Giuseppe
Emeritus
[Source: Antimicrobial Agents and Chemotherapy, full text: (LINK). Abstract, edited.]
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Clonal structure, extended-spectrum β-lactamases and acquired AmpC-type cephalosporinases of Escherichia coli populations colonizing patients in rehabilitation centers in four countries.
R. Izdebski 1, A. Baraniak 1, J. Fiett 1, A. Adler 2, M. Kazma 2, J. Salomon 3, C. Lawrence 4, A. Rossini 5, A. Salvia 5, J. Vidal Samso 6, J. Fierro 6, M. Paul 7, Y. Lerman 8, S. Malhotra-Kumar 9, C. Lammens 9, H. Goossens 9, W. Hryniewicz 1, C. Brun-Buisson 10, Y. Carmeli 2 and M. Gniadkowski 1,*on behalf of the MOSAR WP2 & WP5 study groups
Author Affiliations: <SUP>1</SUP>National Medicines Institute, Warsaw, Poland; <SUP>2</SUP>Division of Epidemiology and Preventive Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; <SUP>3</SUP>INSERM, Institut Pasteur, Cnam, Paris, France; <SUP>4</SUP>H?pital Maritime de Berck, Berck/Garches/Paris, France; <SUP>5</SUP>Fondazione Santa Lucia IRCCS, Rome, Italy; <SUP>6</SUP>Institute Guttmann, Barcelona, Spain; <SUP>7</SUP>Loewenstein Hospital, Ra'anana, Israel; <SUP>8</SUP>Geriatric Division, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; <SUP>9</SUP>University of Antwerp, Antwerp, Belgium; <SUP>10</SUP>INSERM, U957 & Universit? Paris-Est, Cr?teil, France
ABSTRACT
The prospective project MOSAR was conducted in five rehabilitation units: BM (France), FS (Italy), GI (Spain), and LH and TA (Israel). Patients were screened for carriage of Enterobacteriaceae resistant to expanded-spectrum cephalosporins (ESCs) from admission until discharge. The aim of this study was to characterize clonal structure, and extended-spectrum β-lactamases (ESBLs) and acquired AmpC-like cephalosporinases in Escherichia coli populations collected. A total of 376 isolates were randomly selected. The overall number of sequence types (STs) was 76, including seven STs that grouped at least 10 isolates from at least three centers each, namely STs: 10, 38, 69, 131, 405, 410 and 648. These clones comprised 65.2% of all isolates, and ST131 alone ? 41.2%. Of 54 STs observed only in one center, some STs played a locally significant role, like ST156 and ST393 in GI or ST372 and ST398 in TA. Among 16 new STs, five arose from the evolution within the ST10 and ST131 clonal complexes. ESBLs and AmpCs accounted for 94.7% and 5.6% of the ESC-hydrolyzing β-lactamases, respectively, being dominated by the CTX-M-like enzymes (79.9%), followed by SHV (13.5%) and CMY-2 (5.3%) types. CTX-M-15 was the most prevalent β-lactamase overall (40.6%); other ubiquitous enzymes were CTX-M-14 and CMY-2. Almost none of the common clones correlated strictly with one β-lactamase; although 58.7% of ST131 isolates produced CTX-M-15, the clone expressed also nine other enzymes. A number of clone variants with specific PFGE and ESBL types were spread in some locales, potentially representing newly emerging E. coli epidemic strains.
FOOTNOTES
* Corresponding author: Marek Gniadkowski, National Medicines Institute, ul. Chełmska 30/34, 00-725 Warsaw, Poland. Fax: (+48) 22 ? 841 29 49. E-mail: gniadkow@cls.edu.pl
Copyright ? 2012, American Society for Microbiology. All Rights Reserved.
-Author Affiliations: <SUP>1</SUP>National Medicines Institute, Warsaw, Poland; <SUP>2</SUP>Division of Epidemiology and Preventive Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; <SUP>3</SUP>INSERM, Institut Pasteur, Cnam, Paris, France; <SUP>4</SUP>H?pital Maritime de Berck, Berck/Garches/Paris, France; <SUP>5</SUP>Fondazione Santa Lucia IRCCS, Rome, Italy; <SUP>6</SUP>Institute Guttmann, Barcelona, Spain; <SUP>7</SUP>Loewenstein Hospital, Ra'anana, Israel; <SUP>8</SUP>Geriatric Division, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; <SUP>9</SUP>University of Antwerp, Antwerp, Belgium; <SUP>10</SUP>INSERM, U957 & Universit? Paris-Est, Cr?teil, France
ABSTRACT
The prospective project MOSAR was conducted in five rehabilitation units: BM (France), FS (Italy), GI (Spain), and LH and TA (Israel). Patients were screened for carriage of Enterobacteriaceae resistant to expanded-spectrum cephalosporins (ESCs) from admission until discharge. The aim of this study was to characterize clonal structure, and extended-spectrum β-lactamases (ESBLs) and acquired AmpC-like cephalosporinases in Escherichia coli populations collected. A total of 376 isolates were randomly selected. The overall number of sequence types (STs) was 76, including seven STs that grouped at least 10 isolates from at least three centers each, namely STs: 10, 38, 69, 131, 405, 410 and 648. These clones comprised 65.2% of all isolates, and ST131 alone ? 41.2%. Of 54 STs observed only in one center, some STs played a locally significant role, like ST156 and ST393 in GI or ST372 and ST398 in TA. Among 16 new STs, five arose from the evolution within the ST10 and ST131 clonal complexes. ESBLs and AmpCs accounted for 94.7% and 5.6% of the ESC-hydrolyzing β-lactamases, respectively, being dominated by the CTX-M-like enzymes (79.9%), followed by SHV (13.5%) and CMY-2 (5.3%) types. CTX-M-15 was the most prevalent β-lactamase overall (40.6%); other ubiquitous enzymes were CTX-M-14 and CMY-2. Almost none of the common clones correlated strictly with one β-lactamase; although 58.7% of ST131 isolates produced CTX-M-15, the clone expressed also nine other enzymes. A number of clone variants with specific PFGE and ESBL types were spread in some locales, potentially representing newly emerging E. coli epidemic strains.
FOOTNOTES
* Corresponding author: Marek Gniadkowski, National Medicines Institute, ul. Chełmska 30/34, 00-725 Warsaw, Poland. Fax: (+48) 22 ? 841 29 49. E-mail: gniadkow@cls.edu.pl
Copyright ? 2012, American Society for Microbiology. All Rights Reserved.
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