Escherichia coli in West Bengal: active surveillance of uropathogenicity, ESBL, MDR and XDR
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20244017Keywords:
Escherichia coli, Extended-spectrum β-lactamase, Extensive drug resistance, Multi-drug-resistance, Uropathogenicity, West BengalAbstract
Background: Urinary tract infection (UTI) is one of the Escherichia coli (E. coli) induced extraintestinal disorders that dramatically raise morbidity and mortality rates. Treatment ineffectiveness resulted from the emergence of multidrug resistance (MDR), extensive-drug resistance (XDR), and extended-spectrum β-lactamases (ESBL). This study in West Bengal, India, explored the prevalence of uropathogenic, ESBL, MDR, and XDR E. coli strains.
Methods: It was a cross-sectional study. Examining 77 clinical isolates from diverse regions of West Bengal, the research identified ESBL, AmpC, metallo-β-lactamase (MBL), MDR, and XRD production through phenotypic methods and polymerase chain reaction (PCR).
Results: Disc agar diffusion (DAD) test detected 84.4% as ESBL producers, with 31.19% AmpC, 6.49% MBL, and 12.98% carbapenem-resistant isolates. 87.01% and 2.95% isolates were suspected to be MDR and XDR. The presence of specific 16S rRNA identifies all isolates as E. coli. Confirmation via PCR revealed ESBL genes in 92.2% of isolates, predominantly blaCTX-M (75.3%), blaTEM (62.3%), and blaSHV (22.1%). Uropathogenicity was confirmed in 80.5% of isolates, all of which co-occurred with ESBL genes.
Conclusions: The study underscores the common occurrence of uropathogenic and antibiotic-resistant E. coli in tertiary care settings, emphasizing the need for robust antimicrobial stewardship and strict infection control practices to address the proliferation of drug-resistant pathogens.
Metrics
References
Rasheed MU, Thajuddin N, Ahamed P, Teklemariam Z, Jamil K. Antimicrobial drug resistance in strains of Escherichia coli isolated from food sources. Rev Inst Med Trop Sao Paulo. 2014;56(4):341-6.
Brons JK, Vink SN, de Vos MGJ, Reuter S, Dobrindt U, van Elsas JD. Fast identification of Escherichia coli in urinary tract infections using a virulence gene based PCR approach in a novel thermal cycler. J Microbiol Methods. 2020;169:105799.
Olorunmola FO, Kolawole DO, Lamikanra A. Antibiotic resistance and virulence properties in Escherichia coli strains from cases of urinary tract infections. Afr J Infect Dis. 2013;7(1):1-7.
Onduru OG, Mkakosya RS, Aboud S, Rumisha SF. Genetic determinants of resistance among ESBL-producing Enterobacteriaceae in Community and hospital settings in east, central, and southern Africa: a systematic review and meta-analysis of prevalence. Can J Infect Dis Med Microbiol. 2021;2021:5153237.
Dirar MH, Bilal NE, Ibrahim ME, Hamid ME. Prevalence of extended-spectrum β-lactamase (ESBL) and molecular detection of blaTEM, blaSHV and blaCTX-M genotypes among Enterobacteriaceae isolates from patients in Khartoum, Sudan. Pan Afr Med J. 2020;37:213.
Xu Y, Sun H, Bai X, Fu S, Fan R, Xiong Y. Occurrence of multidrug-resistant and ESBL-producing atypical enteropathogenic Escherichia coli in China. Gut Pathog. 2018;10:8.
Szmolka A, Nagy B. Multidrug resistant commensal Escherichia coli in animals and its impact for public health. Front Microbiol. 2013;4:258.
Govindaswamy A, Bajpai V, Khurana S, Aravinda A, Batra P, Malhotra R, et al. Prevalence and characterization of beta-lactamase-producing Escherichia coli isolates from a tertiary care hospital in India. J Lab Phys. 2019;11(02):123-7.
