Multidrug-Resistant ESBL-Producing <i>E. coli</i> in Clinical Samples from the UK

• Main Authors: Delveen R. Ibrahim (Author), Christine E. R. Dodd (Author), Dov J. Stekel (Author), Remilekun T. Meshioye (Author), Mathew Diggle (Author), Michelle Lister (Author), Jon L. Hobman (Author)
• Format: Book
• Published: MDPI AG, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics12010169; 2079-6382
• Keywords: <i>Escherichia coli</i>; multidrug-resistant; cephalosporin-resistant; ESBL; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 12, Iss 1, p 169 (2023)

Globally, cephalosporin therapy failure is a serious problem for infection control. One causative agent of cephalosporin-resistant infections is multidrug-resistant (MDR) <i>E. coli</i> 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 <i>E. coli</i> 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. <i>bla</i>_CTX-M, <i>bla</i>_TEM and <i>bla</i>_OXA-1 genes were detected in 23, 13 and 12 strains, respectively, and <i>Intl1</i> was detected in 17 isolates. The most common subtypes among the definite sequence types were CTX-M-15 (40%) and TEM-1 (75%). No <i>E. coli</i> isolates carried pAmpC genes. Significant correlations were seen between CTX-M carriage and cefotaxime, ceftiofur, aztreonam, ceftazidime and cefquinome resistance; between <i>bla</i>_CTX-M, <i>bla</i>_TEM and <i>bla</i>_OXA-1 carriage and ciprofloxacin resistance; and between <i>Intl1</i> 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.