Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK

Delveen R Ibrahim; Christine E R Dodd; Dov J Stekel; Remilekun T Meshioye; Mathew Diggle; Michelle Lister; Jon L Hobman

doi:10.3390/antibiotics12010169

Multidrug-Resistant ESBL-Producing E. coli in Clinical Samples from the UK

Antibiotics (Basel). 2023 Jan 13;12(1):169. doi: 10.3390/antibiotics12010169.

Authors

Delveen R Ibrahim^{1

2}, Christine E R Dodd², Dov J Stekel^{2

3}, Remilekun T Meshioye^{2

4}, Mathew Diggle^{5

6}, Michelle Lister⁶, Jon L Hobman²

Affiliations

¹ Department of Biology, School of Science, The University of Duhok, Duhok 42001, Iraq.
² School of Biosciences, University of Nottingham, Loughborough, Leicestershire LE12 5RD, UK.
³ Department of Mathematics and Applied Mathematics, University of Johannesburg, Rossmore 2029, South Africa.
⁴ Fidson Healthcare Plc, 268 Ikorodu-Ososun Rd, Obanikoro, Lagos 100232, Nigeria.
⁵ Alberta Health Services, Edmonton, AB T6G 2J2, Canada.
⁶ Department of Microbiology, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham NG7 2UH, UK.

Abstract

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

Keywords: ESBL; Escherichia coli; cephalosporin-resistant; multidrug-resistant.

Grants and funding

This research has been funded by the Kurdistan Regional Government through a KRG-HCDP scholarship to D.R.I. and supported by research funding from Applied Microbiology International to D.R.I.