Journal Article

Predominance and genetic diversity of community- and hospital-acquired CTX-M extended-spectrum β-lactamases in York, UK

C. J. Munday, G. M. Whitehead, N. J. Todd, M. Campbell and P. M. Hawkey

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 54, issue 3, pages 628-633
Published in print September 2004 | ISSN: 0305-7453
Published online September 2004 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dkh397
Predominance and genetic diversity of community- and hospital-acquired CTX-M extended-spectrum β-lactamases in York, UK

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Objectives: This study was conducted to detect the presence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae within the faecal flora of both community- and hospital-based patients in York and to characterize the blaTEM, blaSHV and blaCTX-M genes present in these isolates.

Methods: One thousand faeces samples were collected and screened at York Hospital during October–December 2003. Ninety-five non-duplicate Enterobacteriaceae isolates resistant to third-generation cephalosporins were recovered; 22 isolates were selected for further study on the basis of a positive double disc diffusion test for ESBL production. Antibiotic susceptibility testing was performed to a range of antibiotics. The TEM, SHV and CTX-M genes were detected by PCR and the DNA sequenced.

Results: The distribution of ESBL-positive isolates from the hospital and community was 1.4:1. These included nine Escherichia coli, seven Enterobacter cloacae, four Citrobacter freundii and a single isolate each of Klebsiella spp. and Salmonella spp. A total of 17 isolates contained blaCTX-M (five blaCTX-M-15, three blaCTX-M-14 and nine blaCTX-M-9). ISEcp1 was present in isolates expressing CTX-M-14 and -15, but was absent upstream of In60-associated blaCTX-M-9. E. coli isolates also contained either a blaTEM-1 or blaTEM-2, whereas six of the E. cloacae carried blaSHV-12 and the Klebsiella spp. blaSHV-36 in addition to blaCTX-M-9. The single Salmonella spp. carried blaSHV-12.

Conclusions: The overall prevalence of ESBL in isolates of Enterobacteriaceae from York was 1.9%. ESBL-producing isolates were found in both the community and hospital, with the CTX-M type most common. This is also the first report of an ESBL-producing Salmonella in the UK.

Keywords: ESBLs; Salmonella; Enterobacteriaceae

Journal Article.  4195 words. 

Subjects: Medical Oncology ; Critical Care

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