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Jamali H, Akrami F, Bouakkaz S, Dozois CM. Prevalence of specific serogroups, antibiotic resistance and virulence factors of avian pathogenic Escherichia coli (APEC) isolated from clinical cases: A systematic review and meta-analysis. Microb Pathog 2024; 194:106843. [PMID: 39117015 DOI: 10.1016/j.micpath.2024.106843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/22/2024] [Accepted: 08/05/2024] [Indexed: 08/10/2024]
Abstract
Pathogenic strains of Escherichia coli infecting poultry, commonly called avian pathogenic E. coli (APEC) present significant risks, to the health of both poultry and the general public. This systematic review aimed to examine the prevalence of APEC serotypes, sequence types (ST), phylogenetic groups, virulence factors and antibiotic resistance patterns based on 189 research papers sourced from PubMed, Web of Science, and ProQuest. Then, data were extracted from the selected studies and analyzed to assess the global distribution and characteristics of APEC strains. The metaprop codes in the Meta and Metafor packages of R as implemented in RStudio were then used to conduct meta-analysis. Among APEC strains identified from these different research reports serogroup O78 had the highest overall prevalence (16 %), followed by serogroups O2 (10 %), and O117 (8 %). The most common ST profiles were ST117 (20 %), ST140 (15 %), ST95 (12 %), and ST131 (9 %). ST117 and ST140 are known reservoirs for pathogenic E. coli in humans. Moreover, phylogenetic assessment highlighted the prevalence of phylogroups A, A1, F, D, and B2 among APEC strains indicating diversity in phylogenetic origin within poultry populations. The presence of antimicrobial resistance was notable among APEC strains against antibiotics such as tetracyclines, penicillins, and cephalosporins. This resistance may be linked to use of antimicrobials in poultry production in certain regions presenting challenges for both animal health management and human infection control. Analysis of sequences linked to adherence or virulence indicated that genes encoding adhesins (csg, fimC), iron/metal uptake (sitB, sitC, iroD) and cytotoxicity (estB, hlyF), and serum resistance (traT, iss) were highly prevalent. These factors have been reported to contribute to APEC host colonization and virulence in poultry. In summary, this overview of the characteristics of APEC highlights the pressing importance of monitoring and implementing management approaches to reduce antimicrobial resistance considering that a phylogenetic diversity of E. coli strains causes infections in both poultry and humans and represents a risk to both animal and public health. Further, determining the major conserved aspects and predominant mechanisms of virulence of APEC is critical for improving diagnostics and developing preventative measures to reduce the burden of infection caused by pathogenic E. coli in poultry and lower risks associated with foodborne transmission of E. coli to humans through poultry and poultry products.
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Affiliation(s)
- Hossein Jamali
- Institut National de La Recherche Scientifique (INRS), Centre Armand-Frappier Santé Biotechnologie, 531 Boul. des Prairies, Laval, QC H7V 1B7, Canada; Centre de Recherche en Infectiologie Porcine et Avicole (CRIPA), Faculté de Médecine Vétérinaire, Université de Montréal Saint-Hyacinthe, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Fariba Akrami
- Institut National de La Recherche Scientifique (INRS), Centre Armand-Frappier Santé Biotechnologie, 531 Boul. des Prairies, Laval, QC H7V 1B7, Canada; Centre de Recherche en Infectiologie Porcine et Avicole (CRIPA), Faculté de Médecine Vétérinaire, Université de Montréal Saint-Hyacinthe, Saint-Hyacinthe, QC J2S 2M2, Canada
| | - Souhaib Bouakkaz
- École de Technologie Supérieure, 1100 R. Notre Dame Ouest, Montréal, QC H3C 1K3, Canada
| | - Charles M Dozois
- Institut National de La Recherche Scientifique (INRS), Centre Armand-Frappier Santé Biotechnologie, 531 Boul. des Prairies, Laval, QC H7V 1B7, Canada; Centre de Recherche en Infectiologie Porcine et Avicole (CRIPA), Faculté de Médecine Vétérinaire, Université de Montréal Saint-Hyacinthe, Saint-Hyacinthe, QC J2S 2M2, Canada.
