Journal Article

Clinical Features and Molecular Epidemiology of CMY-Type β-Lactamase–Producing <i>Escherichia coli</i>

Hanna E. Sidjabat, David L. Paterson, Zubair A. Qureshi, Jennifer M. Adams-Haduch, Alexandra O'Keefe, Alvaro Pascual, Jesús Rodrçguez-Bano and Yohei Doi

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 48, issue 6, pages 739-744
Published in print March 2009 | ISSN: 1058-4838
Published online March 2009 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/597037
Clinical Features and Molecular Epidemiology of CMY-Type β-Lactamase–Producing Escherichia coli

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Background.Knowledge of the clinical features of infections caused by Escherichia coli strains that produce plasmid-mediated AmpC β-lactamase is limited. Of the several groups of plasmid-mediated AmpC β-lactamases, CMY-type β-lactamase is the most common in the United States.

Methods.We prospectively identified patients infected or colonized with E. coli strains that produce CMY-type β-lactamase, and we collected clinical data over a 7-month period. A retrospective cohort study was performed to identify features associated with these cases. Patients with extended-spectrum β-lactamase–producing E. coli were used as a control group. Pulsed-field gel electrophoresis, plasmid analysis, and phylogenetic typing were performed.

Results.Twenty-two patients with infection or colonization due to CMY-type β-lactamase–producing E. coli and 25 patients with infection or colonization due to extended-spectrum β-lactamase–producing E. coli were identified. The demographic characteristics of the patients were similar in both cohorts. Patients with CMY-type β-lactamase–producing E. coli were significantly more likely to have symptomatic infection than were patients with extended-spectrum β-lactamase–producing E. coli (P=.028). The CMY-type β-lactamase was identified as CMY-2 or its variants. Ninety-four percent of the CMY-type β-lactamase–producing isolates belonged to E. coli phylogenetic groups B2 and D, which are associated with virulence. Many of the isolates shared similar plasmid profiles, whereas the pulsed-field gel electrophoresis profiles were diverse. Co-resistance to non–β-lactam antimicrobials was common.

Conclusion.In Pittsburgh, Pennsylvania, CMY-type β-lactamase–producing E. coli strains are almost as common as extended-spectrum β-lactamase–producing E. coli strains, and they cause symptomatic infection in the majority of cases.

Journal Article.  3574 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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