Título:
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Vaginal versus Obstetric Infection Escherichia coli Isolates
among Pregnant Women: Antimicrobial Resistance and Genetic
Virulence Profile
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Autor/a:
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Sáez-López, Emma; Guiral, Elisabet; Fernández-Orth, Dietmar; Villanueva, Sonia; Goncé, Anna; López, Marta; Teixidó, Irene; Pericot, Anna; Figueras Retuerta, Francesc; Palacio i Riera, Montserrat; Cobo Cobo, María Teresa; Bosch Mestres, Jordi; Soto, Sara M. (Sara Maria)
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Abstract:
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Vaginal Escherichia coli colonization is related to obstetric
infections and the consequent development of infections in
newborns. Ampicillin resistance among E. coli strains is
increasing, which is the main choice for treating empirically
many obstetric and neonatal infections. Vaginal E. coli strains
are very similar to extraintestinal pathogenic E. coli with
regards to the virulence factors and the belonging to phylogroup
B2. We studied the antimicrobial resistance and the genetic
virulence profile of 82 E. coli isolates from 638 vaginal
samples and 63 isolated from endometrial aspirate, placental and
amniotic fluid samples from pregnant women with obstetric
infections. The prevalence of E. coli in the vaginal samples was
13%, which was significant among women with associated risk
factors during pregnancy, especially premature preterm rupture
of membranes (p<0.0001). Sixty-five percent of the strains
were ampicillin-resistant. The E. coli isolates causing
obstetric infections showed higher resistance levels than
vaginal isolates, particularly for gentamicin (p = 0.001). The
most prevalent virulence factor genes were those related to the
iron uptake systems revealing clear targets for interventions.
More than 50% of the isolates belonged to the virulent B2 group
possessing the highest number of virulence factor genes. The
ampicillin-resistant isolates had high number of virulence
factors primarily related to pathogenicity islands, and the
remarkable gentamicin resistance in E. coli isolates from women
presenting obstetric infections, the choice of the most
appropriate empiric treatment and clinical management of
pregnant women and neonates should be carefully made. Taking
into account host-susceptibility, the heterogeneity of E. coli
due to evolution over time and the geographical area,
characterization of E. coli isolates colonizing the vagina and
causing obstetric infections in different regions may help to
develop interventions and avoid the aetiological link between
maternal carriage and obstetric and subsequent puerperal
infections. |
Materia(s):
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-Obstetrícia -Escheríchia coli -Embarassades -Obstetrics -Escherichia coli -Pregnant women |
Derechos:
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cc by (c) Sáez-López et al., 2016
http://creativecommons.org/licenses/by/3.0/es/ |
Tipo de documento:
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Artículo Artículo - Versión publicada |
Editor:
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Public Library of Science (PLoS)
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Compartir:
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