Abstract
Extended spectrum beta-lactamase producing E. coli (ESBL-EC) are an emerging public health issue. In New Zealand (NZ), bla CTX-M-14 and bla CTX-M-15 are the most common ESBL genes. Although many studies describe risk factors for ESBL-EC, few describe risk factors for specific ESBL genes. Between January 2006 and December 2007, we characterized 108 consecutive, non-duplicate isolates of ESBL-EC at the Auckland Hospital laboratory. Demographic and clinical data were recorded. Of the 108, 54.6% (59) were CTX-M-15-EC, 26.9% (29) were CTX-M-14-EC and 12.09% were CTX-M-9 (13). The remaining seven isolates carried CTX-M-3 (3; 2.7%), CTX-M-65 (2; 1.8%), CTX-M-27 (1; 0.9%) and CTX-M-57 (1; 0.9%). CTX-M-15-EC were more likely than CTX-M-14-EC to be fluoroquinolone-resistant (86.4% versus 32.4%; p = 0.006) and to be non-susceptible to amoxicillin-clavulanate (84.7% versus 41.4%; p = 0.0001). Patients with CTX-M-15-EC were more likely to be of Indian ethnicity (34.5% versus 0%; p = 0.0012) and to have travelled recently (31.6% versus 4%; p = 0.0088). Patients with CTX-M-14-EC were more likely to have Chinese or South-East Asian ethnicity (48.1% versus 5.2%; p < 0.0001) and to have no history of either travel or prior hospital admission (44% versus 8.9%; p = 0.0006). These data imply that CTX-M-15 and CTX-M-14 producing E. coli are associated with distinct demographic subgroups in NZ.
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References
Cantón R, Coque TM (2006) The CTX-M β-lactamase pandemic. Curr Opin Microbiol 9:466–475
Heffernan H, Pope C, Carter P (2007) Identification of extended-spectrum β-lactamase types, plasmid mediated AmpC β-lactamases and strains among urinary Escherichia coli and Klebsiella in New Zealand in 2006. URL: http://www.surv.esr.cri.nz/PDF_surveillance/Antimicrobial/ESBL/ESBLIdentification_2006.pdf. Accessed 9 January 2012
Rossolini GM, D’Andrea MM, Mugnaioli C (2008) The spread of CTX-M-type extended-spectrum β-lactamases. Clin Microbiol Infect 14:33–41
Pitout JD, Gregson DB, Church DL et al (2005) Community-wide outbreaks of clonally related CTX-M-14 β-lactamase-producing Escherichia coli strains in the Calgary health region. J Clin Microbiol 43:2844–2849
Ben Ami R, Schwaber MJ, Nanon-Venezia S et al (2006) Influx of extended-spectrum β-lactamase-producing Enterobacteriaceae into the hospital. Clin Infect Dis 42:925–934
Calbo E, Romani V, Xercavins M et al (2006) Risk factors for community-onset urinary tract infections due to Escherichia coli harbouring extended-spectrum β-lactamases. J Antimicrob Chemother 57:780–783
Rodríguez-Baño J, Picón E, Gijón P et al (2010) Community-onset bacteremia due to extended-spectrum beta-lactamase-producing Escherichia coli: risk factors and prognosis. Clin Infect Dis 50(1):40–48
Clinical and Laboratory Standards Institute (2010) Performance standards for antimicrobial susceptibility testing; CLSI document M100-S20. Clinical and Laboratory Standards Institute, Wayne, PA
Jeong SH, Bae IK, Kwon SB et al (2005) Dissemination of transferable CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli in Korea. J Appl Microbiol 98:921–927
De Gheldre Y, Avesani V, Berhin C, Delmee M, Glupczynski Y (2003) Evaluation of Oxoid combination discs for detection of extended-spectrum ß-lactamases. J Antimicrob Chemother 52:591–597
Tenover FC, Arbeit RD, Goering RV et al (1995) Interpreting chromosomal DNA restriction patterns produced by pulsed field gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 33:2233–2239
Ensor V, Shahid M, Evans J, Hawkey P (2006) Occurrence, prevalence and genetic environment of CTX-M β-lactamases in Enterobacteriaceae from Indian hospitals. J Antimicrob Chemother 58:1260–1263
Chen YH, Hsueh PR, Badal RE et al (2011) Antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region according to currently established susceptibility interpretive criteria. J Infect 62(4):280–291
Pitout JD, Campbell L, Church DL et al (2009) Molecular characteristics of travel-related extended-spectrum β-lactamase-producing Escherichia coli isolates from the Calgary health region. Antimicrob Agents Chemother 53:2539–2543
Manges AR, Tabor H, Tellis P, Vincent C, Tellier PP (2008) Endemic and epidemic lineages of Escherichia coli that cause urinary tract infections. Emerg Infect Dis 14:1575–1583
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The authors would like to acknowledge Tracy Bathgate, Audrey Tiong, Sarah Baines and Rosemary Woodhouse for their help with this study.
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Freeman, J.T., Williamson, D.A., Heffernan, H. et al. Comparative epidemiology of CTX-M-14 and CTX-M-15 producing Escherichia coli: Association with distinct demographic groups in the community in New Zealand. Eur J Clin Microbiol Infect Dis 31, 2057–2060 (2012). https://doi.org/10.1007/s10096-011-1540-3
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DOI: https://doi.org/10.1007/s10096-011-1540-3