CTX-M-producing Escherichia coli and Klebsiella pneumoniae isolated from community-acquired urinary tract infections in Valledupar, Colombia.

Abstract

OBJECTIVE:

Describe the presence of CTX-M-1 phylogenetic subgroup extended-spectrum β-lactamases (ESBL), associated with TEM and SHV genes, and the gene encoding cephalosporinase, CMY-2 in Escherichia coli and Klebsiella pneumoniae isolates from community-acquired urinary tract infections.

METHODS:

102 E. coli and 21K. pneumoniae were collected from patients with culture-proven urinary tract infection (UTI), during February and March, 2011. Antimicrobial susceptibility test was performed by disk diffusion according to the standards of the Clinical Laboratory Standard Institute. Screening for cephalosporins-resistant E. coli and K. pneumoniae was performed by PCR assay for bla(TEM), bla(SHV), bla(CTX-M-1),(-2),(-8),(-9), bla(PER-2) and bla(CMY-2) genes. Statistical analysis was performed by chi-squared test and multivariate logistic regression analysis.

RESULTS:

ESBL production was detected in 12 (11.7%) E. coli and four (19%) K. pneumoniae isolates. TEM ESBLs were detected in seven E. coli and three K. pneumoniae isolates. SHV ESBLs were found in four K. pneumoniae isolates. CTX-M-1 phylogenetic subgroup was positive in seven E. coli and three K. pneumoniae isolates. CMY-2 β-lactamase gene was detected in nine E. coli and one K. pneumoniae isolates. A significant association of ESBL expression in E. coli was observed with resistance to tobramycin (p≤0.001), tetracycline (p=0.043), and ciprofloxacin (p≤0.001). In K. pneumoniae isolates, significant association was found with resistance to tobramycin and ciprofloxacin (p=0.006), and trimethoprim-sulfamethoxazole (p=0.043). Multivariate analyses did not show association between ESBL production in E. coli and K. pneumoniae, and resistance to non-β-lactams drugs.

CONCLUSIONS:

CTX-M ESBL in uropathogens isolated from the community is cause for concern due to the enormous potential for multidrug resistance from strains that produce these enzymes, which could lead to failure of empirically-administered therapies and development of complicated UTIs.

• Authors: Pedro Martinez, Denisse Garzón, Salim Mattar
• Journal: The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases (Braz J Infect Dis) 2012 Sep-Oct Vol. 16 Issue 5 Pg. 420-5 ISSN: 1678-4391 [Electronic] Brazil
• PMID: 22964287 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2012 Elsevier Editora Ltda. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• beta-Lactamases

Topics

• Anti-Bacterial Agents (pharmacology)
• Colombia
• Community-Acquired Infections (microbiology)
• Disk Diffusion Antimicrobial Tests
• Escherichia coli (drug effects, enzymology, isolation & purification)
• Escherichia coli Infections (microbiology)
• Humans
• Klebsiella Infections (microbiology)
• Klebsiella pneumoniae (drug effects, enzymology, isolation & purification)
• Microbial Sensitivity Tests
• Urinary Tract Infections (microbiology)
• beta-Lactamases (metabolism)