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Genetic Predictive Factors for Nonsusceptible Phenotypes and Multidrug Resistance in Expanded-Spectrum Cephalosporin-Resistant Uropathogenic Escherichia coli from a Multicenter Cohort: Insights into the Phenotypic and Genetic Basis of Coresistance.
Jackson, Nicole; Belmont, Cheyenne R; Tarlton, Nicole J; Allegretti, Yuan Hu; Adams-Sapper, Sheila; Huang, Yolanda Yue; Borges, Clarissa A; Frazee, Bradley W; Florence-Petrovic, Danka; Hufana, Clarisse; Parker, Anna; Mastrangelo, Claire F; Awasthi, Shevya; Kane, Isha; Coralic, Zlatan; Miller, Steve; Diaz, Joycelyn; Fee, Christopher; Bittencourt, Cassiana E; Garner, Omai; Chandrasekaran, Sukantha; Crandall, Claudia; Marcha, Julian C; Noorbakhsh, Mir H; Rodrigues-Wong, Patricia; deBoer, Tara R; Riley, Lee W.
Afiliação
  • Jackson N; School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Belmont CR; School of Public Health, Division of Epidemiology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Tarlton NJ; Department of Microbiology, BioAmp Diagnostics, Inc., San Carlos, California, USA.
  • Allegretti YH; School of Public Health, Division of Epidemiology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Adams-Sapper S; School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Huang YY; Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, California, USA.
  • Borges CA; School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Frazee BW; Department of Emergency Medicine, Highland Hospitalgrid.414076.0, Alameda Health Systemgrid.413529.8, Oakland, California, USA.
  • Florence-Petrovic D; Department of Laboratory Medicine and Pathology, Highland Hospitalgrid.414076.0, Alameda Health Systemgrid.413529.8, Oakland, California, USA.
  • Hufana C; Department of Microbiology, BioAmp Diagnostics, Inc., San Carlos, California, USA.
  • Parker A; School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Mastrangelo CF; School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Awasthi S; School of Public Health, Division of Infectious Diseases and Vaccinology, University of California, Berkeleygrid.47840.3f, California, USA.
  • Kane I; Department of Microbiology, BioAmp Diagnostics, Inc., San Carlos, California, USA.
  • Coralic Z; Department of Pharmacy, University of California, San Franciscogrid.266102.1, California, USA.
  • Miller S; Department of Emergency Medicine, University of California, San Franciscogrid.266102.1, California, USA.
  • Diaz J; Department of Laboratory Medicine, University of California, San Franciscogrid.266102.1, California, USA.
  • Fee C; Department of Laboratory Medicine, University of California, San Franciscogrid.266102.1, California, USA.
  • Bittencourt CE; Department of Laboratory Medicine, University of California, San Franciscogrid.266102.1, California, USA.
  • Garner O; Department of Pathology and Laboratory Medicine, University of California, Irvinegrid.266093.8, California, USA.
  • Chandrasekaran S; Department of Pathology and Laboratory Medicine, University of California, Los Angelesgrid.19006.3e, California, USA.
  • Crandall C; Department of Pathology and Laboratory Medicine, University of California, Los Angelesgrid.19006.3e, California, USA.
  • Marcha JC; John Muir Microbiology, John Muir Healthgrid.414728.c, Concord, California, USA.
  • Noorbakhsh MH; John Muir Microbiology, John Muir Healthgrid.414728.c, Concord, California, USA.
  • Rodrigues-Wong P; Sutter Shared Lab, Sutter Health, Livermore, California, USA.
  • deBoer TR; Sutter Shared Lab, Sutter Health, Livermore, California, USA.
  • Riley LW; Department of Chemistry, BioAmp Diagnostics, Inc., San Carlos, California, USA.
mSphere ; 7(6): e0047122, 2022 12 21.
Article em En | MEDLINE | ID: mdl-36377882
Antimicrobial resistance in urinary tract infections (UTIs) is a major public health concern. This study aims to characterize the phenotypic and genetic basis of multidrug resistance (MDR) among expanded-spectrum cephalosporin-resistant (ESCR) uropathogenic Escherichia coli (UPEC) causing UTIs in California patient populations. Between February and October 2019, 577 ESCR UPEC isolates were collected from patients at 6 clinical laboratory sites across California. Lineage and antibiotic resistance genes were determined by analysis of whole-genome sequence data. The lineages ST131, ST1193, ST648, and ST69 were predominant, representing 46%, 5.5%, 4.5%, and 4.5% of the collection, respectively. Overall, 527 (91%) isolates had an expanded-spectrum ß-lactamase (ESBL) phenotype, with blaCTX-M-15, blaCTX-M-27, blaCTX-M-55, and blaCTX-M-14 being the most prevalent ESBL genes. In the 50 non-ESBL phenotype isolates, 40 (62%) contained blaCMY-2, which was the predominant plasmid-mediated AmpC (pAmpC) gene. Narrow-spectrum ß-lactamases, blaTEM-1B and blaOXA-1, were also found in 44.9% and 32.1% of isolates, respectively. Among ESCR UPEC isolates, isolates with an ESBL phenotype had a 1.7-times-greater likelihood of being MDR than non-ESBL phenotype isolates (P < 0.001). The cooccurrence of blaCTX-M-15, blaOXA-1, and aac(6')-Ib-cr within ESCR UPEC isolates was strongly correlated. Cooccurrence of blaCTX-M-15, blaOXA-1, and aac(6')-Ib-cr was associated with an increased risk of nonsusceptibility to piperacillin-tazobactam, cefepime, fluoroquinolones, and amikacin as well as MDR. Multivariate regression revealed the presence of blaCTX-M-55, blaTEM-1B, and the ST131 genotype as predictors of MDR. IMPORTANCE The rising incidence of resistance to expanded-spectrum cephalosporins among Escherichia coli strains, the most common cause of UTIs, is threatening our ability to successfully empirically treat these infections. ESCR E. coli strains are often MDR; therefore, UTI caused by these organisms often leads to treatment failure, increased length of hospital stay, and severe complications (D. G. Mark, Y.-Y. Hung, Z. Salim, N. J. Tarlton, et al., Ann Emerg Med 78:357-369, 2021, https://doi.org/10.1016/j.annemergmed.2021.01.003). Here, we performed an in-depth analysis of genetic factors of ESCR E. coli associated with coresistance and MDR. Such knowledge is critical to advance UTI diagnosis, treatment, and antibiotic stewardship.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por Escherichia coli / Escherichia coli Uropatogênica Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: MSphere Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Infecções por Escherichia coli / Escherichia coli Uropatogênica Tipo de estudo: Prognostic_studies / Risk_factors_studies Limite: Humans Idioma: En Revista: MSphere Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Estados Unidos