Sheng WH, Badal RE, Hsueh PR. Distribution of extended-spectrum β-lactamases, AmpC β-lactamases, and carbapenemases among Enterobacteriaceae isolates causing intra-abdominal infections in the Asia-Pacific region: results of the study for Monitoring Antimicrobial Resistance Trends (SMART). Antimicrob Agents Chemother. 2013;57(7):2981-8.
Manishimwe R, Moncada PM, Bugarel M, Scott HM, Loneragan GH. Antibiotic resistance among Escherichia coli and Salmonella isolated from dairy cattle feces in Texas. PLoS One. 2021;16(5):e0242390.
Seale AC, Gordon NC, Islam J, Peacock SJ, Scott JAG. AMR Surveillance in low and middle-income settings- a roadmap for participation in the Global Antimicrobial Surveillance System (GLASS). Wellcome Open Res. 2017;2:92.
Hoelzer K, Cummings KJ, Warnick LD, Schukken YH, Siler JD, Gröhn YT, et al. Agar disk diffusion and automated microbroth dilution produce similar antimicrobial susceptibility testing results for Salmonella serotypes Newport, Typhimurium, and 4, 5, 12: i-, but differ in economic cost. Foodborne pathogens and disease. 2011;8(12):1281-8.
Reuland EA, Al Naiemi N, Raadsen SA, Savelkoul PH, Kluytmans JA, Vandenbroucke-Grauls CM. Prevalence of ESBL-producing Enterobacteriaceae in raw vegetables. Eur J Clin Microbiol Infect Dis. 2014;33(10):1843-6.
Naing L, Nordin RB, Abdul Rahman H, Naing YT. Sample size calculation for prevalence studies using Scalex and ScalaR calculators. BMC Med Res Methodol. 2022;22(1):209.
Tripathy N, Sapra A. Gram Staining. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
Sabat G, Rose P, Hickey WJ, Harkin JM. Selective and sensitive method for PCR amplification of Escherichia coli 16S rRNA genes in soil. Appl Environ Microbiol. 2000;66(2):844-9.
Shoorashetty RM, Nagarathnamma T, Prathibha J. Comparison of the boronic acid disk potentiation test and cefepime-clavulanic acid method for the detection of ESBL among AmpC-producing Enterobacteriaceae. Indian J Med Microbiol. 2011;29(3):297-301.
Bajpai T, Pandey M, Varma M, Bhatambare GS. Prevalence of TEM, SHV, and CTX-M beta-lactamase genes in the urinary isolates of a tertiary care hospital. Avicenna J Med. 2017;7(1):12-6.
Kumar A, Mallappa RH, Jaswal A, Kumar B, Kumar N, Hirikyathanahalli R. Genotypic identification of extended spectrum β-lactamase producing Escherichia coli in dairy supply chain. Indian J Dairy Sci. 2021;74(1):61-7.
WHO Fact Sheet. Antimicrobial resistance. 2018. Available from: http://www.who.int/en/news-room/fact-sheets/detail/antimicrobial-resistance. Accessed on 12 August 2024.
Exner M, Bhattacharya S, Christiansen B, Gebel J, Goroncy-Bermes P, Hartemann P, et al. Antibiotic resistance: What is so special about multidrug-resistant Gram-negative bacteria? GMS Hyg Infect Control. 2017;12.
Bhattacharya S. Is screening patients for antibiotic-resistant bacteria justified in the Indian context? Indian J Med Microbiol. 2011;29(3):213-7.
Abhilash KP, Veeraraghavan B, Abraham OC. Epidemiology and outcome of bacteremia caused by extended spectrum beta-lactamase (ESBL)-producing Escherichia coli and Klebsiella spp. in a tertiary care teaching hospital in south India. J Assoc Phys India. 2010;58:13-7.
Srivastava R, Agarwal J, Srivastava S, Kumar M, Singh M. Multidrug resistant Gram-negative bacilli from neonatal septicaemia at a tertiary care centre in North India: a phenotypic and genotypic study. Indian J Med Microbiol. 2014;32(1):97-8.
