The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections
We carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing <i>E. coli</i> strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were pe...
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| Format: | Article |
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MDPI AG
2023-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/12/3/522 |
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| author | Kazuma Sakaeda Takuya Sadahira Yuki Maruyama Takehiro Iwata Masami Watanabe Koichiro Wada Motoo Araki |
| author_facet | Kazuma Sakaeda Takuya Sadahira Yuki Maruyama Takehiro Iwata Masami Watanabe Koichiro Wada Motoo Araki |
| author_sort | Kazuma Sakaeda |
| collection | DOAJ |
| description | We carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing <i>E. coli</i> strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing <i>E. coli</i> strains isolated from urine samples collected from patients treated at our institution between 2008 and 2018. These sequences were compared with results for antimicrobial drug susceptibility determined using a micro-liquid dilution method. We also analyzed cases treated with FMOX at our institution to examine its clinical efficacy. Of the 911 <i>E. coli</i> strains identified, 158 (17.3%) were ESBL-producing. Of these, 67.7% (107/158) were strain ST-131 in ST analysis. Nearly all (154/158; 97.5%) were CTX-M genotypes, with M-14 and M-27 predominating. The isolated strains were sensitive to FMOX in drug susceptibility tests. Among the patient samples, 33 cases received FMOX, and of these, 5 had ESBL-producing <i>E. coli</i>. Among these five cases, three received FMOX for surgical prophylaxis as urinary carriers of ESBL-producing <i>E. coli</i>, and postoperative infections were prevented in all three patients. The other two patients received FMOX treatment for urinary tract infections. FMOX treatment was successful for one, and the other was switched to carbapenem. Our results suggest that FMOX has efficacy for perioperative prophylactic administration in urologic surgery involving carriers of ESBL-producing bacteria and for therapeutic administration for urinary tract infections. Use of FMOX avoids over-reliance on carbapenems or β-lactamase inhibitors and thus is an effective antimicrobial countermeasure. |
| first_indexed | 2024-03-11T07:01:19Z |
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| id | doaj.art-403b43b0f3844340aa6541489738451f |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-11T07:01:19Z |
| publishDate | 2023-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-403b43b0f3844340aa6541489738451f2023-11-17T09:14:11ZengMDPI AGAntibiotics2079-63822023-03-0112352210.3390/antibiotics12030522The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract InfectionsKazuma Sakaeda0Takuya Sadahira1Yuki Maruyama2Takehiro Iwata3Masami Watanabe4Koichiro Wada5Motoo Araki6Department of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, JapanDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, JapanDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, JapanDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, JapanDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, JapanKoichiro Wada Department of Urology, School of Medicine, Shimane University, 89-1, Enya-cho, Izumo 693-8501, JapanDepartment of Urology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, 2-5-1, Shikata-cho, Kita-ku, Okayama 700-8558, JapanWe carried out a molecular biological analysis of extended-spectrum β-lactamase (ESBL)-producing <i>E. coli</i> strains and their sensitivity to flomoxef (FMOX). Sequence type (ST) analysis by multilocus sequence typing (MLST) and classification of ESBL genotypes by multiplex PCR were performed on ESBL-producing <i>E. coli</i> strains isolated from urine samples collected from patients treated at our institution between 2008 and 2018. These sequences were compared with results for antimicrobial drug susceptibility determined using a micro-liquid dilution method. We also analyzed cases treated with FMOX at our institution to examine its clinical efficacy. Of the 911 <i>E. coli</i> strains identified, 158 (17.3%) were ESBL-producing. Of these, 67.7% (107/158) were strain ST-131 in ST analysis. Nearly all (154/158; 97.5%) were CTX-M genotypes, with M-14 and M-27 predominating. The isolated strains were sensitive to FMOX in drug susceptibility tests. Among the patient samples, 33 cases received FMOX, and of these, 5 had ESBL-producing <i>E. coli</i>. Among these five cases, three received FMOX for surgical prophylaxis as urinary carriers of ESBL-producing <i>E. coli</i>, and postoperative infections were prevented in all three patients. The other two patients received FMOX treatment for urinary tract infections. FMOX treatment was successful for one, and the other was switched to carbapenem. Our results suggest that FMOX has efficacy for perioperative prophylactic administration in urologic surgery involving carriers of ESBL-producing bacteria and for therapeutic administration for urinary tract infections. Use of FMOX avoids over-reliance on carbapenems or β-lactamase inhibitors and thus is an effective antimicrobial countermeasure.https://www.mdpi.com/2079-6382/12/3/522antimicrobial resistance<i>Escherichia coli</i>urinary tract infectionsflomoxefST131 |
| spellingShingle | Kazuma Sakaeda Takuya Sadahira Yuki Maruyama Takehiro Iwata Masami Watanabe Koichiro Wada Motoo Araki The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections Antibiotics antimicrobial resistance <i>Escherichia coli</i> urinary tract infections flomoxef ST131 |
| title | The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections |
| title_full | The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections |
| title_fullStr | The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections |
| title_full_unstemmed | The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections |
| title_short | The Genotypic and Phenotypic Characteristics Contributing to Flomoxef Sensitivity in Clinical Isolates of ESBL-Producing <i>E. coli</i> Strains from Urinary Tract Infections |
| title_sort | genotypic and phenotypic characteristics contributing to flomoxef sensitivity in clinical isolates of esbl producing i e coli i strains from urinary tract infections |
| topic | antimicrobial resistance <i>Escherichia coli</i> urinary tract infections flomoxef ST131 |
| url | https://www.mdpi.com/2079-6382/12/3/522 |
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