scholarly journals War Wound Treatment Complications Due to Transfer of an IncN Plasmid HarboringblaOXA-181from Morganella morganii to CTX-M-27-Producing Sequence Type 131 Escherichia coli

2015 ◽  
Vol 59 (6) ◽  
pp. 3556-3562 ◽  
Author(s):  
Patrick McGann ◽  
Erik Snesrud ◽  
Ana C. Ong ◽  
Lakshmi Appalla ◽  
Michael Koren ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Carbapenem Resistance ◽  
Sequence Type ◽  
Molecular Techniques ◽  
Morganella Morganii ◽  
Genetic Changes ◽  
Content Type ◽  
Surgical Interventions ◽  
E Coli ◽  
Extended Spectrum

ABSTRACTA 22-year-old male developed a recurrent sacral abscess associated with embedded shrapnel following a blast injury. Cultures grew extended-spectrum β-lactamase (ESBL)-producing, carbapenem-susceptibleEscherichia coli. Ertapenem was administered, but the infection recurred after each course of antibiotics. Initial surgical interventions were unsuccessful, and subsequent cultures yieldedE. coliandMorganella morganii, both nonsusceptible to carbapenems. The isolates were Carba NP test negative, gave ambiguous results with the modified Hodge test, and amplified theblaOXA48-like gene by real-time PCR. AllE. coliisolates were sequence type 131 (ST131), carried nine resistance genes (includingblaCTX-M-27) on an IncF plasmid, and were identical by genome sequencing, except for 150 kb of plasmid DNA in carbapenem-nonsusceptible isolates only. Sixty kilobases of this was shared byM. morganiiand represented an IncN plasmid harboringblaOXA-181. InM. morganii, the gene was flanked by IS3000and ISKpn19, but in all but one of theE. coliisolates containingblaOXA-181, a second copy of ISKpn19had inserted adjacent to IS3000. To the best of our knowledge, this is the first report ofblaOXA-181in the virulent ST131 clonal group and carried by the promiscuous IncN family of plasmids. The tendency ofM. morganiito have high MICs of imipenem, ablaOXA-181substrate profile that includes penicillins but not extended-spectrum cephalosporins, and weak carbapenemase activity almost resulted in the presence ofblaOXA-181being overlooked. We highlight the importance of surveillance for carbapenem resistance in all species, even those with intrinsic resistances, and the value of advanced molecular techniques in detecting subtle genetic changes.

scholarly journals Emergence of Escherichia coli Sequence Type 131 Isolates Producing KPC-2 Carbapenemase in China

2013 ◽  
Vol 58 (2) ◽  
pp. 1146-1152 ◽  
Author(s):  
Jia Chang Cai ◽  
Rong Zhang ◽  
Yan Yan Hu ◽  
Hong Wei Zhou ◽  
Gong-Xiang Chen
Keyword(s):  
Escherichia Coli ◽  
Carbapenem Resistance ◽  
Sequence Type ◽  
Content Type ◽  
E Coli ◽  
Predominant Type ◽  
Group A ◽  
Dna Fragment ◽  
High Level ◽  
Group D

ABSTRACTTwenty-two KPC-2-producingEscherichia coliisolates were obtained from three hospitals in Hangzhou, China, from 2007 to 2011. One isolate, with OmpC porin deficiency, exhibited high-level carbapenem resistance. Pulsed-field gel electrophoresis showed that few isolates were indistinguishable or closely related. Multilocus sequence typing indicated that sequence type 131 (ST131) was the predominant type (9 isolates, 40.9%), followed by ST648 (5 isolates), ST405 (2 isolates), ST38 (2 isolates), and 4 single STs, ST69, ST2003, ST2179, and ST744. Phylogenetic analysis indicated that 9 group B2 isolates belonged to ST131, and 5 of 11 group D isolates belonged to ST648. Only one group B1 isolate and one group A isolate were identified. A representative plasmid (pE1) was partially sequenced, and a 7,788-bp DNA fragment encoding Tn3transposase, Tn3resolvase, ISKpn8transposase, KPC-2, and ISKpn6-like transposase was obtained. TheblaKPC-2-surrounding sequence was amplified by a series of primers. The PCR results showed that 13 isolates were consistent with the genetic environment in pE1. It is the first report of rapid emergence of KPC-2-producingE. coliST131 in China. TheblaKPC-2gene of most isolates was located on a similar genetic structure.

