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Antimicrobial Agents and Chemotherapy, August 2007, p. 2720-2725, Vol. 51, No. 8
0066-4804/07/$08.00+0     doi:10.1128/AAC.00026-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Rapid Dissemination and Diversity of CTX-M Extended-Spectrum ß-Lactamase Genes in Commensal Escherichia coli Isolates from Healthy Children from Low-Resource Settings in Latin America{triangledown}

Lucia Pallecchi,1 Alessandro Bartoloni,2 Costanza Fiorelli,2 Antonia Mantella,2 Tiziana Di Maggio,1 Herlan Gamboa,3 Eduardo Gotuzzo,4 Göran Kronvall,5 Franco Paradisi,2 and Gian Maria Rossolini1*

Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena, Italy,1 Dipartimento Area Critica Medico Chirurgica, Clinica Malattie Infettive, Università di Firenze, Florence, Italy,2 Distrito de Salud Cordillera, Departamento Santa Cruz, Camiri, Bolivia,3 Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia, Lima, Peru,4 Department of Microbiology and Tumor Biology-MTC, Clinical Microbiology, Karolinska Institut, Stockholm, Sweden5

Received 9 January 2007/ Returned for modification 1 March 2007/ Accepted 24 May 2007

A survey carried out in 2005 among members of a healthy population of children living in Bolivia and Peru revealed that fecal carriage of Escherichia coli strains resistant to expanded-spectrum cephalosporins was remarkably increased compared to that observed in the same settings in 2002 (1.7% in 2005 versus 0.1% in 2002). In this work, we demonstrated that this phenomenon was mainly related to the dissemination of CTX-M-type extended-spectrum ß-lactamase (ESBL) determinants among commensal E. coli strains. Of 50 ESBL-producing isolates collected in the 2005 survey, 44 harbored a CTX-M-type and 6 an SHV-type (SHV-2 or SHV-12) ESBL. Compared to 2002 results, an increased diversity of CTX-M-type ESBLs was also observed: members of the CTX-M-1 group (CTX-M-15) emerged in Bolivia (where only CTX-M-2 was observed in 2002), while members of the CTX-M-9 group (CTX-M-14 and CTX-M-24) emerged in Peru (where only CTX-M-15 and CTX-M-2 were observed in 2002). A new CTX-M-2 variant named CTX-M-56 was also detected. Molecular characterization of the CTX-M-producing isolates and gene transfer experiments suggested that different mechanisms could be involved in the spreading of different CTX-M group determinants and revealed that additional resistance determinants for non-ß-lactam antibiotics were preferentially carried by plasmids encoding certain CTX-M variants (CTX-M-15 and variants of the CTX-M-2 group). Three CTX-M-15-encoding conjugative plasmids from Peruvian isolates carried the new fluoroquinolone resistance gene aac(6')-Ib-cr. To our best knowledge, this is the first report of the detection of aac(6')-Ib-cr in Latin America.

* Corresponding author. Mailing address: Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Policlinico Santa Maria alle Scotte, 53100 Siena, Italy. Phone: 39 0577 233327. Fax: 39 0577 233334. E-mail: rossolini{at}unisi.it

{triangledown} Published ahead of print on 4 June 2007.

Antimicrobial Agents and Chemotherapy, August 2007, p. 2720-2725, Vol. 51, No. 8
0066-4804/07/$08.00+0     doi:10.1128/AAC.00026-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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