title: Conjugative IncFI plasmids carrying CTX-M-15 among Escherichia coli ESBL producing isolates at a University hospital in Germany.
abstract: BACKGROUND
  Multi-drug-resistant, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae, constitute an emerging public-health concern. Little data on the molecular epidemiology of ESBL producing Escherichia coli is available in Germany. Here we describe the prevalence and molecular epidemiology of ESBL producing-Escherichia coli isolates at a German University hospital.
  
  
  METHODS
  We analysed 63 non-duplicate clinical ESBL isolates obtained over an 8-month period using PCR and sequence-based ESBL allele typing, plasmid replicon typing, phylogenetic group typing. Pulsed-field gel electrophoresis (PFGE) based genotyping and plasmid profiling was performed, as well as confirmatory DNA-based hybridization assays.
  
  
  RESULTS
  Examination of the 63 Escherichia coli isolates revealed an almost equal distribution among the E. coli phylogenetic groups A, B1, B2 and D. High prevalence (36/63) of the CTX-M-15 gene was observed and an analysis of PFGE-based patterns revealed the presence of this CTX-M allele in multiple clones. Resistance to cefotaxime was a transferable trait and a commonly occurring 145.5 kb conjugative IncFI plasmid was detected in 65% of E. coli carrying the CTX-M-15 allele. The rate of transferable antibiotic resistances for GM, SXT, TET, GM-SXT-TET, SXT-TET and GM-TET was 33%, 61%, 61%, 27%, 44% and 11%, respectively. The remaining strains did not have a common IncFI plasmid but harboured transferable IncFI plasmids with sizes that ranged from 97 to 242.5 kb.
  
  
  CONCLUSIONS
  Our data demonstrate the presence of IncFI plasmids within the prevailing E. coli population in a hospital setting and suggest that the dissemination of CTX-M-15 allele is associated to lateral transfer of these well-adapted, conjugative IncFI plasmids among various E. coli genotypes.
authors.affiliation: Institute of Medical Microbiology, Justus-Liebig University, Giessen, Germany. mshana72@yahoo.com
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Mshana
authors.forename: Can
authors.initials: C
authors.lastname: Imirzalioglu
authors.forename: Hamid
authors.initials: H
authors.lastname: Hossain
authors.forename: Torsten
authors.initials: T
authors.lastname: Hain
authors.forename: Eugen
authors.initials: E
authors.lastname: Domann
authors.forename: Trinad
authors.initials: T
authors.lastname: Chakraborty
mesh_terms: D015373:Bacterial Typing Techniques; D003227:Conjugation, Genetic; D004269:DNA, Bacterial / Q000235:genetics; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification / Q000235:genetics*; D004927:Escherichia coli Infections / Q000453:epidemiology*; D005798:Genes, Bacterial; D005858:Germany / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D017720:Molecular Epidemiology; D010802:Phylogeny; D010957:Plasmids; D015995:Prevalence; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D004269:DNA, Bacterial; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases