Dominance of CTX-M-type extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolated from patients with community-onset and hospital-onset infection in China

PLoS One. 2014 Jul 1;9(7):e100707. doi: 10.1371/journal.pone.0100707. eCollection 2014.

Abstract

Objective: To investigate CTX-M genotypes among extended-spectrum β-lactamase-producing Escherichia coli (ESBL-EC) isolated from patients with community-onset and hospital-onset infections in China, their clonality and the distribution of CTX-M variants in different specimens of community-onset and hospital-onset infections.

Methods: ESBL-EC isolates were collected from general hospitals from 2011 to 2012 in China. Broth microdilution method antimicrobial susceptibility testing of 16 antibiotics was performed. Clinical data from community-onset and hospital-onset infections due to ESBL-EC were analyzed. ESBL-encoding genes were amplified by PCR and sequenced, and multilocus sequence typing (MLST) was performed for a random selection of predominant CTX-M type strains identified.

Results: A total of 1,168 ESBL-EC isolates were obtained from various clinical specimens, 41.7% of which were responsible for causing community-onset infections. The presence of urinary calculi was higher in community-onset infections, whereas malignancy, cardiovascular and cerebrovascular diseases, dementia, chronic renal disease, diabetes mellitus and surgical treatment were found to have higher proportions in hospital-onset infections. There was no significant difference in trauma between community-onset and hospital-onset infections. 96.2% of the isolates were detected to harbor blaCTX-M genes. blaCTX-M-1 group and blaCTX-M-9 group were detected at 40.7% and 48.7% respectively, and both positive group accounted for 10.6%. blaCTX-M-55 (24.8%) and blaCTX-M-15 (18.2%) were the major genotypes in blaCTX-M-1 group while blaCTX-M-14 (46.8%) was predominant in blaCTX-M-9 group. A comparison of blaCTX-M distribution in different specimens between ESBL-EC causing community-onset and hospital-onset infection showed no significant difference. A total of 229 isolates were tested for MLST. ST131 (14%) was the predominant type. ST648, ST405 and ST1193 were also detected.

Conclusions: Community-onset ESBL-EC has emerged as a common pathogen in China. CTX-M-14 is the most commonly encountered, CTX-M-55 and CTX-M-15 have spread rapidly. ST131 is the predominant clonal group, and the great diversity of CTX-M-producing isolates of E. coli has emerged in China.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • China / epidemiology
  • Community-Acquired Infections* / enzymology
  • Community-Acquired Infections* / epidemiology
  • Community-Acquired Infections* / genetics
  • Cross Infection* / enzymology
  • Cross Infection* / epidemiology
  • Cross Infection* / genetics
  • Escherichia coli Infections* / enzymology
  • Escherichia coli Infections* / epidemiology
  • Escherichia coli Infections* / genetics
  • Escherichia coli Proteins / genetics*
  • Escherichia coli* / enzymology
  • Escherichia coli* / genetics
  • Escherichia coli* / isolation & purification
  • Female
  • Genotype*
  • Humans
  • Male
  • beta-Lactamases / genetics

Substances

  • Escherichia coli Proteins
  • beta-Lactamases

Grants and funding

This work was supported by National Natural Science Foundation of China (http://www.nsfc.gov.cn/publish/portal0/default.htm) (grant number: 81271881) and Special Fund for Scientific Research of Public Health Service Industry of China (http://www.nhfpc.gov.cn/) (grant number: 201002021). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.