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2025 ; 25
(1
): 1397
Nephropedia Template TP
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Molecular characterization of antimicrobial resistance genes and plasmid profiles
in enterobacterales isolated from urinary tract infections in rural outpatient
women in Otavalo, Ecuador
#MMPMID41131447
Hernández-Alomía F
; Bastidas-Caldes C
; Zambrano A
; Narváez M
; Castillejo P
BMC Infect Dis
2025[Oct]; 25
(1
): 1397
PMID41131447
show ga
BACKGROUND: The rise of antibiotic-resistant bacteria poses a significant public
health threat, particularly in the context of urinary tract infections (UTIs),
which rank as the second most common ambulatory illness. UTIs are often caused by
Enterobacterales species, such as Escherichia coli and Klebsiella pneumoniae,
with increasing resistance to critical antibiotics complicating treatment.
Indigenous rural populations, like those in Ecuador, face unique challenges due
to cultural, social, and economic barriers that hinder access to healthcare,
exacerbating the issue of antibiotic resistance. METHODS: This study analyzed 154
Enterobacterales strains isolated from ambulatory UTI cases in outpatiens from
Otavalo, Ecuador, between October 2021 and February 2022. DNA was extracted, and
the presence of antibiotic resistance genes (ARGs) was screened using PCR for
extended-spectrum beta-lactamases and carbapenemases. Plasmid incompatibility
groups were identified through replicon typing, and multi-locus sequence typing
(MLST) was performed to characterize strains. RESULTS: The analysis revealed four
prevalent ARGs, with bla(TEM) being the most common (87.01% of isolates),
followed by bla(CTX-M-1) (44.16%), bla(SHV) (18.83%), and bla(CTX-M-9) (13.64%).
No carbapenemases or mcr-1 genes were detected. Among the incompatibility groups,
IncFIB, IncF, and IncY were the most prevalent. A diverse array of ARG
combinations was observed, indicating significant plasmid-mediated genetic
plasticity. MLST identified 33 distinct sequence types among E. coli isolates,
with ST10 and ST3944 being the most frequent. For K. pneumoniae, ST15 and ST25
were predominant. CONCLUSIONS: This study reveals significant antibiotic
resistance among Enterobacterales from urinary tract infections in rural
outpatients in Ecuador. The bla(TEM) gene was found in 87.01% of isolates, with
notable clones like E. coli ST10 and ST3944 linked to extraintestinal infections.
K. pneumoniae ST15 and ST25 were prevalent, indicating multidrug resistance. The
findings highlight the need for ongoing surveillance and targeted public health
strategies to combat resistance in these vulnerable communities.