Journal article
Molecular Characterization and Antimicrobial Susceptibility Testing of Escherichia coli Isolates from Patients with Urinary Tract Infections in 20 Chinese Hospitals
A total of 222 urinary Escherichia coli isolates from 20 tertiary hospitals in 15 different provinces and 4 municipalities in mainland China were characterized by antimicrobial susceptibility, phylogrouping, and the presence of plasmid-mediated quinolone resistance genes. A subset of 138 suspected extended-spectrum cephalosporinase (ESC) producers were examined for genes encoding cephalosporin resistance.
Forty-three isolates harboring blaCTX-M-14 or blaCTX-M-15 were analyzed by pulsed-field gel electrophoresis (PFGE), and plasmids containing these genes were typed using PCR-based replicon typing (PBRT). Thirteen phylogroup B2 blaCTX-M-14- and blaCTX-M-15-positive isolates were analyzed by multilocus sequence typing (MLST).
A frequent occurrence of resistance (>46%) was observed toward cephalosporins, gentamicin, and fluoroquinolones. Among the 222 isolates, 4 qnrS1, 4 qepA, and 16 aac(6')-Ib-cr genes were confirmed. Four major phylogroups (A, B1, B2, and D) and nontypeable isolates (NTs) were found among the isolates, with phylogroup D (54%) being the most common phylogroup.
A total of 110 (80%) of the 138 screened isolates harbored blaCTX-M genes, with blaCTX-M-14 (71%) and blaCTX-M-15 (24%) being the most prevalent of these genes. Nine of the 13 CTX-M-15- or CTX-M-14-containing B2 isolates belonged to ST131. PFGE typing showed a high level of diversity, and plasmid analysis indicated a very large pool of different resistance plasmids mediating the spread of blaCTX-M genes in mainland China.
An equally very high frequency of resistance and equally high levels of diversity in phylogroups, PFGE types, and plasmids were observed among community- and hospital-acquired E. coli isolates, indicating the presence of a large reservoir in the community and a long-term spread of cephalosporin resistance in China.
Language: | English |
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Publisher: | American Society for Microbiology |
Year: | 2011 |
Pages: | 2496-2501 |
ISSN: | 1098660x , 00951137 and 1070633x |
Types: | Journal article |
DOI: | 10.1128/JCM.02503-10 |
ORCIDs: | Cavaco, Lina and Aarestrup, Frank Møller |
Anti-Bacterial Agents China Cluster Analysis Electrophoresis, Gel, Pulsed-Field Escherichia coli Escherichia coli Infections Genetic Variation Genotype Hospitals Humans Microbial Sensitivity Tests Molecular Typing Multilocus Sequence Typing Plasmids Polymerase Chain Reaction Urinary Tract Infections beta-Lactamases