Detection of CTX-M-Type β-Lactamase Genes in Fecal
            <i>Escherichia coli</i>
            Isolates from Healthy Children in Bolivia and Peru

Pallecchi, Lucia; Malossi, Monica; Mantella, Antonia; Gotuzzo, Eduardo; Trigoso, Christian; Bartoloni, Alessandro; Paradisi, Franco; Kronvall, Göran; Rossolini, Gian María

doi:10.1128/aac.48.12.4556-4561.2004

Cited by 81 publications

(61 citation statements)

References 35 publications

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“…In contrast, they differ from those obtained in children from Asia and South America (28,29) and particularly from those obtained in the North American pediatric study by Chandramohan et al (30), who found 60% bla CTX-M-15 , 14.3% bla CTX-M-14 , and 2.1% bla CTX-M-27 ESBLs. In addition, CTX-M diversity was higher in our study, with the presence of CTX-M-1, -14, -15, -3, -2, -27, and -57 (28)(29)(30).…”

Section: Discussioncontrasting

confidence: 51%

Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Strains Involved in Maternal-Fetal Colonization: Prevalence of E. coli ST131

et al. 2013

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dMaternal-fetal Escherichia coli infections, such as neonatal bacteremia and meningitis, are important causes of morbidity and mortality. From 2006 to 2010, we studied newborns and their mothers who were colonized with E. coli in a French hospital in order to document (i) the epidemiology and genetic characteristics of extended-spectrum-beta-lactamase (ESBL)-producing E. coli strains, (ii) the prevalence of associated virulence genes, (iii) the prevalence of clone sequence type 131 (ST131), and (iv) the genetic relationship among ESBL-producing strains. Among the 2,755 E. coli cultures recovered from vaginal or neonatal samples, 68 were ESBL producers (2.46%). We found a wide diversity of ESBL genes, with the majority being bla CTX-M-14 , bla CTX-M-1 , and bla CTX-M-15 , distributed among the 4 main phylogenetic groups. Genes encoding virulence factors were found in 90.7% of the isolates, with >2 virulence genes present in 76% of cases. The prevalence of ST131 among ESBL-producing E. coli isolates was 9.4% (6/64). Five of these 6 ST131 isolates possessed bla CTX-M-15 enzymes (and also were resistant to quinolones), and one possessed bla CTX-M-2 enzymes. Two possessed virulence genes, suggesting the presence of pathogenicity island II J96 (PAI II J96 )-like domains. Pulsed-field gel electrophoresis (PFGE) revealed a high level of genomic diversity overall, except for 3 closely related isolates belonging to clonal group ST131. Repetitive PCR showed that the six ST131 isolates were closely related to ST131 control strains (>95% similarity). This study shows a high prevalence of ESBL-producing E. coli strains and clonal group ST131 in the French maternal-fetal population. These results suggest a widespread distribution of ESBL enzymes in the community and highlight the early transmission between mothers and neonates. These findings are worrisome, especially for this particularly vulnerable population. In the past decade, there has been an alarming increase in antibiotic-resistant Enterobacteriaceae producing extended-spectrum beta-lactamases (ESBLs), due at least in part to the overuse of broad-spectrum cephalosporins.The majority of ESBLs identified in clinical isolates during the 1980s to 1990 were of the SHV or TEM type (1). However, since the mid-2000s, CTX-M ESBLs, originating from environmental Kluyvera spp., have gained prominence and are considered pandemic enzymes. CTX-M has been identified in several members of the Enterobacteriaceae family, and especially in Escherichia coli, which has replaced Klebsiella spp. as the principal ESBL-producing member of the Enterobacteriaceae (2-4).ESBL enzymes are important causes of cephalosporin treatment failure. E. coli strains carrying these enzymes were initially responsible mainly for nosocomial infections, but they have now disseminated into the community. One of the best examples of this trend is the global spread of E. coli clone sequence type 131 (ST131), expressing CTX-M enzymes (5). Maternal-fetal E. coli infections, such as neonatal bacteremia and meningitis,...

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Section: Discussioncontrasting

confidence: 51%

Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Strains Involved in Maternal-Fetal Colonization: Prevalence of E. coli ST131

et al. 2013

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“…Amplicons were sequenced on both strands at an external facility (Macrogen Inc., Seoul, South Korea), and the deduced protein sequences were compared with those available in the GenBank database by using the BLAST program (http://blast.ncbi.nlm.nih.gov). The presence of bla CTX-M , bla OXA-9 , bla SHV , bla TEM , bla IMP , bla VIM , and bla KPC ␤-lactamase genes was investigated using primers and methods described previously (26)(27)(28)(29).…”