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Occurrence, Phenotypic and Molecular Characteristics of Extended-Spectrum Beta-Lactamase-Producing Escherichia coli in Healthy Turkeys in Northern Egypt. Antibiotics (Basel) 2022; 11:antibiotics11081075. [PMID: 36009944 PMCID: PMC9404839 DOI: 10.3390/antibiotics11081075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 07/29/2022] [Accepted: 08/03/2022] [Indexed: 12/01/2022] Open
Abstract
Poultry is one of the most important reservoirs for zoonotic multidrug-resistant pathogens. The indiscriminate use of antimicrobials in poultry production is a leading factor for development and dissemination of antimicrobial resistance. This study aimed to describe the prevalence and antimicrobial resistance of E. coli isolated from healthy turkey flocks of different ages in Nile delta region, Egypt. In the current investigation, 250 cloacal swabs were collected from 12 turkey farms in five governorates in the northern Egypt. Collected samples were cultivated on BrillianceTM ESBL agar media supplemented with cefotaxime (100 mg/L). The E. coli isolates were identified using MALDI-TOF-MS and confirmed by a conventional PCR assay targeting 16S rRNA-DNA. The phenotypic antibiogram against 14 antimicrobial agents was determined using the broth micro-dilution method. DNA-microarray-based assay was applied for genotyping and determination of both, virulence and resistance-associated gene markers. Multiplex real-time PCR was additionally applied for all isolates for detection of the actual most relevant Carbapenemase genes. The phenotypic identification of colistin resistance was carried out using E-test. A total of 26 E. coli isolates were recovered from the cloacal samples. All isolates were defined as multidrug-resistant. Interestingly, two different E. coli strains were isolated from one sample. Both strains had different phenotypic and genotypic profiles. All isolates were phenotypically susceptible to imipenem, while resistant to penicillin, rifampicin, streptomycin, and erythromycin. None of the examined carbapenem resistance genes was detected among isolates. At least one beta-lactamase gene was identified in most of isolates, where blaTEM was the most commonly identified determinant (80.8%), in addition to blaCTX-M9 (23.1%), blaSHV (19.2%) and blaOXA-10 (15.4%). Genes associated with chloramphenicol resistance were floR (65.4%) and cmlA1 (46.2%). Tetracycline- and quinolone-resistance-associated genes tetA and qnrS were detected in (57.7%) and (50.0%) of isolates, respectively. The aminoglycoside resistance associated genes aadA1 (65.4%), aadA2 (53.8%), aphA (50.0%), strA (69.2%), and strB (65.4%), were detected among isolates. Macrolide resistance associated genes mph and mrx were also detected in (53.8%) and (34.6%). Moreover, colistin resistance associated gene mcr-9 was identified in one isolate (3.8%). The class 1 integron integrase intI1 (84.6%), transposase for the transposon tnpISEcp1 (34.6%) and OqxB -integral membrane and component of RND-type multidrug efflux pump oqxB (7.7%) were identified among the isolates. The existing high incidence of ESBL/colistin-producing E. coli identified in healthy turkeys is a major concern that demands prompt control; otherwise, such strains and their resistance determinants could be transmitted to other bacteria and, eventually, to people via the food chain.
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Yu L, Li W, Liu Z, Yu J, Wang W, Shang F, Xue T. Role of McbR in the regulation of antibiotic susceptibility in avian pathogenic Escherichia coli. Poult Sci 2020; 99:6390-6401. [PMID: 33248554 PMCID: PMC7705038 DOI: 10.1016/j.psj.2020.09.048] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022] Open
Abstract
Avian pathogenic Escherichia coli (APEC) causes a variety of bacterial infectious diseases known as avian colibacillosis leading to significant economic losses in the poultry industry worldwide and restricting the development of the poultry industry. The development of efflux pumps is one important bacterial antibiotic resistance mechanism. Efflux pumps are capable of extruding a wide range of antibiotics out of the cytoplasm of some bacterial species, including β-lactams, polymyxins, tetracyclines, fluoroquinolones, aminoglycosides, novobiocin, nalidixic acid, and fosfomycin. In the present study, we constructed the mcbR mutant and the mcbR-overexpressing strain of E. coli strain APECX40 and performed antimicrobial susceptibility testing, antibacterial activity assays, real-time reverse transcription PCR, and electrophoretic mobility shift assays (EMSA) to investigate the molecular regulatory mechanism of McbR on the genes encoding efflux pumps. Our results showed that McbR positively regulates cell susceptibility to 12 antibiotics, including clindamycin, lincomycin, cefotaxime, cefalexin, doxycycline, tetracycline, gentamicin, kanamycin, norfloxacin, ofloxacin, erythromycin, and rifampicin by activating the transcription of acrAB, acrD, emrD, and mdtD (P < 0.01). Additionally, EMSA indicated that McbR specifically binds to the promoter regions of acrAB, acrD, acrR, emrD, and mdtD. This study suggests that, in APECX40, McbR plays an important role in the regulation of bacterial susceptibility by directly activating the transcription of efflux pumps genes.
