Antimicrobial susceptibility profile in urinary pathogens causing community-acquired infections in diabetic patients in Colombia
Abstract
Introduction: Urinary tract infection is the most common pathology in diabetic patients, and an important determinant of morbidity and mortality among them. The increasing resistance of uropathogens acquired in the community to commonly used antibiotics is alarming.
Objective: To identify the profile of antibiotic susceptibility of uropathogens responsible for communityacquired infections among diabetic patients in hospitals in Colombia.
Materials and methods: We conducted a descriptive study in a subgroup of diabetic patients in the framework of a larger study in adults with urinary tract infection acquired in the community. Over one year, we collected Escherichia coli, Klebsiella spp. and Proteus mirabilis isolates from nine hospitals in Colombia. Their susceptibility profile was determined using microbiological and molecular methods to establish the presence of extended-spectrum AmpC betalactamases and KPC carbapenemases.
Results: We collected 68 isolates (58 E. coli, nine Klebsiella spp. and one Proteus mirabilis). Four (6.9%) of the E. coli isolates expressed extended spectrum betalactamases, two (3.4%) of them belonged to the phylogenetic group B2 and to ST131 clone and expressed the TEM-1 and CTM-X-15 betalactamases. The AmpC phenotype was found in four (6.9%) of the E. coli isolates, three of which produced TEM-1 and CMY-2 betalactamases. One K. pneumoniae isolate expressed the KPC-3 carbapenemase. Conclusion: The presence of extended spectrum betalactamases and carbapenemases in uropathogens responsible for community-acquired infection was confirmed in diabetic patients.
Downloads
References
Ribera MC, Pascual R, Orozco D, Pérez-Barba C, Pedrera V, Gil V. Incidence and risk factors associated with urinary tract infection in diabetic patients with and without asymptomatic bacteriuria. Eur J Clin Microbiol Infect Dis. 2006;25:389-93. https://doi.org/10.1007/s10096-006-0148-5
Martínez E, Osorio J, Delgado J, Esparza GE, Motoa G, Blanco VM, et al. Infecciones del tracto urinario bajo en adultos y embarazadas: consenso para el manejo empírico. Infectio. 2013;17:122-35. https://doi.org/10.1016/S0123-9392(13)70719-7
Geerlings SE, Stolk RP, Camps MJ, Netten PM, Hoekstra JB, Bouter KP, et al. Asymptomatic bacteriuria may be considered a complication in women with diabetes. Diabetes Mellitus Women Asymptomatic Bacteriuria Utrecht Study Group. Diabetes Care 2000;23:744-9. https://doi.org/10.2337/diacare.23.6.744
Nitzan O, Elias M, Chazan B, Saliba W. Urinary tract infections in patients with type 2 diabetes mellitus: Review of prevalence, diagnosis, and management. Diabetes Metab Syndr Obes. 2015;8:129-36. https://doi.org/10.2147/DMSO.S51792
Neal DE. Complicated urinary tract infections. Urol Clin North Am. 2008;35:13-22. https://doi.org/10.1016/j.ucl.2007.09.010
Stapleton A. Urinary tract infections in patients with diabetes treated with dapagliflozin. J Diabetes Complications. 2013;27:473-8. https://doi.org/10.1016/j.jdiacomp.2013.05.004
Sobel JD, Fisher JF, Kauffman CA, Newman CA. Candida urinary tract infections-epidemiology. Clin Infect Dis. 2011; 52(Suppl.6):S433-6. https://doi.org/10.1093/cid/cir109
Leal AL, Cortés JA, Arias G, Ovalle MV, Saavedra SY, Buitrago G, et al. Emergencia de fenotipos resistentes a cefalosporinas de tercera generación en Enterobacteriaceae causantes de infección del tracto urinario de inicio comunitario en hospitales de Colombia. Enferm Infecc Microbiol Clin. 2013;31:298-303. https://doi.org/10.1016/j.eimc.2012.04.007
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement. Wayne: CSLI; 2014 .p.230.
Monstein HJ, Ostholm-Balkhed A, Nilsson MV, Nilsson M, Dornbusch K, Nilsson LE. Multiplex PCR amplification assay for the detection of blaSHV, blaTEM and blaCTX-M genes in Enterobacteriaceae. APMIS. 2007;115:1400-8. https://doi.org/10.1111/j.1600-0463.2007.00722.x
Woodford N, Fagan EJ, Ellington MJ. Multiplex PCR for rapid detection of genes encoding CTX-M extendedspectrum (beta)-lactamases. J Antimicrob Chemother. 2006;57:154-5. https://doi.org/10.1093/jac/dki412
Pérez-Pérez FJ, Hanson ND. Detection of plasmidmediated AmpC beta-lactamase genes in clinical isolates by using multiplex PCR. J Clin Microbiol. 2002;40:2153-62.
