Extended-spectrum beta-lactamases and plasmid diversity in urinary isolates of Escherichia coli in Croatia: a nation-wide, multicentric, retrospective study

• Published in: Folia microbiologica Vol. 65; no. 4; pp. 649 - 667
• Main Authors: Krilanović, Marija, Tomić-Paradžik, Maja, Meštrović, Tomislav, Beader, Nataša, Herljević, Zoran, Conzemius, Rick, Barišić, Ivan, Vraneš, Jasmina, Elveđi-Gašparović, Vesna, Bedenić, Branka
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-08-2020; Springer Nature B.V
• Subjects: Anti-Bacterial Agents - pharmacology; Applied Microbiology; beta-Lactamases - genetics; Biomedical and Life Sciences; Cephalosporins; Croatia - epidemiology; Drug Resistance, Bacterial - drug effects; Drug Resistance, Bacterial - genetics; E coli; Electrophoresis; Environmental Engineering/Biotechnology; Escherichia coli; Escherichia coli - drug effects; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Gel electrophoresis; Gene sequencing; Genes; Genetic Variation; Genome, Bacterial - genetics; Genomes; Genotype; Genotyping; Health care; Humans; Immunology; Life Sciences; Microbial Sensitivity Tests; Microbiology; Molecular Epidemiology; Nursing homes; Original Article; Plasmids; Plasmids - genetics; Prevalence; Pulsed-field gel electrophoresis; Retrospective Studies; Serogroup; Urinary tract; Urinary tract infections; Urinary Tract Infections - epidemiology; Urinary Tract Infections - microbiology; Whole genome sequencing; Croatia; Plasmid; ESBL; CTX-M beta-lactamase type; Urinary tract infection; E. coli
• ISSN: 0015-5632; 1874-9356
• DOI: 10.1007/s12223-019-00769-1

In recent years, a dramatic increase in the prevalence of
Escherichia coli
strains producing extended-spectrum β-lactamases (ESBLs) has been observed — both in the community and in healthcare settings. This multicentric study aimed to characterize ESBLs produced by
E. coli
isolates causing hospital-onset and community urinary tract infections, as well as to compare their antimicrobial sensitivity patterns, β-lactamase content and plasmid types. Phenotypic tests for the detection of ESBLs and plasmid-mediated AmpC β-lactamases were initially pursued, followed by molecular detection of resistance genes, plasmid characterization, genotyping with pulsed-field gel electrophoresis and whole genome sequencing (WGS). The isolates exhibited high level of resistance to expanded-spectrum cephalosporins (ESC) and carried CTX-M (cefotaximase-Munich) or TEM (Temoniera) β-lactamases. All six representative isolates subjected to WGS belonged to the widespread clone ST131. In conclusion, our study demonstrated dissemination of group 1 CTX-M positive
E. coli
in different geographic regions of Croatia, but also different components of the health care systems (hospitals, nursing homes and the community) and confirmed the switch from SHV-2 (suphydril variant) and SHV-5 ESBLs to the nation-wide predominance of group 1 CTX-M β-lactamases. Different plasmids were shown to be associated with the dissemination of
bla
CTX-M
genes in different geographic regions of Croatia.