title: Turkey: a further country concerned by community-acquired Escherichia coli clone O25-ST131 producing CTX-M-15.
abstract: OBJECTIVE
  The aim of this study was to assess the frequency and diversity of extended-spectrum beta-lactamases (ESBLs) produced by exclusively community-acquired Escherichia coli isolates in Izmir (Turkey) and to search for isolates producing CTX-M-15 and belonging to the pandemic clone E. coli O25-ST131.
  
  
  METHODS
  The patients with E. coli urinary tract infections (UTIs) and no hospitalization in the last 12 months, and no transfer from hospital, no stay in nursing home and no antimicrobial treatment in the previous 3 months were prospectively included over a 1 year period. Those E. coli detected positive for ESBL were characterized and compared with a representative of E. coli clone O25-ST131 with regard to bla genes, antibiotic resistance, phylogenetic groups, PFGE profiles and virulence factor genes (n = 17). O serotyping, multilocus sequence typing (MLST) and AmpC typing were performed to confirm that the Turkish isolate belonged to the clone O25-ST131.
  
  
  RESULTS
  Among the 3108 UTIs diagnosed, 82 (2.6%) were due to community E. coli isolates and followed the strict inclusion criteria. Seventeen of them (21%) produced an ESBL, of which CTX-M-15 was predominant (53%). These ESBL-positive isolates, distributed equally into three phylogenetic groups, displayed 13 PFGE profiles and three clusters. A Turkish CTX-M-15-producing isolate as a member of the clone ST131 was suggested by a high similarity of its PFGE profile to that of the clone representative and was confirmed by O serotyping, AmpC typing and MLST.
  
  
  CONCLUSIONS
  This study describes the community emergence of CTX-M-15-producing E. coli isolates, including an isolate of clone O25-ST131, in Turkey.
authors.affiliation: Department of Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey.
authors.forename: Zeki
authors.initials: Z
authors.lastname: Yumuk
authors.forename: Gokhan
authors.initials: G
authors.lastname: Afacan
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Nicolas-Chanoine
authors.forename: Albert
authors.initials: A
authors.lastname: Sotto
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lavigne
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D017714:Community-Acquired Infections / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D011446:Prospective Studies; D017422:Sequence Analysis, DNA; D014421:Turkey; D014552:Urinary Tract Infections / Q000382:microbiology*; D037521:Virulence Factors / Q000235:genetics; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D004269:DNA, Bacterial; D029968:Escherichia coli Proteins; D037521:Virulence Factors; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases