Antimicrobial Resistance, β-Lactamases, and Virulence-Associated Genes in Clinical Escherichia coli Isolates from a Pediatric Tertiary-Care Hospital in Honduras

Abstract

The co-occurrence of antimicrobial resistance and virulence in Escherichia coli threatens the treatment of pediatric infections, particularly in regions with limited molecular data. We characterized 67 clinical isolates recovered at a tertiary-care pediatric hospital in Tegucigalpa, Honduras, during 2017–2018. Antimicrobial susceptibility was assessed by disk diffusion; extended-spectrum β-lactamase (ESBL) and carbapenemase phenotypes by Etest; and β-lactam resistance and virulence-associated genes by PCR. Overall, 35.8% of isolates were multidrug-resistant. The highest resistance frequencies were observed for trimethoprim/sulfamethoxazole (65.7%), ciprofloxacin (37.3%), cefepime and ceftriaxone (35.8% each), and ceftazidime (34.3%). Of the 24 isolates resistant to third- and/or fourth-generation cephalosporins, 19 had a confirmed ESBL phenotype. One isolate exhibited a metallo-β-lactamase phenotype. A total of 23 isolates underwent molecular analysis, and at least one β-lactamase gene was detected in nine isolates; blaTEM was detected in seven isolates, blaSHV in two, and blaNDM in one. In addition, 65 isolates (97.0%) carried virulence-associated genes, most commonly fimH (85.1%), feoB (74.6%), and iucD (67.2%). The marked co-occurrence observed among resistance phenotypes and among virulence-associated genes underscores the need to strengthen epidemiological and molecular surveillance of E. coli in the Honduran pediatric population.