scholarly journals Multiresistant Uropathogenic Escherichia coli from a Region in India Where Urinary Tract Infections Are Endemic: Genotypic and Phenotypic Characteristics of Sequence Type 131 Isolates of the CTX-M-15 Extended-Spectrum-β-Lactamase-Producing Lineage

2012 ◽  
Vol 56 (12) ◽  
pp. 6358-6365 ◽  
Author(s):  
Arif Hussain ◽  
Christa Ewers ◽  
Nishant Nandanwar ◽  
Sebastian Guenther ◽  
Savita Jadhav ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Urinary Tract ◽  
Urinary Tract Infections ◽  
Sequence Type ◽  
Health Concern ◽  
Beta Lactam ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Tract Infections

ABSTRACTEscherichia colisequence type 131 (O25b:H4), associated with the CTX-M-15 extended-spectrum beta-lactamases (ESBLs) and linked predominantly to the community-onset antimicrobial-resistant infections, has globally emerged as a public health concern. However, scant attention is given to the understanding of the molecular epidemiology of these strains in high-burden countries such as India. Of the 100 clinicalE. coliisolates obtained by us from a setting where urinary tract infections are endemic, 16 ST131E. coliisolates were identified by multilocus sequence typing (MLST). Further, genotyping and phenotyping methods were employed to characterize their virulence and drug resistance patterns. All the 16 ST131 isolates harbored the CTX-M-15 gene, and half of them also carried TEM-1; 11 of these were positive forblaOXAgroups 1 and 12 foraac(6′)-Ib-cr. At least 12 isolates were refractory to four non-beta-lactam antibiotics: ciprofloxacin, gentamicin, sulfamethoxazole-trimethoprim, and tetracycline. Nine isolates carried the class 1 integron. Plasmid analysis indicated a large pool of up to six plasmids per strain with a mean of approximately three plasmids. Conjugation and PCR-based replicon typing (PBRT) revealed that the spread of resistance was associated with the FIA incompatibility group of plasmids. Pulsed-field gel electrophoresis (PFGE) and genotyping of the virulence genes showed a low level of diversity among these strains. The association of ESBL-encoding plasmid with virulence was demonstrated in transconjugants by serum assay. None of the 16 ST131 ESBL-producingE. colistrains were known to synthesize carbapenemase enzymes. In conclusion, our study reports a snapshot of the highly virulent/multiresistant clone ST131 of uropathogenicE. colifrom India. This study suggests that the ST131 genotypes from this region are clonally evolved and are strongly associated with the CTX-M-15 enzyme, carry a high antibiotic resistance background, and have emerged as an important cause of community-acquired urinary tract infections.

scholarly journals Characteristics of CTX-M Extended-Spectrum β-Lactamase-Producing Escherichia coli Strains Isolated from Multiple Rivers in Southern Taiwan

2016 ◽  
Vol 82 (6) ◽  
pp. 1889-1897 ◽  
Author(s):  
Po-An Chen ◽  
Chih-Hsin Hung ◽  
Ping-Chih Huang ◽  
Jung-Ren Chen ◽  
I-Fei Huang ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
River Water ◽  
Sequence Type ◽  
Content Type ◽  
Mlst Analysis ◽  
River Waters ◽  
E Coli ◽  
Extended Spectrum ◽  
Southern Taiwan ◽  
Tract Infections