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Affiliation(s)
- Lumin Yu
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China; Institute of Microbe and Host Health, Linyi University, Linyi, Shandong 276005, China.
| | - Wenchang Li
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Zhichao Liu
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Jiangliu Yu
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Wenhui Wang
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Fei Shang
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China.
| | - Ting Xue
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China.
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Yu L, Li W, Zhang M, Cui Y, Chen X, Ni J, Yu L, Shang F, Xue T. Autoinducer2 affects trimethoprim-sulfamethoxazole susceptibility in avian pathogenic Escherichia coli dependent on the folate synthesis-associate pathway. Microbiologyopen 2018; 7:e00582. [PMID: 29423970 PMCID: PMC6079169 DOI: 10.1002/mbo3.582] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 12/13/2017] [Accepted: 12/18/2017] [Indexed: 01/01/2023] Open
Abstract
Avian pathogenic Escherichia coli (APEC) causes airsacculitis, polyserositis, septicemia, and other mainly extraintestinal diseases in chickens, ducks, geese, pigeons, and other avian species, and is responsible for great economic losses in the avian industry. The autoinducer 2 (AI‐2) quorum sensing system is widely present in many species of gram‐negative and gram‐positive bacteria and has been proposed to be involved in interspecies communication. In clinical APEC strains, whether or not AI‐2 affects the expression of antibiotic‐related genes has not been reported. In this study, we have reported that exogenous AI‐2 increase the susceptibility of APEC strains to trimethoprim‐sulfamethoxazole (SXT) in a folate synthesis‐dependent pathway but not in the LsrR‐dependent manner. Our results further explained that exogenous AI‐2 can down regulate the transcription of the folate synthetase encoding genes folA and folC, and the folate synthesis‐related genes luxS, metE, and metH. Gel shift assays confirmed that LsrR, the AI‐2 receptor, did not bind to the promoters of folA and folC, suggesting that exogenous AI‐2 might influence folate metabolism by a feedback inhibition effect but not in the LsrR‐dependent pathway. This study might provide further information in the search for potential drug targets for prophylaxis of avian colibacillosis and for auxiliary antibiotics in the treatment of avian colibacillosis.
