Year: 2019
Type: article
Abstract: Introduction: Pandemic multi-resistant and virulent Escherichia coli (E. coli) O25b-ST131 has been repeatedly associated with the health-care network. Nursing-homes (NH) and long-term-care- acilities (LTCF), usually receive patients discharged from the acute-care setting, potentially colonized with CTX-M-15 producers.. Objectives: Our main goal is to describe the installation of CTX-M-15-producing-O25b-ST131 clonal-group E. coli in the hospital setting and extra-hospital institutions (7NH and 3LTCF) in the same geographical area. Methods: Susceptibility was accessed by disc-diffusion-methods according to the CLSI, and bacterial identification of intestinal colonization isolates was achieved by API20E and ID32GN and by Vitek2-system in clinical isolates. ESBL-producers were confirmed by E-test and the double-disk-synergy-test. PCR was performed for detection of TEM/OXA/SHV/CTX-M-group1/CTX-M-15 genes, phylogenetic-groups, O25b-ST131-clonal-group, genes coding for resistance to non-β-lactam-antibiotics and twenty-two virulence-factors. Sequencing was performed using group-specific primers for β-lactamase-genes. E. coli isolates relationship was addressed by pulsed-field-gel-electrophoresis (PFGE). Results: Fifty-eight CTX-M-15-producing-E. coli-O25b-ST131 isolates were detected and clustered in nine PFGE-profiles (≥80%-homology). Each PFGE type contains clinical isolates from different products, and intestinal-colonization isolates. These isolates showed also extended-resistance-phenotype to non-β-lactam-antibiotics and a virulent profile. Conclusions: Clonality relationships of CTX-M-producing-E. coli-O25b-ST131, alert to the circulation of patients between different types of care, favoring the dissemination of these multi-resistant bacteria in elder-care network. Intestinal colonization is a silent form of dissemination of CTX-M-15-producing-E. coli and resistance genes, promoted by patient circulation through the healthcare network.
Authors: D Gonçalves, P Cecílio, H Ferreira
Language: English
Subfield: Microbiology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2941650656