Detection of ctx-M gene in ESBL-producing E. coli strains isolated from urinary tract infection in Semnan, Iran
Keywords:
E. coli, ctx-M gene, urinary tract infection, ESBLAbstract
Introduction: The incidence of urinary tract infections caused by Extended-Spectrum Beta Lactamase (ESBL) producing Escherichia coli (E. coli) strains due to long term and overuse of broad-spectrum cephalosporine is on the rise. CTX beta-lactamase type, a broad-spectrum beta-lactamase, has been expanding in many countries. The ctx gene is harbored on a plasmid that is spread between Enterobacteriaceae family, especially in E. coli. The aim of this study was to determine the pattern of antimicrobial resistance and investigate the prevalent ESBL phenotype and the ctx-M gene in E. coli isolated from patients with urinary tract infections (UTI) in Semnan.
Methods: A cross sectional study was performed on 109 strains of E. coli isolated from the urine culture of patient suffering from a UTI referred to Shafa hospital (Semnan, Iran) during March-July 2015. Antimicrobial susceptibility testing was applied and the prevalence of the ESBL phenotype was confirmed using combination disk. PCR methods were completed for amplification of the bla ctx gene. Data were analyzed using SPSS version 18 software.
Results: One hundred ninety samples (4.16%) were identified as E. coli. Twenty one (26.6%) of E. coli were ESBL positive and 73.4% were ESBL negative. There was 100% susceptibility to imipeneme. Twenty (68.97%) out of 29 isolates were positive for the ctx-M gene, as detected by PCR.
Conclusion: In urinary tract infections, antibiotic treatment was experimental and detailed information regarding the sensitivity of bacteria in the area can be useful to achieve the best treatment.
References
Thomas M, Hooton MD. Uncomplicated urinary tract infection. N Engl J Med. 2012; 366: 1028-37. doi:
1056/NEJMcp1104429.
Dormingy JA, Nabeth P, Juergens-Behr A, Perrier-Gros- Claude JD. Risk factors for antibiotic resistance
Escherchia coli isolated from community–aquired urinary tract infections in Dakar,Senegal. J Antimicrob
Chemother. 2005; 56(1): 236-9. doi: 10.1093/jac/dki158. PMID: 15890716.
Giske CG, Sundsfjord AS, Kahlmeter G, Woodford N, Nordmann P, Paterson DI, et al. Redefining
extended-spectrum beta lactamase: Balancing science and clinical need. J Antimicrob Chemother. 2009;
(1): 1-4. doi: 10.1093/jac/dkn444. PMID: 18957393, PMCID: PMC2721700.
Rao SP, Rama PS, Gurushanthappa V, Manipura R, Srinivasan K. Extended–Spectrum Beta lactamase
producing Escherchia coli and Klebsiellapneumoniae: A multi-centric study across Karnataka. J Lab
Phyicians. 2014; 6(1): 7-13. doi: 10.4103/0974-2727.129083. PMID: 24696553, PMCID: PMC3969652.
Eckert C, Gautier V, Arlet G. DNA sequence analysis of the genetic environment of various bla CTXM
genes. J Antimicrob chemother. 2006; 57(1): 14-23. doi: 10.1093/jac/dki398. PMID: 16291869.
Gupta V. An update on newer bata- lactamase. Indian J Med Res. 2007; 126(5): 417-27. PMID: 18160745.
Bonnet R. Growing group of extended–spectrum B-lactamase the CTXM enzymes. Antimicrob Agents
Chemother. 2004; 48(1): 1-14. doi: 10.1128/AAC.48.1.1-14.2004. PMID: 14693512, PMCID:
PMC310187.
Canton R, Gonzalez-Alba JM, Galan JC. CTX-M Enzymes origion and diffusion. Front Microbiol. 2012; 3:
doi: 10.3389/fmicb.2012.00110. PMCID: PMC3316993.
Naseer U, Sundsfjord A. The CTX-M conundrum: dissemination of plasmids and Escherchia coli clones.
Microb Drug resist. 2011; 83-97. doi: 10.1089/mdr.2010.0132. PMID: 21281129.
Paterson DL, Bonome RA: Extended–Spectrum beta lactamases: A clinical update. Clin Microbiol Rev.
; 18: 657-86. doi: 10.1128/CMR.18.4.657-686.2005. PMID: 16223952, PMCID: PMC1265908.
Feizabadi MM, Delfani S, Raji N, Majnooni A, Aligoli M, Shahcheraghi F, et al. Distribution of beta TEM,
bla SHV, bla CTXM genes among clinical isolates of klebsiellapneumoniae at labafinejad hospital, Tehran,
Iran. Microb drug resist. 2010; 16(1): 49-53. doi: 10.1089/mdr.2009.0096. PMID: 19961397.
Ruppe E, Hem S, Lath S, Gautier V, Arieg F, sarthau JL, et al. CTX B-lactamase in Escherchia coli from
community–acquired urinary tract infections, Cambodia. Emerg Infect Dis. 2009; 15(5): 741. doi:
3201/eid1505.071299. PMID: 19402960, PMCID: PMC2687024.
Edelstein M, Pimkin M, Palagin I, Edelstein I, Stratchoun Sh. Prevalence and molecular epidemiology of
CTXM extended–Spectrum B-lactamase-producing Escherchia coli and Klebsiellapneumoniae in Russian
hospitals. Antimicrob Agents Chemother. 2003; 47(12); 3724-32. doi: 10.1128/AAC.47.12.3724- 3732.2003. PMCID: PMC296190.
Tzouvelekis LS, Tzelepi E, Tassios PT, Legakis NJ. CTX-M type B-lactamases: an emerging group of
extended–Spectrum enzymes. Int J Antimicrob Agents. 2000; 14(2): 137-42. doi: 10.1016/S0924- 8579(99)00165-X. PMID: 10720804.
Rossolini GM, Anderson MM, Mugnaioli C. The spread of CTX M type extended-spectrum–beta
lactamases. Clin Microbiol Infect. 2008; 14(1): 33-41. doi: 10.1111/j.1469-0691.2007.01867.x. PMID:
Lopez-Cerero L, Pascual A. Epidemiology of ESBL in the community an increasing problem. Enferm
Infect MicrobiolClin. 2007; 25(52): 23-8.
Garcia-Hernandez AM, Garcia Nazquez E, Hernandez-TorroesA et al. Bacteremia due to E. coli producing
Extended- Spectrum beta-lactamase (ESBL): clinical relevance and today’s insights. Rev Esp Quimioter.
; 24(2): 57-66. PMID: 21666996.
Silvia N, Oliveira M, Bandeiral AC, Brites C. Risk factors for infection by extended spectrum beta
lactamase producing Klebsiellapneumoniae in a tertiary hospital in Salvador, Brazil. Braz J infects Dis.
; 10(3): 191-3. doi: 10.1590/S1413-86702006000300007. PMID: 17568851.
Fernandes R, Amador P, Oliveira C, Prudencio C. Molecular characterization of ESBL, producing
Enterobacteriaceae in Northern Portugal. Sci World J. 2014(2014): 6. doi: 10.1155/2014/782897.
Giske CG, Monnet DL, Cars O, Carmeli Y. Clinical and economic impact of common multi drug resistant
gram-negaative bacilli. Antimicrob AgentsChemother. 2008; 52(3): 813-21. doi: 10.1128/AAC.01169-07.
PMID: 1807096, PMCID: PMC2258516.
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