1887

Abstract

Mobile drug-resistance genes with identical nucleic acid sequences carried by multidrug-resistant strains that cause community-acquired infections are becomingly increasingly dispersed worldwide. Over a 2-year period, we analysed Gram-negative bacterial (GNB) pathogens from the blood of inpatients at an urban public hospital to determine what proportion of these isolates carried such globally dispersed drug-resistance genes. Of 376 GNB isolates, 167 (44 %) were , 50 (13 %) were , 25 (7 %) were , 25 (7 %) were and 20 (5 %) were ; the remainder (24 %) comprised 26 different GNB species. Among isolates, class 1 integrons were detected in 64 (38 %). The most common integron gene cassette configuration was , found in 30 (25 %) of 119 drug-resistant isolates and in one isolate of . Extended-spectrum β-lactamase (ESBL) genes were found in 16 isolates (10 %). These genes with identical sequences were found in nearly 40 % of bloodstream isolates in the study hospital, as well as in a variety of bacterial species from clinical and non-clinical sources worldwide. Thus, a substantial proportion of bloodstream infections among hospitalized patients were caused by strains carrying drug-resistance genes that are dispersed globally in a wide variety of bacterial species.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.041970-0
2012-07-01
2019-10-24
Loading full text...

Full text loading...

/deliver/fulltext/jmm/61/7/968.html?itemId=/content/journal/jmm/10.1099/jmm.0.041970-0&mimeType=html&fmt=ahah

