TY - JOUR
T1 - Emergence of Fosfomycin Resistance by Plasmid-Mediated fos Genes in Uropathogenic ESBL-Producing E. coli Isolates in Mexico
AU - Galindo-Méndez, Mario
AU - Navarrete-Salazar, Humberto
AU - Baltazar-Jiménez, Francisco
AU - Muñoz-de la Paz, Eduardo
AU - Sánchez-Mawcinitt, María Fernanda
AU - Gómez-Pardo, Alexis
AU - Garza-González, Elvira
AU - Ponce-de-León-Garduño, Luis Alfredo
AU - Franco-Cendejas, Rafael
AU - Morfín-Otero, Rayo
AU - Rojas-Larios, Fabián
AU - Mena-Ramírez, Juan Pablo
AU - Morales-de-la-Peña, Cecilia Teresita
AU - García-Mendoza, Lourdes
AU - Choy-Chang, Elena Victoria
AU - Avilés-Benítez, Laura Karina
AU - López-Gutiérrez, Eduardo
AU - Canizales-Oviedo, Jorge Luis
AU - Barlandas-Rendón, Nicolás Eric
AU - Maldonado-Anicacio, Joyarib Yanelli
AU - Rosales-García, Alina Aracely
AU - Ostos-Cantú, Heidy Leticia
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Fosfomycin is currently a viable option against urinary tract infections, particularly against extended-spectrum β-lactamases (ESBL)-producing E. coli, due to its unique mechanism of action and its low resistance among bacteria. The objective of this study was to investigate two of the three most common mechanisms of resistance against this antibiotic among 350 ESBL-producing E. coli strains isolated from the urine of Mexican patients. The prevalence of fosfomycin resistance in our study was 10.9% (38/350). Of all resistant isolates analyzed, 23 (60.5%) were identified as fos-producing organisms, with 14 strains carrying fosA3 and 9, fosA1. Additionally, 11 (28.9%) fosfomycin-resistant isolates presented resistance due to impaired antibiotic transport and 8 (21.0%) both mechanisms. No resistance mechanism investigated in the study was found on 12 strains. All 38 confirmed ESBL-producing isolates carried a blaCTX-M subtype, 36 (94.5%) belonged to the O25b-ST131 clone, and all of them were able to transfer the fosfomycin resistance trait to recipient strains horizontally. This is the first study in Mexico demonstrating a plasmid-mediated fosfomycin resistance mechanism among clinical E. coli strains. Since our results suggest a strong association among fos and blaCTX-M genes and ST131 clones in uropathogenic E. coli, plasmid-mediated fosfomycin resistance should be closely monitored.
AB - Fosfomycin is currently a viable option against urinary tract infections, particularly against extended-spectrum β-lactamases (ESBL)-producing E. coli, due to its unique mechanism of action and its low resistance among bacteria. The objective of this study was to investigate two of the three most common mechanisms of resistance against this antibiotic among 350 ESBL-producing E. coli strains isolated from the urine of Mexican patients. The prevalence of fosfomycin resistance in our study was 10.9% (38/350). Of all resistant isolates analyzed, 23 (60.5%) were identified as fos-producing organisms, with 14 strains carrying fosA3 and 9, fosA1. Additionally, 11 (28.9%) fosfomycin-resistant isolates presented resistance due to impaired antibiotic transport and 8 (21.0%) both mechanisms. No resistance mechanism investigated in the study was found on 12 strains. All 38 confirmed ESBL-producing isolates carried a blaCTX-M subtype, 36 (94.5%) belonged to the O25b-ST131 clone, and all of them were able to transfer the fosfomycin resistance trait to recipient strains horizontally. This is the first study in Mexico demonstrating a plasmid-mediated fosfomycin resistance mechanism among clinical E. coli strains. Since our results suggest a strong association among fos and blaCTX-M genes and ST131 clones in uropathogenic E. coli, plasmid-mediated fosfomycin resistance should be closely monitored.
KW - antimicrobial resistance
KW - CTX-M
KW - ESBL
KW - fosfomycin resistance
KW - ST131
UR - http://www.scopus.com/inward/record.url?scp=85140486589&partnerID=8YFLogxK
U2 - 10.3390/antibiotics11101383
DO - 10.3390/antibiotics11101383
M3 - Artículo
AN - SCOPUS:85140486589
SN - 2079-6382
VL - 11
JO - Antibiotics
JF - Antibiotics
IS - 10
M1 - 1383
ER -