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Extended-spectrum cephalosporin-resistant Escherichia coli in community, specialized outpatient clinic and hospital settings in Switzerland

Seiffert, Salome N. ; Hilty, Markus ; Kronenberg, Andreas ; Droz, Sara ; Perreten, Vincent ; Endimiani, Andrea

In: Journal of Antimicrobial Chemotherapy, 2013, vol. 68, no. 10, p. 2249-2254

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    Titre
    • Extended-spectrum cephalosporin-resistant Escherichia coli in community, specialized outpatient clinic and hospital settings in Switzerland
    Auteur
    • Seiffert, Salome N.. Institute for Infectious Diseases, University of Bern, Bern, Switzerland
    • Hilty, Markus. Institute for Infectious Diseases, University of Bern, Bern, Switzerland
    • Kronenberg, Andreas. Institute for Infectious Diseases, University of Bern, Bern, Switzerland
    • Droz, Sara. Institute for Infectious Diseases, University of Bern, Bern, Switzerland
    • Perreten, Vincent. Institute of Veterinary Bacteriology, Vetsuisse Faculty, University of Bern, Bern, Switzerland
    • Endimiani, Andrea. Institute for Infectious Diseases, University of Bern, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Antimicrobial Chemotherapy, 2013, vol. 68, no. 10, p. 2249-2254. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:293390
    Summary
    Objectives Resistance to extended-spectrum cephalosporins (ESCs) in Escherichia coli can be due to the production of ESBLs, plasmid-mediated AmpCs (pAmpCs) or chromosomal AmpCs (cAmpCs). Information regarding type and prevalence of β-lactamases, clonal relations and plasmids associated with the bla genes for ESC-R E. coli (ESC-R-Ec) detected in Switzerland is lacking. Moreover, data focusing on patients referred to the specialized outpatient clinics (SOCs) are needed. Methods We analysed 611 unique E. coli isolated during September-December 2011. ESC-R-Ec were studied with microarrays, PCR/DNA sequencing for blaESBLs, blapAmpCs, promoter region of blacAmpC, IS elements, plasmid incompatibility group, and also implementing transformation, aIEF, rep-PCR and MLST. Results The highest resistance rates were observed in the SOCs, whereas those in the hospital and community were lower (e.g. quinolone resistance of 22.6%, 17.2% and 9.0%, respectively; P = 0.003 for SOCs versus community). The prevalence of ESC-R-Ec in the three settings was 5.3% (n = 11), 7.8% (n = 22) and 5.7% (n = 7), respectively. Thirty isolates produced CTX-M ESBLs (14 were CTX-M-15), 5 produced CMY-2 pAmpC and 5 hyper-expressed cAmpCs due to promoter mutations. Fourteen isolates were of sequence type 131 (ST131; 10 with CTX-M-15). blaCTX-M and blaCMY-2 were associated with an intact or truncated ISEcp1 and were mainly carried by IncF, IncFII and IncI1plasmids. Conclusions ST131 producing CTX-M-15 is the predominant clone. The prevalence of ESC-R-Ec (overall 6.5%) is low, but an unusual relatively high frequency of AmpC producers (25%) was noted. The presence of ESC-R-Ec in the SOCs and their potential ability to be exchanged between hospital and community should be taken into serious consideration