A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE
Intro: Urinary tract infection (UTI) is one of the most common infections in children. Escherichia coli is the predominant organism causing UTI. The emergence of ESBL+ve E.coli harbouring other resistance genes poses a major challenge to clinicians. Though antimicrobial resistance (AMR) is of global...
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Elsevier
2023-08-01
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Series: | International Journal of Infectious Diseases |
Online Access: | http://www.sciencedirect.com/science/article/pii/S120197122300574X |
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author | S. Mohapatra S. Venugopal S. Chunchanur R. Panigrahi V. Tak V. Perumal D. Ghosh T. Sharma S. Pundir S. Chaudhuri P. Hari S. Kant |
author_facet | S. Mohapatra S. Venugopal S. Chunchanur R. Panigrahi V. Tak V. Perumal D. Ghosh T. Sharma S. Pundir S. Chaudhuri P. Hari S. Kant |
author_sort | S. Mohapatra |
collection | DOAJ |
description | Intro: Urinary tract infection (UTI) is one of the most common infections in children. Escherichia coli is the predominant organism causing UTI. The emergence of ESBL+ve E.coli harbouring other resistance genes poses a major challenge to clinicians. Though antimicrobial resistance (AMR) is of global concern, gathering local data in community-settings cannot be overemphasized. It is prudent to have knowledge about the genome of ESBL+ve E.coli at the country level to mitigate the risk in near future. Methods: Children (2-18 years) having UTI symptoms for less than a week in community health centres of Delhi, Bangalore, Jodhpur and Bhubaneswar representing north, south, west and east India were enrolled from 2019-2021. Phenotypic identification and antimicrobial susceptibility testing of the isolates causing significant bacteriuria was performed using MALDI-TOF and VITEK 2. Nineteen ESBL+ve E. coli isolates were analyzed by whole genome sequencing. Findings: 9.1% (42/461) of children were positive causing significant bacteriuria. [M:F 1:1, > 50% > 10 years]. E.coli was the predominant uropathogen (83.3%, 35/42) followed by Klebsiella pneumoniae (12%, 5/42), and Proteus spp. (4.7%, 2/42). Sixty percent of the E.coli isolates were ESBL producers. Genome sequence of the ESBL+ve E.coli was observed to carry large number of AMR genes such as blaNDM-5, blaOxa-1, blaCTX-M-15/14, AmpC, AAC(3)-IIa/IIc/Ib and others. ST131phylogroup was the most prevalent. Plasmid IncFIB and IncFIA found in more than 50% isolates. Composite transposon, IS26 was found in many isolates carrying blaOxa-1, blaNDM-5, blaCTX-M-15/14, blaTEM, aac(3′)-lb with at least 98% identity and coverage. Conclusion: Our data represents a large-scale nationwide community study among children indicating ESBL+ve E.coli isolates harbouring multidrug-resistant genes with high-risk clones. There is an urgent need for augmented surveillance at the local level for the recent knowledge of AMR patterns in the community; thereby preventing the imminent threat of an epidemic of AMR in near future. |
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institution | Directory Open Access Journal |
issn | 1201-9712 |
language | English |
last_indexed | 2024-03-12T15:22:05Z |
publishDate | 2023-08-01 |
publisher | Elsevier |
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spelling | doaj.art-b0460c6aba4b4b8080eeeab4133d456e2023-08-11T05:32:12ZengElsevierInternational Journal of Infectious Diseases1201-97122023-08-01134S1S2A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURES. Mohapatra0S. Venugopal1S. Chunchanur2R. Panigrahi3V. Tak4V. Perumal5D. Ghosh6T. Sharma7S. Pundir8S. Chaudhuri9P. Hari10S. Kant11All India Institute of Medical Sciences, Microbiology, New Delhi, IndiaBangalore Medical College and Research Institute, Microbiology, Bangalore, IndiaBangalore Medical College and Research Institute, Microbiology, Bangalore, IndiaSUM