Genotypic detection and molecular epidemiology of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a regional hospital in central Taiwan

This study was conducted to detect the genes encoding extended-spectrum β-lactamases (ESBLs) and determine the epidemiological relatedness of 69 Escherichia coli and 33 Klebsiella pneumoniae isolates collected from a regional hospital in central Taiwan, mostly from inpatients (E. coli 87.0 %; K. pneumoniae 88.0 %). The phenotypes of these isolates were examined according to the combination disc method recommended by the Clinical and Laboratory Standards Institute. Most of the ESBL-producing E. coli and K. pneumoniae isolates (98.6 % and 97 %, respectively) could be detected using cefotaxime discs with and without clavulanate. Genotyping was performed by PCR with type-specific primers. CTX-M-14 type (53.6 %) was the most prevalent ESBL among E. coli isolates while SHV type (57.6 %) was the most dominant among K. pneumoniae isolates. Six E. coli and three K. pneumoniae isolates did not carry genes encoding ESBLs of types TEM, SHV, CTX-M-3, CTX-M-14, CMY-2 and DHA-1. The co-existence of two or more kinds of ESBL in a single isolate was common, occurring in 40.6 % and 72.7 % of E. coli and K. pneumoniae isolates, respectively. PFGE analysis revealed that ESBL producers isolated in this setting were genetically divergent.

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CTX-M-14 and CTX-M-15 enzymes are the dominant type of extended-spectrum β-lactamase in clinical isolates of Escherichia coli from Korea

Journal of Medical Microbiology ◽

10.1099/jmm.0.004507-0 ◽

2009 ◽

Vol 58 (2) ◽

pp. 261-266 ◽

Cited By ~ 53

Author(s):

Wonkeun Song ◽

Hyukmin Lee ◽

Kyungwon Lee ◽

Seok Hoon Jeong ◽

Il Kwon Bae ◽

...

Keyword(s):

Escherichia Coli ◽

Hydrolytic Activity ◽

Common Type ◽

Clinical Isolates ◽

Confirmatory Test ◽

Dominant Type ◽

E Coli ◽

Extended Spectrum ◽

Genes Encoding ◽

M 14

This study was performed to assess the prevalence and genotypes of plasmid-borne extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases in Escherichia coli in Korea. A total of 576 isolates of E. coli was collected from 12 Korean hospitals during May and July 2007. A phenotypic confirmatory test detected ESBLs in 82 (14.2 %) of the 576 E. coli isolates. The most common types of ESBLs identified were CTX-M-14 (n=32) and CTX-M-15 (n=27). The prevalence and diversity of the CTX-M mutants, including CTX-M-15, CTX-M-27 and CTX-M-57, with significant hydrolytic activity against ceftazidime were increased. PCR experiments detected genes encoding plasmid-borne AmpC β-lactamases in 15/56 cefoxitin-intermediate or cefoxitin-resistant isolates, and the most common type of AmpC β-lactamase identified was DHA-1 (n=10). These data suggest that the incidence of ESBLs in E. coli has increased as a result of the dissemination of CTX-M enzymes in Korea. In addition, CTX-M-22, CTX-M-27 and CTX-M-57 have appeared in Korea.

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Prevalence of Extended Spectrum Beta-Lactamase Producing Escherichia coli and Klebsiella species from Urinary Specimens of Children attending Friendship International Children’s Hospital

Nepal Journal of Biotechnology ◽

10.3126/njb.v5i1.18868 ◽

2017 ◽

Vol 5 (1) ◽

pp. 32-38 ◽

Cited By ~ 1

Author(s):

