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Survival in the environment is a possible key factor for the expansion of Escherichia coli strains producing extended-spectrum beta-lactamases
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Clinical Bacteriology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Clinical Bacteriology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Clinical Bacteriology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical Microbiology and Infectious Medicine, Clinical Bacteriology.
2014 (English)In: Acta Pathologica, Microbiologica et Immunologica Scandinavica (APMIS), ISSN 0903-4641, E-ISSN 1600-0463, Vol. 122, no 1, 59-67 p.Article in journal (Refereed) Published
Abstract [en]

Acquired resistance to cephalosporins in Enterobacteriaceae is a global problem. After an outbreak at Uppsala University Hospital of extended-spectrum -lactamase (ESBL)-positive Klebsiella pneumoniae producing CTX-M-15, there was a shift from AmpC to ESBL production among Escherichia coli isolates. To explore the basis for this epidemiological shift, 46 E. coli isolates (ESBLs, n=23; AmpC, n=23) were characterized with regard to genetic relatedness, -lactamase, replicon and integron types, antibiotic resistance profiles, and genes encoding virulence factors. In addition, the survival in the environment and on hospital-associated materials was analysed. CTX-M-15 was the most frequent ESBL (78%). Only three (13%) of the AmpC enzymes were harboured on plasmids (CMY-2, DHA-1). Independent of plasmid-mediated beta-lactamase, IncF plasmids predominated and only class I integrons were detected. The ESBL producers carried more virulence genes (p=0.04), exhibited a broader resistance phenotype (p=0.01) and survived significantly longer (p=0.03) on different materials than the AmpC-producing isolates. In conclusion, ESBL-producing isolates had properties which are likely to augment their competitiveness. Apart from antibiotic resistance and virulence factors, extended survival in the environment could be a selective trait for successful ESBL-producing E. coli strains.

Place, publisher, year, edition, pages
2014. Vol. 122, no 1, 59-67 p.
Keyword [en]
E-coli, AmpC, ESBL, environment, virulence genes, plasmids
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-216726DOI: 10.1111/apm.12102ISI: 000328909100008OAI: oai:DiVA.org:uu-216726DiVA: diva2:691212
Available from: 2014-01-27 Created: 2014-01-24 Last updated: 2017-12-06Bibliographically approved

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Starlander, GustafMelhus, Åsa

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