title: Multidrug resistance dissemination by extended-spectrum β-lactamase-producing Escherichia coli causing community-acquired urinary tract infection in the Central-Western Region, Brazil.
abstract: The aim of this work was to analyse extended-spectrum β-lactamase (ESBL)-producing Escherichia coli strains isolated from outpatients with signs of cystitis in Hospital Universitário de Brasília (Brasília, Brazil) during the period July 2013 to April 2014. E. coli isolated from urine culture were identified and their antibiotic susceptibility profile was determined by VITEK 2. ESBL-producing strains identified were submitted to PCR for Clermont phylotyping, CTX-M group typing and virulence determinant detection, and clonal relationships were determined by enterobacterial repetitive intergenic consensus (ERIC)-PCR. One strain belonging to each cluster of the dendrogram obtained by ERIC-PCR was selected for multilocus sequence typing (MLST). Among 324 uropathogenic E. coli (UPEC) analysed, 23 (7.1%) were identified as producing ESBL. All ESBL-producing strains were multidrug-resistant (MDR), i.e. presented non-susceptibility to at least one agent in three or more antimicrobial categories. Of the 23 ESBL-producing UPEC strains, 9 were assigned to phylogenetic group B2 and 7 each belonged to phylogenetic groups D and A. Virulence genotyping showed that aer was the most prevalent gene observed among the strains (21/23), followed by traT (18/23), pap (5/23), afa (5/23), PAI (5/23), cnf (3/23) and sfa (1/23). Analysis of the dendrogram showed that multidrug resistance and CTX-M ESBL groups were distributed among all strains, independent of clonality and phylogroup. Sequence types (STs) associated with pandemic resistance clones, such as B2-ST131 and D-ST648, were observed among the isolates. In conclusion, the results showed worrisome evidence of the potential for antibiotic multiresistant dissemination among community-acquired urinary tract infection caused by UPEC.
authors.affiliation: Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília, Campus Universitário 'Darcy Ribeiro', Asa Norte, CEP 70910-900 Brasília, DF, Brazil.
authors.forename: Laura Fernandes
authors.initials: LF
authors.lastname: Gonçalves
authors.affiliation: Centro de Patologia Clínica, Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF, Brazil.
authors.forename: Paulo
authors.initials: P
authors.lastname: de Oliveira Martins-Júnior
authors.affiliation: Centro de Patologia Clínica, Hospital Universitário de Brasília, Universidade de Brasília, Brasília, DF, Brazil.
authors.forename: Ana Beatriz Fabrício
authors.initials: ABF
authors.lastname: de Melo
authors.affiliation: Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília, Campus Universitário 'Darcy Ribeiro', Asa Norte, CEP 70910-900 Brasília, DF, Brazil.
authors.forename: Rafaella Christina Rocha Moreira
authors.initials: RCRM
authors.lastname: da Silva
authors.affiliation: Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília, Campus Universitário 'Darcy Ribeiro', Asa Norte, CEP 70910-900 Brasília, DF, Brazil.
authors.forename: Vicente
authors.initials: V
authors.lastname: de Paulo Martins
authors.affiliation: Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: André
authors.initials: A
authors.lastname: Pitondo-Silva
authors.affiliation: Departamento de Biologia Celular, Instituto de Ciências Biológicas, Universidade de Brasília, Campus Universitário 'Darcy Ribeiro', Asa Norte, CEP 70910-900 Brasília, DF, Brazil. Electronic address: tatianadecampos@unb.br.
authors.forename: Tatiana Amabile
authors.initials: TA
authors.lastname: de Campos
mesh_terms: D015373:Bacterial Typing Techniques; D001938:Brazil / Q000453:epidemiology; D024901:Drug Resistance, Multiple, Bacterial; D004926:Escherichia coli / Q000145:classification / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000453:epidemiology*; D006801:Humans; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001618:beta-Lactamases
keywords: CTX-M β-lactamase; Community-acquired urinary tract infection; Extended-spectrum β-lactamase (ESBL); Multidrug resistance; Uropathogenic Escherichia coli (UPEC)