ABSTRACTExtended-spectrum β-lactamase (ESBL)-producingEscherichia colisequence type ST131 has emerged as the leading cause of community-acquired urinary tract infections and bacteremia worldwide. Whether environmental water is a potential reservoir of these strains remains unclear. River water samples were collected from 40 stations in southern Taiwan from February to August 2014. PCR assay and multilocus sequence typing (MLST) analysis were conducted to determine the CTX-M group and sequence type, respectively. In addition, we identified the seasonal frequency of ESBL-producingE. colistrains and their geographical relationship with runoffs from livestock and poultry farms between February and August 2014. ESBL-producingE. coliaccounted for 30% of the 621E. colistrains isolated from river water in southern Taiwan. ESBL-producingE. coliST131 was not detected among the isolates. The most commonly detected strain wasE. coliCTX-M group 9. Among the 92 isolates selected for MLST analysis, the most common ESBL-producing clonal complexes were ST10 and ST58. The proportion of ESBL-producingE. coliwas significantly higher in areas with a lower river pollution index (P= 0.025) and regions with a large number of chickens being raised (P= 0.013). ESBL-producingE. colistrains were commonly isolated from river waters in southern Taiwan. The most commonly isolated ESBL-producing clonal complexes were ST10 and ST58, which were geographically related to chicken farms. ESBL-producingE. coliST131, the major clone causing community-acquired infections in Taiwan and worldwide, was not detected in river waters.

scholarly journals Widespread Dissemination of CTX-M-15 Genotype Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae among Patients Presenting to Community Hospitals in the Southeastern United States

2013 ◽  
Vol 58 (2) ◽  
pp. 1200-1202 ◽  
Author(s):  
Luke F. Chen ◽  
Joshua T. Freeman ◽  
Brad Nicholson ◽  
Anna Keiger ◽  
Sarah Lancaster ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
North Carolina ◽  
Southeastern United States ◽  
Sequence Type ◽  
Community Hospitals ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Widespread Dissemination ◽  
M 14

ABSTRACTExtended-spectrum-β-lactamase (ESBL)-producing organisms are increasingly prevalent. We determined the characteristics of 66 consecutive ESBL-producing isolates from six community hospitals in North Carolina and Virginia from 2010 to 2012. Fifty-three (80%) ESBL-producing isolates contained CTX-M enzymes; CTX-M-15 was found in 68% ofEscherichia coliand 73% ofKlebsiellaisolates. Sequence type 131 (ST131) was the commonest type ofE. coli, accounting for 48% of CTX-M-15-producing and 66% of CTX-M-14-producing isolates. In conclusion, the CTX-M genotype and ST131E. coliwere common among ESBL isolates from U.S. community hospitals.

scholarly journals Complete Genome Sequence of blaCTX-M-27-Encoding Escherichia coli Strain H105 of Sequence Type 131 Lineage C1/H30R

2017 ◽  
Vol 5 (31) ◽  
Author(s):  
Hiren Ghosh ◽  
Boyke Bunk ◽  
Swapnil Doijad ◽  
Judith Schmiedel ◽  
Linda Falgenhauer ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Genome Sequence ◽  
Complete Genome Sequence ◽  
Complete Genome ◽  
Coli Strain ◽  
Sequence Type ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Rate Of Increase

ABSTRACT Escherichia coli sequence type 131 (ST131) is the most frequent antimicrobial-resistant lineage of E. coli, propagating extended-spectrum β-lactamases (ESBL) worldwide. Recently, an alarming rate of increase in isolates of the sublineage C1/H30R-bla CTX-M-27 of ST131 in geographically distant countries was reported. Here, we present the complete genome sequence of the ST131 sublineage C1/H30R E. coli isolate harboring bla CTX-M-27 from Germany.

scholarly journals Occurrence of Clinically Important Lineages, Including the Sequence Type 131 C1-M27 Subclone, among Extended-Spectrum-β-Lactamase-Producing Escherichia coli in Wastewater

2017 ◽  
Vol 61 (9) ◽  
Author(s):  
Ryota Gomi ◽  
Tomonari Matsuda ◽  
Yasufumi Matsumura ◽  
Masaki Yamamoto ◽  
Michio Tanaka ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Wastewater Treatment Plants ◽  
Genomic Analysis ◽  
Sequence Type ◽  
Hospital Wastewater ◽  
Environmental Waters ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Content Status

