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Antimicrobial Resistance Profiles of Adherent Invasive Escherichia coli Show Increased Resistance to β-Lactams.
Antibiotics ( IF 4.8 ) Pub Date : 2020-05-13 , DOI: 10.3390/antibiotics9050251
Margarita Martinez-Medina 1 , Francesco Strozzi 2 , Belén Ruiz Del Castillo 3 , Natalia Serrano-Morillas 1 , Nuria Ferrer Bustins 1 , Luis Martínez-Martínez 4, 5, 6
Affiliation  

The adherent invasive Escherichia coli (AIEC) pathotype has been associated with the aetiology of Crohn's disease (CD). Scarce reports have shown the antimicrobial resistance (AMR) profiles of AIEC. Despite antibiotics not being recommended to treat CD, antimicrobial therapy could be useful in stratified patients, such as AIEC carriers. We examined the antimicrobial resistance profiles of AIEC strains to identify which therapies could be effective or confer a risk for such patients. Phenotypic resistance to 30 antimicrobials was tested according to CLSI standards. AIEC (n = 22) and non-pathogenic E. coli (non-AIEC) strains (n = 37) isolated from the gut mucosa of 31 CD patients and 18 controls were studied. De novo genome sequencing was carried out for 39 of the 59 strains, and AMR genes were searched using the DeepARG database in these genomes and 33 additional AIEC publicly available genomes. The strains isolated from CD and controls showed similar phenotypic AMR profiles. The genomic analysis did not reveal an increased prevalence of AMR genes. However, AIEC strains were more frequently resistant to β-lactams than non-AIEC strains (11 AIEC (50%) and 5 non-AIEC (22%) strains were resistant to at least one β-lactam; p < 0.042). Two AIEC strains were resistant to expanded-spectrum cephalosporins. One strain carried a plasmid-mediated AmpC β-lactamase (CMY-69), and the other presented mutations in the promotor of the intrinsic chromosomal AmpC related to the hyperproduction of this enzyme. The rest of the strains were resistant to β-lactams not including expanded-spectrum cephalosporins. The majority carried TEM-related β-lactamases. Genomic analysis including external AIEC revealed that the gene sul1 encoding for sulphonamide resistance was more frequent in AIEC strains than non-AIEC strains (34.6% vs. 9.5%, p = 0.030). AMR in AIEC is a matter of concern regarding the putative implication of the pathotype in CD. The high proportion of AIEC resistant to β-lactams warrants caution about the risk there may be in the use of these antimicrobials in AIEC-colonized CD patients.

中文翻译:

粘附的侵袭性大肠杆菌的抗菌素耐药性谱显示对β-内酰胺的耐药性增加。

粘附性侵袭性大肠杆菌(AIEC)病态型已与克罗恩病(CD)的病因相关。稀少的报告显示了AIEC的抗药性(AMR)特性。尽管不推荐使用抗生素来治疗CD,但抗菌治疗仍可用于分层患者,例如AIEC携带者。我们检查了AIEC菌株的抗药性概况,以确定哪些疗法可能有效或给此类患者带来风险。根据CLSI标准测试了对30种抗菌素的表型耐药性。研究人员从31名CD患者和18名对照的肠粘膜中分离出AIEC(n = 22)和非病原性大肠杆菌(non-AIEC)菌株(n = 37)。对59个菌株中的39个进行了从头基因组测序,使用DeepARG数据库在这些基因组和33个其他AIEC公众可获得的基因组中搜索AMR和AMR基因。从CD和对照中分离出的菌株显示出相似的表型AMR谱。基因组分析未发现AMR基因的患病率增加。但是,与非AIEC菌株相比,AIEC菌株对β-内酰胺的抗药性更高(11株AIEC(50%)和5例非AIEC(22%)菌株对至少一种β-内酰胺具有抗性; p <0.042)。两种AIEC菌株均对广谱头孢菌素具有抗性。一种菌株携带质粒介导的AmpCβ-内酰胺酶(CMY-69),另一种菌株在固有染色体AmpC的启动子中出现了与该酶超量生产有关的突变。其余菌株对β-内酰胺类耐药,但不包括扩谱头孢菌素。大多数携带TEM相关的β-内酰胺酶。包括外部AIEC在内的基因组分析表明,与非AIEC菌株相比,在AIEC菌株中编码磺酰胺抗性的基因sul1更为频繁(34.6%vs. 9.5%,p = 0.030)。ACD中的AMR与CD病态的推定含义有关。AIEC对β-内酰胺类药物有很高的抗药性,因此有必要对在AIEC克隆的CD患者中使用这些抗微生物剂的风险保持谨慎。
更新日期:2020-05-13
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