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Affiliation(s)
- Lumin Yu
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Wenchang Li
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Ming Zhang
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Yunmei Cui
- School of SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Xiaolin Chen
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Jingtian Ni
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Li Yu
- Department of Microbiology and ParasitologyAnhui Key Laboratory of ZoonosesAnhui Medical UniversityHefeiChina
| | - Fei Shang
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
| | - Ting Xue
- School of Life SciencesAnhui Agricultural UniversityHefeiAnhuiChina
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Piccirillo A, Giovanardi D, Dotto G, Grilli G, Montesissa C, Boldrin C, Salata C, Giacomelli M. Antimicrobial resistance and class 1 and 2 integrons inEscherichia colifrom meat turkeys in Northern Italy. Avian Pathol 2014; 43:396-405. [DOI: 10.1080/03079457.2014.943690] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Jones EM, Snow LC, Carrique-Mas JJ, Gosling RJ, Clouting C, Davies RH. Risk factors for antimicrobial resistance in Escherichia coli found in GB turkey flocks. Vet Rec 2013; 173:422. [DOI: 10.1136/vr.101759] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- E. M. Jones
- Animal Health and Veterinary Laboratories Agency (Weybridge); New Haw Addlestone Surrey KT15 3NB UK
| | - L. C. Snow
- Animal Health and Veterinary Laboratories Agency (Weybridge); New Haw Addlestone Surrey KT15 3NB UK
| | - J. J. Carrique-Mas
- Animal Health and Veterinary Laboratories Agency (Weybridge); New Haw Addlestone Surrey KT15 3NB UK
| | - R. J. Gosling
- Animal Health and Veterinary Laboratories Agency (Weybridge); New Haw Addlestone Surrey KT15 3NB UK
| | - C. Clouting
- Animal Health and Veterinary Laboratories Agency (Weybridge); New Haw Addlestone Surrey KT15 3NB UK
| | - R. H. Davies
- Animal Health and Veterinary Laboratories Agency (Weybridge); New Haw Addlestone Surrey KT15 3NB UK
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Baker SA, Van-Balen J, Lu B, Hillier A, Hoet AE. Antimicrobial drug use in dogs prior to admission to a veterinary teaching hospital. J Am Vet Med Assoc 2012; 241:210-7. [DOI: 10.2460/javma.241.2.210] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Gosling RJ, Clouting CS, Randall LP, Horton RA, Davies RH. Ciprofloxacin resistance inE. coliisolated from turkeys in Great Britain. Avian Pathol 2012; 41:83-9. [DOI: 10.1080/03079457.2011.640659] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Ozawa M, Harada K, Kojima A, Asai T, Sameshima T. Antimicrobial Susceptibilities, Serogroups, and Molecular Characterization of Avian Pathogenic Escherichia coli Isolates in Japan. Avian Dis 2008; 52:392-7. [DOI: 10.1637/8193-120907-reg] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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García-Feliz C, Collazos JA, Carvajal A, Herrera S, Echeita MA, Rubio P. Antimicrobial Resistance of Salmonella enterica Isolates from Apparently Healthy and Clinically Ill Finishing Pigs in Spain. Zoonoses Public Health 2008; 55:195-205. [DOI: 10.1111/j.1863-2378.2008.01110.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arshad N, Neubauer C, Hasnain S, Hess M. Peganum harmala Can Minimize Escherichia coli Infection in Poultry, but Long-Term Feeding May Induce Side Effects. Poult Sci 2008; 87:240-9. [DOI: 10.3382/ps.2007-00341] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Li XS, Wang GQ, Du XD, Cui BA, Zhang SM, Shen JZ. Antimicrobial susceptibility and molecular detection of chloramphenicol and florfenicol resistance among Escherichia coli isolates from diseased chickens. J Vet Sci 2007; 8:243-7. [PMID: 17679770 PMCID: PMC2868130 DOI: 10.4142/jvs.2007.8.3.243] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Seventy Escherichia coli isolates recovered from diseased chickens diagnosed with colibacillosis in Henan Province, China, between 2004 and 2005 were characterized for antimicrobial susceptibility profiles via a broth doubling dilution method. Overall, the isolates displayed resistance to trimethoprim-sulfamethoxazole (100%), oxytetracycline (100%), ampicillin (83%), enrofloxacin (83%), and ciprofloxacin (81%), respectively. Among the phenicols, resistance was approximately 79% and 29% for chloramphenicol and florfenicol, respectively. Molecular detection revealed that the incidence rates of the floR, cmlA, cat1, cat2 and cat3 were 29, 31, 16, 13, and 0%, respectively. Additionally, 10% of the isolates were positive for both floR and cmlA. As these antimicrobial agents may potentially induce cross-resistance between animal and human bacterial pathogens, their prudent use in veterinary medicine is highly recommended.
