Dataset Information

Recent changes in the epidemiology and management of extended-spectrum ?-lactamase-producing Enterobacteriaceae.

ABSTRACT: Since 2000, Escherichia coli producing CTX-M enzymes (especially CTX-M-15) have emerged worldwide as important causes of community-onset urinary tract and blood stream infections due to extended-spectrum ?-lactamase (ESBL) producing bacteria. Studies suggest that the sudden worldwide increase of CTX-M-15-producing E. coli is mostly due to a single clone named ST131 and that foreign travel to high-risk areas, such as the Indian subcontinent, play in part a role in the spread of this clone across different continents. Empiric antibiotic coverage for these resistant organisms should be considered in community patients presenting with sepsis involving the urinary tract, especially if a patient recently traveled to a high-risk area. If this emerging public health threat is ignored, it is possible that the medical community may be forced in the near future to use carbapenems as the first choice for the empirical treatment of serious infections associated with urinary tract infections originating in the community.

SUBMITTER: Pitout JD

PROVIDER: S-EPMC2948317 | biostudies-literature | 2009 Nov

REPOSITORIES: biostudies-literature

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Recent changes in the epidemiology and management of extended-spectrum β-lactamase-producing Enterobacteriaceae.

Pitout Johann Dd JD

F1000 medicine reports 20091116

Since 2000, Escherichia coli producing CTX-M enzymes (especially CTX-M-15) have emerged worldwide as important causes of community-onset urinary tract and blood stream infections due to extended-spectrum β-lactamase (ESBL) producing bacteria. Studies suggest that the sudden worldwide increase of CTX-M-15-producing E. coli is mostly due to a single clone named ST131 and that foreign travel to high-risk areas, such as the Indian subcontinent, play in part a role in the spread of this clone across ...[more]

PMID: 20948694

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Project description:In this study, we characterized the ?-lactamase genes and phenotypic resistance of cephalosporin-resistant Enterobacteriaceae isolated from retail foods in China. Of 1,024 Enterobacteriaceae isolates recovered from raw meat products, aquatic products, raw vegetables, retail-level ready-to-eat (RTE) foods, frozen foods, and mushrooms from 2011 to 2014, 164 (16.0%) showed cefotaxime (CTX) and/or ceftazidime (CAZ) cephalosporin resistance, and 96 (9.4%) showed the extended-spectrum ?-lactamase (ESBL) phenotype. More than 30% isolates were resistant to all antimicrobial agents except carbapenems (MEM 3.1% and IPM 5.2%), cefoxitin (FOX 6.3%), and amoxicillin/clavulanic acid (AMC 26%), and 94.8% of the strains were resistant to up to seven antibiotics. Polymerase chain reaction analysis showed that blaTEM (81.9%) was the most common gene, followed by blaCTX-M (68.1%) and blaSHV (38.9%). Moreover, 16.8% (72/429) of food samples contained ESBL-positive Enterobacteriaceae, with the following patterns: 32.9% (23/70) in frozen foods, 27.2% (5/29) in mushrooms, 17.6% (24/131) in raw meats, 13.3% (4/30) in fresh vegetables, 11.1% (8/72) in RTE foods, and 9.3% (9/97) in aquatic products. In addition, 24 of 217 foods collected in South China (11.1%), 25 of 131 foods collected in North of the Yangtze River region (19.1%), and 23 of 81 foods collected in South of the Yangtze River region (28.4%) were positive for ESBL- Enterobacteriaceae. Conjugation experiments demonstrated that the 22 of 72 isolates were transconjugants that had received the ?-lactamase gene and were resistant to ?-lactam antibiotics as well as some non-?-lactam antibiotics. These findings demonstrated that retail foods may be reservoirs for the dissemination of ?-lactam antibiotics and that resistance genes could be transmitted to humans through the food chain; and the predominant ESBL-producing Enterobacteriaceae in China was isolated from in frozen chicken-meat, followed by frozen pork, cold noodles in sauce, cucumber, raw chicken meat, frozen pasta, brine-soaked chicken and tomato.

Dataset Information

Recent changes in the epidemiology and management of extended-spectrum ?-lactamase-producing Enterobacteriaceae.

Publications

Recent changes in the epidemiology and management of extended-spectrum β-lactamase-producing Enterobacteriaceae.

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