Behzadi P, Behzadi E, Yazdanbod H, Aghapour R, Akbari Cheshmeh M, Salehian Omran D. A survey on urinary tract infections associated with the three most common uropathogenic bacteria. Maedica. 2010;5(2):111-5.
Iqbal Z, Mumtaz MZ, Malik A. Extensive drug-resistance in strains of Escherichia coli and Klebsiella pneumoniae isolated from paediatric urinary tract infections. J Taibah Univ Med Sci. 2021;16(4):565-74.
Cohen-Nahum K, Saidel-Odes L, Riesenberg K, Schlaeffer F, Borer A. Urinary tract infections caused by multi-drug-resistant Proteus mirabilis: risk factors and clinical outcomes. Infection. 2010;38(1):41-6.
Mandell GL, Bennett JE, Dolin R. Principles and practices of infectious diseases. 7th edn. St Louis: Elsevier; 2010.
Nagvekar V, Sawant S, Amey S. Prevalence of multidrug-resistant Gram-negative bacteria cases at admission in a multispeciality hospital. J Glob Antimicrob Resist. 2020;22:457-61.
Yang X, Chen H, Zheng Y, Qu S, Wang H, Yi F. Disease burden and long-term trends of urinary tract infections: A worldwide report. Front Public Health. 2022;10:888205.
Reale M, Strazzulla A, Quirino A, Rizzo C, Marano V, Postorino MC, Mazzitelli M, Greco G, Pisani V, Costa C, Cesana BM. Patterns of multi-drug resistant bacteria at first culture from patients admitted to a third level University hospital in Calabria from 2011 to 2014: implications for empirical therapy and infection control. Le Infez Med. 2017;25(2):98-107.
Kaur J, Mahajan G, Chand K, Sheevani, Chopra S. Enhancing phenotypic detection of ESBL in AmpC co-producers by using cefepime and tazobactam. J Clin Diagn Res. 2016;10(1):Dc05-08.
Bora A, Ahmed GU, Hazarika NK. Phenotypic detection of extended spectrum β-lactamase and AmpC β-lactamase in urinary isolates of Escherichia coli at a tertiary care referral hospital in Northeast India. J Coll Med Sci Nepal. 2013;8(3):22-9.
Arora S, Bal M. AmpC beta-lactamase producing bacterial isolates from Kolkata hospital. Indian J Med Res. 2005;122(3):224-33.
Rossolini GM, D’Andrea MM, Mugnaioli C. The spread of CTX-M-type extended-spectrum beta-lactamases. Clin Microbiol Infect. 2008;14(1):33-41.
Chaudhary U, Agarwal S, Raghuraman K. Identification of extended spectrum beta lactamases, AmpC and carbapenemase production among isolates of Escherichia coli in north Indian tertiary care centre. Avicenna J Med. 2018;8(2):46-50.
Cartelle M, del Mar Tomas M, Molina F, Moure R, Villanueva R, Bou G. High-level resistance to ceftazidime conferred by a novel enzyme, CTX-M-32, derived from CTX-M-1 through a single Asp240-Gly substitution. Antimicrob Agents Chemother. 2004;48(6):2308-13.
Jalil MB, Al Atbee MYN. The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections. J Clin Lab Anal. 2022;36(9):e24619.
Eshwarappa M, Dosegowda R, Aprameya IV, Khan MW, Kumar PS, Kempegowda P. Clinico-microbiological profile of urinary tract infection in south India. Indian J Nephrol. 2011;21(1):30-6.
Mohapatra S, Panigrahy R, Tak V, Shwetha JV, Sneha KC, Chaudhuri S, et al. Prevalence and resistance pattern of uropathogens from community settings of different regions: an experience from India. Access Microbiol. 2022;4(2):000321.
Downloads
Published
How to Cite
Issue
Section
