title: Detection of CTX-M-15-Producing Escherichia coli Isolates of Lineages ST131-B2 and ST167-A in Environmental Samples of a Tunisian Hospital.
abstract: To investigate the possible role of the hospital environment in the dissemination of extended-spectrum-beta-lactamase (ESBL)-producing Escherichia coli isolates, 300 samples were taken during 2013 from abiotic surfaces (n = 250), healthcare worker hands (n = 27), and hands of patients (n = 23) in a Tunisian Hospital. ESBL-producing E. coli isolates were recovered in 3.7% of analyzed samples (4% abiotic surfaces; 4.3% hands of patients; 0% in healthcare worker hands), and one isolate/sample was further studied. The characterization of beta-lactamase genes, as well as the genetic environment of blaCTX-M gene, was performed by PCR and sequencing. The ESBL genes found were as follows: blaCTX-M-15 (eight isolates), blaCTX-M-15+blaSHV-12 (two isolates), and blaSHV-12 (one isolate). The blaTEM-1b gene was detected in seven ESBL-positive isolates. The orf477 was found downstream of blaCTX-M-15 gene in 10 strains, whereas the ISEcp1 sequence was identified upstream of this gene in two isolates. The analysis of class 1 integrons by PCR and sequencing revealed five positive isolates with the following gene cassette arrangements: dfrA1-aadA1 (two isolates), aadA1 (two isolates), and aadA2 (one isolate). The virulence-encoding genes aer, eae, bfp, and hly were detected by PCR in six, four, four, and three isolates, respectively. The following sequence types and associated phylogroups were detected among ESBL-producing strains: ST167-phylogroup-A (six isolates) and ST131-phylogroup-B2 (two isolates). In conclusion, the hospital environment could be a reservoir of multiresistant bacteria, including ESBL-positive E. coli isolates, which could be acquired by the patient population, and strict control measures should be established to minimize this problem.
authors.affiliation: 1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar , Tunis, Tunisia .
authors.forename: Raoudha
authors.initials: R
authors.lastname: Dziri
authors.affiliation: 1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar , Tunis, Tunisia .
authors.forename: Naouel
authors.initials: N
authors.lastname: Klibi
authors.affiliation: 2 Área de Bioquímica y Biología Molecular, Universidad de La Rioja , Logroño, Spain .
authors.forename: Carla Andrea
authors.initials: CA
authors.lastname: Alonso
authors.affiliation: 3 Laboratory of Epidemiology and Veterinary Microbiology, Pasteur Institute of Tunis , Tunis, Tunisia .
authors.forename: Ahlem
authors.initials: A
authors.lastname: Jouini
authors.affiliation: 1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar , Tunis, Tunisia .
authors.forename: Leila
authors.initials: L
authors.lastname: Ben Said
authors.affiliation: 1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar , Tunis, Tunisia .
authors.forename: Sarra
authors.initials: S
authors.lastname: Chairat
authors.affiliation: 4 Service d'Hygiène Hospitalière et de Protection de l'Environnement, Hôpital Militaire de Tunis HMPIT , Montfleury, Tunisia .
authors.forename: Ridha
authors.initials: R
authors.lastname: Bellaaj
authors.affiliation: 1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar , Tunis, Tunisia .
authors.forename: Abdellatif
authors.initials: A
authors.lastname: Boudabous
authors.affiliation: 1 Laboratoire des Microorganismes et Biomolécules Actives, Faculté de Sciences de Tunis, Université de Tunis El Manar , Tunis, Tunisia .|5 Institut Supérieur des Sciences Biologiques Appliquées de Tunis, Université de Tunis El Manar , Tunis, Tunisia .
authors.forename: Karim
authors.initials: K
authors.lastname: Ben Slama
authors.affiliation: 2 Área de Bioquímica y Biología Molecular, Universidad de La Rioja , Logroño, Spain .
authors.forename: Carmen
authors.initials: C
authors.lastname: Torres
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000382:microbiology / Q000635:transmission; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology / Q000635:transmission; D005260:Female; D050456:Fomites / Q000382:microbiology*; D015870:Gene Expression; D006761:Hospitals; D006801:Humans; D032023:Integrons; D008297:Male; D008826:Microbial Sensitivity Tests; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D012867:Skin / Q000382:microbiology; D014416:Tunisia; D037521:Virulence Factors / Q000235:genetics*; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D037521:Virulence Factors; D047090:beta-Lactams; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases