Identification of CTX-M beta-lactamases in Escherichia coli from hospitalized patients and residents of long-term care facilities.
Bacteria harboring CTX-M extended-spectrum beta-lactamases (ESBLs) have been identified worldwide, with most reports coming from regions outside North America. We have identified CTX-M enzymes in 31% of ESBL-positive Escherichia coli isolates from our hospital and more than half (53%) of the isolates from associated long-term care facilities. Approximately 3/4 of all CTX-M-bearing isolates were from urine specimens, with a predominance of CTX-M-15. A large proportion of such isolates were nonsusceptible to levofloxacin, trimethoprim/sulfamethoxazole, and all beta-lactam antimicrobials with the exception of the carbapenems, requiring carbapenem therapy for acute urinary tract infection or urinary tract-related sepsis. CTX-M beta-lactamases have emerged within our location, and detection of bacteria harboring these enzymes in the clinical microbiology laboratory remains problematic because molecular methods are needed for their identification.
Urban
Carl
C
Infectious Disease Section, New York Hospital Queens, Flushing, NY 11355, USA. cmurban@nyp.org
Mariano
Noriel
N
Bradford
Patricia A
PA
Tuckman
Margareta
M
Segal-Maurer
Sorana
S
Wehbeh
Wehbeh
W
Grenner
Louise
L
Colon-Urban
Rita
R
Johnston
Brian
B
Johnson
James R
JR
Rahal
James J
JJ
D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D003428:Cross Infection / Q000382:microbiology*; D016172:DNA Fingerprinting; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000096:biosynthesis* / Q000235:genetics; D005260:Female; D005838:Genotype; D006761:Hospitals; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D014481:United States; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; D001618:beta-Lactamases