First Description of CTX-M-15-Producing
            <i>Klebsiella pneumoniae</i>
            in Portugal

Conceição, Teresa; Brizio, Ana Paula Dutra Resem; Duarte, Aida; Lito, Luı́s; Melo‐Cristino, José; Salgado, Maria José

doi:10.1128/aac.49.1.477-478.2005

Cited by 35 publications

(29 citation statements)

References 12 publications

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“…There has been a recent dramatic increase in reports describing bacteria producing CTX-M-15 from different parts of the world, including North America (2), Europe (5,8,22), Asia (19), the Middle East (23), and Africa (1, 9) Therefore, results obtained with strains producing CTX-M-15 were of interest (Table 1). This is similar to the findings of Leflon-Guibout et al, who investigated clonally related E. coli isolates producing CTX-M-15 which caused outbreaks of UTIs in a geriatric hospital in France (20).…”

Section: Resultsmentioning

confidence: 99%

Virulence Factors of Escherichia coli Isolates That Produce CTX-M-Type Extended-Spectrum β-Lactamases

Pitout

Laupland

Church

et al. 2005

Antimicrob Agents Chemother

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This study determined the phylogenetic groups and virulence factors of 37 Escherichia coli isolates producing types of CTX-M compared with those of 19 isolates producing different types of extended-spectrum ␤-lactamases (ESBLs) in a well-defined North American population. Most CTX-M-14 producers (97%) were from phylogenic group D; 67% of the CTX-M-15 producers were from group B2. A single CTX-M-14-producing strain belonged to clonal group A. There were significant prevalence differences for individual virulence factors among CTX-M producers and nonproducers; however, aggregate virulence factor scores were similar. CTX-M producers more commonly caused repeat urinary tract infections. Our results indicate that CTX-M type predicts phylogenetic background, and the virulence potential of ESBL-producing E. coli isolates is a complex issue, requiring further study and ongoing surveillance.Enterobacteriaceae, especially Klebsiella spp. producing extended-spectrum ␤-lactamases (ESBLs), such as SHV and TEM types, have been recognized since the 1980s as a major cause of hospital-acquired infections (3). However, during the late 1990s and 2000s, Enterobacteriaceae (mostly Escherichia coli) producing novel ESBLs, the CTX-M enzymes, have been identified, from both the hospital and community settings (26). Surveys from several countries, including Canada (25), Spain (27), and the United Kingdom (31) show that CTX-M-producing E. coli strains isolated from community sites, exhibited coresistance to trimethoprim-sulfamethoxazole, tetracycline, gentamicin, and ciprofloxacin, further limiting therapeutic options.Phylogenetic analyses have shown that E. coli strains fall into four main phylogenetic groups (A, B1, B2, and D) (10). Virulent extraintestinal strains derive mainly from group B2 and, to a lesser extent, group D, whereas most commensal strains derive from groups A and B1 (11). Most virulence factors are concentrated predominantly either within group B2 or jointly within groups B2 and D, although certain factors are concentrated significantly in group D but not in group B2, while others are distributed across the population without a significant concentration in either group B2 or group D. These diverse patterns suggest more complex evolutionary histories for the various virulence factors present in E. coli. Fluoroquinolone-resistant E. coli isolates causing urinary tract infections (UTIs) most often belong to the low-virulence phylogenetic groups A and B1 (12) or group D (14). Such resistant strains typically exhibit a decreased prevalence of certain virulence factors and a seemingly reduced invasive capacity (30). We studied a well-defined population from North America to determine the virulence-associated traits of E. coli isolates from community and hospital source specimens. Specifically, isolates producing types of CTX-M ␤-lactamases were compared, according to phylogenetic group and virulence factor profile, with E. coli isolates producing different types of well-characterized ESBLs.

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Section: Resultsmentioning

confidence: 99%

Virulence Factors of Escherichia coli Isolates That Produce CTX-M-Type Extended-Spectrum β-Lactamases

Pitout

Laupland

Church

et al. 2005

Antimicrob Agents Chemother

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“…According to the antibiotic susceptibility, ESBL genes (bla TEM and bla CTX-M type) and cephalosporinases (AmpC) were characterized by polymerase chain reaction (PCR) and sequencing using specific primers previously described [11][12][13][14].…”

Section: Antibiotic Susceptibility and β-Lactamases Identificationmentioning

confidence: 99%

Persistence of uropathogenic Escherichia coli strains in the host for long periods of time: relationship between phylogenetic groups and virulence factors

Narciso

Nunes

Amores

et al. 2011

Eur J Clin Microbiol Infect Dis

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Escherichia coli cause the majority of urinary tract infections (UTIs). Virulence plays an important role in the initial stages of interaction with the host, facilitating colonization of the urinary tract tissue. The purpose of this study was to assess whether there is a relationship between virulence and antibiotic resistance in the persistence of uropathogenic E. coli strains. This study included five patients with UTI between 2001 and 2009. The antibiotic resistance phenotype of 29 E. coli isolates was determined by the disk diffusion method. Clonal relationship was determined through M13 polymerase chain reaction (PCR) fingerprinting. Phylogeny, virulence factors, β-lactamases, and replicon typing were studied through PCR. Antibiogram profiles were found from different patients and corresponded to CTX-M-2, CTX-M-15, CTX-M-32, and TEM-52 enzymes. Plasmids belonged essentially to incompatibility group IncF. No clonal relationship was observed among isolates from different patients, except for patients 4 and 5. Phylogenetic group A was predominant. Our work showed that commensal group A possesses the same virulence factors as the pathogenic groups B1 and D. E. coli common pilus and type 1 fimbriae could play an important role in the persistence in the host and in symptomatic UTI, respectively, which, combined with extended-spectrum β-lactamases (ESBLs), are a cause of the dissemination of microorganisms in the hospital and the community.

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“…CTX-M-15, recently detected in Portugal, is an extended-spectrum ␤-lactamase (ESBL) that has spread worldwide (3,4,9,10,15). The basis for the successful dissemination of bla CTX-M-15 is unknown, although the spread of epidemic Escherichia coli strains and/or conjugative plasmids harboring bla CTX-M-15 has been documented (3,6).…”

mentioning

confidence: 99%

Dissemination in Portugal of CTX-M-15-, OXA-1-, and TEM-1-Producing Enterobacteriaceae Strains Containing the aac(6 ′ )-Ib-cr Gene, Which Encodes an Aminoglycoside- and Fluoroquinolone-Modifying Enzyme

Machado

Coque

Cantón

et al. 2006

Antimicrob Agents Chemother

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First Description of CTX-M-15-Producing Klebsiella pneumoniae in Portugal

Cited by 35 publications

References 12 publications

Virulence Factors of Escherichia coli Isolates That Produce CTX-M-Type Extended-Spectrum β-Lactamases

Virulence Factors of Escherichia coli Isolates That Produce CTX-M-Type Extended-Spectrum β-Lactamases

Persistence of uropathogenic Escherichia coli strains in the host for long periods of time: relationship between phylogenetic groups and virulence factors

Dissemination in Portugal of CTX-M-15-, OXA-1-, and TEM-1-Producing Enterobacteriaceae Strains Containing the aac(6 ′ )-Ib-cr Gene, Which Encodes an Aminoglycoside- and Fluoroquinolone-Modifying Enzyme

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