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Regional survey of CTX-M-type extended-spectrum β-lactamases among Enterobacteriaceae reveals marked heterogeneity in the distribution of the ST131 clone.
J Antimicrob Chemother. 2011 Mar; 66(3):505-11.JA

Abstract

OBJECTIVES

To establish the prevalence and diversity of clinically significant extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae harbouring bla(CTX-M) in the West Midlands region of the UK.

METHODS

During a 2 month period, 370 consecutive, non-duplicate isolates were collected from 13 laboratories. Isolates were screened for the presence of bla(CTX-M) by multiplex PCR and genotyped using denaturing HPLC (DHPLC). Clonal relationships were studied by PFGE and O25b-ST131 Escherichia coli were identified by PCR.

RESULTS

Two hundred and ninety-four out of 345 ESBL-producing isolates (85.2%) carried bla(CTX-M). CTX-M group 1 enzymes were expressed in 284 (96.6%) isolates, with the other 10 carrying group 9, 2 and 25/26 genes. All group 1 isolates had bla(CTX-M-15) DHPLC profiles. The bla(CTX-M) E. coli were split into 23 PFGE clusters. The largest cluster (RE1) was indistinguishable from the previously described strain A and all but one harboured bla(CTX-M-15.) A total of 66% of E. coli were O25b-ST131 positive.

CONCLUSIONS

The CTX-M-15-producing RE1 clone (strain A) is the predominant clone in the West Midlands. This clone has spread throughout the region since its emergence in an outbreak 3 years earlier. Most, but not all, RE1 isolates belong to the O25b-ST131 lineage, providing further evidence that this lineage plays a pivotal role in the clonal dispersal of CTX-M-15-producing Enterobacteriaceae. Strain A was found to be considerably more heterogeneous than when first described and has acquired greater resistance to gentamicin. Approximately one-third of CTX-M producers represented a wide variety of unrelated strains. The study shows the rapid spread and diversification of CTX-M-producing Enterobacteriaceae over a 3 year period.

Authors+Show Affiliations

Health Protection Agency, West Midlands Public Health Laboratory, Heart of England NHS Foundation Trust, Bordesley Green East, Birmingham B9 5SS, UK. l.mccrae@bham.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21183528

Citation

Xu, Li, et al. "Regional Survey of CTX-M-type Extended-spectrum Β-lactamases Among Enterobacteriaceae Reveals Marked Heterogeneity in the Distribution of the ST131 Clone." The Journal of Antimicrobial Chemotherapy, vol. 66, no. 3, 2011, pp. 505-11.
Xu L, Shabir S, Bodah T, et al. Regional survey of CTX-M-type extended-spectrum β-lactamases among Enterobacteriaceae reveals marked heterogeneity in the distribution of the ST131 clone. J Antimicrob Chemother. 2011;66(3):505-11.
Xu, L., Shabir, S., Bodah, T., McMurray, C., Hardy, K., Hawkey, P., & Nye, K. (2011). Regional survey of CTX-M-type extended-spectrum β-lactamases among Enterobacteriaceae reveals marked heterogeneity in the distribution of the ST131 clone. The Journal of Antimicrobial Chemotherapy, 66(3), 505-11. https://doi.org/10.1093/jac/dkq482
Xu L, et al. Regional Survey of CTX-M-type Extended-spectrum Β-lactamases Among Enterobacteriaceae Reveals Marked Heterogeneity in the Distribution of the ST131 Clone. J Antimicrob Chemother. 2011;66(3):505-11. PubMed PMID: 21183528.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Regional survey of CTX-M-type extended-spectrum β-lactamases among Enterobacteriaceae reveals marked heterogeneity in the distribution of the ST131 clone. AU - Xu,Li, AU - Shabir,Sahida, AU - Bodah,Thomas, AU - McMurray,Claire, AU - Hardy,Katie, AU - Hawkey,Peter, AU - Nye,Kathryn, Y1 - 2010/12/23/ PY - 2010/12/25/entrez PY - 2010/12/25/pubmed PY - 2011/7/16/medline SP - 505 EP - 11 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 66 IS - 3 N2 - OBJECTIVES: To establish the prevalence and diversity of clinically significant extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae harbouring bla(CTX-M) in the West Midlands region of the UK. METHODS: During a 2 month period, 370 consecutive, non-duplicate isolates were collected from 13 laboratories. Isolates were screened for the presence of bla(CTX-M) by multiplex PCR and genotyped using denaturing HPLC (DHPLC). Clonal relationships were studied by PFGE and O25b-ST131 Escherichia coli were identified by PCR. RESULTS: Two hundred and ninety-four out of 345 ESBL-producing isolates (85.2%) carried bla(CTX-M). CTX-M group 1 enzymes were expressed in 284 (96.6%) isolates, with the other 10 carrying group 9, 2 and 25/26 genes. All group 1 isolates had bla(CTX-M-15) DHPLC profiles. The bla(CTX-M) E. coli were split into 23 PFGE clusters. The largest cluster (RE1) was indistinguishable from the previously described strain A and all but one harboured bla(CTX-M-15.) A total of 66% of E. coli were O25b-ST131 positive. CONCLUSIONS: The CTX-M-15-producing RE1 clone (strain A) is the predominant clone in the West Midlands. This clone has spread throughout the region since its emergence in an outbreak 3 years earlier. Most, but not all, RE1 isolates belong to the O25b-ST131 lineage, providing further evidence that this lineage plays a pivotal role in the clonal dispersal of CTX-M-15-producing Enterobacteriaceae. Strain A was found to be considerably more heterogeneous than when first described and has acquired greater resistance to gentamicin. Approximately one-third of CTX-M producers represented a wide variety of unrelated strains. The study shows the rapid spread and diversification of CTX-M-producing Enterobacteriaceae over a 3 year period. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/21183528/Regional_survey_of_CTX_M_type_extended_spectrum_β_lactamases_among_Enterobacteriaceae_reveals_marked_heterogeneity_in_the_distribution_of_the_ST131_clone_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkq482 DB - PRIME DP - Unbound Medicine ER -