Evolution of CTX-M-type β-lactamases in isolates of Escherichia coli infecting hospital and community patients

Brigante, Gioconda; Luzzaro, Francesco; Perilli, Mariagrazia; Lombardi, Giuseppe; Colì, Alessandra; Rossolini, Gian María; Amicosante, Gianfranco; Toniolo, Antonio

doi:10.1016/j.ijantimicag.2004.09.013

Cited by 87 publications

(54 citation statements)

References 27 publications

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“…The prevalence of CTX-Ms among ESBL-positive K. pneumoniae strains was also similarly high in Lausanne (76%) and in Paris (83%), whereas this value was much lower in Austria (30%) and in Italy (12.3%) (20). Most ESBL-producing E. coli isolates (62%) have been isolated from urinary tract infections, as found in other studies (4,23,29). More than one-third of CTX-M-producing isolates were from community-acquired infections, as reported from other European countries (3,4,22).…”

Section: Discussionsupporting

confidence: 71%

“…as reported in France (Bicêtre Hospital [personal data]) and especially in central and southern France (17), in Austria (9), and in Amsterdam (1). CTX-M-15 was the predominant CTX-M in Lausanne (94%), as elsewhere in Western Europe (4,17,20,29). Twenty percent of the CTX-M enzymes were CTX-M-9-like in Lausanne, 26% were CTX-M-9-like in Austria, and only 11% were CTX-M-9-like in Bicêtre Hospital.…”

Section: Discussionmentioning

confidence: 94%

“…Since those CTX-Ms are reported increasingly in France (8,15,17,26), Italy (4,20), and recently Austria (9), it was interesting to search for those enzymes in Switzerland, a country known to have a strict policy of antibiotic prescription and to have an overall low level of multidrug resistance in bacteria (10).…”

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confidence: 99%

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Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

Lartigue

Zinsius

Wenger

et al. 2007

Antimicrob Agents Chemother

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The epidemiology of clavulanic acid-inhibited extended-spectrum ␤-lactamases (ESBLs) was investigated among infection-associated enterobacterial isolates at the University Hospital in Lausanne, Switzerland, from January 2004 to June 2005. Out of 57 nonrepetitive ESBL producers (prevalence rate of 0.7%), 45 produced CTX-M-like ESBLs. CTX-M enzymes were mostly from clonally nonrelated Escherichia coli isolates, from urinary infections and community-acquired infections. Pediatric patients (20 out of 57) accounted for a large number of CTX-M producers. CTX-M-15 was the most frequent CTX-M-type enzyme. The plasmid-located bla CTX-M genes were associated with either ISEcp1 or ISCR1 insertion sequences. This study is the first published report of CTX-M-type ␤-lactamases in Switzerland.Plasmid-mediated extended-spectrum ␤-lactamases (ESBLs) were first identified in a Klebsiella pneumoniae isolate in Germany in 1983 (14). Since then, ESBL-positive Enterobacteriaceae have been isolated worldwide mostly from hospitalized patients (18). These enzymes hydrolyze significantly expandedspectrum cephalosporins such as cefotaxime and ceftazidime and the monobactam aztreonam, sparing carbapenems. Their activity is inhibited in vitro by clavulanic acid. Until the 2000s, most of the ESBLs were structurally related to the narrowspectrum TEM-and SHV-type ␤-lactamases, with one to several amino acid substitutions surrounding their active site (18). Beginning in the late 1990s, novel types of ESBLs, the CTX-M enzymes, emerged worldwide, mostly from Escherichia coli. The CTX-Ms are mostly from community-acquired isolates (2,22). The over 50 CTX-M enzymes so far reported may be grouped into five main subgroups according to amino acid sequence identity (CTX-M-1, -M-2, -M-8, -M-9, and -M-25) (2). Most of the CTX-Ms hydrolyze cefotaxime better than ceftazidime. However, several CTX-Ms including CTX-M-15 (2, 12, 25), which is now the most widespread CTX-M enzyme worldwide (6), hydrolyze ceftazidime efficiently (25).Since those CTX-Ms are reported increasingly in France (8,15,17,26), Italy (4,20), and recently Austria (9), it was interesting to search for those enzymes in Switzerland, a country known to have a strict policy of antibiotic prescription and to have an overall low level of multidrug resistance in bacteria (10).The aim of the present study was to estimate the prevalence and the type of the ESBLs produced by enterobacterial isolates among nonrepetitive clinical isolates over an 18-month period from January 2004 to June 2005 at the University Hospital of Lausanne, Switzerland. MATERIALS AND METHODSBacterial isolates. ESBL-producing enterobacterial isolates resulted from the screening of 8,259 enterobacterial isolates obtained from infection samples that were sent to the Department of Microbiology of the Lausanne University Hospital, Switzerland, from January 2004 to June 2005. Isolates were first identified by using the Vitek2 system (bioMérieux SA, Marcy-l'Etoile, France). Electrocompetent E. coli TOP10 (Invitrogen, Cergy Pontoise, ...

