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Community and hospital spread of Escherichia coli producing CTX-M extended-spectrum beta-lactamases in the UK.
- Source :
-
The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2004 Oct; Vol. 54 (4), pp. 735-43. Date of Electronic Publication: 2004 Sep 03. - Publication Year :
- 2004
-
Abstract
- Objectives: During 2003, the Health Protection Agency's Antibiotic Resistance Monitoring and Reference Laboratory began to receive isolates of Escherichia coli for confirmation of extended-spectrum beta-lactamase production with a phenotype implying a CTX-M-type beta-lactamase, i.e. MICs of cefotaxime > or = 8-fold higher than MICs of ceftazidime. Many were referred as being from community patients. We examined 291 CTX-M-producing isolates from the UK and investigated the genetic basis of their phenotype.<br />Methods: PCR was used to detect alleles encoding CTX-M enzymes and to assign these to their blaCTX-M phylogenetic groups. Selected alleles were sequenced. Producers were compared by analysis of banding patterns generated by pulsed-field gel electrophoresis of XbaI-digested genomic DNA. MICs were determined by an agar dilution method or by Etest.<br />Results: Of 291 CTX-M-producing E. coli isolates studied from 42 UK centres, 70 (24%) were reportedly from community patients, many of whom had only limited recent hospital contact. Community isolates were referred by 12 centres. Two hundred and seventy-nine (95.9%) producers contained genes encoding group 1 CTX-M enzymes and 12 contained blaCTX-M-9-like alleles. An epidemic CTX-M-15-producing strain was identified, with 110 community and inpatient isolates referred from six centres. Representatives of four other major strains also produced CTX-M-15, as did several sporadic isolates examined. Most producers were multi-resistant to fluoroquinolones, trimethoprim, tetracycline and aminoglycosides as well as to non-carbapenem beta-lactams.<br />Conclusions: CTX-M-producing E. coli are a rapidly developing problem in the UK, with CTX-M-15 particularly common. The diversity of producers and geographical scatter of referring laboratories indicates wide dissemination of blaCTX-M genes. Because of the public health implications, including for the treatment of community-acquired urinary tract infections, the spread of these strains--and CTX-M-15 beta-lactamase in particular--merits close monitoring.
- Subjects :
- Alleles
Anti-Bacterial Agents pharmacology
Community-Acquired Infections epidemiology
Community-Acquired Infections microbiology
Conjugation, Genetic
Cross Infection epidemiology
Cross Infection microbiology
Electrophoresis, Gel, Pulsed-Field
Escherichia coli drug effects
Escherichia coli enzymology
Escherichia coli isolation & purification
Escherichia coli Infections microbiology
Genes, Bacterial genetics
Humans
Microbial Sensitivity Tests
Phenotype
United Kingdom epidemiology
beta-Lactamases genetics
Drug Resistance, Bacterial genetics
Escherichia coli genetics
Escherichia coli Infections epidemiology
beta-Lactamases biosynthesis
Subjects
Details
- Language :
- English
- ISSN :
- 0305-7453
- Volume :
- 54
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- The Journal of antimicrobial chemotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 15347638
- Full Text :
- https://doi.org/10.1093/jac/dkh424