Extraintestinal pathogenic Escherichia coli: An update on antimicrobial resistance, laboratory diagnosis and treatment
ABSTRACT Escherichia coli remains one of the most frequent causes of nosocomial and community-acquired bacterial infections including urinary tract infections, enteric infections and systemic infections in humans. Extraintestinal pathogenic E. coli (ExPEC) had emerged during the 2000s as an important player in the resistance to antibiotics, especially to the cephalosporins and fluoroquinolones. Most importantly, among ExPEC is the increasing recognition of isolates producing 'newer β-lactamases' that consist of plasmid-mediated AmpC β-lactamases (e.g., CMY), extended-spectrum β-lactamases (e.g., CTX-M) and carbapenemases (e.g., New Delhi metallo-β-lactamase, Klebsiella pneumonaie carbapenemase and OXA-48). This review will highlight recent aspects on antimicrobial resistance in ExPEC, including the laboratory detection of these isolates, and describe some treatment options for infections due to antimicrobial-resistant isolates.
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- "The problem of antibiotic resistance is also on the rise since women with frequent recurrent infections and symptoms can self-initiate a 3-day regimen of antibiotics therapy without consulting a physician. Due to the increasing resistance of uropathogenic bacteria to different antibiotics, carbapenems and ertapenem remain the last line of defense that requires cautious use and are reserved only to cases of recurrent UTI due to ESBL strains of uropathogenic E. coli . "
ABSTRACT: Urinary tract infections (UTIs) are among the most common bacterial infections affecting women. UTIs are primarily caused by Escherichia coli, which increases the likelihood of a recurrent infection. We encountered two cases of recurrent UTIs (rUTIs) with a positive E. coli culture, not improving with antibiotics due to the development of antibiotic resistance. An alternative therapeutic regimen based on parsley and garlic, L-arginine, probiotics, and cranberry tablets has been given. This regimen showed a significant health improvement and symptoms relief without recurrence for more than 12 months. In conclusion, the case supports the concept of using alternative medicine in treating rUTI and as a prophylaxis or in patients who had developed antibiotic resistance.Case Reports in Medicine 12/2014; 2014. DOI:10.1155/2014/698758
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ABSTRACT: Escherichia coli ST131emerged during the early to mid-2000s is an important human pathogen, has spread extensively throughout the world, and is responsible for the rapid increase in antimicrobial resistance among E. coli. ST131 is known to cause extraintestinal infections, being fluoroquinolone resistant, and is associated with ESBL production most often due to CTX-M-15. Recent molecular epidemiologic studies using whole-genome sequencing and phylogenetic analysis have demonstrated that the H30 ST131 lineage emerged in early 2000s that was followed by the rapid expansion of its sublineages H30-R and H30-Rx. Escherichia coli ST131 clearly has all of the essential characteristics that define a high-risk clone and might be the quintessential example of an international multiresistant high-risk clone. We urgently need rapid cost-effective detection methods for E. coli ST131, as well as well-designed epidemiological and molecular studies to understand the dynamics of transmission, risk factors, and reservoirs for ST131. This will provide insight into the emergence and spread of this multiresistant sequence type that will hopefully lead to information essential for preventing the spread of ST131. Copyright © 2015 Elsevier Inc. All rights reserved.Advances in applied microbiology 90C:109-154. DOI:10.1016/bs.aambs.2014.09.002 · 2.24 Impact Factor
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ABSTRACT: Acute cystitis is one of the most commonly encountered bacterial infections, and is responsible for substantial morbidity and high medical costs in the United States and across the globe. Though often thought to be self-limiting and easily treated by antibiotics, urinary tract infections (UTIs) are often incompletely resolved by antibiotic therapy and frequently recur. This is in part due to the ability of uropathogenic bacteria to invade, replicate, and persist within host epithelial cells. The biological complexity of these infections combined with a dramatic rise in antibiotic resistant pathogens highlight the need for alternative therapies. In this review we will examine current management strategies for UTIs, as well as emerging treatments, including novel compounds that block bacterial interactions with the urothelium and vaccines focused on preventing both acute and recurrent infections.Clinical Infectious Diseases 05/2013; 57(5). DOI:10.1093/cid/cit284 · 9.42 Impact Factor