Volume 12 Supplement 1
Incidence of bla genes among uropathogenic Escherichia coli isolates from HIV and non-HIV patients in South India
© Padmavathy et al; licensee BioMed Central Ltd. 2012
Published: 4 May 2012
Group 3a/b cephalosporins are currently being used in the treatment of UTI and urosepsis. However, Extended Spectrum Beta-Lactamase (ESBL) mediated resistance has been increasingly reported among uropathogens from HIV patients. We sought to determine the incidence of ESBL genes- bla CTX -M, bla TEM and bla SHV among E. coli isolates from HIV (with increased exposure to cephalosporins) and non-HIV antenatal patients.
PCR detection of bla CTX-M , bla TEM and bla SHV were carried out among ESBL producing urinary E. coli isolates from HIV (n=57) and non-HIV antenatal patients (n=22). Fisher’s exact test was employed to analyze the statistical significance of the results.
Overall, 31.7%, 59.5% of the E. coli isolates carried bla TEM , bla CTX-M respectively, while none harboured blaSHV. When stratified based on host group, significant difference was observed in the incidence of bla CTX-M among the isolates from HIV and non-HIV patients (70.2% vs 31.8% respectively, p = 0.0024; OR 5.042; 95% CI = 1.7441-14.5759). Nonetheless, difference in prevalence of bla TEM among the HIV and non-HIV isolates was not statistically significant (29.8% vs 36.4%, p = 0.5979). Co-occurrence of bla TEM and bla CTX-M was detected among 22.8%, 0% of the E. coli isolates from HIV and non-HIV patients respectively (OR 5.1447; 95% CI = 1.3766-19.2273).
Our results augment the fact that frequent exposure to cephalosporins serves as the driving selection force leading to increased incidence of ESBL (bla CTX-M ) mediated resistance among the E. coli isolates from HIV patients. Hence, the risk associated with antimicrobial exposure needs to be considered in therapeutic decision making.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.