Abstract
Increase of extraintestinal pathogenic Escherichia coli (ExPEC) showing resistance to beta-lactams is a major public health concern. This study was conducted as a first molecular epidemiological study on ExPEC in Cuba, regarding prevalence of extended-spectrum beta-lactamases (ESBLs) and carbapenemase genes. A total of 306 ExPEC isolates collected in medical institutions in 16 regions in Cuba (2014–2018) were analyzed for their genotypes and presence of genes encoding ESBL, carbapenemase, plasmid-mediated quinolone resistance (PMQR) determinants by PCR and sequencing. The most common phylogenetic group of ExPEC was B2 (49%), followed by D (23%), A (21%), and B1 (7%). Among ESBL genes detected, blaCTX-M was the most common and detected in 61% of ExPEC, with blaCTX-M-15 being dominant and distributed to all the phylogenetic groups. NDM-1 type carbapenemase gene was identified in two isolates of phylogenetic group B1-ST448. Phylogenetic group B2 ExPEC belonged to mostly ST131 (or its single-locus variant) with O25b allele, harboring blaCTX-M-27, and included an isolate of emerging type ST1193. aac (6’)-Ib-cr was the most prevalent PMQR gene (40.5%), being present in 54.5% of CTX-M-positive isolates. These results indicated high prevalence of CTX-M genes and the emergence of NDM-1 gene among recent ExPEC in Cuba, depicting an alarming situation.
Highlights
Escherichia coli is the most representative Gram-negative bacteria in the intestinal tracts of humans and animals as a commensal organism
Infectious diseases in humans are caused by a group of E. coli strains, e.g., pathogenic E. coli, which is classified into diarrheagenic E. coli and extraintestinal pathogenic E. coli (ExPEC)
CTX-M gene belonged to CTX-M-1 group which was found in 54.9% of all isolates and accounted for 90% of blaCTX-M genes
Summary
Escherichia coli is the most representative Gram-negative bacteria in the intestinal tracts of humans and animals as a commensal organism. Infectious diseases in humans are caused by a group of E. coli strains, e.g., pathogenic E. coli, which is classified into diarrheagenic E. coli and extraintestinal pathogenic E. coli (ExPEC). While both pathogenic E. coli are distributed globally, ExPEC has been. ExPEC consists of strains with many lineages, only a subset of lineages represented by sequence type (ST) 131 (ST131) is responsible for majority of infections in humans and considered a pandemic multiresistant clone [2]. Beta-lactamases that represent the most common cause of resistance to this class of antimicrobials have been classified into four major groups; penicillinases, cephalosporinases, extended-spectrum beta-lactamases (ESBLs), and carbapenemases. ESBLs hydrolyze all the beta-lactams except carbapenems and cephamycins, and are inactivated by beta-lactamase inhibitors such as clavulanic acid, sulbactam or tazobactam
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