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Abstract: Objectives: The objective of this study was to assess the prevalence and molecular epidemiology of ESBLproducing Escherichia coli causing healthcare-associated (HCA) and community-associated (CA) bacteraemia of urinary origin (BUO) in Spain. Methods: An observational cohort study was conducted at eight hospitals from different Spanish geographical areas (2010?11). BUO episodes (n¼425) were classified as HCA (n¼215) and CA (n¼210), and one blood isolate per episode was collected. Susceptibility testing was performed, ESBLs were screened by double-disc diffusion test and ESBL and OXA-1 genes were characterized (PCR and sequencing). Population structure (phylogenetic groups, XbaI-PFGE and MLST) and ST131 subtyping (PCR)were determined. Virulence genes were detected by PCR and virulence score, profiles and extraintestinal pathogenic E. coli (ExPEC) status calculated. Results: ESBL-producing E. coli prevalence was 9.2% (39/425). ESBL-producing E. coli episodes were significantly associated with HCA-BUO episodes [14% (30/215) versus 4.3% (9/210); P¼0.001]. The highest non-susceptibility proportions corresponded to ciprofloxacin (97.4%), amoxicillin/clavulanate (74.4%), co-trimoxazole (69.2%) and tobramycin (61.5%). Of the 39 ESBL-producing E. coli isolates, 34 produced CTX-M enzymes (21 CTX-M-15, 11 CTX-M-14 and 2 CTX-M-1). Fifteen STs were identified, the B2-ST131 clone being the most prevalent (54%; 21/39). All ST131 isolates were ExPEC and had the highest virulence scores, but they showed less diversity in virulence profiles than other STs. The H30Rx subclone accounted for most ST131 isolates (20/21), co-produced CTX-M-15 (20/20) and OXA-1 (19/20) enzymes and was associated with HCA episodes (16/20). Conclusions: The CTX-M-15-ST131-H30Rx subclone is a relevant MDR pathogen causing BUO, mainly HCA episodes. The dominance of this subclone with comparatively less diversity of virulence profiles reflects the spread of a successful and MDR ESBL ST131 lineage in Spain.
Fuente: J Antimicrob Chemother 2016; 71: 2125?2130
Editorial: Oxford University Press
Año de publicación: 2016
Nº de páginas: 6
Tipo de publicación: Artículo de Revista
DOI: 10.1093/jac/dkw133
ISSN: 0305-7453,1460-2091
Leer publicación
MERINO, IRENE
SHAW, EVELYN
HORCAJADA, JUAN PABLO
CERCENADO, EMILIA
MIRELIS, BEATRIZ
PALLARÉS, M. ANGELES
GÓMEZ, JULIA
XERCAVINS, M.
LUIS MARTINEZ MARTINEZ
CUETO, MARINA DE
CANTÓN, RAFAEL
RUIZ GARBAJOSA, PATRICIA
MARIA DEL CARMEN FARIÑAS ALVAREZ
GONZALO, M.
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