Several pieces of evidence suggest that certain pathobionts belonging to Enterobacterales are associated with the development and progression of inflammatory bowel diseases (IBD). Extended-spectrum β-lactamases (ESBLs) ESBLs are frequently found in the Enterobacterales members, particularly in Escherichia coli and Klebsiella spp., and might trigger antibiotic-induced perturbations of the intestinal microbiota and led to more severe disease activity in IBD. Therefore, the severity of IBD could be influenced by ESBL-producing Enterobacterales, and hence, this study aimed to investigate the presence of ESBLs and carbapenemases among mucosa-associated E. coli and Klebsiella pneumoniae isolated from colonic biopsies of Iranian patients with IBD. In this cross-sectional study, E. coli and K. pneumoniae were isolated from inflamed ileum and/or colon tissue of patients with IBD, including Ulcerative colitis (UC) and Crohn’s disease (CD), during colonoscopy. Demographic data and clinical characteristics were recorded, and UC and CD disease activity and extent were evaluated according to the full Mayo score and Crohn’s disease activity index (CDAI), respectively. Phenotypic and molecular detection of ESBL- and carbapenemase-producing E. coli and Klebsiella pneumoniae were carried out. Disease activity and other clinical and microbial features were compared in patients with and without gut colonization with ESBL producers. A total of 83 IBD patients, including 67 UC and 16 CD, were enrolled in the initial analysis. Intestinal colonization with ESBL-producing E. coli and/or Klebsiella pneumoniae was found in 37 (55.2%) of UC and 9 (56.2%) of DC patients – mostly harbored E. coli containing the blaCTX−M and blaTEM genes. UC patients with intestinal colonization with ESBL-producers had more severe disease compared with patients without colonization. Moreover, 10.2% of tested E. coli and 34.8% of K. pneumoniea were recognized as potential carbapenemase producers. Intestinal colonization with ESBL producers could arise disease activity in IBD patients. Further large-scale case-control studies should be performed to investigate the possible confounding factors that could contribute to this outcome.

中文翻译：

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伊朗炎症性肠病 (IBD) 患者中粘膜相关超广谱 β-内酰胺酶大肠杆菌和肺炎克雷伯菌的患病率较高

多项证据表明，某些属于肠杆菌目的病原体与炎症性肠病 (IBD) 的发生和进展有关。超广谱 β-内酰胺酶 (ESBL) ESBL 常见于肠杆菌目成员，特别是大肠杆菌和克雷伯氏菌属，可能会引发抗生素引起的肠道微生物群扰动，并导致 IBD 疾病活动更为严重。因此，IBD 的严重程度可能受到产 ESBL 肠杆菌的影响，因此，本研究旨在调查从伊朗 IBD 患者结肠活检中分离出的粘膜相关大肠杆菌和肺炎克雷伯菌中是否存在 ESBL 和碳青霉烯酶。在这项横断面研究中，在结肠镜检查期间，从IBD（包括溃疡性结肠炎（UC）和克罗恩病（CD））患者发炎的回肠和/或结肠组织中分离出大肠杆菌和肺炎克雷伯菌。记录人口统计数据和临床特征，并分别根据完整 Mayo 评分和克罗恩病活动指数 (CDAI) 评估 UC 和 CD 疾病活动度和程度。对产 ESBL 和碳青霉烯酶的大肠杆菌和肺炎克雷伯菌进行了表型和分子检测。对有和没有 ESBL 产生者肠道定植的患者的疾病活动性以及其他临床和微生物特征进行了比较。总共 83 名 IBD 患者（包括 67 名 UC 和 16 名 CD）参与了初步分析。在 37 名 (55.2%) UC 和 9 名 (56.2%) DC 患者中发现产 ESBL 大肠杆菌和/或肺炎克雷伯菌的肠道定植，其中大部分含有含有 blaCTX−M 和 blaTEM 基因的大肠杆菌。与未定植的患者相比，肠道定植有 ESBL 产生者的 UC 患者病情更严重。此外，10.2% 的测试大肠杆菌和 34.8% 的肺炎克雷伯菌被认为是潜在的碳青霉烯酶生产者。ESBL 产生者的肠道定植可能会导致 IBD 患者出现疾病活动。应进行进一步的大规模病例对照研究，以调查可能导致这一结果的混杂因素。