title: Sequence analysis of bla(CTX-M) genes carried by clinically significant Escherichia coli isolates in Kuwait hospitals.
abstract: OBJECTIVE
  To investigate the extent, distribution and sequence analysis of bla(CTX-M) genes carried by Escherichia coli isolated from patients admitted to all government hospitals in Kuwait.
  
  
  METHODS
  Extended-spectrum β-lactamase (ESBL)-producing E. coli isolates were collected from the 8 major hospitals in Kuwait. CTX-M ESBLs were analyzed by PCR and sequenced. Clonality of the positive isolates was determined for genetic relatedness using pulsed-field gel electrophoresis (PFGE) with XbaI digestion of the genomic DNA.
  
  
  RESULTS
  Of the 136 ESBL-positive isolates, 106 (77.9%) harbored bla(CTX-M) genes. Among these, bla(CTX-M-15) was the most frequent with a prevalence rate of 84.1%, followed by bla(CTX-M-14) (6.8%), bla(CTX-M-14b) (5.7%) and bla(TOHO-1) (3.4%). Ninety-three (87.7%) were isolated from Kuwaiti (35.9%), Egyptian (31.1%) and Indian (20.8%) nationals; the majority of isolates positive for bla(CTX-M-15) were mainly from these 3 nationalities. PFGE analysis did not demonstrate any clustering of positive isolates in any particular hospital.
  
  
  CONCLUSIONS
  This study confirms an explosive emergence of CTX-M-15 β-lactamase among E. coli isolates in Kuwait and shows that the strains were clonally heterogeneous with no evidence of inter- or intra-hospital spread. Thus Kuwait may represent an important source of CTX-M-15-positive E. coli.
authors: Department of Microbiology, Faculty of Medicine, Health Sciences Centre, Kuwait University, Jabriya, Kuwait.
authors: G
authors: G
authors: Al Hashem
authors: N
authors: N
authors: Al Sweih
authors: W
authors: W
authors: Jamal
authors: V O
authors: VO
authors: Rotimi
mesh_terms: D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000382:microbiology*; D004926:Escherichia coli / Q000201:enzymology* / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics / Q000302:isolation & purification; D005260:Female; D005838:Genotype; D006801:Humans; D007730:Kuwait; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D017421:Sequence Analysis; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D029968:Escherichia coli Proteins; C456080:beta-lactamase CTX-M-14; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases; C495977:beta-lactamase Toho-1, E coli