TEM,CTX-M,SHV Genes in ESBL-Producing Escherichia coli and Klebsiella pneumoniae Isolated from Clinical Samples in a County Clinical Emergency Hospital Romania-Predominance of CTX-M-15

Abstract

Background: CTX-M betalactamases have shown a rapid spread in the recent years among Enterobacteriaceae and have become the most prevalent Extended Spectrum Beta-Lactamases (ESBLs) in many parts of the world. The introduction and dissemination of antibiotic-resistant genes limits options for treatment, increases mortality and morbidity in patients, and leads to longer hospitalization and expensive costs. We aimed to identify the beta-lactamases circulating encoded by the genes blaCTX-M-15, blaSHV-1 and blaTEM-1 in Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) strains. Furthermore, we established the associated resistance phenotypes among patients hospitalized in the Intensive Care Unit (ICU) from County Clinical Emergency Hospital of Craiova, Romania. Methods: A total of 46 non-duplicated bacterial strains (14 strains of E. coli and 32 strains of K. pneumoniae), which were resistant to ceftazidime (CAZ) and cefotaxime (CTX) by Kirby–Bauer disk diffusion method, were identified using the automated VITEK2 system. Detection of ESBL-encoding genes and other resistance genes was carried out by PCR. Results. E. coli strains were resistant to 3rd generation cephalosporins and moderately resistant to quinolones, whereas K. pneumoniae strains were resistant to penicillins, cephalosporins, and sulfamides, and moderately resistant to quinolones and carbapenems. Most E. coli strains harbored blaCTX-M-15 gene (13/14 strains), a single strain had the blaSHV-1 gene, but 11 strains harbored blaTEM-1 gene. The mcr-1 gene was not detected. We detected tet(A) gene in six strains and tet(B) in one strain. In K. pneumoniae strains we detected blaCTX-M-15 in 23 strains, blaSHV-1 in all strains and blaTEM-1 in 14 strains. The colistin resistance gene mcr-1 was not detected. The tetracycline gene tet(A) was detected in 11 strains, but the gene tet(B) was not detected in any strains. Conclusions. The development in antibiotic resistance highlights the importance of establishing policies to reduce antibiotic use and improving the national resistance surveillance system in order to create local antibiotic therapy guidelines.

Large-scale analysis of putative plasmids in clinical multidrug-resistant Escherichia coli isolates from Vietnamese patients

“…The most frequently detected genes encoded antibiotic efflux pumps that eliminate antimicrobial agents from host cells ( Kumar et al, 2020 ). Genes encoding CTX-M β-lactamases also were frequently identified on plasmids of ESBL-producing and CR isolates, as already previously observed in clinical ESBL-producing E. coli isolates ( Ma et al, 2005 ; Ghenea et al, 2022 ). Strikingly, each CTX-M variant is widespread over a particular geographic area, thus providing epidemiological evidence for the transmission of β-lactamase-encoding genes within and between communities ( Canton and Coque, 2006 ; Rossolini et al, 2008 ).…”

“One Health” perspective on prevalence of co-existing extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Klebsiella pneumoniae: a comprehensive systematic review and meta-analysis

“…In recent years, there has been an increase in ESBL-producing E. coli and K. pneumoniae , mostly identified using phenotypic methods [ 42 , 43 ]. We report the first global PPE of co-existing ESBL-producing E. coli and K. pneumoniae .…”

“…We report the first global PPE of co-existing ESBL-producing E. coli and K. pneumoniae . A number of studies have investigated bla TEM , bla SHV , bla OXA , and bla CTX−M genes, with bla CTX−M being the type most commonly associated with ESBL [ 43 – 45 ]. These genes reside on plasmids, which can be transferred horizontally to other bacteria [ 46 ].…”

Abundance and phenotypic-genotypic analysis of antibiotic-resistant Escherichia coli isolated from wastewater of the Zainoel Abidin Hospital, Banda Aceh, Indonesia

“…Of 41 E. coli isolates in clinical samples at Wahidin Sudirohusodo General Hospital Makassar, 82% had the ESBL-producing CTX-M gene (Pratama et al 2019). E. coli isolates in clinical samples in Romanian hospitals almost entirely have the bla-CTX-M gene, namely 92.8% of isolates (Ghenea et al 2022). There is a CTX-M gene of 95% in a hospital WWTP in Wisconsin, United States (Liedhegner et al 2022).…”