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 94%

See 1 more Smart Citation

Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

Lartigue

Zinsius

Wenger

et al. 2007

Antimicrob Agents Chemother

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“…Therefore, CTX-M production had no influence on virulence but was a major factor in clinical outcome [25]. However, this study results were in contrast with other studies [41][42] in which it was found that CTX-M-type ESBLs were mainly in E. coli strains with few virulence factors or in strains causing minor infections. Furthermore, 94.4% of CTX-M producers in this study were multidrug resistant of which 47.0% belonged to group B2, whereas only 26.3% of ESBL non-producers were MDR.…”

Section: Discussioncontrasting

confidence: 82%

Phylogenetic Grouping and Virulence Characterization of ESBL-Producing and Non-Producing Vaginal Escherichia Coli

Al-Mayahie¹

2014

AJBLS

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Abstract:The initial colonization of the vaginal mucosa with Escherichia coli is considered as a critical step toward urinary tract and neonatal infections. This study was conducted to characterize ESBL-producing (n=40) vaginal E. coli isolates from pregnant and non-pregnant women. These isolates were compared with corresponding ESBL-non-producing E. coli isolates (n=21). Both groups were investigated using PCR-based protocols for their phylogenetic origin and virulence genotype. High numbers of ESBL producers and non-producers were from group B2 (47.5% vs. 42.8%, respectively). None of ESBL nonproducers clustered in group D, whereas significant numbers (P ≤ 0.05) of them belonged to group B1 (33.3%) in comparison with 20.0% and 7.5% of ESBL producers, respectively. Significant differences in the prevalence of this study included virulence factors were not observed between these two groups. In both high rates of multiple virulence factors possession were demonstrated among isolates belonged to groups B2 and D. Comparison of CTX-M-producers with non-CTX-M-ESBLproducers and ESBL-non-producers revealed no significant differences among these three groups. In total, 60.8%, 17.3%, 17.3% and 4.3% of multidrug resistant (MDR) isolates clustered in groups B2, D, A and B1, respectively. All MDR-ESBL-non producers (100%) belonged to phylogroup B2 compared with 50% of MDR ESBL-producers and their virulence was much more higher. This study indicates that significant differences are not present between ESBL-producing and non-producing vaginal E. coli for both phylogenetic group distribution and virulence genes possession. Also, ESBL-producing vaginal E. coli, especially CTX-M producers, tend to be more dominant among the highly virulent phylogroup B2 and to a lesser extent group D. These data reveal the importance of vaginal colonization by these highly virulent, MDR, ESBL-producing E. coli as a source of extraintestinal E. coli infections.

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“…Similarly, CTX-M-15 producing isolates appear with increased in frequency among clonally related E. coli strains across Italy, Portugal and France [21][22][23][24]. In Spain, the clonal spread of E. coli harboring CTX-M-15 has occurred as well, but the situation appears more complex [25].…”

Section: The Emerging Threat Of Ctx-m Beta-lactamases In the Communitymentioning

confidence: 99%

The continuing challenge of ESBLs

Pérez

Endimiani

Hujer

et al. 2007

Current Opinion in Pharmacology

265

209

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Summary of recent advancesSince their first description more than twenty years ago, Escherichia coli and Klebsiella pneumoniae possessing extended-spectrum class A beta-lactamases (ESBLs) continue to thwart our best clinical efforts. In the "early years" the most common beta-lactamases were of the TEM and SHV varieties. Now, CTX-M enzymes are being discovered though out the world and are becoming the most prevalent beta-lactamases found in clinical isolates. The Klebsiella pneumoniae carbapenemases (KPC) (ESBL type enzymes that confer resistance to extended spectrum cephalosporins and carbapenems) present the most significant challenge to date. Structural studies of ESBLs indicate that active site expansion and remodeling are responsible for this extended hydrolytic activity. Continuing questions still exist regarding the optimal detection method for ESBLs. Most relevant are the increasing concerns regarding the status of carbapenems as "best therapy" for ESBL producing bacteria in light of the emergence of carbapenemases.

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Evolution of CTX-M-type β-lactamases in isolates of Escherichia coli infecting hospital and community patients

Cited by 87 publications

References 27 publications

Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland

Phylogenetic Grouping and Virulence Characterization of ESBL-Producing and Non-Producing Vaginal Escherichia Coli

The continuing challenge of ESBLs

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