ABSTRACT Contamination of environmental waters by extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli (ESBLEC) is of great concern. Wastewater treatment plants (WWTPs) and hospitals release large amounts of ESBLEC into the environment. In the present study, we isolated ESBLEC strains from wastewater collected from a WWTP and a hospital in Japan and performed whole-genome sequencing to characterize these strains. Genomic analysis of 54 strains (32 from the WWTP and 22 from hospital wastewater) revealed the occurrence of clinically important clonal groups with extraintestinal pathogenic E. coli status in the WWTP and hospital wastewater. Fine-scale phylogenetic analysis was performed to further characterize 15 sequence type 131 (ST131) complex strains (11 from the WWTP and 4 from hospital wastewater). These ST131 complex strains were comprised of the following different subgroups: clade A (n = 2), C1-M27 (n = 8), and C1 (non-C1-M27) (n = 1) for strains from the WWTP and clade A (n = 2), C1-M27 (n = 1), and C1 (non-C1-M27) (n = 1) for strains from hospital wastewater. The results indicate that ESBLEC strains belonging to clinically important lineages, including the C1-M27 clade, may disseminate into the environment through wastewater, highlighting the need to monitor for antibiotic resistance in wastewater.

scholarly journals In VivoEvolution of CMY-2 to CMY-33 β-Lactamase in Escherichia coli Sequence Type 131: Characterization of an Acquired Extended-Spectrum AmpC Conferring Resistance to Cefepime

2015 ◽  
Vol 59 (12) ◽  
pp. 7483-7488 ◽  
Author(s):  
João Pires ◽  
Magdalena Taracila ◽  
Christopher R. Bethel ◽  
Yohei Doi ◽  
Sara Kasraian ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Bronchoalveolar Lavage Fluid ◽  
Lavage Fluid ◽  
Sequence Type ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Repetitive Extragenic Palindromic Pcr

ABSTRACTCefepime is frequently prescribed to treat infections caused by AmpC-producing Gram-negative bacteria. CMY-2 is the most common plasmid-mediated AmpC (pAmpC) β-lactamase. Unfortunately, CMY variants conferring enhanced cefepime resistance have been reported. Here, we describe the evolution of CMY-2 to an extended-spectrum AmpC (ESAC) in clonally identicalEscherichia coliisolates obtained from a patient. The CMY-2-producingE. coliisolate (CMY-2-Ec) was isolated from a wound. Thirty days later, one CMY-33-producingE. coliisolate (CMY-33-Ec) was detected in a bronchoalveolar lavage fluid sample. Two weeks before the isolation of CMY-33-Ec, the patient received cefepime. CMY-33-Ecand CMY-2-Ecwere identical by repetitive extragenic palindromic-PCR (rep-PCR), being of hyperepidemic sequence type 131 (ST131) but showing different β-lactam MICs (e.g., cefepime MIC, 16 and ≤0.5 μg/ml for CMY-33-Ecand CMY-2-Ec, respectively). Identical CMY-2-Ecisolates were also found in a rectal swab. CMY-33 differs from CMY-2 by a Leu293-Ala294 deletion. Expressed inE. colistrain DH10B, both CMYs conferred resistance to ceftazidime (≥256 μg/ml), but the cefepime MICs were higher for CMY-33 than CMY-2 (8 versus 0.25 μg/ml, respectively). Thekcat/Kmor inhibitor complex inactivation (kinact)/Kiapp(μM−1s−1) indicated that CMY-33 possesses an extended-spectrum β-lactamase (ESBL)-like spectrum compared to that of CMY-2 (e.g., cefoxitin, 0.2 versus 0.4; ceftazidime, 0.2 versus not measurable; cefepime, 0.2 versus not measurable; and tazobactam, 0.0018 versus 0.0009, respectively). Using molecular modeling, we show that a widened active site (∼4-Å shift) may play a significant role in enhancing cefepime hydrolysis. This is the firstin vivodemonstration of a pAmpC that under cephalosporin treatment expands its substrate spectrum, resembling an ESBL. The prevalence of CMY-2-Ecisolates is rapidly increasing worldwide; therefore, awareness that cefepime treatment may select for resistant isolates is critical.

scholarly journals Characterization of IncI1 Sequence Type 71 Epidemic Plasmid Lineage Responsible for the Recent Dissemination of CTX-M-65 Extended-Spectrum β-Lactamase in the Bolivian Chaco Region

2015 ◽  
Vol 59 (9) ◽  
pp. 5340-5347 ◽  
Author(s):  
Eleonora Riccobono ◽  
Vincenzo Di Pilato ◽  
Tiziana Di Maggio ◽  
Carmen Revollo ◽  
Alessandro Bartoloni ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Oxytoca ◽  
Sequence Type ◽  
Healthy Children ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Chaco Region ◽  
Complete Sequencing ◽  
Biological Cost

