinical isolates from Peruvian hospitals, 2019, pp.9, 10874~
  36. Ruiz-Roldán L, "Presence of multidrug resistant Enterobacteriaceae and Escherichia coli in meat purchased in traditional markets of Lima", Rev Peru Med Exp Salud Publica, 35, pp.425~432 (2018)
  37. Bauernfeind A, "A new plasmidic cefotaximase in a clinical isolate of Escherichia coli", Infection, 18, pp.294~298 (1990)
  38. Larson A, "Antibiotic-resistant Escherichia coli in drinking water samples from rural andean households in Cajamarca, Peru", Am J Trop Med Hyg, 100, pp.1363~1368 (2019)
  39. Olesen B, "Temporal trends in antimicrobial resistance and virulenceassociated traits within the Escherichia coli sequence type 131 clonal group and its H30 and H30-Rx subclones, 1968 to 2012", Antimicrob Agents Chemother, 58, pp.6886~6895 (2014)
  40. Nicolas-Chanoine MH, "Escherichia coli ST131, an intriguing clonal group", Clin Microbiol Rev, 27, pp.543~574 (2014)

이 간행물의 다른 논문 (23건)

Hemorrhagic Fever with Renal Syndrome: Literature Review, Epidemiology, Clinical Picture and PathogenesisTariq Misbah, 김동민pp. 1-19Buerger’s Disease May be a Chronic Rickettsial Infection with Superimposed Thrombosis: Literature Review and Efficacy of Doxycycline in Three PatientsLee Jin-Soo, 강재승, Chung Moon-Hyunpp. 20-58Isoniazid Preventive Therapy for Tuberculosis in People Living with HIV: A Cross Sectional Study in Butebo, UgandaKang Sunjoo, 강영애, Konlan Kennedy Diema, Oonyu Lawrencepp. 70-79Clinical Efficacy and Safety of Arbekacin against Pneumonia in Febrile Neutropenia: A Retrospective Study in Patients with Hematologic MalignanciesSaito Taeko, Ohashi Takashi, Fujita Yukiyoshi, Irisawa Hiroyuki, Nakaminami Hidemasa, Arai Takahiro, Takahashi Masumi, Momiyama Emi, Murata Naoya, Murayama Kayokopp. 80-90Effectiveness of Regdanvimab at Preventing the Need for Oxygen Therapy in Patients with Mild-to-Moderate COVID-19: A Retrospective Cohort StudyChoi Seong Jin, Lee Eunyoung, 박상원pp. 91-101
원문 보기