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Affiliation(s)
- Xin Sheng Li
- College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou, PR China
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Kim TE, Jeong YW, Cho SH, Kim SJ, Kwon HJ. Chronological study of antibiotic resistances and their relevant genes in Korean avian pathogenic Escherichia coli isolates. J Clin Microbiol 2007; 45:3309-15. [PMID: 17687022 PMCID: PMC2045358 DOI: 10.1128/jcm.01922-06] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Antibiograms and relevant genotypes of Korean avian pathogenic Escherichia coli (APEC) isolates (n = 101) recovered between 1985 and 2005 were assessed via disc diffusion test, PCR, restriction enzyme analysis, and sequencing. These isolates were highly resistant to tetracycline (84.2%), streptomycin (84.2%), enrofloxacin (71.3%), and ampicillin (67.3%), and most of the tetracycline, streptomycin, enrofloxacin, and ampicillin resistances were associated with tetA and/or tetB, aadA and/or strA-strB, mutations in gyrA and/or parC, and TEM, respectively. Class 1 integrons were detected in 40 isolates (39.6%), and a variety of gene cassettes conferring streptomycin (aadA), gentamicin (aadB), and trimethoprim (dfr) resistances were identified: aadA1a (27.5%), dfrV-orfD (2.5%), aadB-aadA1a (2.5%), dfrI-aadA1a (47.5%), dfrXVII-aadA5 (12.5%), and dfrXII-orfF-aadA2 (7.5%). In addition, several types of common promoters (P(ant)) of the gene cassettes (hybrid P1, weak P1, or weak P1 plus P2) and single-nucleotide polymorphisms in aadA1a were identified. The results of a chronological analysis demonstrated significant and continuous increases in the frequencies of resistances to several antibiotics (tetracycline, streptomycin, enrofloxacin, ampicillin, and trimethoprim-sulfamethoxazole) and of the relevant resistance genes (tetA, strA-strB, and TEM), mutations in gyrA and parC, and multidrug-resistant APEC strains during the period 2000 to 2005.
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Affiliation(s)
- Tae-Eun Kim
- Laboratory of Avian Diseases, Seoul National University, San 56-1, Shillim-Dong, Gwanak-Gu, Seoul, 151-742, Korea
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Zhao S, Maurer JJ, Hubert S, De Villena JF, McDermott PF, Meng J, Ayers S, English L, White DG. Antimicrobial susceptibility and molecular characterization of avian pathogenic Escherichia coli isolates. Vet Microbiol 2005; 107:215-24. [PMID: 15863280 DOI: 10.1016/j.vetmic.2005.01.021] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2004] [Revised: 12/22/2004] [Accepted: 01/28/2005] [Indexed: 10/25/2022]
Abstract
Ninety-five avian pathogenic Escherichia coli (APEC) isolates recovered from diagnosed cases of avian colibacillosis from North Georgia between 1996 and 2000 were serotyped and examined for typical virulence-factors, susceptibility to antimicrobials of human and veterinary significance, and genetic relatedness. Twenty different serotypes were identified, with O78 being the most common (12%). The majority of the avian E. coli isolates (60%), however, were non-typeable with standard O antisera. Eighty-four percent of isolates were PCR positive for the temperature-sensitive hemagglutinin (tsh) gene and 86% positive for the increased serum survival (iss) gene. Multiple antimicrobial-resistant phenotypes (> or =3 antimicrobials) were observed in 92% of E. coli isolates, with the majority of isolates displaying resistance to sulfamethoxazole (93%), tetracycline (87%), streptomycin (86%), gentamicin (69%), and nalidixic acid (59%). Fifty-six E. coli isolates displaying resistance to nalidixic acid were co-resistant to difloxacin (57%), enrofloxacin (16%), gatifloxacin (2%), and levofloxacin (2%). DNA sequencing revealed point mutations in gyrA (Ser83-Leu, Asp87-Tyr, Asp87-Gly, Asp87-Ala), gyrB (Glu466-Asp, Asp426-Thr), and parC (Ser80-Ile, Ser80-Arg). No mutations were observed in parE. Twelve of the quinolone-resistant E. coli isolates were tolerant to cyclohexane, a marker for upregulation of the acrAB multi-drug resistance efflux pump. Quinolone-resistant isolates were further genetically characterized via ribotyping. Twenty-two distinct ribogroups were identified, with 61% of isolates clustering into four major ribogroups, indicating that quinolone resistance has emerged among multiple avian pathogenic E. coli serogroups and chromosomal backgrounds.
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Affiliation(s)
- Shaohua Zhao
- Office of Research, Center for Veterinary Medicine, U.S. Food and Drug Administration, 8401 Muirkirk Road, Laurel, MD 20708, USA
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