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Multi-locus sequence typing of extended-spectrum β-lactamase-producing Escherichia coli based on dnaJ, purA and fumC and correlation with ESBL types

Authors Nahid Karami
Christel Unosson
Christina Åhrén
Edward R.B. Moore
Published in FEMS 2009 - 3rd Congress of European Microbiologists
Publication year 2009
Published at Institute of Biomedicine, Department of Infectious Medicine
Language en
Subject categories Microbiology in the medical area


Background: Four extended-spectrum β-lactamase (ESBL) types: CTXM; TEM; OXA; and SHV; are associated with most ESBL Escherichia coli infections in Europe, CTXM being the most predominant. Prevalence of ESBL-E. coli has increased dramatically in hospital- and community-acquired infections in the past 5 years in Sweden. Objectives: Adapt a multi-locus sequence typing (MLST) analysis for ESBL-E. coli isolates and to correlate MLST data to the prevalence of ESBL types. Methods: Forty-eight isolates from urinary tract samples were collected from November 2007 to March 2008 at Sahlgrenska University Hospital, Göteborg. E. coli were identified by standard methods and screening for ESBL was performed by the double disk assay and ESBL Etest strips. The diversity and prevalence of ESBL-types: CTXM; TEM; OXA; and SHV; were determined by a multiplex PCR assay. CTXM-positive isolates were further typed by PCR, for CTXM sub-types: CTXM-1; CTXM-2; and CTXM-9. MLST of ESBL-E. coli, using house-keeping gene sequences for dnaJ, encoding heat shock protein 40, as well as purA (adenylosuccinate dehydrogenase) and fumC (fumarate hydratase) sequences. Results: Among all isolates analysed, 94% of ESBL-E. coli strains were CTXM-positive. Combinations of ESBL-genes were observed in 90% of strains: CTXM+TEM (36%); and CTXM+OXA (33%). Among CTXM-positive E. coli, 76% were observed to be CTXM-1 sub-type. MLST of strains detected eighteen different MLST sequence types, with 38% of strains belonging to one sequence type. Among strains of the most prevalent MLST sequence type, 46% exhibited CTXM+TEM and 39% exhibited CTXM+OXA combinations. Conclusions: A clear predominance of CTXM-ESBL in combination with TEM or OXA was observed in ESBL-E. coli recovered from Swedish patients. No clear correlation could be determined between MLST sequence types and ESBL types, although two MLST-ESBL types were observed to be distinctly prevalent among ESBL-E. coli analysed.

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