Predominance and genetic diversity of community- and hospital-acquired CTX-M extended-spectrum β-lactamases in York, UK

被引:106
作者
Munday, CJ
Whitehead, GM
Todd, NJ
Campbell, M
Hawkey, PM
机构
[1] Univ Birmingham, Sch Med, Div Immunobiol & Infect, Antimicrobial Agents Res Grp, Birmingham B15 2TT, W Midlands, England
[2] York Hosp, Dept Microbiol, York YO31 8HE, N Yorkshire, England
[3] Glasgow Caledonian Univ, Dept Biol & Biomed Sci, Glasgow G4 0BA, Lanark, Scotland
[4] Heartlands Hosp, Hlth Protect Agcy, Birmingham Publ Hlth Lab, Birmingham B9 5SS, W Midlands, England
关键词
ESBLs; Salmonella; Enterobacteriaceae;
D O I
10.1093/jac/dkh397
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: This study was conducted to detect the presence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae within the faecal flora of both community- and hospital-based patients in York and to characterize the bla(TEM), bla(SHV) and bla(CTX-M) genes present in these isolates. Methods: One thousand faeces samples were collected and screened at York Hospital during October-December 2003. Ninety-five non-duplicate Enterobacteriaceae isolates resistant to third-generation cephalosporins were recovered; 22 isolates were selected for further study on the basis of a positive double disc diffusion test for ESBL production. Antibiotic susceptibility testing was performed to a range of antibiotics. The TEM, SHV and CTX-M genes were detected by PCR and the DNA sequenced. Results: The distribution of ESBL-positive isolates from the hospital and community was 1.4:1. These included nine Escherichia coli, seven Enterobacter cloacae, four Citrobacter freundii and a single isolate each of Klebsiella spp. and Salmonella spp. A total of 17 isolates contained bla(CTX-M) (five bla(CTX-M-15), three bla(CTX-M-14) and nine bla(CTX-M-9)). ISEcp1 was present in isolates expressing CTX-M-14 and -15, but was absent upstream of In60-associated bla(CTX-M-9). E. coli isolates also contained either a bla(TEM-1) or bla(TEM-2), whereas six of the E. cloacae carried bla(SHV-12) and the Klebsiella spp. bla(SHV-36) in addition to bla(CTX-M-9). The single Salmonella spp. carried bla(SHV-12). Conclusions: The overall prevalence of ESBL in isolates of Enterobacteriaceae from York was 1.9%. ESBL-producing isolates were found in both the community and hospital, with the CTX-M type most common. This is also the first report of an ESBL-producing Salmonella in the UK.
引用
收藏
页码:628 / 633
页数:6
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