https://doi.org/10.1128/JCM.40.6.2153-2162.2002
Mendes RE, Kiyota KA, Monteiro J, Castanheira M, Andrade SS, Gales AC, et al. Rapid detection and identification of metallo-beta-lactamase-encoding genes by multiplex real-time PCR assay and melt curve analysis. J Clin Microbiol. 2007;45:544-7. https://doi.org/10.1128/JCM.01728-06
Poirel L, Walsh TR, Cuvillier V, Nordmann P. Multiplex PCR for detection of acquired carbapenemase genes. Diagn Microbiol Infect Dis. 2011;70:119-23. https://doi.org/10.1016/j.diagmicrobio.2010.12.002
Clermont O, Bonacorsi S, Bingen E. Rapid and simple determination of the Escherichia coli phylogenetic group. Appl Environ Microbiol. 2000;66:4555-8. https://doi.org/110.1128/AEM.66.10.4555-4558.2000
Dhanji H, Doumith M, Clermont O, Denamur E, Hope R, Livermore DM, et al. Real-time PCR for detection of the O25b-ST131 clone of Escherichia coli and its CTX-M-15-like extended-spectrum beta-lactamases. Int J Antimicrob Agents 2010;36:355-8. https://doi.org/10.1016/j.ijantimicag.2010.06.007
Versalovic J, Koeuth T, Lupski JR. Distribution of repetitive DNA sequences in eubacteria and application to fingerprinting of bacterial genomes. Nucleic Acids Res. 1991;19:6823-31. https://doi.org/10.1093/nar/19.24.6823
Pitout JD, Nordmann P, Laupland KB, Poirel L. Emergence of Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs) in the community. J Antimicrob Chemother. 2005;56:52-9. https://doi.org/10.1093/jac/dki166
Ruiz SJ, Montealegre MC, Ruiz-Garbajosa P, Correa A, Briceño DF, Martínez E, et al. First characterization of CTXM-15-producing Escherichia coli ST131 and ST405 clones causing community-onset infections in South America. J Clin Microbiol. 2011;49:1993-6. https://doi.org/10.1128/JCM.00045-11
Rogers BA, Sidjabat HE, Paterson DL. Escherichia coli O25b-ST131: A pandemic, multiresistant, communityassociated strain. J Antimicrob Chemother. 2011;66:1-14.
https://doi.org/10.1093/jac/dkq415
Woodford N, Turton JF, Livermore DM. Multiresistant Gram-negative bacteria: The role of high-risk clones in the dissemination of antibiotic resistance. FEMS Microbiol Rev. 2011;35:736-55. https://doi.org/10.1111/j.1574-6976.2011.00268.x
Baudry PJ, Mataseje L, Zhanel GG, Hoban DJ, Mulvey MR. Characterization of plasmids encoding CMY-2 AmpC beta-lactamases from Escherichia coli in Canadian intensive care units. Diagn Microbiol Infect Dis. 2009;65:379-83. https://doi.org/10.1016/j.diagmicrobio.2009.08.011
López JA, Correa A, Navón-Venezia S, Correa AL, Torres JA, Briceño DF, et al. Intercontinental spread from Israel to Colombia of a KPC-3-producing Klebsiella pneumoniae strain. Clin Microbiol Infect. 2011;17:52-6. https://doi.org/10.1111/j.1469-0691.2010.03209.x
Nordmann P, Naas T, Poirel L. Global spread of carbapenemase-producing Enterobacteriaceae. Emerg Infect Dis. 2011;17:1791-8. https://doi.org/10.3201/eid1710.110655
Ramana BV, Chaudhury A. Prevalence of uropathogens in diabetic patients and their resistance pattern at a tertiary care centre in south India. Int J Biol Med Res. 2012;3:1433-5.
Hamdan HZ, Kubbara E, Adam AM, Hassan OS, Suliman SO, Adam I. Urinary tract infections and antimicrobial sensitivity among diabetic patients at Khartoum, Sudan. Ann Clin Microbiol Antimicrob. 2015;14:26. https://doi.org/10.1186/s12941-015-0082-4
González-Pedraza A, Dávila R, Acevedo O, Ramírez ME, Gilbaja S, Valencia C, et al. Infección de las vías urinarias: prevalencia, sensibilidad antimicrobiana y factores de riesgo asociados en pacientes con diabetes mellitus tipo 2. Rev Cubana Endocrinol. 2014;25:57-65.
