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Antimicrobial Agents and Chemotherapy, December 2004, p. 4556-4561, Vol. 48, No. 12
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.12.4556-4561.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Detection of CTX-M-Type ß-Lactamase Genes in Fecal Escherichia coli Isolates from Healthy Children in Bolivia and Peru

Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena,¹ Clinica delle Malattie Infettive, Dipartimento di Area Critica Medico-Chirurgica, Università di Firenze, Florence, Italy,² Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru,³ Instituto Nacional de Laboratorios de Salud INLASA, La Paz, Bolivia,⁴ Department of Microbiology and Tumor Biology-MTC, Clinical Microbiology, Karolinska Institute, Karolinska Hospital L2:02, Stockholm, Sweden⁵

Received 18 March 2004/ Returned for modification 31 May 2004/ Accepted 30 July 2004

A survey was carried out from August to November 2002 to evaluate the antimicrobial susceptibilities of fecal Escherichia coli isolates from 3,208 healthy children from four different urban areas of Latin America, two in Bolivia (Camiri and Villa Montes) and two in Peru (Yurimaguas and Moyobamba). Ceftriaxone-resistant E. coli isolates were detected in four children, one from each of the areas sampled. The isolates exhibited a multidrug-resistant phenotype, including resistance to oxyimino-cephalosporins and aztreonam, and the MICs of ceftazidime for the isolates were lower than those of cefotaxime. By PCR and sequencing, the bla_CTX-M-2 determinant was detected in three isolates and the bla_CTX-M-15 determinant was detected in one isolate (from Peru). The CTX-M-2-producing isolates belonged to three different phylogenetic groups (groups A, B2, and D), while the CTX-M-15-producing isolate belonged to phylogenetic group D. The bla_CTX-M-2 determinants were transferable to E. coli by conjugation, while conjugative transfer of the bla_CTX-M-15 determinant was not detectable. Plasmids harboring the bla_CTX-M-2 determinant exhibited similar restriction profiles, and in all of them the gene was located on a 2.2-kb PstI fragment, suggesting a genetic environment similar to that present in In35 and InS21. The findings of the present study confirm the widespread distribution of CTX-M-type ß-lactamases and underscore the role that commensal E. coli isolates could play as a potential reservoir of these clinically relevant resistance determinants. This is the first report of CTX-M-type enzymes in Bolivia and Peru and also the first report of the detection of CTX-M-15 in Latin America.

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