Dominance of CTX-M group 1 beta-lactamase enzymes in ESBL producing E. coli from outpatient urines in neighboring regions of Austria and Italy

Abstract

The importance of extended spectrum β-lactamases (ESBL) is increasing worldwide. ESBLs of the CTX-M type are on the rise in Europe, not only in the hospital environment but also in outpatients. Therefore we performed a comparative pilot study including ESBL producing Escherichia coli isolated from outpatients suffering from urinary tract infections, 28 from Innsbruck, Austria, and 34 from Bolzano, Italy. Using established PCR methods we detected in nearly 90% of ESBL producing E. coli isolates CTX-M group 1 enzymes and only a few group 2 or group 9 enzymes. bla (TEM), bla (OXA-1) and aminoacyltransferase aac(6')-lb were significantly more frequent in the Austrian region, where also bla (SHV )was found in one isolate. In 2009 the overall prevalence of ESBL in E. coli causing urinary tract infection in outpatient samples was 7.6% in a local laboratory in Innsbruck and 5% in Bolzano. Additionally, we investigated plasmid-mediated qnr genes which can contribute to quinolone resistance, qnrA was found in an AmpC producing E. coli from Innsbruck and qnrS in two ESBL producers from Bolzano. Data confirmed that ESBL-producing E. coli have emerged as important pathogens in urinary tract infections of outpatients in both regions.

The Mediterranean Region : A Reservoir for CTX - M - ESBL - Producing Enterobacteriacae

“…Although the rate of CTX-M production varied between hospitals (1.2 to 49.5% of ESBL producers), all these isolates belonged to CTX-M group 1 with CTX-M-15 and CTX-M-1 being the most prevalent variants (60% and 35%, respectively) and CTX-M-32 carried only by a minority (5%). In 2011, the dominance of CTX-M group 1 ESBL-producing E. coli causing urinary tract infections among outpatients was reported (Huemer et al, 2011). More recently, an outbreak of colonization by ESBL producing E. coli sequence type 11 was identified in a neonatal intensive care unit.…”

Laboratory identification, risk factors, and clinical outcomes of patients with bacteremia due to Escherichia coli and Klebsiella pneumoniae Producing Extended-Spectrum and AmpC type β-Lactamases

“…However, communityacquired ESBL producingeE coli, especially of CTX-M-type ESBL, has now become a growing problem worldwide and has changed the epidemiology of infections related to antibiotic-resistant bacteria. 2,3,4,5 Similarly, plasmidmediated ACBL-producing bacteria also serve as communitybased reservoirs for 3GC-R strains. 3,6 Effective treatments for infections caused by ESBL-producing E coli or K pneumoniae are limited to only a few antibiotics, including carbapenems and noneb-lactam antibiotics.…”

Nationwide study of Escherichia coli producing extended-spectrum β-lactamases TEM, SHV and CTX-M in Turkey

“…11 ESBL-producing E. coli strains isolated from Austria and Italy showed that they expressed CTX-M group I enzymes predominantly. 12 Molecular characterization of ESBLs in 440 E. coli isolates from 10 centers between 2011 and 2012 was examined. Molecular analyses of particular ESBL types on a national level performed in district hospitals have contributed to a better understanding of the epidemiology of the strains producing these enzymes at local, national and international level.…”