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European Journal of Clinical Microbiology & Infectious Diseases

Erschienen in:

27.01.2016 | Original Article

Epidemiological and clinical features for cefepime heteroresistant Escherichia coli infections in Southwest China

verfasst von: W. Ma, J. Sun, S. Yang, L. Zhang

Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases | Ausgabe 4/2016

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Abstract

Phenotypic heteroresistance (PHR) is common in a weight of microbes and plays an important role in the evolution of antibiotic resistance. However, PHR to cefepime (FEP-PHR) among invasive Escherichia coli (E. coli) has not been reported. This study aimed to report the characteristics of invasive E. coli with FEP-PHR traits and further to investigate the predisposing factors for its acquisition. A retrospective case–control study was conducted in a teaching hospital in Southwest China. A total of 319 successive and non-duplicate E. coli strains were isolated from blood and other sterile body fluids between July 2011 and August 2013. Among the seventy (70/319, 21.9 %) isolates harboring FEP-PHR traits, 30 (42.9 %) isolates were isolated from blood, 14 (20.0 %) isolates were isolated from bile, and 13 (18.6 %) isolates were isolated from drainage. FEP-PHR isolates were verified by population analysis profile (PAP) assays. Male gender, receipt of total parenteral nutrition, cephalosporins exposure, and production of extended spectrum betalactamases (ESBL) were independent risk factors for the acquisition of invasive E. coli with FEP-PHR traits. Pulsedfield gel electrophoresis (PFGE) revealed clonal diversity among the FEP-PHR isolates. The prevalence of heteroresistance to cefepime among invasive E. coli isolates merits great attention and heteroresistance may lead to the emergence of resistance strains. Therefore, systematical analysis of risk factors, careful interpretation of antibiotic susceptibility results and appropriate prescription of therapeutic strategy could help to prevent misreporting and therapeutic failure.

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Sievert DM, Ricks P, Edwards JR, Schneider A, Patel J, Srinivasan A et al (2013) Antimicrobial-resistant pathogens associated with healthcare-associated infections: summary of data reported to the national healthcare safety network at the centers for disease control and prevention, 2009–2010. Infect Control Hosp Epidemiol 34:1–14. doi:10.1086/668770 CrossRefPubMed

Tacconelli E, Cataldo MA, Dancer SJ, De Angelis G, Falcone M, Frank U et al (2014) ESCMID guidelines for the management of the infection control measures to reduce transmission of multidrug-resistant Gram-negative bacteria in hospitalized patients. Clin Microbiol Infect 20(Suppl 1):1–55. doi:10.1111/1469-0691.12427 CrossRefPubMed

Tao L, Hu B, Rosenthal VD, Gao X, He L (2011) Device-associated infection rates in 398 intensive care units in shanghai, China: international nosocomial infection control consortium (INICC) findings. Int J Infect Dis 15:e774–e780. doi:10.1016/j.ijid.2011.06.009 CrossRefPubMed

Hayakawa K, Gattu S, Marchaim D, Bhargava A, Palla M, Alshabani K et al (2013) Epidemiology and risk factors for isolation of Escherichia coli producing CTX-M-type extended-spectrum β-lactamase in a large U.S. medical center. Antimicrob Agents Chemother 57:4010–4018. doi:10.1128/AAC.02516-12 CrossRefPubMedPubMedCentral

Liu HY, Lin HC, Lin YC, Yu SH, Wu WH, Lee YJ (2011) Antimicrobial susceptibilities of urinary extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae to fosfomycin and nitrofurantoin in a teaching hospital in Taiwan. J Microbiol Immunol Infect 44:364–368. doi:10.1016/j.jmii.2010.08.012 CrossRefPubMed

Schaumburg F, Alabi A, Kokou C, Grobusch MP, Köck R, Kaba H et al (2013) High burden of extended-spectrum β-lactamase-producing Enterobacteriaeceae in Gabon. J Antimicrob Chemother 68:2140–2143. doi:10.1093/jac/dkt164 CrossRefPubMed

Young BE, Lye DC, Krishnan P, Chan SP, Leo YS (2014) A prospective observational study of the prevalence and risk factors for colonization by antibiotic resistant bacteria in patients at admission to hospital in Singapore. BMC Infect Dis 14:298. doi:10.1186/1471-2334-14-298 CrossRefPubMedPubMedCentral

Kieft H, Hoepelman AI, Rozenberg-Arska M, Branger JM, Voskuil JH, Geers AB et al (1994) Cefepime compared with ceftazidime as initial therapy for serious bacterial infections and sepsis syndrome. Antimicrob Agents Chemother 38:415–421. doi:10.1128/AAC.38.3.415 CrossRefPubMedPubMedCentral

Mansouri M, Ramazanzadeh R, Norabadi P (2011) Cefepime resistance and associated risk factors among Escherichia coli strains isolated from clinical specimens. Chemotherapy 57:134–137. doi:10.1159/000323623 CrossRefPubMed

10.