ABSTRACTDuring the last decade, a significant diffusion of CTX-M-type extended-spectrum β-lactamases (ESBLs) was observed in commensalEscherichia colifrom healthy children in the Bolivian Chaco region, with initial dissemination of CTX-M-2, which was then replaced by CTX-M-15 and CTX-M-65. In this work, we demonstrate that the widespread dissemination of CTX-M-65 observed in this context was related to the polyclonal spreading of an IncI1 sequence type 71 (ST71) epidemic plasmid lineage. The structure of the epidemic plasmid population was characterized by complete sequencing of four representatives and PCR mapping of the remainder (n= 16). Sequence analysis showed identical plasmid backbones (similar to that of the reference IncI1 plasmid, R64) and a multiresistance region (MRR), which underwent local microevolution. The MRR harbored genes responsible for resistance to β-lactams, aminoglycosides, florfenicol, and fosfomycin (with microevolution mainly consisting of deletion events of resistance modules). TheblaCTX-M-65module harbored by the IncI1 ST71 epidemic plasmid was apparently derived from IncN-type plasmids, likely via IS26-mediated mobilization. The plasmid could be transferred by conjugation to several different enterobacterial species (Escherichia coli,Cronobacter sakazakii,Enterobacter cloacae,Klebsiella oxytoca,Klebsiella pneumoniae, andSalmonella enterica) and was stably maintained without selective pressure in these species, with the exception ofK. oxytocaandS. enterica. Fitness assays performed inE. colirecipients demonstrated that the presence of the epidemic plasmid was apparently not associated with a significant biological cost.

scholarly journals Molecular Epidemiology of Escherichia coli Sequence Type 131 and Its H30 and H30-Rx Subclones among Extended-Spectrum-β-Lactamase-Positive and -Negative E. coli Clinical Isolates from the Chicago Region, 2007 to 2010

2013 ◽  
Vol 57 (12) ◽  
pp. 6385-6388 ◽  
Author(s):  
Ritu Banerjee ◽  
Ari Robicsek ◽  
Michael A. Kuskowski ◽  
Stephen Porter ◽  
Brian D. Johnston ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Virulence Genes ◽  
Sequence Type ◽  
Beta Lactamase ◽  
Esbl Production ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum

ABSTRACTWe assessedEscherichia coliST131 and its H30 and H30-Rx subclones for virulence genes, antimicrobial resistance, and extended-spectrum beta-lactamase (ESBL) type. Although both subclones were associated with ESBL production, H30-Rx isolates had higher resistance scores and were associated specifically with CTX-M-15. Three virulence genes (iha,sat, andiutA) were more prevalent among H30 than non-H30 ST131 isolates. Thus, the H30 and H30-Rx subclones are more antimicrobial resistant and have virulence profiles that are distinct from those of non-H30 ST131 isolates.

scholarly journals Complete Sequences ofmcr-1-Harboring Plasmids from Extended-Spectrum-β-Lactamase- and Carbapenemase-Producing Enterobacteriaceae

2016 ◽  
Vol 60 (7) ◽  
pp. 4351-4354 ◽  
Author(s):  
Aiqing Li ◽  
Yong Yang ◽  
Minhui Miao ◽  
Kalyan D. Chavda ◽  
José R. Mediavilla ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Sequence Type ◽  
Clinical Isolates ◽  
Incompatibility Group ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Complete Sequences ◽  
Group A

ABSTRACTHere we completely sequenced fourmcr-1-haboring plasmids, isolated from two extended-spectrum-β-lactamase (ESBL)-producingEscherichia coliand two carbapenemase-producingKlebsiella pneumoniaeclinical isolates. Themcr-1-harboring plasmids from anE. colisequence type 2448 (ST2448) isolate and twoK. pneumoniaeST25 isolates were identical (all pMCR1-IncX4), belonging to the IncX4 incompatibility group, while the plasmid from anE. coliST2085 isolate (pMCR1-IncI2) belongs to the IncI2 group. A nearly identical 2.6-kbmcr-1-pap2element was found to be shared by allmcr-1-carrying plasmids.

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