Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela

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Autor principal: Militza Guzmán
Formato: Artículo científico
Lenguaje:en
Publicado: Instituto Nacional de Salud 2019
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author Militza Guzmán
author_facet Militza Guzmán
contents Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela Militza Guzmán Elsa Salazar Vicmaris Cordero Ana Castro Andreína Villanueva Hectorina Rodulfo Marcos De Donato Medicina beta bacterial community lactamases rug resistance Introduction: The treatment of urinary tract infections has become more challenging due to the increasing frequency of multidrug-resistant Escherichia coli in human populations. Objective: To characterize multidrug-resistant E. coli isolates causing community-acquired urinary tract infections in Cumaná, Venezuela, and associate possible risk factors for infection by extended-spectrum beta-lactamases (ESBL)-producing isolates. Materials and methods: We included all the patients with urinary tract infections attending the urology outpatient consultation and emergency unit in the Hospital de Cumaná, Estado Sucre, Venezuela, from January through June, 2014. blaTEM, blaSHV and blaCTX-M genes detection was carried out by PCR. Results: We found a high prevalence of multidrug-resistant E. coli (25.2%) with 20.4% of the isolates producing ESBL. The ESBL-producing isolates showed a high frequency (66.7%) of simultaneous resistance to trimethoprim-sulphamethoxazole, fluoroquinolones and aminoglycosides compared to non-producing isolates (2.4%). Of the resistant isolates, 65.4% carried the blaTEM gene, 34.6% the blaCTX-M and 23.1% the blaSHV. The blaCTX-M genes detected belonged to the CTX-M-1 and CTX-M-2 groups. Plasmid transfer was demonstrated by in vitro conjugation in 17 of the 26 ESBL-producing isolates. All three genes detected were transferred to the transconjugants. Age over 60 years, complicated urinary tract infections and previous use of a catheter predisposed patients to infection by ESBL-producing E. coli. Conclusions: The high frequency of multidrug-resistant ESBL-producing isolates should alert the regional health authorities to take measures to reduce the risk of outbreaks caused by these types of bacteria in the community. 2019 artículo científico 0120-4157 https://www.redalyc.org/articulo.oa?id=84359814009 https://www.redalyc.org/journal/843/84359814009/ https://www.redalyc.org/journal/843/84359814009/html/ https://www.redalyc.org/journal/843/84359814009/84359814009.epub https://www.redalyc.org/journal/843/84359814009/movil 10.7705/biomedica.v39i2.4030 en http://www.redalyc.org/revista.oa?id=843 Biomédica application/pdf Instituto Nacional de Salud Biomédica (Colombia) Num.1 Vol.39
format Artículo científico
id redalyc_84359814009
institution Redalyc
language en
publishDate 2019
publisher Instituto Nacional de Salud
spellingShingle Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela
Militza Guzmán
Medicina
beta
bacterial
community
lactamases
rug resistance
Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela Militza Guzmán Elsa Salazar Vicmaris Cordero Ana Castro Andreína Villanueva Hectorina Rodulfo Marcos De Donato Medicina beta bacterial community lactamases rug resistance Introduction: The treatment of urinary tract infections has become more challenging due to the increasing frequency of multidrug-resistant Escherichia coli in human populations. Objective: To characterize multidrug-resistant E. coli isolates causing community-acquired urinary tract infections in Cumaná, Venezuela, and associate possible risk factors for infection by extended-spectrum beta-lactamases (ESBL)-producing isolates. Materials and methods: We included all the patients with urinary tract infections attending the urology outpatient consultation and emergency unit in the Hospital de Cumaná, Estado Sucre, Venezuela, from January through June, 2014. blaTEM, blaSHV and blaCTX-M genes detection was carried out by PCR. Results: We found a high prevalence of multidrug-resistant E. coli (25.2%) with 20.4% of the isolates producing ESBL. The ESBL-producing isolates showed a high frequency (66.7%) of simultaneous resistance to trimethoprim-sulphamethoxazole, fluoroquinolones and aminoglycosides compared to non-producing isolates (2.4%). Of the resistant isolates, 65.4% carried the blaTEM gene, 34.6% the blaCTX-M and 23.1% the blaSHV. The blaCTX-M genes detected belonged to the CTX-M-1 and CTX-M-2 groups. Plasmid transfer was demonstrated by in vitro conjugation in 17 of the 26 ESBL-producing isolates. All three genes detected were transferred to the transconjugants. Age over 60 years, complicated urinary tract infections and previous use of a catheter predisposed patients to infection by ESBL-producing E. coli. Conclusions: The high frequency of multidrug-resistant ESBL-producing isolates should alert the regional health authorities to take measures to reduce the risk of outbreaks caused by these types of bacteria in the community. 2019 artículo científico 0120-4157 https://www.redalyc.org/articulo.oa?id=84359814009 https://www.redalyc.org/journal/843/84359814009/ https://www.redalyc.org/journal/843/84359814009/html/ https://www.redalyc.org/journal/843/84359814009/84359814009.epub https://www.redalyc.org/journal/843/84359814009/movil 10.7705/biomedica.v39i2.4030 en http://www.redalyc.org/revista.oa?id=843 Biomédica application/pdf Instituto Nacional de Salud Biomédica (Colombia) Num.1 Vol.39
title Multidrug resistance and risk factors associated with community-acquired urinary tract infections caused by Escherichia coli in Venezuela
topic Medicina
beta
bacterial
community
lactamases
rug resistance
url https://www.redalyc.org/articulo.oa?id=84359814009
https://www.redalyc.org/journal/843/84359814009/
https://www.redalyc.org/journal/843/84359814009/html/
https://www.redalyc.org/journal/843/84359814009/84359814009.epub
https://www.redalyc.org/journal/843/84359814009/movil