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BMC Infect Dis. 2012; 12(Suppl 1): P21.
Published online 2012 May 4. doi:  10.1186/1471-2334-12-S1-P21
PMCID: PMC3344762

Incidence of bla genes among uropathogenic Escherichia coli isolates from HIV and non-HIV patients in South India

Background

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- blaCTX-M, blaTEM and blaSHV among E. coli isolates from HIV (with increased exposure to cephalosporins) and non-HIV antenatal patients.

Methods

PCR detection of blaCTX-M, blaTEM and blaSHV 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.

Results

Overall, 31.7%, 59.5% of the E. coli isolates carried blaTEM, blaCTX-M respectively, while none harboured blaSHV. When stratified based on host group, significant difference was observed in the incidence of blaCTX-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 blaTEM among the HIV and non-HIV isolates was not statistically significant (29.8% vs 36.4%, p = 0.5979). Co-occurrence of blaTEM and blaCTX-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).

Conclusion

Our results augment the fact that frequent exposure to cephalosporins serves as the driving selection force leading to increased incidence of ESBL (blaCTX-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.


Articles from BMC Infectious Diseases are provided here courtesy of BioMed Central