Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun 30;8(6):200-7.
doi: 10.4066/AMJ.2015.2358. eCollection 2015.

Simultaneous gut colonisation and infection by ESBL-producing Escherichia coli in hospitalised patients

Johny Asir  1 , Shashikala Nair  1 , Sheela Devi  1 , Kenchappa Prashanth  2 , Rajagopalan Saranathan  2 , Reba Kanungo  1
Affiliations

Simultaneous gut colonisation and infection by ESBL-producing Escherichia coli in hospitalised patients

Johny Asir et al. Australas Med J. .

Abstract

Background: Extended spectrum betalactamase (ESBL)-producing organisms are a major cause of hospital-acquired infections. ESBL-producing Escherichia coli (E. coli) have been recovered from the hospital environment. These drug-resistant organisms have also been found to be present in humans as commensals. The present investigation intended to isolate ESBL-producing E. coli from the gut of already infected patients; to date, only a few studies have shown evidence of the gut microflora as a major source of infection.

Aims: This study aimed to detect the presence of ESBL genes in E.coli that are isolated from the gut of patients who have already been infected with the same organism.

Methods: A total of 70 non-repetitive faecal samples were collected from in-patients of our hospital. These in-patients were clinically diagnosed and were culture-positive for ESBL-producing E. coli either from blood, urine, or pus. Standard microbiological methods were used to detect ESBL from clinical and gut isolates. Genes coding for major betalactamase enzymes such as bla CTX-M , bla TEM, and bla SHV were investigated by polymerase chain reaction (PCR).

Results: ESBL-producing E. coli was isolated from 15 (21 per cent) faecal samples of the 70 samples that were cultured. PCR revealed that out of these 15 isolates, the bla CTX-M gene was found in 13 (86.6 per cent) isolates, the bla TEM was present in 11 (73.3 per cent) isolates, and bla SHV only in eight (53.3 per cent) isolates. All 15 clinical and gut isolates had similar phenotypic characters and eight of the 15 patients had similar pattern of genes (bla TEM, bla CTX-M, and bla SHV) in their clinical and gut isolates.

Conclusion: Strains with multiple betalactamase genes that colonise the gut of hospitalised patients are a potential threat and it may be a potential source of infection.

Keywords: ESBL E.coli; Stool; colonisation.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

The authors declare that they have no competing interests.

Figures

Figure 1: Gel electrophoresis showing PCR amplification of blaCTX-M gene
Figure 1: Gel electrophoresis showing PCR amplification of blaCTX-M gene
Figure 2: Antimicrobial resistance profiles of 15 gut isolates in comparison to the clinical isolates
Figure 2: Antimicrobial resistance profiles of 15 gut isolates in comparison to the clinical isolates
See this image and copyright information in PMC

References

    1. Paterson DL, Bonomo RA. Extended spectrum betalactamases: A clinical update. Clin Microbiol Rev. 2005;18:657–86. - PMC - PubMed
    1. Bradford PA. Extended spectrum betalactamases in the 21st century: Characterization, epidemiology and detection of this important resistance threat. Clin Microbiol Rev. 2001;14:933–51. - PMC - PubMed
    1. Osthoff M, Mcguinness SL, Wagen AZ. et al. Urinary tract infections due to extended-spectrum beta lactamase-producing gram-negative bacteria: identification of risk factors and outcome predictors in an Australian tertiary-referral hospital. Int J Infect Dis. 2015 Mar 10. pii: S1201-9712(15)00067-3. doi: 10.1016/j.ijid.2015.03.006. - PubMed
    1. Chaudhary U, Aggarwal R. Extended spectrum betalactamases-An emerging threat to clinical therapeutics. Indian J Med Microbiol. 2004;22:75–80. - PubMed
    1. Ben-Ami R, Schwaber MJ, Navon-Venezia S. et al. Influx of extended-spectrum b-lactamase-producing Enterobacteriaceae into the hospital. Clin Infect Dis. 2006;42:925–34. - PubMed

LinkOut - more resources