Calbo E, Romani V, Xercavins M, Gómez L, Vidal CG, Quintana S, et al. Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extendedspectrum beta-lactamases. J Antimicrob Chemother. 2006;57:780-3. https://doi.org/10.1093/jac/dkl035
Kang CI, Wi YM, Lee MY, Ko KS, Chung DR, Peck KR, et al. Epidemiology and risk factors of community onset infections caused by extended-spectrum beta-lactamaseproducing Escherichia coli strains. J Clin Microbiol. 2012;50:312-7. https://doi.org/10.1128/JCM.06002-11
Park SH, Choi SM, Lee DG, Cho SY, Lee HJ, Choi JK, et al. Impact of extended-spectrum beta-lactamase production on treatment outcomes of acute pyelonephritis caused by Escherichia coli in patients without health care-associated risk factors. Antimicrob Agents Chemother. 2015;59:1962-8. https://doi.org/10.1128/AAC.04821-14
Seija V, Fratchez V, Ventura V, Pintos M, González M. Factores asociados al desarrollo de infección urinaria de origen comunitario causada por Escherichia coli resistente a fluoroquinolonas. Rev Chilena Infectol. 2014;31:400-5. https://doi.org/10.4067/S0716-10182014000400004
Geerlings SE. Urinary tract infections in patients with diabetes mellitus: Epidemiology, pathogenesis and treatment. Int J Antimicrob Agents. 2008;31:54-7. https://doi.org/10.1016/j.ijantimicag.2007.07.042
Shah BR, Hux JE. Quantifying the risk of infectious diseases for people with diabetes. Diabetes Care. 2003;26:510-3. https://doi.org/10.2337/diacare.26.2.510
Davey PG, Marwick C. Appropriate Vs. inappropriate antimicrobial therapy. Clin Microbiol Infect. 2008;14(Suppl.3):15-21. https://doi.org/10.1111/j.1469-0691.2008.01959.x
Some similar items:
- Isabel Mayorga-Fayad, Gloria I. Lafaurie, Adolfo Contreras, Diana M. Castillo, Alexandra Barón, María del Rosario Aya, Subgingival microbiota in chronic and aggressive periodontitis in Bogotá, Colombia: an epidemiological approach , Biomedica: Vol. 27 No. 1 (2007)
- Jessika Consuegra, Sonia Jakeline Gutiérrez, Adriana Jaramillo, Ignacio Sanz, Gilberto Olave, Jorge Enrique Soto, Carlos Valencia, Adolfo Contreras, Enteric Gram negative rods and unfermented of glucose bacteria in patients with peri-implant disease , Biomedica: Vol. 31 No. 1 (2011)
- Sandra Paola Ochoa, Carlos Andrés Ospina, Kelly Johana Colorado, Yenny Paola Montoya, Andrés Fernando Saldarriaga, Marisol Miranda, Natalia Muñoz, María Eugenia Gómez, Fanny Lucía Yepes, Javier Enrique Botero, Periodontal condition and tooth loss in diabetic patients , Biomedica: Vol. 32 No. 1 (2012)
- Luz E. Botero, Andrés E. Toro, Alber J. Patiño, Guillermo Salazar, Juan C. Rodríguez, Juan C. Suárez-Escudero, Gustavo A. Alarcón, Ana Corcimaru, Cristina Osorio, Joseph S. Y. Jeong, Oscar Alzate, Diabetes mellitus in patients with Alzheimer’s disease: clinical description and correlation with the APOE genotype in a sample population from the province of Antioquia, Colombia , Biomedica: Vol. 32 No. 2 (2012)
- Silvana Marisa Montenegro, María Cristina Tarrés, Juan Carlos Picena, Stella Maris Martínez, Feeding behavior and glycemic profile in two lines of rats with genetic diabetes. , Biomedica: Vol. 25 No. 4 (2005)
- Argemiro Fragozo, María Fernanda Puerta, Juan Diego Misas, Comparative analysis of insulin glargine vs. insulin detemir: A cost-minimization study applicable to Colombia , Biomedica: Vol. 35 No. 2 (2015)
- Leidy González, Jorge Alberto Cortés, Systematic review of antimicrobial resistance in Enterobacteriaceae isolates from Colombian hospitals , Biomedica: Vol. 34 No. 2 (2014)
- Verônica Dias-Gonçalves, Françoise Bohrer-Lengruber, Bianca Oliveira-Fonseca, Renata Meirelles Santos-Pereira, Luis Dione Barbosa de Melo, Ulisses Gazos-Lopes, Alexandre Ribeiro-Bello, José Augusto Adler-Pereira, Detection and characterization of multidrug-resistant enterobacteria bearing aminoglycoside-modifying gene in a university hospital at Rio de Janeiro, Brazil, along three decades , Biomedica: Vol. 35 No. 1 (2015)
- Sara Catalina Penagos, Sebastián Gómez, Pablo Villa, Santiago Estrada, Carlos Andrés Agudelo, Osteomyelitis due to Yokenella regensburgei following craniotomy in an immunocompetent patient , Biomedica: Vol. 35 No. 4 (2015)
- Henry A. Vargas, Martín Rondón, Rodolfo Dennis, Pharmacological treatment and impairment of pulmonary function in patients with type 2 diabetes: a cross-sectional study , Biomedica: Vol. 36 No. 2 (2016)
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
