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.

scholarly journals Carbapenem Therapy for Bacteremia Due to Extended-Spectrum-β-Lactamase-Producing Escherichia coli or Klebsiella pneumoniae: Implications of Ertapenem Susceptibility

2012 ◽  
Vol 56 (6) ◽  
pp. 2888-2893 ◽  
Author(s):  
Nan-Yao Lee ◽  
Ching-Chi Lee ◽  
Wei-Han Huang ◽  
Ko-Chung Tsui ◽  
Po-Ren Hsueh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Medical Centers ◽  
Extended Spectrum ◽  
Appropriate Therapy ◽  
Related Mortality

ABSTRACTA retrospective study was conducted at two medical centers in Taiwan to evaluate the clinical characteristics, outcomes, and risk factors for mortality among patients treated with a carbapenem for bacteremia caused by extended-spectrum-beta-lactamase (ESBL)-producing organisms. A total of 251 patients with bacteremia caused by ESBL-producingEscherichia coliandKlebsiella pneumoniaeisolates treated by a carbapenem were identified. Among these ESBL-producing isolates, rates of susceptibility to ertapenem (MICs ≤ 0.25 μg/ml) were 83.8% and 76.4%, respectively; those to meropenem were 100% and 99.3%, respectively; and those to imipenem were 100% and 97.9%, respectively. There were no significant differences in the critical illness rate (P= 0.1) or sepsis-related mortality rate (P= 0.2) for patients with bacteremia caused by ESBL-producingK. pneumoniae(140 isolates, 55.8%) andE. coli(111 isolates, 44.2%). Multivariate analysis of variables related to sepsis-related mortality revealed that the presence of severe sepsis (odds ratio [OR], 15.9; 95% confidence interval [CI], 5.84 to 43.34;P< 0.001), hospital-onset bacteremia (OR, 4.65; 95% CI, 1.42 to 15.24;P= 0.01), and ertapenem-nonsusceptible isolates (OR, 5.12; 95% CI, 2.04 to 12.88;P= 0.001) were independent risk factors. The patients receiving inappropriate therapy had a higher sepsis-related mortality than those with appropriate therapy (P= 0.002), irrespective of ertapenem, imipenem, or meropenem therapy. Infections due to the ertapenem-susceptible isolates (MICs ≤ 0.25 μg/ml) were associated with a more favorable outcome than those due to ertapenem-nonsusceptible isolates (MICs > 0.25 μg/ml), if treated by a carbapenem. However, the mortality for patients with bacteremic episodes due to isolates with MICs of ≤0.5 μg/ml was similar to the mortality for those whose isolates had MICs of >0.5 μg/ml (P= 0.8). Such a finding supports the rationale of the current CLSI 2011 criteria for carbapenems forEnterobacteriaceae.

scholarly journals Survey of Extended-Spectrum β-Lactamases in Clinical Isolates of Escherichia coli and Klebsiella pneumoniae: Prevalence of TEM-52 in Korea

1999 ◽  
Vol 37 (6) ◽  
pp. 1758-1763 ◽  
Author(s):  
Hyunjoo Pai ◽  
Sen Lyu ◽  
Ji Hyang Lee ◽  
Jungmin Kim ◽  
Youngmi Kwon ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Genetic Relatedness ◽  
Clinical Isolates ◽  
E Coli ◽  
Extended Spectrum ◽  
High Prevalence

Two hundred ninety isolates of Escherichia coli were investigated for the production of extended-spectrum β-lactamases (ESBLs). Fourteen (4.8%) of the 290 strains were found to produce ESBLs. Each of the 14 strains produced one or two ESBLs, as follows: 10 strains produced TEM-52, 1 strain produced SHV-2a, 1 strain produced SHV-12, 1 strain produced a CMY-1-like enzyme, and 1 strain expressed SHV-2a and a CMY-1-like enzyme. Another two strains for which the MICs of ceftazidime and cefoxitin were high, were probable AmpC enzyme hyperproducers. Because of the high prevalence of TEM-52 in E. coli isolates, we further investigated the TEM-type ESBLs produced by Klebsiella pneumoniae in order to observe the distribution of TEM-52 enzymes among Enterobacteriaceae in Korea. All TEM enzymes produced by 12 strains of K. pneumoniae were identified as TEM-52. To evaluate the genetic relatedness among the organisms, ribotyping of TEM-52-producingE. coli and K. pneumoniae was performed. The ribotyping profiles of the organisms showed similar but clearly different patterns. In conclusion, TEM-52 is the most prevalent TEM-type ESBL in Korea.