Ujjwal Rimal ◽

Shovana Thapa ◽

Roshani Maharjan

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Beta Lactamase ◽

Disc Diffusion ◽

Extended Spectrum Beta Lactamase ◽

E Coli ◽

Extended Spectrum ◽

Significant Bacteriuria ◽

Klebsiella Spp ◽

Esbl Producers

Extended-spectrum β-lactamase producing E. coli and K. pneumoniae is a serious threat to the patients. These organisms are major extended spectrum beta lactamase (ESBL) producers. The objective of this study was to determine the prevalence of Extended spectrum β- lactamase producing strains of Escherichia coli and Klebsiella spp isolates from the urine sample of children visiting International Friendship Children Hospital. During the seven months, between June 2016 to December 2016, 1018 mid-stream urine samples(MSU) were collected from patients suspected of having UTI. The samples were investigated by conventional semi-quantitative culture technique and identification of E. coli and Klebsiella spp. was done by microscopy and biochemical test. Antibiotic susceptibility test of isolates was performed by modified Kirby Bauer Disc diffusion test. ESBL screening test was done by using 3rd generation Cephalosporin and confirmation done by combination disc diffusion method. Out of total 1018 MSU samples investigated, 200(19.64%) isolates of E. coli and 28(2.7%) isolates of Klebsiella spp. making a total of 228(22.39%) were found to cause significant bacteriuria. 76(33.33%) isolates, from those causing significant bacteriuria, were Multi-drug resistant organisms. Out of 228 isolates, 54(23.68%) were ESBL producers, that includes 51(25.5%) Escherichia coli and 3(12.5%) Klebsiella pneumoniae. ESBL producers were more common in in-patient (36.17%) than out-patient (20.44%). Most of the ESBL producers were resistance to amoxicillin, followed by Cotrimoxazole and Ciprofloxacin respectively. They were highly sensitive to Imipenem, Tigecycline, Amikacin, Piperacillin-Tazobactam, and Nitrofurantoin. High prevalence of ESBL producing E. coli and Klebsiella pneumoniae was found among children. Regular and routine monitoring of ESBL producing isolates is essential.Nepal Journal of Biotechnology. Dec. 2017 Vol. 5, No. 1: 32-38

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Distribution of Extended-Spectrum β-Lactamases in Clinical Isolates of Enterobacteriaceae in Vietnam

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.46.12.3739-3743.2002 ◽

2002 ◽

Vol 46 (12) ◽

pp. 3739-3743 ◽

Cited By ~ 68

Author(s):

Van Cao ◽

Thierry Lambert ◽

Duong Quynh Nhu ◽

Huynh Kim Loan ◽

Nguyen Kim Hoang ◽

...

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Broad Spectrum ◽

Molecular Typing ◽

Ho Chi Minh City ◽

Structural Genes ◽

E Coli ◽

Extended Spectrum ◽

Pcr Products ◽

M 14

ABSTRACT Among 730 Escherichia coli, 438 Klebsiella pneumoniae, and 141 Proteus mirabilis isolates obtained between September 2000 and September 2001 in seven hospitals in Ho Chi Minh City, Vietnam, 26.6% were resistant to ceftazidime, 30% were resistant to cefotaxime, 31.5% were resistant to ceftriaxone, 15.9% were resistant to cefoperazone, and 6% were resistant to cefepime. Resistance to imipenem was found in 5.6% of the isolates. In 55 strains producing extended-spectrum β-lactamases (32 E. coli isolates, 13 K. pneumoniae isolates, and 10 P. mirabilis isolates), structural genes for VEB-1 (25.5%), CTX-M (25.5%), SHV (38.1%), and TEM (76.3%) enzymes were detected alone or in combination. Sequencing of the PCR products obtained from the K. pneumoniae isolates revealed the presence of bla VEB-1, bla CTX-M-14, bla CTX-M-17, bla SHV-2, and bla TEM-1. Molecular typing of the strains with a similar resistance phenotype to broad-spectrum cephalosporins indicated polyclonal spread. ISEcp1 was presumably responsible for dissemination of the bla CTX-M-like gene.

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The Occurrence of blaCTX-M, blaSHV, and blaTEM Genes in Extended-Spectrum β-Lactamase-Positive Strains of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis in Poland

International Journal of Antibiotics ◽

10.1155/2014/935842 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 18

Author(s):

Dominika Ojdana ◽

Paweł Sacha ◽

Piotr Wieczorek ◽

Sławomir Czaban ◽

Anna Michalska ◽

...

