title: High prevalence of ST131 among CTX-M-producing Escherichia coli from community-acquired infections, in the Czech Republic.
abstract: A total of 2,683 nonrepetitive Escherichia coli isolates were collected from microbiological laboratories covering all regions of the Czech Republic, during April 2011. Antimicrobial susceptibility patterns of E. coli were assessed. All 38 cefotaxime-resistant (CTX-R) isolates were found to be extended-spectrum β-lactamase (ESBL)-positive by the double-disc synergy test. Thirty-two of those isolates produced enzymes of CTX-M-1 family, five of CTX-M-9 family, and one isolate both CTX-M types. Genotyping by multilocus sequence typing classified all ESBL-producing isolates into 13 sequence types (STs). ST131 was the most prevalent and was exclusively correlated with E. coli belonging to the more-virulent phylogroup B2. blaCTX-M-15 and blaCTX-M-9-like genes were mainly carried by plasmids belonging to the IncF group, while replicon I1 was predominant among CTX-M-1-encoding plasmids. Additionally, 63% of the ESBL-producing isolates were also resistant to ciprofloxacin. Sequence analysis of quinolone resistance-determining regions of gyrA and parC revealed the presence of amino acid substitutions in 22 out of 23 ciprofloxacin-resistant isolates. The acc(6')-Ib-cr and qnrB1 plasmid-mediated quinolone resistance genes were also detected in some of the isolates. This is the first report on the emergence and spread of CTX-M-producing E. coli in the community of the Czech Republic, indicating the high prevalence of ST131 clone among CTX-M producers.
authors.affiliation: 1 Department of Microbiology, Faculty of Medicine and University Hospital in Plzen, Charles University in Prague , Plzen, Czech Republic .
authors.forename: Costas C
authors.initials: CC
authors.lastname: Papagiannitsis
authors.forename: Vendula
authors.initials: V
authors.lastname: Študentová
authors.forename: Vladislav
authors.initials: V
authors.lastname: Jakubů
authors.forename: Petra
authors.initials: P
authors.lastname: Španělová
authors.forename: Pavla
authors.initials: P
authors.lastname: Urbášková
authors.forename: Helena
authors.initials: H
authors.lastname: Žemličková
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Hrabák
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D002999:Clone Cells; D017714:Community-Acquired Infections / Q000453:epidemiology / Q000382:microbiology*; D003227:Conjugation, Genetic; D018153:Czech Republic / Q000453:epidemiology; D004269:DNA, Bacterial / Q000235:genetics; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification* / Q000472:pathogenicity; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000235:genetics*; D005260:Female; D024841:Fluoroquinolones / Q000494:pharmacology; D005798:Genes, Bacterial; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D010957:Plasmids / Q000235:genetics; D015995:Prevalence; D014774:Virulence / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D029968:Escherichia coli Proteins; D024841:Fluoroquinolones; D001618:beta-Lactamases; C000602253:beta-lactamase CTX-M, E coli