Multidrug Resistant CTX-M-Producing Escherichia coli: A Growing Threat among HIV Patients in India

الملخص EN

Extended Spectrum β-Lactamases (ESBLs) confer resistance to third-generation cephalosporins and CTX-M types have emerged as the most prominent ESBLs worldwide.

This study was designed to determine the prevalence of CTX-M positive ESBL-producing urinary E.

coli isolates from HIV patients and to establish the association of multidrug resistance, phylogeny, and virulence profile with CTX-M production.

A total of 57 ESBL producers identified among 76 E.

coli strains isolated from HIV patients from South India were screened for b l a C T X - M , AmpC production, multidrug resistance, and nine virulence associated genes (VAGs), fimH, pap, afa/dra, sfa/foc, iutA, fyuA, iroN, usp, and kpsMII.

The majority (70.2%) of the ESBL producers harbored b l a C T X - M and were AmpC coproducers.

Among the CTX-M producers, 47.5% were found to be UPEC, 10% harbored as many as 7 VAGs, and 45% possessed kpsMII.

Multidrug resistance (CIPRSXTRGENR) was significantly more common among the CTX-M producers compared to the nonproducers (70% versus 41.2%).

However, 71.4% of the multidrug resistant CTX-M producers exhibited susceptibility to nitrofurantoin thereby making it an effective alternative to cephalosporins/fluoroquinolones.

The emergence of CTX-M-producing highly virulent, multidrug resistant uropathogenic E.

coli is of significant public health concern in countries like India with a high burden of HIV/AIDS.