Section: Fig 1 Evolution Of the Outbreak Caused By Esc-resistant K Pmentioning

confidence: 99%

Large Oligoclonal Outbreak Due to Klebsiella pneumoniae ST14 and ST26 Producing the FOX-7 AmpC β-Lactamase in a Neonatal Intensive Care Unit

et al. 2013

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A large outbreak caused by expanded-spectrum cephalosporin-resistant Klebsiella pneumoniae (ESCRKP) was observed in a neonatal intensive care unit (NICU) in central Italy. The outbreak involved 127 neonates (99 colonizations and 28 infections, with seven cases of sepsis and two deaths) over a period of more than 2 years (February 2008 to April 2010). Characterization of the 92 nonredundant isolates that were available for further investigation revealed that all of them except one produced the FOX-7 AmpC-type ␤-lactamase and belonged to either sequence type 14 (ST14) or ST26. All of the FOX-7-positive isolates were resistant to cefotaxime, ceftazidime, and piperacillin-tazobactam, while 76% were susceptible to cefepime, 98% to ertapenem, 99% to meropenem, and 100% to imipenem. The two carbapenem-nonsusceptible isolates had alterations in the genes encoding outer membrane proteins K35 and K36, which resulted in truncated and likely nonfunctional proteins. The outbreak was eventually controlled by the reinforcement of infection control measures based on a multitiered interventional approach. This is the first report of a large NICU outbreak caused by ESCRKP producing an AmpC-type enzyme. This study demonstrates that AmpCtype enzyme-producing strains can cause large outbreaks with significant morbidity and mortality effects (the mortality rate at 14 days was 28.5% for episodes of sepsis), and it underscores the role of laboratory-based surveillance and infection control measures to contain similar episodes.

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“…According to several recent publications, E. coli isolates producing extended-spectrum ␤-lactamases (ESBL) of the CTX-M type have emerged in the community in numerous countries (25)(26)(27)(28). These isolates resist extended-spectrum cephalosporins because of CTX-M production and are often resistant to other antibiotic families, in particular fluoroquinolones and/or cotrimoxazole (28).…”

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confidence: 99%

Absence of CTX-M Enzymes but High Prevalence of Clones, Including Clone ST131, among Fecal Escherichia coli Isolates from Healthy Subjects Living in the Area of Paris, France

et al. 2008

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Quinolone-resistant and CTX-M-15-producing Escherichia coli isolates belonging to clone ST131 have been reported in the community. This study was designed to identify these E. coli isolates in the stools of 332 independent healthy subjects living in the area of Paris, France. Stools were plated on media without antibiotics, in order to obtain the dominant (Dm) fecal E. coli strain, and with nalidixic acid (NAL) and cefotaxime. Quinolone susceptibility, phylogenetic groups, and molecular profiles, including multilocus sequence types (ST), were determined for all NAL-resistant (NAL-R) isolates. Groups were also determined for the Dm strains from participants with NAL-R isolates and from a subgroup without NAL-R isolates. All B2 isolates were typed; pulsed-field gel electrophoresis was performed for the ST131 isolates, and the results were compared with those for intercontinental clone ST131. Two participants (0.6%) had extended-spectrum ␤-lactamase-producing (SHV-2, TEM-52) fecal E. coli isolates, and 51 (15%) had NAL-R isolates; 51% of NAL-R isolates belonged to phylogenetic group A, 31% to group D, 16% to group B2, and 2% to group B1. The Dm strain was NAL-R in 3.3% of the 332 subjects. Forty-nine percent of the NAL-R isolates belonged to clones: ST10 and ST606 for group A isolates, ST117 and ST393 for group D isolates. Of all B2 isolates studied from 100 subjects (8 NAL-R strains; 19 NAL-susceptible dominant strains), 52% belonged to three clones: ST131 (n ‫؍‬ 7), ST95 (n ‫؍‬ 4), and ST141 (n ‫؍‬ 3). This is the first study to show the presence of fecal E. coli isolates of clone ST131 in 7% of independent healthy subjects not colonized by CTX-M-15-producing isolates.Escherichia coli, a universal commensal of humans and several animal species, is also one of the most common enterobacterial species to cause extraintestinal infections in their hosts (30). According to several recent publications, E. coli isolates producing extended-spectrum ␤-lactamases (ESBL) of the CTX-M type have emerged in the community in numerous countries (25)(26)(27)(28). These isolates resist extended-spectrum cephalosporins because of CTX-M production and are often resistant to other antibiotic families, in particular fluoroquinolones and/or cotrimoxazole (28). This pattern of multidrug resistance is dangerous for the treatment of communityacquired infections, because these drugs are often prescribed by general practitioners, especially for urinary tract infections (UTIs). Moreover, a clonal group producing CTX-M-15 has been identified among fluoroquinolone-resistant and CTX-M-producing E. coli isolates (phylogenetic group B2, O25:H4, ST131) in both inpatients and outpatients all over the world, strongly suggesting that this clone can disseminate widely (20).Because of these recent data and because the main reservoir of extraintestinal pathogenic E. coli isolates is the human digestive tract (8), the aim of this study was to identify CTX-M-15-producing E. coli isolates and E. coli clone ST131 in the guts of healthy adult subjects living ...

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Detection of CTX-M-Type β-Lactamase Genes in Fecal Escherichia coli Isolates from Healthy Children in Bolivia and Peru

Cited by 81 publications

References 35 publications

Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Strains Involved in Maternal-Fetal Colonization: Prevalence of E. coli ST131

Characterization of Extended-Spectrum-Beta-Lactamase-Producing Escherichia coli Strains Involved in Maternal-Fetal Colonization: Prevalence of E. coli ST131

Large Oligoclonal Outbreak Due to Klebsiella pneumoniae ST14 and ST26 Producing the FOX-7 AmpC β-Lactamase in a Neonatal Intensive Care Unit

Absence of CTX-M Enzymes but High Prevalence of Clones, Including Clone ST131, among Fecal Escherichia coli Isolates from Healthy Subjects Living in the Area of Paris, France

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