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Characteristics of ESBL-Producing Enterobacterales Colonizing the Gastrointestinal Tract in Patients Admitted to the Oncological Hospital

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Abstract

We analyzed the prevalence and genetic characteristics of the extended-spectrum β-lactamases (ESBLs)-producing Enterobacterales isolated from adult patients hospitalized in the oncological center in 2019. Out of 9372 patients admitted to the hospital, 1373 had been in various medical facilities during the last year, which was an indication to perform a screening test for ESBL-producing Enterobacterales colonizing their gastrointestinal tract. In eighty-three patients (6.1%), 85 ESBL producers were detected. These isolates included the following: Escherichia coli (n = 67; 78.8%), Klebsiella pneumoniae (n = 14; 16.5%), Enterobacter cloacae cplx (n = 3; 3.5%), and Klebsiella oxytoca (n = 1; 1.2%). CTX-M-1-like enzymes were the most common ESBLs (n = 67; 78.8%). Two K. pneumoniae isolates (2/85; 2.4%) additionally produced New Delhi-metallo-β-lactamases (NDM). All isolates, except for K. oxytoca, were typed by pulsed-field gel electrophoresis (PFGE) and demonstrated high genetic diversity. The most prevalent phylogroups of E. coli were B2 group (n = 30; 44.8%), followed by A group (n = 25; 37.3%). These observations have motivated us to investigate the link between ESBL-E colonization and infection among patients with solid tumors.

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Authors and Affiliations

  1. Department of Microbiology, Prof. F. Łukaszczyk Center of Oncology in Bydgoszcz, Romanowskiej 2, 85-796, Bydgoszcz, Poland

    Maria Szymankiewicz

  2. Chair and Clinic of Oncological Surgery, Collegium Medicum UMK in Bydgoszcz, Bydgoszcz, Poland

    Tomasz Nowikiewicz

  3. Clinical Department of Breast Cancer and Reconstructive Surgery, Prof. F. Łukaszczyk Center of Oncology in Bydgoszcz, Bydgoszcz, Poland

    Tomasz Nowikiewicz

  4. Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, Poland

    Elżbieta Stefaniuk

  5. Department of Molecular Microbiology, National Medicines Institute, Warsaw, Poland

    Anna Baraniak

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  1. Maria Szymankiewicz
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Contributions

MS—conception, design, data analysis and interpretation, and wrote the manuscript, TN—acquisition and interpretation of clinical data, and ES and AB—performed the genetic characteristics of ESBL-E. Baraniak also critically reviewed the manuscript and revising for important intellectual content. All authors read and approved the final manuscript.

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Correspondence to Maria Szymankiewicz.

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The authors declare no conflicts of interest.

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The study received approval from the Bioethical Commission at the Collegium Medicum of Nicolaus Copernicus University in Toruń (KB approval number 216/2020).

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284_2020_2334_MOESM1_ESM.tif

Fig 1 a-c Pulsed-field gel electrophoresis patterns (PFGE) of 67 isolates of E. coli. Identical isolates are marked with asterisks and dots. The remaining isolates represent unique PFGE patterns. M: λ ladder DNA (48.5 - 1,018 kb) (New England Biolabs, USA). (TIFF 2294 kb)

Supplementary material 2 (TIFF 2867 kb)

Supplementary material 3 (TIFF 1554 kb)

284_2020_2334_MOESM4_ESM.tif

PFGE gel image of 14 K. pneumoniae isolates. The asterisks denote indistinguishable isolates with NDM carbapenemases. Three isolates, slightly different from each other are marked with dots. M: λ ladder DNA (48.5 - 1,018 kb) (New England Biolabs, USA). (TIFF 764 kb)

284_2020_2334_MOESM5_ESM.tif

Fig 3 Three isolates of E. cloacae cplx with unique PFGE patterns. M: λ ladder DNA (48.5 - 1,018 kb) (New England Biolabs, USA). (TIFF 646 kb)

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Szymankiewicz, M., Nowikiewicz, T., Stefaniuk, E. et al. Characteristics of ESBL-Producing Enterobacterales Colonizing the Gastrointestinal Tract in Patients Admitted to the Oncological Hospital. Curr Microbiol 78, 642–648 (2021). https://doi.org/10.1007/s00284-020-02334-3

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