Extended-spectrum β-lactamases producing E. coli

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Extended-spectrum beta-lactamase-producing E. coli
Other names: ESBL-E. coli[1]
  • Top:Classification of extended-spectrum β-lactamases a) Ambler classification. b) Bush–Jacoby–Medeiros classification[2]

  • Bottom:Twenty-year trend extended-spectrum-β-lactamase -resistant and carbapenem-resistant Enterobacteriaceae (bloodstream infection)[3]
SpecialtyInfectious disease
SymptomsFever, loss of appetite , stomach cramp, and diarrhea[4]
ComplicationsSepsis, bloodstream infections, and organ failure[2]
CausesMutations in genes for TEM-1, TEM-2, or SHV-1[2]
Risk factorsRecent antibiotic use, especially fluoroquinolones[5][6]
Diagnostic methodDisk diffusion assay[7][8]
PreventionAntibiotic cycling[1][9]
TreatmentNitrofurantoin and fosfomycin [10]
Frequency197,400 cases (9,100 deaths in the United States) 2007[11]

Extended-spectrum beta-lactamase-producing E. coli (ESBL-E. coli) is a type of bacteria that can cause serious infections and is a major contributor to multidrug resistance.[11][12]

ESBLs are enzymes that break down certain antibiotics, making them difficult to manage. ESBL-producing bacteria causes infections in healthcare settings(hospitals and nursing homes).[11]

ESBLs are a unwelcome influence worldwide, with 1.5 billion individuals colonized with ESBL-producing Enterobacteriaceae per a 2017 review.[13]

Signs and symptoms

In terms of the presentation of infections due to Extended-spectrum β-lactamases-producing E. coli depend on type of infection,in the case of gut infection we find:[4]

Cause

a-e)Genetic structures harbouring genes encoding ESBLs[14]

Extended-spectrum β-lactamases are enzymes that neutralize β-lactam antibiotics by inactivating the β-lactam ring. This mechanism makes E. coli as well as other bacteria resistant to many antibiotics. [2]

ESBLs are produced by mutations in genes for TEM-1, TEM-2, or SHV-1; these mutations change the amino acid configuration around the active site of enzymes. [12]

  • TEM-1 is a β-lactamase enzyme that makes bacteria resistant to antibiotics (penicillins and early cephalosporins). As to the structure TEM-1 is a monomeric protein with two domains and catalytic cleft where a sulfate anion ligand binds. TEM-1 is the most common β-lactamase in Gram-negative bacteria.[15][16]
  • TEM-2 is a plasmid-mediated beta-lactamase gene that encodes enzyme closely related to TEM-1,[14]and is the same in biochemical properties, except for one single amino acid substitution[17]
  • SHV-1 is a broad-spectrum beta-lactamase enzyme associated with antibiotic resistance. It is classified as a class A, group 2b beta-lactamase. It is similar to TEM-1, but more active against ampicillin[18]

Risk factors

In terms of risk factors for extended-spectrum β-lactamases -producing E. coli we find:[5][6]

  • Recent antibiotic use, especially fluoroquinolones
  • Age (over 65 )
  • Recent hospitalization or ICU

Diagnosis

PCR

The evaluation of Extended-spectrum β-lactamases producing E. coli involves the following:[7][8]

  • Disk diffusion assay
  • Combination disk test

Prevention

We find that the prevention of ESBL-E. coli is done via the following:[9][1]

Treatment

In terms of the management of ESBL- E. coli we find that nitrofurantoin and fosfomycin are used (urinary infection). For infections outside of the urinary tract the recommendation is meropenem, imipenem-cilastatin, ertapenem.[10][4]

Prevalence

According to the Centers for Disease Control and Prevention in the U.S. there were 197,400 cases and 9,100 estimated deaths in the country in 1997[11]

The prevalence of Extended-spectrum β-lactamases producing E. coli in the general population varies between countries, e.g. approximately 6% in Germany[19] and France,[20] 13% in Saudi Arabia,[21] and 63% in Egypt.[22]

History

Extended-spectrum β-lactamases were first discovered in the 1980s, and the first classification scheme for β-lactamases that recognized ESBLs was established by Karen Bush (1989)[14]