References

  1. Ajiboye R. M. , Solberg O. D. , Lee B. M. , Raphael E. , Debroy C. , Riley L. W. . ( 2009; ). Global spread of mobile antimicrobial drug resistance determinants in human and animal Escherichia coli and Salmonella strains causing community-acquired infections. . Clin Infect Dis 49:, 365–371.[PubMed] [CrossRef]
    [Google Scholar]
  2. CLSI ( 2011; ). Performance Standards for Antimicrobial Susceptibility Testing, 21st Informational Supplement. M100-S21. . Wayne, PA:: Clinical and Laboratory Standards Institute;.
  3. Cocchi S. , Grasselli E. , Gutacker M. , Benagli C. , Convert M. , Piffaretti J. C. . ( 2007; ). Distribution and characterization of integrons in Escherichia coli strains of animal and human origin. . FEMS Immunol Med Microbiol 50:, 126–132.[PubMed] [CrossRef]
    [Google Scholar]
  4. Coque T. M. , Novais A. , Carattoli A. , Poirel L. , Pitout J. , Peixe L. , Baquero F. , Cantón R. , Nordmann P. . ( 2008; ). Dissemination of clonally related Escherichia coli strains expressing extended-spectrum β-lactamase CTX-M-15. . Emerg Infect Dis 14:, 195–200.[PubMed] [CrossRef]
    [Google Scholar]
  5. Dallenne C. , Da Costa A. , Decré D. , Favier C. , Arlet G. . ( 2010; ). Development of a set of multiplex PCR assays for the detection of genes encoding important β-lactamases in Enterobacteriaceae . . J Antimicrob Chemother 65:, 490–495.[PubMed] [CrossRef]
    [Google Scholar]
  6. Dias R. C. , Marangoni D. V. , Smith S. P. , Alves E. M. , Pellegrino F. L. , Riley L. W. , Moreira B. M. . ( 2009; ). Clonal composition of Escherichia coli causing community-acquired urinary tract infections in the State of Rio de Janeiro, Brazil. . Microb Drug Resist 15:, 303–308.[PubMed] [CrossRef]
    [Google Scholar]
  7. Enne V. I. , Livermore D. M. , Stephens P. , Hall L. M. . ( 2001; ). Persistence of sulphonamide resistance in Escherichia coli in the UK despite national prescribing restriction. . Lancet 357:, 1325–1328.[PubMed] [CrossRef]
    [Google Scholar]
  8. Friedman N. D. , Kaye K. S. , Stout J. E. , McGarry S. A. , Trivette S. L. , Briggs J. P. , Lamm W. , Clark C. , MacFarquhar J. . & other authors ( 2002; ). Health care-associated bloodstream infections in adults: a reason to change the accepted definition of community-acquired infections. . Ann Intern Med 137:, 791–797.[PubMed] [CrossRef]
    [Google Scholar]
  9. Johnson L. , Sabel A. , Burman W. J. , Everhart R. M. , Rome M. , MacKenzie T. D. , Rozwadowski J. , Mehler P. S. , Price C. S. . ( 2008; ). Emergence of fluoroquinolone resistance in outpatient urinary Escherichia coli isolates. . Am J Med 121:, 876–884.[PubMed] [CrossRef]
    [Google Scholar]
  10. Johnson J. R. , Menard M. , Johnston B. , Kuskowski M. A. , Nichol K. , Zhanel G. G. . ( 2009; ). Epidemic clonal groups of Escherichia coli as a cause of antimicrobial-resistant urinary tract infections in Canada, 2002 to 2004. . Antimicrob Agents Chemother 53:, 2733–2739.[PubMed] [CrossRef]
    [Google Scholar]
  11. Johnson J. R. , Johnston B. , Clabots C. , Kuskowski M. A. , Castanheira M. . ( 2010; ). Escherichia coli sequence type ST131 as the major cause of serious multidrug-resistant E. coli infections in the United States. . Clin Infect Dis 51:, 286–294.[PubMed] [CrossRef]
    [Google Scholar]
  12. Kumarasamy K. K. , Toleman M. A. , Walsh T. R. , Bagaria J. , Butt F. , Balakrishnan R. , Chaudhary U. , Doumith M. , Giske C. G. . & other authors ( 2010; ). Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. . Lancet Infect Dis 10:, 597–602.[PubMed] [CrossRef]
    [Google Scholar]
  13. Lévesque C. , Piché L. , Larose C. , Roy P. H. . ( 1995; ). PCR mapping of integrons reveals several novel combinations of resistance genes. . Antimicrob Agents Chemother 39:, 185–191.[PubMed] [CrossRef]
    [Google Scholar]
  14. Li J. , Ma Y. , Hu C. , Jin S. , Zhang Q. , Ding H. , Ran L. , Cui S. . ( 2010; ). Dissemination of cefotaxime-M-producing Escherichia coli isolates in poultry farms, but not swine farms, in China. . Foodborne Pathog Dis 7:, 1387–1392.[PubMed] [CrossRef]
    [Google Scholar]
  15. Manges A. R. , Johnson J. R. , Foxman B. , O’Bryan T. T. , Fullerton K. E. , Riley L. W. . ( 2001; ). Widespread distribution of urinary tract infections caused by a multidrug-resistant Escherichia coli clonal group. . N Engl J Med 345:, 1007–1013.[PubMed] [CrossRef]
    [Google Scholar]
  16. Manges A. R. , Natarajan P. , Solberg O. D. , Dietrich P. S. , Riley L. W. . ( 2006; ). The changing prevalence of drug-resistant Escherichia coli clonal groups in a community: evidence for community outbreaks of urinary tract infections. . Epidemiol Infect 134:, 425–431.[PubMed] [CrossRef]
    [Google Scholar]
