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Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam
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 s...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8418716/ https://www.ncbi.nlm.nih.gov/pubmed/34481499 http://dx.doi.org/10.1186/s12941-021-00466-3 |
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author | Son, Trinh Van Manh, Nguyen Dang Trung, Ngo Tat Quyen, Dao Thanh Meyer, Christian G. Phuong, Nguyen Thi Kim Hoan, Phan Quoc Sang, Vu Viet Nurjadi, Dennis Velavan, Thirumalaisamy P. Bang, Mai Hong Song, Le Huu |
author_facet | Son, Trinh Van Manh, Nguyen Dang Trung, Ngo Tat Quyen, Dao Thanh Meyer, Christian G. Phuong, Nguyen Thi Kim Hoan, Phan Quoc Sang, Vu Viet Nurjadi, Dennis Velavan, Thirumalaisamy P. Bang, Mai Hong Song, Le Huu |
author_sort | Son, Trinh Van |
collection | PubMed |
description | 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. 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. 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(CTX-M) was the most common ESBL gene detected (70%; 80/115) The sensitivity and specificity of bla(CTX-M)-detection to predict the ESBL phenotype was 87% (76–93% 95% CI) and 54% (39–48% 95% CI), respectively. 28%% (22/80) of bla(CTX-M) were classified as non-ESBL producers by phenotypic testing for ESBL production. The detection of bla(CTX-M) in ESBL-negative E. coli BSI was associated with fatal clinical outcome (27%; 6/22 versus 8%; 2/26, p = 0.07). CONCLUSION: A high prevalence of ESBL-producing E. coli isolates harbouring bla(CTX-M) was observed in BSI patients in Vietnam. The genotypic detection of bla(CTX-M) may have added benefit in optimizing and guiding empirical antibiotic therapy of E. coli BSI to improve clinical outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12941-021-00466-3. |
format | Online Article Text |
id | pubmed-8418716 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-84187162021-09-09 Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam Son, Trinh Van Manh, Nguyen Dang Trung, Ngo Tat Quyen, Dao Thanh Meyer, Christian G. Phuong, Nguyen Thi Kim Hoan, Phan Quoc Sang, Vu Viet Nurjadi, Dennis Velavan, Thirumalaisamy P. Bang, Mai Hong Song, Le Huu Ann Clin Microbiol Antimicrob Research 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. 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. 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(CTX-M) was the most common ESBL gene detected (70%; 80/115) The sensitivity and specificity of bla(CTX-M)-detection to predict the ESBL phenotype was 87% (76–93% 95% CI) and 54% (39–48% 95% CI), respectively. 28%% (22/80) of bla(CTX-M) were classified as non-ESBL producers by phenotypic testing for ESBL production. The detection of bla(CTX-M) in ESBL-negative E. coli BSI was associated with fatal clinical outcome (27%; 6/22 versus 8%; 2/26, p = 0.07). CONCLUSION: A high prevalence of ESBL-producing E. coli isolates harbouring bla(CTX-M) was observed in BSI patients in Vietnam. The genotypic detection of bla(CTX-M) may have added benefit in optimizing and guiding empirical antibiotic therapy of E. coli BSI to improve clinical outcome. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12941-021-00466-3. BioMed Central 2021-09-04 /pmc/articles/PMC8418716/ /pubmed/34481499 http://dx.doi.org/10.1186/s12941-021-00466-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Son, Trinh Van Manh, Nguyen Dang Trung, Ngo Tat Quyen, Dao Thanh Meyer, Christian G. Phuong, Nguyen Thi Kim Hoan, Phan Quoc Sang, Vu Viet Nurjadi, Dennis Velavan, Thirumalaisamy P. Bang, Mai Hong Song, Le Huu Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam |
title | Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam |
title_full | Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam |
title_fullStr | Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam |
title_full_unstemmed | Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam |
title_short | Molecular detection of bla(CTX-M) gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam |
title_sort | molecular detection of bla(ctx-m) gene to predict phenotypic cephalosporin resistance and clinical outcome of escherichia coli bloodstream infections in vietnam |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8418716/ https://www.ncbi.nlm.nih.gov/pubmed/34481499 http://dx.doi.org/10.1186/s12941-021-00466-3 |
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