High prevalence of CTX-M-15 and first report of CTX-M-3, CTX-M-22, CTX-M-28 and plasmid-mediated AmpC beta-lactamase producing Enterobacteriaceae causing urinary tract infections in Bosnia and Herzegovina in hospital and community settings.

Abstract

AIM:

To investigate molecular epidemiology of extended-spectrum β-lactamase/ESBL and plasmid-mediated AmpC β-lactamase/pAmpC producing Gram-negative bacteria causing urinary tract infections (UTIs) in Zenica-Doboj Canton, Bosnia and Herzegovina, in the period Decembar 2009-May 2010.

METHODS:

Antibiotic susceptibility was determined by disc diffusion and broth microdilution according to CLSI guidelines. Double-disk synergy test was performed in order to screen for ESBLs/pAmpC beta-lactamases. PCR was used to detect bla(ESBL)/bla(ampC)/bla(carb) genes. Genetic relatedness of the strains was determined by pulsed-field-gel-electrophoresis (PFGE).

RESULTS:

Among 85 patients with UTIs caused by ESBL producing isolates, 44 (51.8%) were from in-patients and 41 (48.2%) from outpatients. Klebsiella spp. was the most frequently isolated from in-patients, in 28 (63.6%) cases. Among outpatients, Klebsiella spp./Escherichia coli were the most frequently isolated, in 19 (46.3%)/16 (39.0%) cases. Twenty-one (75.0%) from hospital and nine (47.4%) from outpatient Klebsiella spp. isolates were positive for blaTEM, whereas 27 (96.4%) from in-patients and 6 (31.6%) from outpatient were bla(CTX-M) positive (18 hospital and five outpatient isolates were encoding bla(CTX-M-15)). One Klebsiella oxytoca and one Enterobacter cloacae inpatient isolates were positive for blaCTX-M-28. One Klebsiella pneumoniae outpatient isolate were positive for bla(CTX-M-22) and one E. coli for bla(CTX-M-3). One hospital Proteus mirabilis strain was positive for bla(CMY-2) and two Klebsiella spp. strains for blaDHA-1, whereas two E. coli, one K. oxytoca and one Proteus vulgaris outpatient strains were positive for bla(CMY-2).

CONCLUSION:

Identification of bla(CTX-M-3), bla(CTX-M-22) and bla(CTX-M-28) among Enterobacteriaceae is uncommon. In this study we report the emergency of CMY-2 and DHA-1 plasmid-mediated beta-lactamases.

• Authors: Amir Ibrahimagić, Branka Bedenić, Farah Kamberović, Selma Uzunović
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 21 Issue 5 Pg. 363-9 (May 2015) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 25638292 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Bacterial Proteins
• Escherichia coli Proteins
• beta-lactamase CMY-2
• beta-lactamase CTX-M-15
• beta-lactamase CTX-M-3
• AmpC beta-lactamases
• CTX-M-28 beta-lactamase, Klebsiella pneumoniae
• beta-Lactamases
• beta-lactamase CTX-M-22, E coli
• beta-lactamase DHA-1, Klebsiella pneumoniae

Topics

• Ambulatory Care
• Bacterial Proteins (genetics)
• Bosnia and Herzegovina (epidemiology)
• Citrobacter freundii (enzymology, genetics, isolation & purification)
• Disk Diffusion Antimicrobial Tests
• Electrophoresis, Gel, Pulsed-Field
• Enterobacter cloacae (enzymology, genetics, isolation & purification)
• Enterobacteriaceae (enzymology, genetics, isolation & purification)
• Escherichia coli (enzymology, genetics, isolation & purification)
• Escherichia coli Proteins (genetics)
• Hospitalization
• Humans
• Infant
• Klebsiella oxytoca (enzymology, genetics, isolation & purification)
• Klebsiella pneumoniae (enzymology, genetics, isolation & purification)
• Middle Aged
• Molecular Epidemiology
• Molecular Typing
• Plasmids (genetics)
• Prevalence
• Proteus mirabilis (enzymology, genetics, isolation & purification)
• Urinary Tract Infections (epidemiology, genetics, microbiology)
• beta-Lactamases (genetics)