High prevalence of multidrug resistant ESBL- and plasmid mediated AmpC-producing clinical isolates of Escherichia coli at Maputo Central Hospital, Mozambique

Abstract Background Epidemiological data of cephalosporin-resistant Enterobacterales in Sub-Saharan Africa is still restricted, and particular Mozambique. The aim this study was to detect characterize extended-spectrum ?-lactamase (ESBL) - plasmid-mediated AmpC (pAmpC)-producing clinical strains Escherichia coli at Maputo Central Hospital (MCH), a 1000-bed reference hospital Maputo, Methods A total 230 isolates E. from urine ( n = 199) blood cultures 31) were collected MCH during August–November 2015. Antimicrobial susceptibility testing performed by the disc diffusion method interpreted according EUCAST guidelines. Isolates with reduced 3rd generation cephalosporins examined further; phenotypically for an ESBL?/AmpC-phenotype combined methods genetically ESBL- pAmpC-encoding genes PCR partial amplicon sequencing as well genetic relatedness ERIC-PCR. Results 75 cefotaxime and/or ceftazidime 75) 58/199; 29%) 17/31; 55%) detected. All ESBL-positive 25/75 (33%) those also expressed AmpC-phenotype. ESBL-PCR revealed majority bla CTX-M 58/75; 77%) dominated CTX-M-15 . AmpC-phenotype positive 25/75; 33%) scored one or more pAmpC-genes MOX/FOX Multidrug resistance (resistance ? three antibiotic classes) observed all trimethoprim-sulfamethoxazole, ciprofloxacin gentamicin. ERIC-PCR diversity among minor clusters indicating intra-hospital spread. Conclusion We have high prevalence MDR pAmpC- ESBL-producing FOX/MOX CTX-Ms major types, respectively. analyses some within-hospital overall findings strongly support urgent need accurate rapid diagnostic services guide treatment improved infection control measures.