See also

References

  1. ↑ 1.0 1.1 1.2 Rawat, Deepti; Nair, Deepthi (2010). "Extended-spectrum β-lactamases in Gram Negative Bacteria". Journal of Global Infectious Diseases. 2 (3): 263–274. doi:10.4103/0974-777X.68531. ISSN 0974-777X. Archived from the original on 2024-10-09. Retrieved 2024-10-21.
  2. ↑ 2.0 2.1 2.2 2.3 Husna, Asmaul; Rahman, Md Masudur; Badruzzaman, A. T. M.; Sikder, Mahmudul Hasan; Islam, Mohammad Rafiqul; Rahman, Md Tanvir; Alam, Jahangir; Ashour, Hossam M. (30 October 2023). "Extended-Spectrum β-Lactamases (ESBL): Challenges and Opportunities". Biomedicines. 11 (11): 2937. doi:10.3390/biomedicines11112937. ISSN 2227-9059. Archived from the original on 3 June 2024. Retrieved 2 October 2024.
  3. ↑ Diekema, Daniel J.; Hsueh, Po-Ren; Mendes, Rodrigo E.; Pfaller, Michael A.; Rolston, Kenneth V.; Sader, Helio S.; Jones, Ronald N. (July 2019). "The Microbiology of Bloodstream Infection: 20-Year Trends from the SENTRY Antimicrobial Surveillance Program". Antimicrobial Agents and Chemotherapy. 63 (7). doi:10.1128/AAC.00355-19.
  4. ↑ 4.0 4.1 4.2 "Extended-spectrum beta-lactamases". patient.info. Archived from the original on 3 October 2024. Retrieved 10 October 2024.
  5. ↑ 5.0 5.1 Ben‐Ami, Ronen; Rodríguez‐Baño, Jesús; Arslan, Hande; Pitout, Johann D. D.; Quentin, Claudine; Calbo, Esther S.; Azap, Özlem K.; Arpin, Corinne; Pascual, Alvaro; Livermore, David M.; Garau, Javier; Carmeli, Yehuda (September 2009). "A Multinational Survey of Risk Factors for Infection with Extended‐Spectrum β‐Lactamase–Producing Enterobacteriaceae in Nonhospitalized Patients". Clinical Infectious Diseases. 49 (5): 682–690. doi:10.1086/604713. Archived from the original on 2024-03-14. Retrieved 2024-10-12.
  6. ↑ 6.0 6.1 Xiao, Tingting; Wu, Zhenzhu; Shi, Qingyi; Zhang, Xiaoli; Zhou, Yanzi; Yu, Xiao; Xiao, Yonghong (1 June 2019). "A retrospective analysis of risk factors and outcomes in patients with extended-spectrum beta-lactamase-producing Escherichia coli bloodstream infections". Journal of Global Antimicrobial Resistance. 17: 147–156. doi:10.1016/j.jgar.2018.12.014. ISSN 2213-7165. Archived from the original on 5 May 2022. Retrieved 12 October 2024.
  7. ↑ 7.0 7.1 Hrovat, Katja; Molan, Katja; Seme, Katja; Ambrožič Avguštin, Jerneja (13 January 2024). "Molecular characterization of extended-spectrum β-lactamase-producing Escherichia coli isolated from lower respiratory tract samples between 2002 and 2019 in the Central Slovenia region". Annals of Clinical Microbiology and Antimicrobials. 23 (1): 6. doi:10.1186/s12941-023-00664-1. ISSN 1476-0711. Archived from the original on 2 September 2024. Retrieved 21 October 2024.
  8. ↑ 8.0 8.1 Correa-Martínez, Carlos L.; Idelevich, Evgeny A.; Sparbier, Katrin; Kostrzewa, Markus; Becker, Karsten (24 January 2019). "Rapid Detection of Extended-Spectrum β-Lactamases (ESBL) and AmpC β-Lactamases in Enterobacterales: Development of a Screening Panel Using the MALDI-TOF MS-Based Direct-on-Target Microdroplet Growth Assay". Frontiers in Microbiology. 10. doi:10.3389/fmicb.2019.00013. ISSN 1664-302X. Archived from the original on 26 June 2024. Retrieved 10 October 2024.
  9. ↑ 9.0 9.1 Brown, Erwin M.; Nathwani, Dilip (1 January 2005). "Antibiotic cycling or rotation: a systematic review of the evidence of efficacy". Journal of Antimicrobial Chemotherapy. 55 (1): 6–9. doi:10.1093/jac/dkh482.
  10. ↑ 10.0 10.1 Tamma, Pranita D; Aitken, Samuel L; Bonomo, Robert A; Mathers, Amy J; van Duin, David; Clancy, Cornelius J (8 April 2021). "Infectious Diseases Society of America Guidance on the Treatment of Extended-Spectrum β-lactamase Producing Enterobacterales (ESBL-E), Carbapenem-Resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with Difficult-to-Treat Resistance (DTR- P. aeruginosa )". Clinical Infectious Diseases. 72 (7): e169–e183. doi:10.1093/cid/ciaa1478. Archived from the original on 25 August 2024. Retrieved 21 October 2024.
