Research Article
Antimicrobial Resistance and Virulence Gene Profiles of Escherichia Coli Isolated from Stool Samples of Patients with Gastrointestinal Disorders in Buea, Cameroon
Issue:
Volume 11, Issue 1, February 2025
Pages:
1-10
Received:
3 December 2024
Accepted:
17 December 2024
Published:
7 January 2025
DOI:
10.11648/j.ejcbs.20251101.11
Downloads:
Views:
Abstract: The rising antibiotic resistance in Escherichia coli (E. coli), coupled with the presence of virulence factors, poses significant challenges for infection management, amplifying pathogenicity and therapeutic failure. This study investigated the antimicrobial resistance and virulence gene profiles of E. coli isolates from stool samples of patients with gastrointestinal disorders and explored potential associations between antibiotic resistance and virulence factors. A total of 244 E. coli isolates were recovered from 373 stool samples, identified through biochemical methods and confirmed by polymerase chain reaction (PCR). Singleplex and multiplex PCR assays were employed to screen for 22 virulence genes, categorized into adhesins (fimH, afa, papE, papC, nfaE, bmaE), invasins (ibeA, colV), toxins (stx1, stx2, cdtB, est, elt), capsule synthesis genes (kpsII, rfc), siderophores (iutA, chuA, ire), and others, including pai, hlyA, and eaeA. Antibiotic susceptibility testing (AST) was performed on 50 randomly selected isolates harboring at least one virulence gene using the Kirby-Bauer disc diffusion method. Among the 244 E. coli isolates, 178 (73.0%) harbored at least one virulence gene. The detected genes were categorized into adhesins (33.2%), toxins (13.5%), siderophores (10.7%), and capsule synthesis and invasins (5.3%), with fimH (18.0%) and papC (6.1%) being the most prevalent. Notably, two virulence genes, rfc and eaeA, were not detected in any isolates. Antibiotic susceptibility testing (AST) revealed alarmingly high resistance rates to beta-lactams (90% for Amoxicillin and Ampicillin), Tetracycline (80%), Doxycycline (74%), and Sulfamethoxazole (88%), with all isolates exhibiting complete resistance to Metronidazole. In contrast, Ceftriaxone demonstrated moderate efficacy (48% sensitivity), while Ciprofloxacin (74%) and Gentamicin (76%) were the most effective antibiotics. A significant positive correlation (r = 0.635, P = 0.000) was observed between the presence of virulence genes and antibiotic resistance, underscoring the interplay between these factors. These findings highlight the need for further research to unravel the molecular mechanisms linking virulence and resistance in E. coli. Targeted interventions addressing both virulence and resistance factors are essential to improving therapeutic outcomes and combating multidrug-resistant E. coli.
Abstract: The rising antibiotic resistance in Escherichia coli (E. coli), coupled with the presence of virulence factors, poses significant challenges for infection management, amplifying pathogenicity and therapeutic failure. This study investigated the antimicrobial resistance and virulence gene profiles of E. coli isolates from stool samples of patients w...
Show More
Case Report
Emergence of Non-tuberculous Mycobacteria Infections in Patients with Drug-Resistant Tuberculosis (DR-TB) During Bedaquiline - Containing Treatment
Issue:
Volume 11, Issue 1, February 2025
Pages:
11-15
Received:
29 December 2024
Accepted:
13 January 2025
Published:
11 February 2025
DOI:
10.11648/j.ejcbs.20251101.12
Downloads:
Views:
Abstract: Introduction: Environmental microorganisms known as non-tuberculous mycobacteria (NTM) are frequently found in soil and water, originating from both natural and man-made sources. All mycobacteria species are included in this group, with the exception of Mycobacterium leprae, which causes leprosy, and Mycobacterium tuberculosis complex, which causes tuberculosis. NTM consists of a diverse array of over 190 distinct species. Mycobacterium avium complex (MAC), which consists of Mycobacterium avium and Mycobacterium intracellulare, is the most common pathogen that causes disease in humans. Mycobacterium abscessus (MAB) is the next most common pathogen. Methods: The centre, Saint Peter’s Specialized Hospital, is the pioneering TB specialized hospital in Ethiopia. Both conventional and molecular drug susceptibility testing were used to diagnose the patients with DR-TB. NTM-infected patients received therapy for their DR-TB using regimens containing bedaquiline, and they were monitored once treatment started. Sputum samples were gathered in order to evaluate the effectiveness of the treatment using mycobacterial culture. We have already come across two NTM cases. Result: Concerns have been raised about the occurrence of nontuberculous mycobacteria (NTM) infections in patients with drug-resistant tuberculosis (DR-TB) using bedaquiline-containing regimens. In a recent study, six cases of NTM infection were documented among patients undergoing treatment with Bedaquiline. The final treatment outcomes for these cases were cured. Bedaquiline is a prospective treatment option for NTM infections because it has shown excellent antibacterial action against a variety of NTM species. However, while effective against extra pulmonary NTM infections; its efficacy in pulmonary infections remains less clear. The increasing incidence of NTM infections in this patient population highlights the need for careful monitoring and potential adjustments in treatment strategies to address the complications arising from these co-infections. Conclusion: These outcomes underscore the complexity of managing co-infections in patients already burdened by DR-TB. It suggest that while Bedaquiline shows promise in treating DR-TB, its role in managing concurrent NTM infections requires careful consideration. The emergence of NTM during treatment may be influenced by factors such as the pharmacokinetics of Bedaquiline and the intrinsic resistance of various NTM species. This situation necessitates ongoing monitoring and potentially revised therapeutic strategies to address these co-infections effectively. As the incidence of NTM infections continues to rise globally, it is crucial for healthcare providers to remain vigilant in identifying and managing these infections in patients undergoing treatment for DR-TB.
Abstract: Introduction: Environmental microorganisms known as non-tuberculous mycobacteria (NTM) are frequently found in soil and water, originating from both natural and man-made sources. All mycobacteria species are included in this group, with the exception of Mycobacterium leprae, which causes leprosy, and Mycobacterium tuberculosis complex, which causes...
Show More
,
Seraphine Nkie Esemu*