Keyword(s):

Escherichia Coli ◽

Multidrug Resistance ◽

Klebsiella Pneumoniae ◽

Proteus Mirabilis ◽

Bacterial Strains ◽

E Coli ◽

Extended Spectrum ◽

Genes Encoding

Bacteria belonging to the Enterobacteriaceae family that produce extended-spectrum β-lactamase (ESBL) enzymes are important pathogens of infections. Increasing numbers of ESBL-producing bacterial strains exhibiting multidrug resistance have been observed. The aim of the study was to evaluate the prevalence of blaCTX-M, blaSHV, and blaTEM genes among ESBL-producing Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis strains and to examine susceptibility to antibiotics of tested strains. In our study, thirty-six of the tested strains exhibited blaCTX-M genes (blaCTX-M-15, blaCTX-M-3, blaCTX-M-91, and blaCTX-M-89). Moreover, twelve ESBL-positive strains harbored blaSHV genes (blaSHV-18, blaSHV-7, blaSHV-2, and blaSHV-5), and the presence of a blaTEM gene (blaTEM-1) in twenty-five ESBL-positive strains was revealed. Among K. pneumoniae the multiple ESBL genotype composed of blaCTX-M-15, blaCTX-M-3, blaSHV-18, blaSHV-7, blaSHV-2, and blaSHV-5 genes encoding particular ESBL variants was observed. Analysis of bacterial susceptibility to antibiotics revealed that, among β-lactam antibiotics, the most effective against E. coli strains was meropenem (100%), whereas K. pneumoniae were completely susceptible to ertapenem and meropenem (100%), and P. mirabilis strains were susceptible to ertapenem (91.7%). Moreover, among non-β-lactam antibiotics, gentamicin showed the highest activity to E. coli (91.7%) and ciprofloxacin the highest to K. pneumoniae (83.3%). P. mirabilis revealed the highest susceptibility to amikacin (66.7%).

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In Vitro Efficacy of Flomoxef against Extended-Spectrum Beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Associated with Urinary Tract Infections in Malaysia

Antibiotics ◽

10.3390/antibiotics10020181 ◽

2021 ◽

Vol 10 (2) ◽

pp. 181

Author(s):

Soo Tein Ngoi ◽

Cindy Shuan Ju Teh ◽

Chun Wie Chong ◽

Kartini Abdul Jabar ◽

Shiang Chiet Tan ◽

...

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Klebsiella Pneumoniae ◽

Urinary Tract Infections ◽

In Vitro Susceptibility ◽

E Coli ◽

Extended Spectrum ◽

Tract Infections ◽

Esbl Producers

The increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has greatly affected the clinical efficacy of β-lactam antibiotics in the management of urinary tract infections (UTIs). The limited treatment options have resulted in the increased use of carbapenem. However, flomoxef could be a potential carbapenem-sparing strategy for UTIs caused by ESBL-producers. Here, we compared the in vitro susceptibility of UTI-associated ESBL-producers to flomoxef and established β-lactam antibiotics. Fifty Escherichia coli and Klebsiella pneumoniae strains isolated from urine samples were subjected to broth microdilution assay, and the presence of ESBL genes was detected by polymerase chain reactions. High rates of resistance to amoxicillin-clavulanate (76–80%), ticarcillin-clavulanate (58–76%), and piperacillin-tazobactam (48–50%) were observed, indicated by high minimum inhibitory concentration (MIC) values (32 µg/mL to 128 µg/mL) for both species. The ESBL genes blaCTX-M and blaTEM were detected in both E. coli (58% and 54%, respectively) and K. pneumoniae (88% and 74%, respectively), whereas blaSHV was found only in K. pneumoniae (94%). Carbapenems remained as the most effective antibiotics against ESBL-producing E. coli and K. pneumoniae associated with UTIs, followed by flomoxef and cephamycins. In conclusion, flomoxef may be a potential alternative to carbapenem for UTIs caused by ESBL-producers in Malaysia.