  17. Márquez C. , Labbate M. , Raymondo C. , Fernández J. , Gestal A. M. , Holley M. , Borthagaray G. , Stokes H. W. . ( 2008; ). Urinary tract infections in a South American population: dynamic spread of class 1 integrons and multidrug resistance by homologous and site-specific recombination. . J Clin Microbiol 46:, 3417–3425.[PubMed] [CrossRef]
    [Google Scholar]
  18. Martinez-Freijo P. , Fluit A. C. , Schmitz F. J. , Grek V. S. , Verhoef J. , Jones M. E. . ( 1998; ). Class I integrons in Gram-negative isolates from different European hospitals and association with decreased susceptibility to multiple antibiotic compounds. . J Antimicrob Chemother 42:, 689–696.[PubMed] [CrossRef]
    [Google Scholar]
  19. Olesen B. , Kolmos H. J. , Orskov F. , Orskov I. . ( 1994; ). Cluster of multiresistant Escherichia coli O78 : H10 in Greater Copenhagen. . Scand J Infect Dis 26:, 406–410.[PubMed] [CrossRef]
    [Google Scholar]
  20. Peirano G. , Pitout J. D. . ( 2010; ). Molecular epidemiology of Escherichia coli producing CTX-M β-lactamases: the worldwide emergence of clone ST131 O25 : H4. . Int J Antimicrob Agents 35:, 316–321.[PubMed] [CrossRef]
    [Google Scholar]
  21. Peleg A. Y. , Hooper D. C. . ( 2010; ). Hospital-acquired infections due to Gram-negative bacteria. . N Engl J Med 362:, 1804–1813.[PubMed] [CrossRef]
    [Google Scholar]
  22. Pitout J. D. , Laupland K. B. . ( 2008; ). Extended-spectrum β-lactamase-producing Enterobacteriaceae: an emerging public-health concern. . Lancet Infect Dis 8:, 159–166.[PubMed] [CrossRef]
    [Google Scholar]
  23. Pitout J. D. , Nordmann P. , Laupland K. B. , Poirel L. . ( 2005; ). Emergence of Enterobacteriaceae producing extended-spectrum β-lactamases (ESBLs) in the community. . J Antimicrob Chemother 56:, 52–59.[PubMed] [CrossRef]
    [Google Scholar]
  24. Shibata N. , Kurokawa H. , Doi Y. , Yagi T. , Yamane K. , Wachino J. , Suzuki S. , Kimura K. , Ishikawa S. . & other authors ( 2006; ). PCR classification of CTX-M-type β-lactamase genes identified in clinically isolated Gram-negative bacilli in Japan. . Antimicrob Agents Chemother 50:, 791–795.[PubMed] [CrossRef]
    [Google Scholar]
  25. Smith S. P. , Manges A. R. , Riley L. W. . ( 2008; ). Temporal changes in the prevalence of community-acquired antimicrobial-resistant urinary tract infection affected by Escherichia coli clonal group composition. . Clin Infect Dis 46:, 689–695.[PubMed] [CrossRef]
    [Google Scholar]
  26. Solberg O. D. , Ajiboye R. M. , Riley L. W. . ( 2006; ). Origin of class 1 and 2 integrons and gene cassettes in a population-based sample of uropathogenic Escherichia coli . . J Clin Microbiol 44:, 1347–1351.[PubMed] [CrossRef]
    [Google Scholar]
  27. Suzuki S. , Shibata N. , Yamane K. , Wachino J. , Ito K. , Arakawa Y. . ( 2009; ). Change in the prevalence of extended-spectrum-β-lactamase-producing Escherichia coli in Japan by clonal spread. . J Antimicrob Chemother 63:, 72–79.[PubMed] [CrossRef]
    [Google Scholar]
  28. Tartof S. Y. , Solberg O. D. , Riley L. W. . ( 2007; ). Genotypic analyses of uropathogenic Escherichia coli based on fimH single nucleotide polymorphisms (SNPs). . J Med Microbiol 56:, 1363–1369.[PubMed] [CrossRef]
    [Google Scholar]
  29. Vincent C. , Boerlin P. , Daignault D. , Dozois C. M. , Dutil L. , Galanakis C. , Reid-Smith R. J. , Tellier P. P. , Tellis P. A. . & other authors ( 2010; ). Food reservoir for Escherichia coli causing urinary tract infections. . Emerg Infect Dis 16:, 88–95.[PubMed] [CrossRef]
    [Google Scholar]
  30. Vinué L. , Sáenz Y. , Somalo S. , Escudero E. , Moreno M. A. , Ruiz-Larrea F. , Torres C. . ( 2008; ). Prevalence and diversity of integrons and associated resistance genes in faecal Escherichia coli isolates of healthy humans in Spain. . J Antimicrob Chemother 62:, 934–937.[PubMed] [CrossRef]
    [Google Scholar]
  31. Woerther P. L. , Angebault C. , Lescat M. , Ruppé E. , Skurnik D. , Mniai A. E. , Clermont O. , Jacquier H. , Costa A. D. . & other authors ( 2010; ). Emergence and dissemination of extended-spectrum β-lactamase-producing Escherichia coli in the community: lessons from the study of a remote and controlled population. . J Infect Dis 202:, 515–523.[PubMed] [CrossRef]
    [Google Scholar]
  32. Yu H. S. , Lee J. C. , Kang H. Y. , Jeong Y. S. , Lee E. Y. , Choi C. H. , Tae S. H. , Lee Y. C. , Seol S. Y. , Cho D. T. . ( 2004; ). Prevalence of dfr genes associated with integrons and dissemination of dfrA17 among urinary isolates of Escherichia coli in Korea. . J Antimicrob Chemother 53:, 445–450.[PubMed] [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.041970-0
Loading
/content/journal/jmm/10.1099/jmm.0.041970-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error