Extraintestinal Escherichia coli, a current challenge: contributions for its prevention and control in Cuba
Keywords:
Escherichia coli extraintestinal (ECEI), betalactamasas de espectro extendido (BLEE), carbapenamasas, NDM-1, CubaAbstract
Introduction. Multi-drug-resistant extraintestinal pathogenic Escherichia coli (ExPEC) poses a health challenge given the mortality rate linked to it. National monitoring of it begins at IPK, aiming to learn its clinical, microbiological, and epidemiological behavior in Cuba. Methods. A conventional microbiological characterization was carried out on 1001 isolated patients of ExPEC. They were hospitalized from January, 2014 to December, 2019, as a result of national monitoring. They came from 40 hospitals of the 15 provinces of the country and the Special Municipality Isle of Youth. Randomly, 306 isolated patients were selected for molecular characterization by means of polymerase chain reaction tests and the technique of multilocus sequence for detecting cloning lineages of ExPEC circulating in Cuba. Results and Discussion. The isolated patients of ExPEC recovered at a higher frequency in samples of surgical wound /14.5%), blood (13.7%) and urine (13.4%). In them, resistance to Ciprofloxacin prevailed (50.5%), to Trimetoprim/sulfametoxasol (49.4%), and to cephalosporin (40%). The predominant genes of betalactamases were bla CTX-M (61%) and bla TEM (31,7%), CMY-2 and NDM-1. Plasmid resistance to fluoroquinolones was evidenced in this species, mediated by the genes qnrB, qnrD, qnrS y oqxAB. Gene mcr-1 was not detected in the isolated patients resistant to colistin. The study of multilocus sequence permitted the detection of the pandemic clone ST131, as well as three new sequence types worldwide (ST5716, ST5717 y ST5718) and the emerging clone ST1193. It was concluded that the characterization of Cuban isolated patients of ExPEC represented an important contribution to the knowledge of its epidemiology in both the country and the región.
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