Back to Search
Start Over
Molecular detection of bla CTX-M gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam.
- Source :
-
Annals of clinical microbiology and antimicrobials [Ann Clin Microbiol Antimicrob] 2021 Sep 04; Vol. 20 (1), pp. 60. Date of Electronic Publication: 2021 Sep 04. - Publication Year :
- 2021
-
Abstract
- Background: Blood stream infections (BSI) caused by Extended Spectrum Beta-Lactamases (ESBLs) producing Enterobacteriaceae is a clinical challenge leading to high mortality, especially in developing countries. In this study, we sought to describe the epidemiology of ESBL-producing Escherichia coli strains isolated from Vietnamese individuals with BSI, to investigate the concordance of genotypic-phenotypic resistance, and clinical outcome of ESBL E. coli BSI.<br />Methods: A total of 459 hospitalized patients with BSI were screened between October 2014 and May 2016. 115 E. coli strains from 115 BSI patients were isolated and tested for antibiotic resistance using the VITEK®2 system. The ESBL phenotype was determined by double disk diffusion method following the guideline of Clinical and Laboratory Standards Institute. Screening for beta-lactamase (ESBL and carbapenemase) genes was performed using a multiplex-PCR assay.<br />Results: 58% (67/115) of the E. coli strains were ESBL-producers and all were susceptible to both imipenem and meropenem. Resistance to third-generation cephalosporin was common, 70% (81/115) were cefotaxime-resistant and 45% (52/115) were ceftazidime-resistant. bla <subscript>CTX-M</subscript> was the most common ESBL gene detected (70%; 80/115) The sensitivity and specificity of bla <subscript>CTX-M</subscript> -detection to predict the ESBL phenotype was 87% (76-93% 95% CI) and 54% (39-48% 95% CI), respectively. 28%% (22/80) of bla <subscript>CTX-M</subscript> were classified as non-ESBL producers by phenotypic testing for ESBL production. The detection of bla <subscript>CTX-M</subscript> in ESBL-negative E. coli BSI was associated with fatal clinical outcome (27%; 6/22 versus 8%; 2/26, pā=ā0.07).<br />Conclusion: A high prevalence of ESBL-producing E. coli isolates harbouring bla <subscript>CTX-M</subscript> was observed in BSI patients in Vietnam. The genotypic detection of bla <subscript>CTX-M</subscript> may have added benefit in optimizing and guiding empirical antibiotic therapy of E. coli BSI to improve clinical outcome.<br /> (© 2021. The Author(s).)
- Subjects :
- Bacteremia microbiology
Escherichia coli isolation & purification
Humans
Phenotype
Sepsis
Vietnam epidemiology
Whole Genome Sequencing
Bacteremia drug therapy
Cephalosporin Resistance genetics
Escherichia coli drug effects
Escherichia coli genetics
Escherichia coli Proteins genetics
beta-Lactamases genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1476-0711
- Volume :
- 20
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Annals of clinical microbiology and antimicrobials
- Publication Type :
- Academic Journal
- Accession number :
- 34481499
- Full Text :
- https://doi.org/10.1186/s12941-021-00466-3