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Research article
Molecular characterization of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae among the pediatric population in Qatar
Andres Perez-Lopez
Sidra Medical and Research Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2301-470X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Although extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are a public health problem in the Arabian Peninsula, data on the molecular characteristic of their antimicrobial resistance determinants in children is limited.
Methods: Whole-genome sequencing (WGS) was performed on ESBL-producing E. coli and K. pneumoniae isolates recovered from screening and clinical specimens from pediatric patients at Sidra Medicine in Doha from January to December 2018.
Results: WGS was performed on 327 ESBL producers: 255 E. coli and 72 K. pneumoniae. The most common sequence types (ST) were ST131 (16.5%), ST38 and ST10 (8.2 each%) in E. coli and ST307 (9.7%), ST45 and ST268 (6.9% each) in K. pneumoniae. CTX-M type ESBL were found in all but one isolate, with CTX-M-15 accounting for 87.8%. Co-carriage of OXA-1 alone or in combination with TEM-1B was associated with reduced susceptibility to
amoxicillin/clavulanate (P=0.002 and P<0.0001) and piperacillin/tazobactam (P=0.02 and P=0.004). The most common plasmid-mediated quinolone resistance genes co-carried were qnr A/B/E/S (45.3%). Ninety percent of gentamicin non-susceptible isolates harboured genes encoding AAC(3) enzymes, mainly aac(3)-IIa. Only 2 of 57 isolates harbouring aac(6’)-Ib-cr were non-susceptible to amikacin. Eighty-five percent of isolates carried IncF plasmids.
Conclusions: Our data show that CTX-M is largely the most prevalent ESBL type in the pediatric population in Qatar with a predominance of CTX-M-15. Carbapenem-sparing options to treat ESBL infections are limited given the frequent co-production of OXA-1 and TEM-1B enzymes and co-resistance to antibiotic classes other than β-lactams.
Keywords
children, whole-genome sequencing, E. coli, K. pneumonia, extended-spectrum beta-lactamases; CTX-M-15
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Research article
Molecular characterization of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae among the pediatric population in Qatar
Andres Perez-Lopez
Sidra Medical and Research Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2301-470X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 20 May, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Infectious Diseases
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Although extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are a public health problem in the Arabian Peninsula, data on the molecular characteristic of their antimicrobial resistance determinants in children is limited.
Methods: Whole-genome sequencing (WGS) was performed on ESBL-producing E. coli and K. pneumoniae isolates recovered from screening and clinical specimens from pediatric patients at Sidra Medicine in Doha from January to December 2018.
Results: WGS was performed on 327 ESBL producers: 255 E. coli and 72 K. pneumoniae. The most common sequence types (ST) were ST131 (16.5%), ST38 and ST10 (8.2 each%) in E. coli and ST307 (9.7%), ST45 and ST268 (6.9% each) in K. pneumoniae. CTX-M type ESBL were found in all but one isolate, with CTX-M-15 accounting for 87.8%. Co-carriage of OXA-1 alone or in combination with TEM-1B was associated with reduced susceptibility to
amoxicillin/clavulanate (P=0.002 and P<0.0001) and piperacillin/tazobactam (P=0.02 and P=0.004). The most common plasmid-mediated quinolone resistance genes co-carried were qnr A/B/E/S (45.3%). Ninety percent of gentamicin non-susceptible isolates harboured genes encoding AAC(3) enzymes, mainly aac(3)-IIa. Only 2 of 57 isolates harbouring aac(6’)-Ib-cr were non-susceptible to amikacin. Eighty-five percent of isolates carried IncF plasmids.
Conclusions: Our data show that CTX-M is largely the most prevalent ESBL type in the pediatric population in Qatar with a predominance of CTX-M-15. Carbapenem-sparing options to treat ESBL infections are limited given the frequent co-production of OXA-1 and TEM-1B enzymes and co-resistance to antibiotic classes other than β-lactams.