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Characterization and Sequence Analysis of Extended-Spectrum-β-Lactamase-Encoding Genes from Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Isolates Collected during Tigecycline Phase 3 Clinical Trials

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00883-08 ◽

2008 ◽

Vol 53 (2) ◽

pp. 465-475 ◽

Cited By ~ 39

Author(s):

C. Hal Jones ◽

Margareta Tuckman ◽

David Keeney ◽

Alexey Ruzin ◽

Patricia A. Bradford

Keyword(s):

Escherichia Coli ◽

Clinical Trials ◽

Klebsiella Pneumoniae ◽

Proteus Mirabilis ◽

Confirmatory Test ◽

Phase 3 ◽

E Coli ◽

Current Trends ◽

Extended Spectrum ◽

Genes Encoding

ABSTRACT In concert with the development of novel β-lactams and broad-spectrum cephalosporins, bacterially encoded β-lactamases have evolved to accommodate the new agents. This study was designed to identify, at the sequence level, the genes responsible for the extended-spectrum-β-lactamase (ESBL) phenotypes of Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis isolates collected during the global tigecycline phase 3 clinical trials. PCR assays were developed to identify and clone the bla TEM, bla SHV, bla OXA, and bla CTX genes from clinical strains. Isolates were also screened for AmpC genes of the bla CMY, bla ACT, bla FOX, and bla DHA families as well as the bla KPC genes encoding class A carbapenemases. E. coli, K. pneumoniae, and P. mirabilis isolates with ceftazidime MICs of ≥2 μg/ml were designated possible ESBL-producing pathogens and were then subjected to a confirmatory test for ESBLs by use of Etest. Of 272 unique patient isolates, 239 were confirmed by PCR and sequencing to carry the genes for at least one ESBL, with 44% of the positive isolates harboring the genes for multiple ESBLs. In agreement with current trends for ESBL distribution, bla CTX-M-type β-lactamase genes were found in 83% and 71% of the ESBL-positive E. coli and K. pneumoniae isolates, respectively, whereas bla SHV genes were found in 41% and 28% of the ESBL-positive K. pneumoniae and E. coli isolates, respectively. Ninety-seven percent of the E. coli and K. pneumoniae isolates were tigecycline susceptible (MIC90 = 2 μg/ml), warranting further studies to define the therapeutic utility of tigecycline against strains producing ESBLs in a clinical setting.

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Nationwide Study of Escherichia coli and Klebsiella pneumoniae Producing Extended-Spectrum β-Lactamases in Spain

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.49.5.2122-2125.2005 ◽

2005 ◽

Vol 49 (5) ◽

pp. 2122-2125 ◽

Cited By ~ 92

Author(s):

J. R. Hernández ◽

L. Martínez-Martínez ◽

R. Cantón ◽

T. M. Coque ◽

A. Pascual

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Nationwide Study ◽

E Coli ◽

Extended Spectrum ◽

M 14

ABSTRACT Clonal dissemination of extended-spectrum β-lactamases (ESBL) in 170 Escherichia coli isolates and 70 Klebsiella pneumoniae isolates from a nationwide study of 40 Spanish centers in 2000 was not observed in most centers. The most prevalent ESBL were CTX-M-9 (27.3%), SHV-12 (23.9%), and CTX-M-14 (20.5%) for E. coli and TEM-3 (16.7%) and TEM-4 (25%) for K. pneumoniae. A new ESBL, TEM-133, with mutations L21F, E104K, and R164S, was identified.

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Risk factors for and mortality of extended-spectrum-β-lactamase-producing Klebsiella pneumoniae and Escherichia coli nosocomial bloodstream infections

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652009000400006 ◽

2009 ◽

Vol 51 (4) ◽

pp. 211-216 ◽

Cited By ~ 16

Author(s):

Silvana Vargas Superti ◽

Gustavo Augusti ◽

Alexandre Prehn Zavascki

Keyword(s):

