Epidemiology and Surveillance

Changing Epidemiology of Extended-Spectrum β-Lactamases in Argentina: Emergence of CTX-M-15

S. Sennati, G. Santella, J. Di Conza, L. Pallecchi, M. Pino, B. Ghiglione, G. M. Rossolini, M. Radice, G. Gutkind
DOI: 10.1128/AAC.00745-12

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Tables

  • Table 1

    Number of isolates of each species recovered within the study period, extended-spectrum cephalosporin resistance, and number of resistant isolates that were further studied

    SpeciesNo. of isolatesNo. (%) of ESCa-resistant isolatesESC-resistant isolates recovered within 1 wk
    No. of isolatesNo. of ESBL producers/AmpC producers
    Escherichia coli1,12064 (5.7)1614/2
    Klebsiella pneumoniae19387 (45.1)2222/0
    Proteus mirabilis11514 (12.2)65/1
    Enterobacter cloacae3711 (29.7)31/2
    Morganella morganii2911 (37.9)
    Klebsiella oxytoca206 (30)44/0
    Citrobacter freundii185 (27.8)
    Serratia spp.185 (27.8)33/0
    Providencia spp.132 (15.4)11/0
    Citrobacter spp.8–
    Proteus vulgaris72 (28.6)
    Enterobacter aerogenes3
    Salmonella sp.2
    Shigella spp.2
    Proteus penneri1
    Total1,586207 (13.1)5550/5

    • ↵a ESC, extended-spectrum cephalosporin.

  • Table 2

    Primers used in this study

    NameSequence (5′→3′)Reference
    CTX-M-group-1FGTTACAATGTGTGAGAAGCAG17
    CTX-M-group-1RAACGGAATGAGTTTCCCCATT17
    CTX-M-group-2FACCAGGCTCAATTGTGGAThis study
    CTX-M-group-2RAGATGAGGGTTCGTTGCAAThis study
    CTX-M-group-8FCACGGATTCAATTTTCAGGAG3
    CTX-M-group-8RGAGCGCTCCACATTTTTTAG3
    CTX-M-group-9FGTTACAATGTGTGAGAAGCAG17
    CTX-M-group-9RCAGCCAGAAAGTTATGGAGThis study
    CTX-M-group-25FGGATGATGAGAAAAAGCGTAAGGCThis study
    CTX-M-group-25RGGACTAATAACCGTCGGTGACThis study
  • Table 3

    CTX-M-producing enterobacteria collected during a 1-week studya in 15 hospitals distributed in different regions of Argentina

    Species (no. of isolates)ESBL determinant(s) (no. of isolates)
    Klebsiella pneumoniae (21)blaCTX-M-15 (10)
    blaCTX-M-2 (9)
    blaCTX-M-2 + blaCTX-M-15 (1)
    blaCTX-M-8 (1)
    Escherichia coli (13)blaCTX-M-15 (7)
    blaCTX-M-14 (3)
    blaCTX-M-2 (3)
    Proteus mirabilis (5)blaCTX-M-2 (4)
    blaCTX-M-56 (1)
    Klebsiella oxytoca (4)blaCTX-M-2 (3)
    blaCTX-M-2 + blaCTX-M-15 (1)
    Serratia spp. (3)blaCTX-M-2 (3)
    Providencia spp. (1)blaCTX-M-2 (1)

    • ↵a October 2010.

  • Table 4

    Genotypic characterization of CTX-M-15-producing E. coli and K. pneumoniae isolates

    Species and isolateCityHospitalaPhylogenetic groupCloneGenetic context of blaCTX-M-15b
    E. coli
        CM2Buenos AiresH6B2Ec1II
        L4Buenos AiresH3B2Ec2I
        M1Buenos AiresH7AEc3II
        SM4Buenos AiresH8AEc4II
        SM5Buenos AiresH8AEc5I
        T1ChubutH13B2Ec2I
        T3ChubutH13B2Ec6I
    K. pneumoniae
        B4Buenos AiresH4NDcKp2I
        CL1Buenos AiresH1NDKp3I
        CL4Buenos AiresH1NDKp1I
        CL6Buenos AiresH1NDKp7II
        CL9Buenos AiresH1NDKp4I
        CM4Buenos AiresH6NDKp1I
        CV1Buenos AiresH7NDKp5II
        I3Santa FeH5NDKp1I
        I4Santa FeH5NDKp1I
        L5Buenos AiresH3NDKp6I
        T8ChubutH13NDKp8I

    • ↵a H1, Hospital de Clínicas, Universidad de Buenos Aires; H3, Hospital Alemán, Ciudad Autónoma de Buenos Aires (CABA); H4, Hospital Británico, CABA; H5, Hospital Iturraspe, Santa Fe; H6, CEMIC, CABA; H7, Sanatorio Mater Dei, CABA; H8, Hospital Eva Perón, Buenos Aires; H13, Hospital de Trelew, Chubut.

    • ↵b I, international blaCTX-M-15 genetic environment (GenBank accession no. NC013121.1; II, truncated ISEcp1-blaCTX-M-15 genetic environment (GenBank accession no. HQ157353) (11).

    • ↵c ND, not determined.

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