  11. ↑ 11.0 11.1 11.2 11.3 "About ESBL-producing Enterobacterales". ESBL-producing Enterobacterales. 16 May 2024. Archived from the original on 5 October 2024. Retrieved 1 October 2024.
  12. ↑ 12.0 12.1 Paterson, David L.; Bonomo, Robert A. (October 2005). "Extended-Spectrum β-Lactamases: a Clinical Update". Clinical Microbiology Reviews. 18 (4): 657–686. doi:10.1128/CMR.18.4.657-686.2005. ISSN 0893-8512. Archived from the original on 2023-10-26. Retrieved 2024-10-11.
  13. ↑ Doi, Yohei; Iovleva, Alina; Bonomo, Robert A. (29 April 2017). "The ecology of extended-spectrum β-lactamases (ESBLs) in the developed world". Journal of Travel Medicine. 24 (Suppl 1): S44–S51. doi:10.1093/jtm/taw102. ISSN 1195-1982. Archived from the original on 17 October 2022. Retrieved 1 October 2024.
  14. ↑ 14.0 14.1 14.2 Castanheira, Mariana; Simner, Patricia J; Bradford, Patricia A (12 July 2021). "Extended-spectrum β -lactamases: an update on their characteristics, epidemiology and detection". JAC-Antimicrobial Resistance. 3 (3). doi:10.1093/jacamr/dlab092. Archived from the original on 18 January 2024. Retrieved 10 October 2024.
  15. ↑ Salverda, Merijn L.M.; De Visser, J. Arjan G.M.; Barlow, Miriam (November 2010). "Natural evolution of TEM-1 β-lactamase: experimental reconstruction and clinical relevance". FEMS Microbiology Reviews. 34 (6): 1015–1036. doi:10.1111/j.1574-6976.2010.00222.x. Archived from the original on 2024-04-11. Retrieved 2024-10-12.
  16. ↑ Bank, RCSB Protein Data. "RCSB PDB - 1XPB: STRUCTURE OF BETA-LACTAMASE TEM1". www.rcsb.org. Archived from the original on 21 July 2024. Retrieved 12 October 2024.
  17. ↑ Bradford, Patricia A. (October 2001). "Extended-Spectrum β-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat". Clinical Microbiology Reviews. 14 (4): 933–951. doi:10.1128/CMR.14.4.933-951.2001. ISSN 0893-8512. Archived from the original on 2021-05-25. Retrieved 2024-10-12.
  18. ↑ Chaves, José; Ladona, Margarita G.; Segura, Concepción; Coira, Amparo; Reig, Roser; Ampurdanés, Coral (October 2001). "SHV-1 β-Lactamase Is Mainly a Chromosomally Encoded Species-Specific Enzyme in Klebsiella pneumoniae". Antimicrobial Agents and Chemotherapy. 45 (10): 2856–2861. doi:10.1128/AAC.45.10.2856-2861.2001. ISSN 0066-4804.
  19. ↑ Symanzik C, Hillenbrand J, Stasielowicz L, Greie JC, Friedrich AW, Pulz M, John SM, Esser J (December 2021). "Novel insights into pivotal risk factors for rectal carriage of extended-spectrum-β-lactamase-producing enterobacterales within the general population in Lower Saxony, Germany". Journal of Applied Microbiology. 132 (4): 3256–3264. doi:10.1111/jam.15399. PMID 34856042. S2CID 244854840.
  20. ↑ Nicolas-Chanoine MH, Gruson C, Bialek-Davenet S, Bertrand X, Thomas-Jean F, Bert F, Moyat M, Meiller E, Marcon E, Danchin N, Noussair L, Moreau R, Leflon-Guibout V (March 2013). "10-Fold increase (2006-11) in the rate of healthy subjects with extended-spectrum β-lactamase-producing Escherichia coli faecal carriage in a Parisian check-up centre". The Journal of Antimicrobial Chemotherapy. 68 (3): 562–568. doi:10.1093/jac/dks429. PMID 23143897.
  21. ↑ Kader AA, Kamath KA (2009). "Faecal carriage of extended-spectrum beta-lactamase-producing bacteria in the community". Eastern Mediterranean Health Journal. 15 (6): 1365–1370. PMID 20218126.
  22. ↑ Valverde A, Grill F, Coque TM, Pintado V, Baquero F, Cantón R, Cobo J (August 2008). "High rate of intestinal colonization with extended-spectrum-beta-lactamase-producing organisms in household contacts of infected community patients". Journal of Clinical Microbiology. 46 (8): 2796–2799. doi:10.1128/JCM.01008-08. PMC 2519510. PMID 18562591.

Further reading

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