Risk Factors ◽

Escherichia Coli ◽

Risk Factor ◽

Klebsiella Pneumoniae ◽

Bloodstream Infections ◽

Blood Cultures ◽

Esbl Production ◽

E Coli ◽

Extended Spectrum ◽

Esbl Producers

A case-control study, involving patients with positive blood cultures for Klebsiella pneumoniae (KP) or Escherichia coli (EC) EC and controls with positive blood cultures for non-ESBL-KP or EC, was performed to assess risk factors for extended-spectrum-β-lactamase (ESBL) production from nosocomial bloodstream infections (BSIs). Mortality among patients with BSIs was also assessed. The study included 145 patients (81, 59.5% with K. pneumoniae and 64, 44.1% with E. coli BSI); 51 (35.2%) isolates were ESBL producers and 94 (64.8%) nonproducers. Forty-five (55.6%) K. pneumoniae isolates were ESBL producers, while only six (9.4%) E. coli isolates produced the enzyme. Multivariate analysis showed that recent exposure to piperacillin-tazobactam (adjusted Odds Ratio [aOR] 6.2; 95%CI 1.1-34.7) was a risk factor for ESBL BSI. K. pneumoniae was significantly more likely to be an ESBL-producing isolate than E. coli (aOR 6.7; 95%CI 2.3-20.2). No cephalosporin class was independently associated with ESBLs BSI; however, in a secondary model considering all oxymino-cephalosporins as a single variable, a significant association was demonstrated (aOR 3.7; 95%CI 1.3-10.8). Overall 60-day mortality was significantly higher among ESBL-producing organisms. The finding that piperacillin-tazobactam use is a risk factor for ESBL-production in KP or EC BSIs requires attention, since this drug can be recommended to limit the use of third-generation cephalosporins.

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Occurrence of extended-spectrum beta-lactamaseand AmpC-type cephalosporinase-producing Escherichia coli in mastitic cow’s milk

Medycyna Weterynaryjna ◽

10.21521/mw.6537 ◽

2021 ◽

Vol 77 (06) ◽

pp. 291-294

Author(s):

HANNA RÓŻAŃSKA ◽

MARIA KUBAJKA ◽

MARCIN WEINER

Keyword(s):

Escherichia Coli ◽

Antimicrobial Resistance ◽

Cow’S Milk ◽

Macconkey Agar ◽

E Coli ◽

Milk Samples ◽

Microdilution Method ◽

Extended Spectrum ◽

Genes Encoding ◽

Esbl Producers

The aim of the study was to evaluate the occurrence of Escherichia coli producing extended-spectrum betalactamases (ESBL and/or AmpC) in the milk of cows with mastitis. A total 2,500 milk samples from mastitic cows were tested in 2014-2018. The investigations included the culture of bacteria on MacConkey agar with cefotaxime, identification with the API Rapid 32 E test, synergy disc test D68C, assessment of antimicrobial resistance by the microdilution method and confirmation of the occurrence of genes encoding ESBL and AmpC. Out of 133 isolates identified as E. coli, 87 were recognized as ESBL producers and 46 as chromosomally encoded cephalosporinase AmpC producers. The blaTEM was predominant in the ESBL producers. All 46 AmpC-positive strains had the blaCMY gene. The results confirmed the occurrence of extended-spectrum betalactamase- producing E. coli in inflammatory secretions from mastitic

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High Prevalence of ST131 Isolates Producing CTX-M-15 and CTX-M-14 among Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates from Canada

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01338-09 ◽

2010 ◽

Vol 54 (3) ◽

pp. 1327-1330 ◽

Cited By ~ 75

Author(s):

Gisele Peirano ◽

David Richardson ◽

Jana Nigrin ◽

Allison McGeer ◽

Vivian Loo ◽

...

Keyword(s):

Escherichia Coli ◽

Clonal Complex ◽

E Coli ◽

Medical Centers ◽

Extended Spectrum ◽

High Prevalence ◽

Tract Infections ◽

Community Onset ◽

Esbl Producers ◽

M 14

ABSTRACT Phenotypic and genotypic methods were used to characterize extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli isolated in 2007 from 11 different Canadian medical centers. Of the 209 ESBL-producing E. coli isolates tested, 148 (71%) produced CTX-M-15, 17 (8%) produced CTX-M-14, 5 (2%) produced CTX-M-3, and 1 produced CTX-M-27. Overall, 96 (46%) of the ESBL producers belonged to clonal complex ST131, with the highest prevalence in Brampton, Calgary, and Winnipeg. ST131 is an important cause of community onset urinary tract infections due to ESBL-producing E. coli across Canada.

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