Shubert C, Slaughter J, Creely D, van Belkum A, Gayral JP, Dunne WM et al (2014) Population analysis of Escherichia coli isolates with discordant resistance levels by piperacillin-tazobactam broth microdilution and agar dilution testing. Antimicrob Agents Chemother 58(3):1779–1781. doi:10.1128/AAC.02181-13 CrossRefPubMedPubMedCentral

11.

Hung KH, Wang MC, Huang AH, Yan JJ, Wu JJ (2012) Heteroresistance to cephalosporins and penicillins in Acinetobacter baumannii. J Clin Microbiol 50:721–726. doi:10.1128/JCM.05085-11 CrossRefPubMedPubMedCentral

12.

Falagas ME, Makris GC, Dimopoulos G, Matthaiou DK (2008) Heteroresistance: a concern of increasing clinical significance? Clin Microbiol Infect 14:101–104. doi:10.1111/j.1469-0691.2007.01912.x CrossRefPubMed

13.

Zhang C, Xu X, Pu S, Huang S, Sun J, Yang S et al (2014) Characterization of carbapenemases, extended spectrum β-lactamases, quinolone resistance and aminoglycoside resistance determinants in carbapenem-non-susceptible Escherichia coli from a teaching hospital in Chongqing, Southwest China. Infect Genet Evol 27:271–276. doi:10.1016/j.meegid.2014.07.031 CrossRefPubMed

14.

Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH et al (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239PubMedPubMedCentral

15.

El-Halfawy OM, Valvano MA (2015) Antimicrobial heteroresistance: an emerging field in need of clarity. Clin Microbiol Rev 28:191–207. doi:10.1128/CMR.00058-14 CrossRefPubMedPubMedCentral

16.

Wong Ng J, Chatenay D, Robert J, Poirier MG (2010) Plasmid copy number noise in monoclonal populations of bacteria. Phys Rev E Stat Nonlinear Soft Matter Phys 81(1):011909. doi:10.1103/PhysRevE.81.011909 CrossRef

17.

Adam M, Murali B, Glenn NO, Potter SS (2008) Epigenetic inheritance based evolution of antibiotic resistance in bacteria. BMC Evol Biol 8:52. doi:10.1186/1471-2148-8-52 CrossRefPubMedPubMedCentral

18.

Sun JD, Huang SF, Yang SS, Pu SL, Zhang CM, Zhang LP (2015) Impact of carbapenem heteroresistance among clinical isolates of invasive Escherichia coli in Chongqing, southwestern China. Clin Microbiol Infect 21:469. doi:10.1016/j.cmi.2014.12.013 PubMed

19.

Paterson DL, Bonomo RA (2005) Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev 18:657–686. doi:10.1128/CMR.18.4.657-686.2005 CrossRefPubMedPubMedCentral

20.

Walsh TR, Toleman MA, Poirel L, Nordmann P (2005) Metallo-beta-lactamases: the quiet before the storm? Clin Microbiol Rev 18:306–325. doi:10.1128/CMR.18.2.306-325.2005 CrossRefPubMedPubMedCentral

21.

Wang X, Kang Y, Luo C, Zhao T, Liu L, Jiang X et al (2014) Heteroresistance at the single-cell level: adapting to antibiotic stress through a population-based strategy and growth-controlled interphenotypic coordination. MBio 5:e00942-13. doi:10.1128/mBio.00942-13 CrossRefPubMedPubMedCentral

22.

Fernández-Cuenca F, Gómez-Sánchez M, Rodríguez-Baño J, Martínez-Martínez L, Vila J, Bou G et al (2012) Epidemiological and clinical features associated with colonisation/infection by Acinetobacter baumannii with phenotypic heterogeneous resistance to carbapenems. Int J Antimicrob Agents 40:235–238. doi:10.1016/j.ijantimicag.2012.05.005 CrossRefPubMed

23.

Kudsk KA, Croce MA, Fabian TC, Minard G, Tolley EA, Poret HA et al (1992) Enteral versus parenteral feeding. Effects on septic morbidity after blunt and penetrating abdominal trauma. Ann Surg 215:503–511CrossRefPubMedPubMedCentral

24.

Wan X, Bi J, Gao X, Tian F, Wang X, Li N et al (2015) Partial enteral nutrition preserves elements of gut barrier function, including innate immunity, intestinal alkaline phosphatase (IAP) level, and intestinal microbiota in mice. Nutrients 7:6294–6312. doi:10.3390/nu7085288 CrossRefPubMedPubMedCentral

25.

Ben-Ami R, Rodríguez-Baño J, Arslan H, Pitout JD, Quentin C, Calbo ES et al (2009) A multinational survey of risk factors for infection with extended-spectrum beta-lactamase-producing enterobacteriaceae in nonhospitalized patients. Clin Infect Dis 49:682–690. doi:10.1086/604713 CrossRefPubMed

Titel: Epidemiological and clinical features for cefepime heteroresistant Escherichia coli infections in Southwest China
verfasst von: W. Ma
J. Sun
S. Yang
L. Zhang
Publikationsdatum: 27.01.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: European Journal of Clinical Microbiology & Infectious Diseases / Ausgabe 4/2016
Print ISSN: 0934-9723
Elektronische ISSN: 1435-4373
DOI: https://doi.org/10.1007/s10096-015-2572-x

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