Clonal Dissemination of a CTX-M-15 β-Lactamase-Producing Escherichia coli Strain in the Paris Area, Tunis, and Bangui

Abstract

One hundred twenty CTX-M-15-producing Escherichia coli strains isolated in 10 different hospitals from Paris (France), in the Hospital Charles Nicolle in Tunis (Tunisia), and in the Pasteur Institute in Bangui, Central African Republic (CAR), between 2000 and 2004 were studied. Eighty isolates, recovered from the three countries, were clonally related by repetitive extragenic palindromic PCR and pulsed-field gel electrophoresis. Various resistance profiles were identified among these clonal strains. After conjugation or electroporation of plasmids from E. coli strains representative of each profile and each geographic region, we observed seven resistance profiles in the recipient strains. Incompatibility typing showed that all the plasmids transferred from the clonal strains studied, except one, belonged to the incompatibility group FII. They all shared a multidrug resistance region (MDR) resembling the MDR region located in pC15-1a, a plasmid associated with an outbreak of a CTX-M-15-producing E. coli strain in Canada. They also shared the common backbone of an apparent mosaic plasmid, including several features present in pC15-1a and in pRSB107, a plasmid isolated from a sewage treatment plant. This study suggests that although the plasmid-borne bla CTX-M-15 gene could be transferred horizontally, its dissemination between France, Tunisia, and CAR was due primarily to its residence in an E. coli clone with a strong propensity for dissemination.

Dissemination of Clonally RelatedEscherichia coliStrains Expressing Extended-Spectrum β-Lactamase CTX-M-15

“…Association of the bla CTX-M-15 gene with IncFII replicons has been described in studies conducted in Canada, France, Spain, and the United Kingdom (5,7,8,17,19). Although we observed intercontinental dissemination of 3 major IncFII plasmid scaffolds (A, B, and C) carrying bla CTX-M-15 , similarity >70% among all variants studied and presence of genes also found in pC15-1a, a CTX-M-15 plasmid (GenBank accession no.…”

Regional outbreak of CTX-M-2 β-lactamase-producing Proteus mirabilis in Japan

“…Although CTX-M-2 was not detected among these E. coli strains as previously reported (Lavollay et al, 2006;Novais et al, 2006), incompatibility group IncT is a narrow-host-range plasmid harboured by P. mirabilis as well as E. coli (Shapiro, 1977). These results demonstrate that P. mirabilis produces the CTX-M-2 enzyme exclusively and predominantly, with high prevalence among the Enterobacteriaceae.…”

“…Plasmids were classified according to their incompatibility (Inc) group using the PCR replicon-typing scheme described by Carattoli et al (2005). PCR replicon typing assays have been used to identify plasmids bearing CTX-M b-lactamase genes Lavollay et al, 2006). This PCR assay discriminates plasmids of known Inc groups by the presence of specific genes involved in plasmid maintenance using an inc/rep PCR-based method (5-multiplex and 3-simplex).…”

Characterization of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates from the community in Morocco

“…Isolates harbouring CTX-M-15 were resistant to cefepime, with most of them exhibiting an MIC .64 mg ml 21 . It has been demonstrated that CTX-M ESBLs hydrolyse cefepime with higher efficiency compared with other ESBL types (Lavollay et al, 2006;Mshana et al, 2009). Plasmid analysis revealed that the majority of the transconjugants harboured large plasmids of~125 kb.…”