scholarly journals In Vitro Activities of the Potent, Broad-Spectrum Carbapenem MK-0826 (L-749,345) against Broad-Spectrum β-Lactamase-and Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli Clinical Isolates

1999 ◽  
Vol 43 (5) ◽  
pp. 1170-1176 ◽  
Author(s):  
Joyce Kohler ◽  
Karen L. Dorso ◽  
Katherine Young ◽  
Gail G. Hammond ◽  
Hugh Rosen ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Broad Spectrum ◽  
Bacterial Resistance ◽  
Clinical Isolates ◽  
Inoculum Level ◽  
E Coli ◽  
Extended Spectrum ◽  
Group 1

ABSTRACT An important mechanism of bacterial resistance to β-lactam antibiotics is inactivation by β-lactam-hydrolyzing enzymes (β-lactamases). The evolution of the extended-spectrum β-lactamases (ESBLs) is associated with extensive use of β-lactam antibiotics, particularly cephalosporins, and is a serious threat to therapeutic efficacy. ESBLs and broad-spectrum β-lactamases (BDSBLs) are plasmid-mediated class A enzymes produced by gram-negative pathogens, principallyEscherichia coli and Klebsiella pneumoniae. MK-0826 was highly potent against all ESBL- and BDSBL-producingK. pneumoniae and E. coli clinical isolates tested (MIC range, 0.008 to 0.12 μg/ml). In E. coli, this activity was associated with high-affinity binding to penicillin-binding proteins 2 and 3. When the inoculum level was increased 10-fold, increasing the amount of β-lactamase present, the MK-0826 MIC range increased to 0.008 to 1 μg/ml. By comparison, similar observations were made with meropenem while imipenem MICs were usually less affected. Not surprisingly, MIC increases with noncarbapenem β-lactams were generally substantially greater, resulting in resistance in many cases. E. coli strains that produce chromosomal (Bush group 1) β-lactamase served as controls. All three carbapenems were subject to an inoculum effect with the majority of the BDSBL- and ESBL-producers but not the Bush group 1 strains, implying some effect of the plasmid-borne enzymes on potency. Importantly, MK-0826 MICs remained at or below 1 μg/ml under all test conditions.

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 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 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 Decreased Susceptibility to Noncarbapenem Antimicrobials in Extended-Spectrum-β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates in Toronto, Canada

2012 ◽  
Vol 56 (7) ◽  
pp. 3977-3980 ◽  
Author(s):  
Christopher F. Lowe ◽  
Allison McGeer ◽  
Matthew P. Muller ◽  
Kevin Katz
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Pneumoniae ◽  
Retrospective Review ◽  
Content Type ◽  
E Coli ◽  
Extended Spectrum ◽  
Susceptibility Profiles

ABSTRACTRetrospective review from 11 Canadian hospitals showed increasing incidence of extended-spectrum β-lactamase (ESBL)-producingEscherichia coliandKlebsiella pneumoniaefrom 0.12 per 1,000 inpatient days during 2005 to 0.47 per 1,000 inpatient days during 2009. By 2009, susceptibility rates of ESBL-positiveE. coli/K. pneumoniaewere as follows: ciprofloxacin, 12.8%/9.0%; TMP/SMX, 32.9%/12.2%; and nitrofurantoin, 83.8%/10.3%. Nosocomial and nonnosocomial ESBL-producingE. coliisolates had similar susceptibility profiles, while nonnosocomial ESBL-producingK. pneumoniaewas associated with decreased ciprofloxacin (P= 0.03) and nitrofurantoin (P< 0.001) susceptibilities.

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