Predominance of IncL/M and IncF plasmid types among CTX-M-ESBL-producingEscherichia coliandKlebsiella pneumoniaein Bulgarian hospitals

Abstract

Our objective was to investigate the plasmid replicon-types involved in spread of ESBLs among Bulgarian Klebsiella pneumoniae and Escherichia coli. Sixty-three isolates, with transferable beta-lactam resistance determinants, collected between 2007 and 2009 in six medical institutions, were analysed with respect to their antimicrobial susceptibility, ESBL-, RAPD-, and plasmid replicon-type. Phylogenetic typing and screening for the O25b-ST131 lineage were carried out for E. coli. The predominant ESBLs were CTX-M-15 (81%) among E. coli and CTX-M-3 (58%) among K. pneumoniae. Other sporadically found ESBLs were SHV-12 and TEM-139, and for the first time in Bulgaria, CTX-M-1 and CTX-M-14. Replicon typing revealed that plasmids carrying blaCTX-M-3 exclusively belonged to IncL/M-type, while blaCTX-M-15 was predominantly (94%) associated with IncF-type plasmids. Among E. coli, 59% of the isolates were clonally related. Isolates of that cluster produced CTX-M-15, belonged to the O25b-ST131 lineage, predominantly harboured plasmids with the FIA replicon, and were found in five centres. Among CTX-M-3-producing K. pneumoniae, two prevailing RAPD-types were found, one remained restricted to one centre and the second was found in three centres. The incompatibility groups IncN and IncA/C linked with blaSHV-12 respectively blaTEM-139 were found only once. To the best of our knowledge, this is the first detailed investigation of plasmids carrying ESBL genes among Bulgarian isolates demonstrating wide distribution of conjugative IncF plasmids among CTX-M-15-producing E. coli and IncL/M plasmids among CTX-M-3 positive K. pneumoniae isolates.

Exploring the Genome and Phenotype of Multi-Drug Resistant Klebsiella pneumoniae of Clinical Origin

“…The virulence-encoded incompatibility types IncFIB(K) and IncFII were identified in 91% of the isolates whereas IncR and IncFIA accounted for 45% of these isolates. IncF plasmids are often associated with ESBL-resistance encoding genes (Carattoli, 2009 ; Doumith et al, 2012 ; Markovska et al, 2014 ). Moreover, the isolate K. pneumoniae CFS0363 an isolate with four large plasmids also harbored Inc types including IncFIB(pQil), IncHI1B and the IncL/M.…”

A Review of SHV Extended-Spectrum β-Lactamases: Neglected Yet Ubiquitous

“…The range of bacterial species they have encountered is limited to E. coli, K. pneumoniae, E. cloacae , and the S. enterica serotypes Concord, Enteritidis, Heidelberg and Kiambu. Nevertheless, IncI1 plasmids (19–340 Kb) occur in very diverse settings: bla SHV-2 - and bla SHV-12 -encoding isolates from human infections (Bulgaria, France, Italy, Spain, Taiwan; Tato et al, 2007; Marcadé et al, 2009; Accogli et al, 2013; de Toro et al, 2013; Markovska et al, 2014; Chen C. M. et al, 2015) and colonization (Ethiopia) (Fabre et al, 2009); bla SHV-2 -, bla SHV-2 a –, and bla SHV-12 -encoding isolates from poultry (Canada, Italy, Portugal; Bortolaia et al, 2010, 2011; Accogli et al, 2013; Pouget et al, 2013; Jones-Dias et al, 2015), bla SHV-2 - and bla SHV-2 a -encoding isolates from pigs (Canada) (Pouget et al, 2013); bla SHV-12 -encoding isolates from aquatic birds (Poland) (Literak et al, 2010); and bla SHV-12 -encoding isolates from farming soil (Portugal) (Jones-Dias et al, 2016). Remarkably, bla SHV-12 on IncI1 plasmids belonging to pST26 have been identified among E. coli isolates of human and animal origin (Accogli et al, 2013; Jones-Dias et al, 2015), indicating the potential transmission of these bla SHV-12 -encoding vehicles from human to animals and/or vice versa.…”

“…IncL/M plasmids (60–90 Kb) carrying SHV ESBL genes have been reported only among E. coli, K. pneumoniae, K. oxytoca , and S. enterica serotype Typhimurium of human origin in Portugal ( bla SHV-2 ), Tunisia ( bla SHV-2 a , bla SHV-12 ), Italy ( bla SHV-5 ), USA ( bla SHV-5 ), and recently in China ( bla SHV-12 ) (Villa et al, 2000; Elhani et al, 2010; Mnif et al, 2013; Preston et al, 2014; Rodrigues et al, 2014; Liu et al, 2015). The same bacterial species mostly from human sources carry IncN plasmids (~50 Kb) encoding bla SHV-2 (China, Senegal), bla SHV-2 a (Tunisia) or bla SHV-12 (Bulgaria, Netherlands, Norway, Tunisia; Samuelsen et al, 2011; Naseer et al, 2012; Wang et al, 2012; Dierikx et al, 2013; Mnif et al, 2013; Harrois et al, 2014; Markovska et al, 2014). Interestingly, the presence of IncN (pST1) plasmids encoding bla SHV-12 has been reported among E. coli from human and animal sources (Dierikx et al, 2013), mirroring the situation for IncI1 plasmids and underscoring the contribution of this plasmid family in the transmission of bla SHV-12 within or between these niches.…”

Intestinal Carriage of Carbapenemase-Producing Organisms: Current Status of Surveillance Methods

“…Authorities have advocated for local and regional screening programs, as available evidence shows that travelers are a major source of spread (11,12). Furthermore, in settings where these organisms are endemic, transmission of ESBL-producing Enterobacteriaceae between health care facilities creates a significant challenge for controlling the spread of resistance (13). The number of CPE cases in community hospitals in the Southwestern United States has increased 5-fold in the last few years (14).…”