Abstract
Urinary tract infections caused by extended-spectrum β-lactamase Escherichia coli (ESBL-EC) are increasing worldwide and are a current concern because treatment options are often limited. This study investigated antimicrobial susceptibility, antimicrobial resistance genes (ARGs), and the biological diversity of urinary ESBL-EC isolates at Cerdanya Hospital, a European cross-border hospital that combines French and Spanish healthcare models. Bacterial identification and susceptibility were determined using the Microscan WalkAway® system and ESBL production was examined by the double-disk synergy method. Isolates were sequenced using the Ion S5™ next-generation sequencing system, with the whole-genome sequences then assembled using SPADEs software and analyzed using PubMLST, ResFinder, FimTyper, PlasmidFinder, and VirulenceFinder. A phylogenetic analysis was performed by constructing an assembly-based core-SNV alignment, followed by a phylogenetic tree constructed using Parsnp from the Harvest suite. All isolates studied were multidrug-resistant and could be classified into 19 different sequence types characterized by a high genetic diversity. The most prevalent ESBL-enzymes were CTX-M-14 and CTX-M-15. High-risk international clones (ST131, ST10, and ST405) were also identified. The results demonstrated the absence of a single predominant clone of ESBL-MDR-EC at Cerdanya Hospital.
Highlights
Urinary tract infections (UTIs) are among the most common human infections and can be both nosocomial and community-acquired
UTIs caused by multidrug-resistant Escherichia coli able to produce extended-spectrum β-lactamases (ESBL-MDR-EC) are increasing worldwide. β-lactamases naturally occur in some bacterial species; they may be mobilized by plasmids and have become widespread, in part as a consequence of the use, abuse, and misuse of β-lactam antibiotics
The remained isolates were from men treated at the emergency services, mainly with community acquired infection and diagnosed with acute bacterial prostatitis (Table S1)
Summary
Urinary tract infections (UTIs) are among the most common human infections and can be both nosocomial and community-acquired. UTIs caused by multidrug-resistant Escherichia coli able to produce extended-spectrum β-lactamases (ESBL-MDR-EC) are increasing worldwide. In Gram-negative bacteria, TEM-1 and SHV-1, two broad-spectrum β-lactamases, have greatly increased in frequency as a result of the introduction of first- and secondgeneration cephalosporins. This situation was the driver of the development and introduction of new classes of β-lactams resistant to hydrolysis by these enzymes (the so called expanded-spectrum β-lactam antibiotics). ESBLs were variants of TEM and SHV, multiple variants have been identified [1]
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