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Interspecies plasmid transfer appears rare in sequential infections with extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae

Journal article
Authors Anna Lindblom
K. K. Sriram
V. Muller
R. Oz
H. Sandstrom
Christina Åhrén
F. Westerlund
Nahid Karami
Published in Diagnostic Microbiology and Infectious Disease
Volume 93
Issue 4
Pages 380-385
ISSN 0732-8893
Publication year 2019
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 380-385
Language en
Keywords Extended-spectrum beta-lactamase (ESBL), Recurrent infection, Plasmid, Transfer, E coli, K. pneumoniae, Optical DNA mapping, escherichia-coli strains, klebsiella-pneumoniae, resistance plasmids, virulence, identification, carbapenemase, colonization, outbreak, cloacae, clone, Infectious Diseases, Microbiology
Subject categories Infectious Medicine


From a cohort of 1836 Swedish patients infected with ESBL-producing Enterobacteriaceae (EPE) during 2004-2014, 513 patients with recurrent EPE infection were identified. Only in 14 of the 513 patients was a change of species (ESBL-E. coli to ESBL-K. pneumoniae or vice versa) found between the index and subsequent infection. Eleven sequential urine isolates from 5 of the 14 patients were available for further analysis of possible transfer of ESBL-carrying plasmids. The plasmid content was studied using optical DNA mapping (ODM), PCR-based replicon typing, and ESBL gene sequencing. ODM allowed us to directly compare whole plasmids between isolates and found similar ESBL-carrying plasmids in 3 out of the 5 patients. The ODM results and the rarity in shift of species between ESBL-E. coli and ESBL-K. pneumoniae imply that in recurrent EPE infections interspecies plasmid transfer is uncommon. (C) 2018 Elsevier Inc. All rights reserved.

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