Molecular Epidemiology of Escherichia coli Clinical Isolates from Central Panama

Abstract

<i>Escherichia coli</i> represents one of the most common causes of community-onset and nosocomial infections. Strains carrying extended spectrum β-lactamases (ESBL) are a serious public health problem. In Central America we have not found studies reporting the molecular epidemiology of <i>E. coli</i> strains implicated in local infections, so we conducted this study to fill that gap. <i>Materials and Methods:</i> We report on an epidemiological study in two reference hospitals from central Panama, identifying the susceptibility profile, associated risk factors, and molecular typing of <i>E. coli</i> strains isolated between November 2018 and November 2019 using Pasteur's Multilocus Sequence Typing (MLST) scheme. <i>Results:</i> A total of 30 <i>E. coli</i> isolates with antimicrobial resistance were analyzed, 70% of which came from inpatients and 30% from outpatients (<i>p</i> < 0.001). Two-thirds of the samples came from urine cultures. Forty-three percent of the strains were ESBL producers and 77% were resistant to ciprofloxacin. We identified 10 different sequence types (STs) with 30% of the ESBL strains identified as ST43, which corresponds to ST131 of the Achtman MLST scheme-the <i>E. coli</i> pandemic clone. Thirty-eight percent of the <i>E. coli</i> strains with the ESBL phenotype carried CTX-M-15. <i>Conclusions:</i> To the best of our knowledge, this is the first report confirming the presence of the pandemic <i>E. coli</i> clone ST43/ST131 harboring CTX-M-15 in Central American inpatients and outpatients. This <i>E. coli</i> strain is an important antimicrobial-resistant organism of public health concern, with potential challenges to treat infections in Panama and, perhaps, the rest of Central America.