Hospital, Microbiology, Bhubaneswar, IndiaAll India Institute of Medical Sciences, Microbiology, Jodhpur, IndiaIndian Institute of Technology, Kusuma School of Biological Sciences, New Delhi, IndiaIndian Institute of Technology, Kusuma School of Biological Sciences, New Delhi, IndiaICMR AIIMS Computational Genomics Centre, Indian Council of Medical Research, Division of Biomedical Informatics, New Delhi, IndiaAll India Institute of Medical Sciences, Microbiology, New Delhi, IndiaTranslational Health Science and Technology Institute, Faridabad, Centre for Biodesign and Diagnostics, Faridabad, IndiaAll India Institute of Medical Sciences, Pediatrics, New Delhi, IndiaAll India Institute of Medical Sciences, Centre for Community Medicine, New Delhi, IndiaIntro: Urinary tract infection (UTI) is one of the most common infections in children. Escherichia coli is the predominant organism causing UTI. The emergence of ESBL+ve E.coli harbouring other resistance genes poses a major challenge to clinicians. Though antimicrobial resistance (AMR) is of global concern, gathering local data in community-settings cannot be overemphasized. It is prudent to have knowledge about the genome of ESBL+ve E.coli at the country level to mitigate the risk in near future. Methods: Children (2-18 years) having UTI symptoms for less than a week in community health centres of Delhi, Bangalore, Jodhpur and Bhubaneswar representing north, south, west and east India were enrolled from 2019-2021. Phenotypic identification and antimicrobial susceptibility testing of the isolates causing significant bacteriuria was performed using MALDI-TOF and VITEK 2. Nineteen ESBL+ve E. coli isolates were analyzed by whole genome sequencing. Findings: 9.1% (42/461) of children were positive causing significant bacteriuria. [M:F 1:1, > 50% > 10 years]. E.coli was the predominant uropathogen (83.3%, 35/42) followed by Klebsiella pneumoniae (12%, 5/42), and Proteus spp. (4.7%, 2/42). Sixty percent of the E.coli isolates were ESBL producers. Genome sequence of the ESBL+ve E.coli was observed to carry large number of AMR genes such as blaNDM-5, blaOxa-1, blaCTX-M-15/14, AmpC, AAC(3)-IIa/IIc/Ib and others. ST131phylogroup was the most prevalent. Plasmid IncFIB and IncFIA found in more than 50% isolates. Composite transposon, IS26 was found in many isolates carrying blaOxa-1, blaNDM-5, blaCTX-M-15/14, blaTEM, aac(3′)-lb with at least 98% identity and coverage. Conclusion: Our data represents a large-scale nationwide community study among children indicating ESBL+ve E.coli isolates harbouring multidrug-resistant genes with high-risk clones. There is an urgent need for augmented surveillance at the local level for the recent knowledge of AMR patterns in the community; thereby preventing the imminent threat of an epidemic of AMR in near future.http://www.sciencedirect.com/science/article/pii/S120197122300574X |
spellingShingle | S. Mohapatra S. Venugopal S. Chunchanur R. Panigrahi V. Tak V. Perumal D. Ghosh T. Sharma S. Pundir S. Chaudhuri P. Hari S. Kant A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE International Journal of Infectious Diseases |
title | A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE |
title_full | A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE |
title_fullStr | A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE |
title_full_unstemmed | A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE |
title_short | A MULTICENTRIC STUDY ON GENOMIC INSIGHTS OF ESBL PRODUCING ESCHERICHIA COLI CAUSING COMMUNITY-ACQUIRED URINARY TRACT INFECTION IN CHILDREN IN INDIA: PREDICTING NEAR FUTURE |
title_sort | multicentric study on genomic insights of esbl producing escherichia coli causing community acquired urinary tract infection in children in india predicting near future |
url | http://www.sciencedirect.com/science/article/pii/S120197122300574X |
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