Emergence of extended-spectrum β-lactamase (ESBL) and/or carbapenemase producing Enterobacteriaceae (CPE) and their antimicrobial resistance

Abstract

OBJECTIVES: We focused on detecting the most frequent resistance mechanisms in selected multidrugresistant (MDR) strains and determining their antimicrobial resistance. BACKGROUND: MDR pathogens pose urgent public health threat due to limited treatment options, rigorous control measures and signifi cant mortality. METHODS: We confi rmed extended-spectrum β-lactamase (ESBL) and carbapenemase producing Enterobacteriaceae through guidelines, as well following β-lactamases: AmpC by cloxacillin, class A carbapenemase with phenylboronic acid, class B metallo-β-lactamase with ethylenediaminetetraacetic acid. Multilocus sequence typing was used to investigate 20 Escherichia coli strains. RESULTS: Overall 205 mostly ESBL Escherichia coli demonstrated resistance against amikacin (4.7 %), tigecycline (1.2 %), and no resistance to ceftazidime/avibactam, meropenem, nitrofurantoin and fosfomycin. Out of 41 Klebsiella species (spp.), 37 (90.2 %) showed carbapenemase activity, 13 (35.1 %) of class A and 24 (64.9 %) of class B. Resistance was following: meropenem 66.7 %, tigecyclin 10.2 % and colistin 0 %. From Enterobacter spp. 21 strains, 14 (66.7 %) were ESBL, 5 produced ESBL and/or AmpC and 2 were MDR. We ascertained 14 (70 %) E. coli sequence type-ST131. CONCLUSIONS: The study revealed various resistance mechanisms in concert with different agents and association of specifi c ST131 within E. coli. These characteristics considerably contribute to emergence of antimicrobial resistance (Tab. 4, Ref. 30). Text in PDF www.elis.sk.