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Resistance to quinolones, cephalosporins and macrolides in Escherichia coli causing bacteraemia in Peruvian children

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dc.contributor.author Palma, Noemí
dc.contributor.author Pons, Maria J.
dc.contributor.author Gomes, Cláudia
dc.contributor.author Mateu, Judit
dc.contributor.author Riveros, Maribel
dc.contributor.author García, Wilfredo
dc.contributor.author Jacobs, Jan
dc.contributor.author García, Coralith
dc.contributor.author Ochoa, Theresa J.
dc.contributor.author Ruiz, Joaquim
dc.date.accessioned 2019-01-25T17:00:30Z
dc.date.available 2019-01-25T17:00:30Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4948
dc.description.abstract OBJECTIVES: To characterise the β-lactam, quinolone and macrolide resistance levels and mechanisms in 62 Escherichia coli isolates causing bacteraemia in Peruvian children. METHODS: Minimum inhibitory concentrations (MICs) of ciprofloxacin, nalidixic acid (NAL) and azithromycin were determined in the presence and absence of Phe-Arg-β-naphthylamide. Susceptibility to other 14 antimicrobial agents was also established. Extended-spectrum β-lactamases (ESBLs) were identified, and mutations in gyrA and parC as well as the presence of transferable mechanisms of quinolone resistance (TMQR) and macrolide resistance (TMMR) were determined. RESULTS: Fifty isolates (80.6%) were multidrug-resistant. High proportions of resistance to ampicillin (93.5%), NAL (66.1%) and trimethoprim/sulfamethoxazole (66.1%) were observed. No isolate showed resistance to carbapenems and only two isolates were resistant to nitrofurantoin. Twenty-seven isolates carried ESBL-encoding genes: 2 blaSHV-12; 13 blaCTX-M-15; 4 blaCTX-M-2; 6 blaCTX-M-65; and 2 non-identified ESBLs. Additionally, 27 blaTEM-1 and 9 blaOXA-1-like genes were detected. All quinolone-resistant isolates showed target mutations, whilst TMQR were present in four isolates. Efflux pumps played a role in constitutive NAL resistance. The association between quinolone resistance and ESBL production was significant (P=0.0011). The mph(A) gene was the most frequent TMMR (16 isolates); msr(A) and erm(B) genes were also detected. Only one TMMR-carrying isolate [presenting mph(A) and erm(B) concomitantly] remained resistant to azithromycin when efflux pumps were inhibited. CONCLUSIONS: A variety of ESBL-encoding genes and widespread of blaCTX-M-15 in Lima has been shown. The role of efflux pumps in azithromycin resistance needs to be further evaluated, as well as effective control of the use of antimicrobial agents. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartof urn:issn:2213-7173
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Antimicrobial resistance en_US
dc.subject Bacteraemia en_US
dc.subject Extended-spectrum beta-lactamase (ESBL) en_US
dc.subject Macrolide resistance en_US
dc.subject Peru en_US
dc.subject Quinolone resistance en_US
dc.title Resistance to quinolones, cephalosporins and macrolides in Escherichia coli causing bacteraemia in Peruvian children en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.jgar.2017.06.011
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.03
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.01


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