title: Clonal structure, extended-spectrum β-lactamases, and acquired AmpC-type cephalosporinases of Escherichia coli populations colonizing patients in rehabilitation centers in four countries.
abstract: The prospective project MOSAR was conducted in five rehabilitation units: the Berck Maritime Hôpital (Berck, France), Fondazione Santa Lucia (Rome, Italy), Guttmann Institute (GI; Barcelona, Spain), and Loewenstein Hospital and Tel-Aviv Souraski Medical Center (TA) (Tel-Aviv, Israel). Patients were screened for carriage of Enterobacteriaceae resistant to expanded-spectrum cephalosporins (ESCs) from admission until discharge. The aim of this study was to characterize the clonal structure, extended-spectrum β-lactamases (ESBLs), and acquired AmpC-like cephalosporinases in the Escherichia coli populations collected. A total of 376 isolates were randomly selected. The overall number of sequence types (STs) was 76, including 7 STs that grouped at least 10 isolates from at least three centers each, namely, STs 10, 38, 69, 131, 405, 410, and 648. These clones comprised 65.2% of all isolates, and ST131 alone comprised 41.2%. Of 54 STs observed only in one center, some STs played a locally significant role, like ST156 and ST393 in GI or ST372 and ST398 in TA. Among 16 new STs, five arose from evolution within the ST10 and ST131 clonal complexes. ESBLs and AmpCs accounted for 94.7% and 5.6% of the ESC-hydrolyzing β-lactamases, respectively, being dominated by the CTX-M-like enzymes (79.9%), followed by the SHV (13.5%) and CMY-2 (5.3%) types. CTX-M-15 was the most prevalent β-lactamase overall (40.6%); other ubiquitous enzymes were CTX-M-14 and CMY-2. Almost none of the common clones correlated strictly with one β-lactamase; although 58.7% of ST131 isolates produced CTX-M-15, the clone also expressed nine other enzymes. A number of clone variants with specific pulsed-field gel electrophoresis and ESBL types were spread in some locales, potentially representing newly emerging E. coli epidemic strains.
authors.affiliation: National Medicines Institute, Warsaw, Poland.
authors.forename: R
authors.initials: R
authors.lastname: Izdebski
authors.forename: A
authors.initials: A
authors.lastname: Baraniak
authors.forename: J
authors.initials: J
authors.lastname: Fiett
authors.forename: A
authors.initials: A
authors.lastname: Adler
authors.forename: M
authors.initials: M
authors.lastname: Kazma
authors.forename: J
authors.initials: J
authors.lastname: Salomon
authors.forename: C
authors.initials: C
authors.lastname: Lawrence
authors.forename: A
authors.initials: A
authors.lastname: Rossini
authors.forename: A
authors.initials: A
authors.lastname: Salvia
authors.forename: J
authors.initials: J
authors.lastname: Vidal Samso
authors.forename: J
authors.initials: J
authors.lastname: Fierro
authors.forename: M
authors.initials: M
authors.lastname: Paul
authors.forename: Y
authors.initials: Y
authors.lastname: Lerman
authors.forename: S
authors.initials: S
authors.lastname: Malhotra-Kumar
authors.forename: C
authors.initials: C
authors.lastname: Lammens
authors.forename: H
authors.initials: H
authors.lastname: Goossens
authors.forename: W
authors.initials: W
authors.lastname: Hryniewicz
authors.forename: C
authors.initials: C
authors.lastname: Brun-Buisson
authors.forename: Y
authors.initials: Y
authors.lastname: Carmeli
authors.forename: M
authors.initials: M
authors.lastname: Gniadkowski
mesh_terms: D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D002999:Clone Cells; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification / Q000201:enzymology / Q000235:genetics*; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007557:Israel / Q000453:epidemiology; D010802:Phylogeny; D058974:Phylogeography; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; C048795:AmpC beta-lactamases; D001618:beta-Lactamases