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Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India

Extended Spectrum β-Lactamases (ESBLs) confer resistance to third-generation cephalosporins and CTX-M types have emerged as the most prominent ESBLs worldwide. This study was designed to determine the prevalence of CTX-M positive ESBL-producing urinary E. coli isolates from HIV patients and to estab...

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Autores principales: Padmavathy, Kesavaram, Padma, Krishnan, Rajasekaran, Sikhamani
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829713/
https://www.ncbi.nlm.nih.gov/pubmed/27123344
http://dx.doi.org/10.1155/2016/4152704
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author Padmavathy, Kesavaram
Padma, Krishnan
Rajasekaran, Sikhamani
author_facet Padmavathy, Kesavaram
Padma, Krishnan
Rajasekaran, Sikhamani
author_sort Padmavathy, Kesavaram
collection PubMed
description Extended Spectrum β-Lactamases (ESBLs) confer resistance to third-generation cephalosporins and CTX-M types have emerged as the most prominent ESBLs worldwide. This study was designed to determine the prevalence of CTX-M positive ESBL-producing urinary E. coli isolates from HIV patients and to establish the association of multidrug resistance, phylogeny, and virulence profile with CTX-M production. A total of 57 ESBL producers identified among 76 E. coli strains isolated from HIV patients from South India were screened for bla (CTX-M), AmpC production, multidrug resistance, and nine virulence associated genes (VAGs), fimH, pap, afa/dra, sfa/foc, iutA, fyuA, iroN, usp, and kpsMII. The majority (70.2%) of the ESBL producers harbored bla (CTX-M) and were AmpC coproducers. Among the CTX-M producers, 47.5% were found to be UPEC, 10% harbored as many as 7 VAGs, and 45% possessed kpsMII. Multidrug resistance (CIP(R)SXT(R)GEN(R)) was significantly more common among the CTX-M producers compared to the nonproducers (70% versus 41.2%). However, 71.4% of the multidrug resistant CTX-M producers exhibited susceptibility to nitrofurantoin thereby making it an effective alternative to cephalosporins/fluoroquinolones. The emergence of CTX-M-producing highly virulent, multidrug resistant uropathogenic E. coli is of significant public health concern in countries like India with a high burden of HIV/AIDS.
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spelling pubmed-48297132016-04-27 Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India Padmavathy, Kesavaram Padma, Krishnan Rajasekaran, Sikhamani J Pathog Research Article Extended Spectrum β-Lactamases (ESBLs) confer resistance to third-generation cephalosporins and CTX-M types have emerged as the most prominent ESBLs worldwide. This study was designed to determine the prevalence of CTX-M positive ESBL-producing urinary E. coli isolates from HIV patients and to establish the association of multidrug resistance, phylogeny, and virulence profile with CTX-M production. A total of 57 ESBL producers identified among 76 E. coli strains isolated from HIV patients from South India were screened for bla (CTX-M), AmpC production, multidrug resistance, and nine virulence associated genes (VAGs), fimH, pap, afa/dra, sfa/foc, iutA, fyuA, iroN, usp, and kpsMII. The majority (70.2%) of the ESBL producers harbored bla (CTX-M) and were AmpC coproducers. Among the CTX-M producers, 47.5% were found to be UPEC, 10% harbored as many as 7 VAGs, and 45% possessed kpsMII. Multidrug resistance (CIP(R)SXT(R)GEN(R)) was significantly more common among the CTX-M producers compared to the nonproducers (70% versus 41.2%). However, 71.4% of the multidrug resistant CTX-M producers exhibited susceptibility to nitrofurantoin thereby making it an effective alternative to cephalosporins/fluoroquinolones. The emergence of CTX-M-producing highly virulent, multidrug resistant uropathogenic E. coli is of significant public health concern in countries like India with a high burden of HIV/AIDS. Hindawi Publishing Corporation 2016 2016-03-30 /pmc/articles/PMC4829713/ /pubmed/27123344 http://dx.doi.org/10.1155/2016/4152704 Text en Copyright © 2016 Kesavaram Padmavathy et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Padmavathy, Kesavaram
Padma, Krishnan
Rajasekaran, Sikhamani
Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India
title Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India
title_full Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India
title_fullStr Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India
title_full_unstemmed Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India
title_short Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India
title_sort multidrug resistant ctx-m-producing escherichia coli: a growing threat among hiv patients in india
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4829713/
https://www.ncbi.nlm.nih.gov/pubmed/27123344
http://dx.doi.org/10.1155/2016/4152704
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