Epidemiology and Risk Factors for Isolation of Escherichia coli Producing CTX-M-Type Extended-Spectrum β-Lactamase in a Large U.S. Medical Center

Abstract

A case-case-control study was conducted to identify independent risk factors for recovery of Escherichia coli strains producing CTX-M-type extended-spectrum ␤-lactamases (

Higher CTX-M, Tem, and SHV Extended-Spectrum Beta-Lactamase Plasmid Gene Combination Frequency in Esbl Producing Klebsiella Pneumoniae Compared With Esbl Producing Escherichia Coli

“…Plasmid CTX-M, TEM, and SHV extended-spectrum beta-lactamase gene frequency was higher in this study than in other literature sources, namely: 1) in this study plasmid CTX-M was 97.06% compared to 73.8 -85.4% elsewhere; 2) plasmid TEM was 71.32% compared to elsewhere 42.4 -62.3%; and 3) plasmid SHV was 63.97% compared to the wide range of 7.7 -62.3% in the literature (Hayakawa et al, 2013;Lin, Hsu, Chen, Huang, & Lo, 2010;Manoharan, Premalatha, Chatterjee, & Mathai, 2011). In addition, plasmid gene combination frequency was higher, compared to other similar studies: CTX-M+ TEM+ SHV+ plasmid gene combination (45.59% vs 25.64%); and CTX-M+ TEM+ SHVplasmid gene combination (68.38% vs 26.5-35.5%; Hayakawa et al, 2013;Manoharan et al, 2011). Considerably higher plasmid gene frequency was found in this study compared to the literature for CTX-M+ TEM-SHV+ plasmid gene combination (63.5% vs 4.7-5.98% in literature), as well as CTX-M-TEM+ SHV+ gene combination (47.06% vs 3.42% in literature; Hayakawa et al, 2013;Manoharan et al, 2011).…”

“…In addition, plasmid gene combination frequency was higher, compared to other similar studies: CTX-M+ TEM+ SHV+ plasmid gene combination (45.59% vs 25.64%); and CTX-M+ TEM+ SHVplasmid gene combination (68.38% vs 26.5-35.5%; Hayakawa et al, 2013;Manoharan et al, 2011). Considerably higher plasmid gene frequency was found in this study compared to the literature for CTX-M+ TEM-SHV+ plasmid gene combination (63.5% vs 4.7-5.98% in literature), as well as CTX-M-TEM+ SHV+ gene combination (47.06% vs 3.42% in literature; Hayakawa et al, 2013;Manoharan et al, 2011). This study's finding of higher bacterial plasmid gene frequency could be explained by the use of different material, i.e., the higher plasmid gene frequency in wound infections compared to urinary tract infections and bacteria strains; higher plasmid gene frequency in ESBL producing K. pneumoniae compared to ESBL producing E. coli; as well as geographical differences in plasmid gene expression among different populations worldwide (Alekshun & Levy, 2007;Shaikh et al, 2015;Lee et al, 2012;Cantón et al, 2008).…”

“…Only some of these studies analyzed the differences between male and female patients with ESBL producing Enterobacteriaceae infection, and of these, findings indicated that patients with E. coli and plasmid CTX-M gene presence were more likely to be male patients around the age of 68.2 years (Hayakawa et al, 2013). Prior to this, plasmid gene combination association with demographic factors had not been described in the literature.…”

High prevalence of NDM metallo-β-lactamase among ESBL-producing Escherichia coli İsolates

“…Other studies in the world showed the prevalences of bla TEM and bla SHV genes in E. coli were 46.4% and 11.2%, respectively [28], and CTX-M types have been reported as the most frequent ESBLs (65%) among Enterobacteriaceae isolates [29].The prevalences of bla TEM and bla SHV were 65.5% and 15%, respectively. In a study of patients with ESBLproducing E. coli, 85.4% of isolates contained a CTX-M ESBL gene [25]. Another β-LACTAMASE GENES IN ESBL-POSITIVE E. COLIstudy demonstrated that CTX-M-14 was the most common ESBL among E. coli isolates, while SHV was the predominant among K. pneumoniae isolates.…”

“…Especially CTX-M type has been increasingly reported worldwide. CTX-M-type ESBL-producing E. coli pathogens have become an important cause of community-onset blood stream infections and UTIs [25]. The epidemiological characteristics of infections caused by CTX-M-type ESBLs are different from the TEM or SHV type and they are often isolated from the patients with community-onset infections.…”