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Molecular and phenotypic characterization of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases with focus on CTX-M in a low-endemic area in Sweden
Departments of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
Departments of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
Departments of Laboratory Medicine, Clinical Microbiology, Örebro University Hospital, Örebro, Sweden.
Departments of Laboratory Medicine, Clinical Microbiology and Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.ORCID iD: 0000-0001-5939-2932
2011 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 119, no 4-5, p. 287-295Article in journal (Refereed) Published
Abstract [en]

During the last decade increasing prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae has been detected worldwide, mainly due to dissemination of Escherichia coli and Klebsiella pneumoniae producing CTX-M-type ESBLs. CTX-M-15 is the most widespread CTX-M type, and the predominant type in various countries. Dissemination of ESBL-producing organisms is caused not only by horizontal transfer of plasmids, but also by clonal spread of ESBL-producing strains. In this study, the molecular epidemiology of class A ESBL (ESBL(A))-producing E. coli and K. pneumoniae isolated in Örebro County, Sweden, was investigated. Out of 200 ESBL(A) -producing E. coli and K. pneumoniae isolates, collected over a 10-year period, 87% were producing CTX-M, belonging to subgroup CTX-M-1 (64%), CTX-M-9 (34%), or CTX-M-2 (2%). The remaining isolates were producing variants of SHV and TEM. Sequencing of the bla(CTX-M) genes revealed 10 different CTX-M types, with a dominance of CTX-M-15 (E. coli 54%, K. pneumoniae 50%) followed by CTX-M-14 (E. coli 28%, K. pneumoniae 27%). Phenotypic characterization of the CTX-M-producing isolates was performed using the PhenePlate system. Although a few minor clusters of CTX-M-15 and CTX-M-14 producers were identified, the majority of the isolates did not appear to be clonally related.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2011. Vol. 119, no 4-5, p. 287-295
Keywords [en]
Extended-spectrum beta-lactamase; Escherichia coli; Klebsiella pneumoniae; CTX-M; sequencing
National Category
Immunology in the medical area Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-25340DOI: 10.1111/j.1600-0463.2011.02730.xISI: 000289636600008PubMedID: 21492229Scopus ID: 2-s2.0-79954726789OAI: oai:DiVA.org:oru-25340DiVA, id: diva2:547081
Note

Funding Agency:

Research Committee of Orebro County Council, Sweden 

Available from: 2012-08-27 Created: 2012-08-27 Last updated: 2020-02-26Bibliographically approved
In thesis
1. Long-term molecular epidemiology of extended-spectrum β-lactamase producing Escherichia coli in a low-endemic setting
Open this publication in new window or tab >>Long-term molecular epidemiology of extended-spectrum β-lactamase producing Escherichia coli in a low-endemic setting
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Escherichia coli is a commensal inhabitant in the gastro-intestinal tract of humans and animals but it is also the most common bacterial species causing urinary tract infection, which ranges in severity from distal cystitis to urosepsis and septic shock. During the past decades, the prevalence of antibiotic resistant E. coli has increased worldwide. Extended-spectrum β-lactamases (ESBL) causes resistance to β-lactam antibiotics, the most widely used class of antibiotics. The genes encoding ESBL, bla, are usually carried on conjugative plasmids, which can be transferred between different bacterial lineages and different species. These plasmids frequently also carry resistance genes to additional antibiotic classes, and ESBL-producing E. coli are therefore often multidrug-resistant. The aim of this thesis was to describe the long-term molecular epidemiology of ESBL-producing E. coli in Örebro County during the time when they first started to emerge. In addition, potential transmission to the environment was investigated by performing a comparative analysis on ESBL-producing E. coli isolated from patients and from the aquatic environment in Örebro city. In general, the E. coli population was genetically diverse, but the pandemic lineage ST131, first identified in 2004, appears to have been responsible for the dramatic increase of CTX-M-15-producing E.coli observed during the late 2000s. CTX-M-15 was the most prevalent ESBL-type followed by CTX-M-14 and these genes were mainly found on plasmids belonging to the IncF or IncI1 families. Continuous horizontal transmission of IncI1 ST31 and ST37 plasmids between diverse E. coli lineages have also contributed to the dissemination of blaCTX-M-15 in Örebro County. Extended spectrum β-lactamase-producing E. coli were found to be common in the aquatic environment in Örebro city and E. coli lineages genetically similar to those causing infections in humans were present in environmental waters indicating that transmission of ESBL-producing E. colifrom humans to the aquatic environment likely has occurred.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2020. p. 91
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 207
Keywords
Escherichia coli, extended-spectrum β-lactamase, whole genome sequencing, plasmids, hybrid assembly, environment, IncI1, ST131
National Category
Other Basic Medicine
Identifiers
urn:nbn:se:oru:diva-79292 (URN)978-91-7529-324-0 (ISBN)
Public defence
2020-03-20, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
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Available from: 2020-01-22 Created: 2020-01-22 Last updated: 2020-03-26Bibliographically approved

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Önnberg, AnnaSöderquist, Bo

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