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Antimicrobial Agents and Chemotherapy, June 2009, p. 2539-2543, Vol. 53, No. 6
0066-4804/09/$08.00+0     doi:10.1128/AAC.00061-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Molecular Characteristics of Travel-Related Extended-Spectrum-β-Lactamase-Producing Escherichia coli Isolates from the Calgary Health Region{triangledown}

Johann D. D. Pitout,1,2,4* Lorraine Campbell,1 Deirdre L. Church,1,2,3 Daniel B. Gregson,1,2,3 and Kevin B. Laupland2,3,5

Division of Microbiology, Calgary Laboratory Services,1 Departments of Pathology & Laboratory Medicine,2 Medicine,3 Microbiology and Infectious Diseases,4 Critical Care, University of Calgary, Calgary, Alberta, Canada5

Received 15 January 2009/ Returned for modification 15 March 2009/ Accepted 29 March 2009

Extended-spectrum-β-lactamase (ESBL)-producing Escherichia coli has recently emerged as a major risk factor for community-acquired, travel-related infections in the Calgary Health Region. Molecular characterization was done on isolates associated with infections in returning travelers using isoelectric focusing, PCR, and sequencing for blaCTX-Ms, blaTEMs, blaSHVs, blaOXAs, and plasmid-mediated quinolone resistance determinants. Genetic relatedness was determined with pulsed-field gel electrophoresis using XbaI and multilocus sequence typing (MLST). A total of 105 residents were identified; 6/105 (6%) presented with hospital-acquired infections, 9/105 (9%) with health care-associated community-onset infections, and 90/105 (86%) with community-acquired infections. Seventy-seven of 105 (73%) of the ESBL-producing E. coli isolates were positive for blaCTX-M genes; 55 (58%) produced CTX-M-15, 13 (14%) CTX-M-14, six (6%) CTX-M-24, one (1%) CTX-M-2, one (1%) CTX-M-3, and one (1%) CTX-M-27, while 10 (10%) produced TEM-52, three (3%) TEM-26, 11 (11%) SHV-2, and four (4%) produced SHV-12. Thirty-one (30%) of the ESBL-producing E. coli isolates were positive for aac(6')-Ib-cr, and one (1%) was positive for qnrS. The majority of the ESBL-producing isolates (n = 95 [90%]) were recovered from urine samples, and 83 (87%) were resistant to ciprofloxacin. The isolation of CTX-M-15 producers belonging to clone ST131 was associated with travel to the Indian subcontinent (India, Pakistan), Africa, the Middle East, and Europe, while clonally unrelated strains of CTX-M-14 and -24 were associated with travel to Asia. Our study suggested that clone ST131 coproducing CTX-M-15, OXA-1, TEM-1, and AAC(6')-Ib-cr and clonally unrelated CTX-M-14 producers have emerged as important causes of community-acquired, travel-related infections.

* Corresponding author. Mailing address: Calgary Laboratory Services, #9, 3535 Research Road NW, Calgary, Alberta T2L 2K8, Canada. Phone: (403) 770 3309. Fax: (403) 770 3347. E-mail: johann.pitout{at}cls.ab.ca

{triangledown} Published ahead of print on 13 April 2009.

Antimicrobial Agents and Chemotherapy, June 2009, p. 2539-2543, Vol. 53, No. 6
0066-4804/09/$08.00+0     doi:10.1128/AAC.00061-09
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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