Published online Nov 27, 2020. doi: 10.4331/wjbc.v11.i3.112
Peer-review started: April 26, 2020
First decision: June 7, 2020
Revised: August 24, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: November 27, 2020
Processing time: 198 Days and 18.4 Hours
Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (E. coli) are among the main pathogens in urinary tract infections (UTIs) among kidney transplant patients (KTPs).
To estimate the prevalence of ESBL-producing E. coli in KTPs and to evaluate the most prevalent serotypes and antibacterial susceptibility patterns of isolated bacteria in Tehran, Iran.
A total of 60 clinical isolates of uropathogenic E. coli were collected from 3 kidney transplant centers from April to May 2019. Antimicrobial susceptibility testing was performed by the disk diffusion method as recommended by the Clinical Laboratory and Standards Institute. The serotyping of E. coli isolates was performed by the slide agglutination method. The presence of blaTEM, blaSHV, and blaCTX-M genes was evaluated by polymerase chain reaction.
The frequency of ESBL-producing E. coli in KTPs was found to be 33.4%. All of the 60 E. coli isolates were found to be susceptible to doripenem (100%) and ertapenem (100%). High resistance rates to ampicillin (86%), cefotaxime (80%), and cefazolin (77%) were also documented. The most frequent serotypes were serotype I (50%), serotype II (15%), serotype III (25%), and serotype VI (10%). The gene most frequently found was blaTEM (55%), followed by blaCTX-M (51%) and blaSHV (41%).
Molecular analysis showed that blaTEM was the most common ESBL-encoding gene. The high resistance to β-lactams antibiotics (i.e., ampicillin, cefotaxime, and cefazolin) found in E. coli from KTPs with UTIs remains a serious clinical challenge. Further efforts to control ESBL-producing E. coli should include the careful use of all antibiotics as well as barrier precautions to reduce spread.
Core Tip: Extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli (E. coli) are among the main pathogens in urinary tract infections among kidney transplant patients (KTPs). The aims of this study were: To estimate the prevalence of ESBL-producing E. coli in KTPs, and to evaluate the most prevalent serotypes and antibacterial susceptibility patterns of isolated bacteria in Tehran, Iran. The most important findings were: (1) The frequency of ESBL-producing E. coli in KTPs was 33.4%; (2) High resistance rates to ampicillin (86%) and cefotaxime (80%) were documented; (3) The most frequent serotype was serotype I (50%); (4) The most frequently found related gene was blaTEM (55%); and (5) Further efforts to control ESBL-producing E. coli should include the careful use of all antibiotics as well as barrier precautions to reduce spread.