title: Inventory of Extended-Spectrum-β-Lactamase-Producing Enterobacteriaceae in France as Assessed by a Multicenter Study.
abstract: The objective of this study was to perform an inventory of the extended-spectrum-β-lactamase (ESBL)-producingEnterobacteriaceaeisolates responsible for infections in French hospitals and to assess the mechanisms associated with ESBL diffusion. A total of 200 nonredundant ESBL-producingEnterobacteriaceaestrains isolated from clinical samples were collected during a multicenter study performed in 18 representative French hospitals. Antibiotic resistance genes were identified by PCR and sequencing experiments. The clonal relatedness between isolates was investigated by the use of the DiversiLab system. ESBL-encoding plasmids were compared by PCR-based replicon typing and plasmid multilocus sequence typing. CTX-M-15, CTX-M-1, CTX-M-14, and SHV-12 were the most prevalent ESBLs (8% to 46.5%). The three CTX-M-type EBSLs were significantly observed inEscherichia coli(37.1%, 24.2%, and 21.8%, respectively), and CTX-M-15 was the predominant ESBL inKlebsiella pneumoniae(81.1%). SHV-12 was associated with ESBL-encodingEnterobacter cloacaestrains (37.9%).qnrB,aac(6')-Ib-cr, andaac(3)-IIgenes were the main plasmid-mediated resistance genes, with prevalences ranging between 19.5% and 45% according to the ESBL results. Molecular typing did not identify wide clonal diffusion. Plasmid analysis suggested the diffusion of low numbers of ESBL-encoding plasmids, especially inK. pneumoniaeandE. cloacaeHowever, the ESBL-encoding genes were observed in different plasmid replicons according to the bacterial species. The prevalences of ESBL subtypes differ according to theEnterobacteriaceaespecies. Plasmid spread is a key determinant of this epidemiology, and the link observed between the ESBL-encoding plasmids and the bacterial host explains the differences observed in theEnterobacteriaceaespecies.
authors.affiliation: CHU Clermont-Ferrand, Laboratoire de Bactériologie & CNR de la Résistance aux Antibiotiques, Clermont-Ferrand, France frobin@chu-clermontferrand.fr.|UMR INSERM 1071 usc INRA2018, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: F
authors.initials: F
authors.lastname: Robin
authors.affiliation: CHU Clermont-Ferrand, Laboratoire de Bactériologie & CNR de la Résistance aux Antibiotiques, Clermont-Ferrand, France.|UMR INSERM 1071 usc INRA2018, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: R
authors.initials: R
authors.lastname: Beyrouthy
authors.affiliation: UMR INSERM 1137, IAME, Univ Paris Diderot, Sorbonne Paris Cité, Paris, France.|AP-HP, Hôpital Rober-Debré, CNR Escherichia coli, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonacorsi
authors.affiliation: Laboratoire de Bactériologie, CHRU de Nancy, Nancy, France.
authors.forename: N
authors.initials: N
authors.lastname: Aissa
authors.affiliation: Department of Microbiology, La Source Hospital, CHR Orléans, Orléans, France.
authors.forename: L
authors.initials: L
authors.lastname: Bret
authors.affiliation: CH du Pays d'Aix, Laboratoire de Diagnostic Biologique des Maladies Infectieuses et d'Hygiène, Aix-en-Provence, France.
authors.forename: N
authors.initials: N
authors.lastname: Brieu
authors.affiliation: CHU de Caen, Service de Microbiologie, Université de Caen Basse-Normandie, EA4655 (équipe Antibiorésistance), Caen, France.
authors.forename: V
authors.initials: V
authors.lastname: Cattoir
authors.affiliation: Department of Bacteriology, University Hospital of Dijon, BP 37013, Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Chapuis
authors.affiliation: CH du Pays d'Aix, Laboratoire de Diagnostic Biologique des Maladies Infectieuses et d'Hygiène, Aix-en-Provence, France.
authors.forename: H
authors.initials: H
authors.lastname: Chardon
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Nice, Hôpital Archet II, Nice, France.
authors.forename: N
authors.initials: N
authors.lastname: Degand
authors.affiliation: Service de Bactériologie-Hygiène, Hopital Antoine Béclère, APHP, Université Paris Sud, Clamart, France.
authors.forename: F
authors.initials: F
authors.lastname: Doucet-Populaire
authors.affiliation: UMR 5234 CNRS, University Bordeaux 2, Bordeaux, France.
authors.forename: V
authors.initials: V
authors.lastname: Dubois
authors.affiliation: Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
authors.forename: N
authors.initials: N
authors.lastname: Fortineau
authors.affiliation: Plateau technique de microbiologie, Laboratoire de bactériologie, CHU Strasbourg, Strasbourg, France.
authors.forename: A
authors.initials: A
authors.lastname: Grillon
authors.affiliation: CHU de Tours, Laboratoire de Bactériologie, Tours, France; Université François Rabelais, E5 Bactéries et risque materno-fœtal, UMR 1282 ISP, INRA, Nouzilly, France.
authors.forename: P
authors.initials: P
authors.lastname: Lanotte
authors.affiliation: Laboratoire de Biologie médicale, Centre hospitalier de la Côte Basque, Bayonne, France.
authors.forename: D
authors.initials: D
authors.lastname: Leyssene
authors.affiliation: Laboratoire de Bactériologie, Centre Hospitalier Universitaire de Besançon, Besançon, France.
authors.forename: I
authors.initials: I
authors.lastname: Patry
authors.affiliation: Microbiology, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: I
authors.initials: I
authors.lastname: Podglajen
authors.affiliation: Bacteriology Department, CHU Grenoble, Grenoble, France.
authors.forename: C
authors.initials: C
authors.lastname: Recule
authors.affiliation: Laboratoire de Bactériologie-Virologie-Hygiène, CHU de Saint-Etienne, Saint-Etienne, France.
authors.forename: A
authors.initials: A
authors.lastname: Ros
authors.affiliation: Department of Infectious Diseases, Institut de Veille Sanitaire, French Institute for Public Health Surveillance, Saint-Maurice, France.
authors.forename: M
authors.initials: M
authors.lastname: Colomb-Cotinat
authors.affiliation: Department of Infectious Diseases, Institut de Veille Sanitaire, French Institute for Public Health Surveillance, Saint-Maurice, France.
authors.forename: V
authors.initials: V
authors.lastname: Ponties
authors.affiliation: Laboratoire de bactériologie-virologie-hygiène, centre hospitalier universitaire de Limoges, Limoges, France.
authors.forename: M C
authors.initials: MC
authors.lastname: Ploy
authors.affiliation: CHU Clermont-Ferrand, Laboratoire de Bactériologie & CNR de la Résistance aux Antibiotiques, Clermont-Ferrand, France.|UMR INSERM 1071 usc INRA2018, Université d'Auvergne, Clermont-Ferrand, France.
authors.forename: R
authors.initials: R
authors.lastname: Bonnet
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002999:Clone Cells; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D015870:Gene Expression; D006761:Hospitals / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry / Q000378:metabolism*; D015995:Prevalence; D012093:Replicon; D001618:beta-Lactamases / Q000145:classification / Q000235:genetics* / Q000378:metabolism; D047090:beta-Lactams / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D001618:beta-Lactamases
keywords: AAC(3)-II; AAC(6′)-Ib; ESBL; plasmid; plasmid-mediated quinolone resistance; plasmid-mediated resistance