Bloodstream Infections due to Enterobacteriaceae Among Neonates in Poland – Molecular Analysis of the Isolates

Abstract

Bloodstream infections (BSIs) are associated with a significantly increased risk of fatality. No report has been found about the molecular epidemiology of Enterobacteriaceae causing BSI in neonates in Poland. The aim of this work was to determine the antibiotic resistance profiles, virulence gene prevalence, the epidemiological and genetic relationships among the isolates from Enterobacteriaceae causing BSI in neonates with birth weight < 1501 g. Antimicrobial susceptibility testing was performed. PCR was performed to identify the presence of common beta-lactamase genes, virulence genes. PFGE and MLST were performed. The surveillance group contained 1,695 newborns. The incidence rate for BSIs was 5.9%, the fatality rate 15%. The most common species were Escherichia coli (n = 24) and Klebsiella pneumoniae (n = 16). CTX-M-15 was found in 6 E. coli, 8 K. pneumoniae, 1 Enterobacter cloacae strains. Among E. coli fimH (83.3%), ibeA (37.5%), neuC (20.8%) were the most frequent. PFGE demonstrated unique pulsotypes among E. coli. E. coli ST131 clone was found in 7 E. coli strains. PFGE of 16 K. pneumoniae strains showed 8 pulsotypes. Five isolates from one NICU belonged to one clone. MLST typing revealed 7 different ST with ST336 as the most prevalent. This study provides information about resistance, virulence and typing of Enterobacteriaceae strains causing BSI among neonates. E. coli and Klebsiella spp. isolated in this study have completely different epidemiology from each other.

Sites of colonization in hospitalized patients with infections caused by extended-spectrum beta-lactamase organisms: a prospective cohort study

“…This is in congruence with previous data from our center that showed CTX-M-15 to be the most common ESBL enzyme produced among E. coli and Klebsiella species [18]. High prevalence of the CTX-M gene has been described in various reports from different geographical regions including Europe [21], Asia [22], and the Americas [23]. Of interest is evidence suggesting that this enzyme is expressed in bacterial strains harbored by dogs, livestock, and birds [24, 25].…”

Similar Strains of Coagulase-Negative Staphylococci Found in the Gastrointestinal Tract and Bloodstream of Bacteremic Neonates

“…Because of these factors, neonates treated in the ICU setting are particularly susceptible to acquiring nosocomial infections. As such, the length of hospitalization has been shown to correlate with the prevalence of late-onset BSIs in very-low birth weight neonates [19,20]. It has been shown that almost 40% of all neonates, both full-term and premature, being treated in the NICU will contract a nosocomial infection [21].…”

Long-lasting outbreak due to CTX-M-15-producing Klebsiella pneumoniae ST336 in a rehabilitation ward: report and literature review

“…K. pneumoniae isolates of clonal complex 17 are well recognized contributors to the spread of CTX-M-15 worldwide [31] and ST336 is among the less prevalent yet international clones that have been associated with the spread of various ESBL enzymes, including CTX-M-15, and even carbapenemase resistance [23,32,33]. K. pneumoniae ST336 has been reported in blood, urine, stool, exudate, intraabdominal and respiratory tract specimens and an unknown specimen from 45 patients in North America, Europe and Asia [27,28,[31][32][33][34][35][36]. While 14 of the cases were sporadic and seemingly unrelated, one Portuguese study revealed an almost yearlong nosocomial and clonal outbreak that affected mostly kidney transplant patients and patients with urinary tract disorders; the organism was isolated from urine in 27 of the 31 case patients [31].…”