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Comparison of Six M...
Comparison of Six Methods for Epidemiological Typing of Escherichia coli Producing Extended-Spectrum Beta-Lactamase during a Suspected Outbreak
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- Lytsy, Birgitta, 1968- (author)
- Uppsala universitet,Klinisk bakteriologi,Björn Olsen
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- Heydecke, Anna (author)
- Uppsala universitet,Klinisk bakteriologi,Björn Olsen
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Edqvist, Petra (author)
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Klint, Markus (author)
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Severinsson, Kristofer (author)
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Yin, Hong (author)
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- Melhus, Åsa (author)
- Uppsala universitet,Klinisk bakteriologi,Björn Olsen
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(creator_code:org_t)
- English.
- Related links:
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https://urn.kb.se/re...
Abstract
Subject headings
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- During a suspected outbreak of Escherichia coli producing extended-spectrum beta-lactamase (ESBL) at Uppsala University Hospital 2005-2007, different typing methods were applied to examine their usefulness in a sharp situation. Included methods were antibiogram-based typing, PhenePlate (PhP) system, pulsed-field gel electrophoresis (PFGE), repetitive sequence-based (rep)-PCR (Diversilab), arbitrarily primed (AP)-PCR, and characterization of integrons. A PCR assay was used to define the O25b-ST131 clone, and nosocomial transmission was explored with a locally developed tracing tool. Of the 253 analyzed isolates, 70% harboured CTX-M group 1 enzymes and 19% CTX-X-M group 9 enzymes. Integrons with integrated gene cassettes were detected in 47% of the isolates and 77% were of class 1. One restriction fragment length polymorphism (RFLP) type predominated (n=48), and it was in 40% of the cases associated with the O25b-ST131 clone. Fifty-five (22%) of all isolates were PCR positive for this clone, of which the PhP-system identified 49%. Fifty isolates were further analyzed. Most methods had difficulties with recognizing the O25b-ST131 clone. Rep-PCR identified 100%, PFGE 86%, AP-PCR 68%, PCR-RFLP of integrons 39% and antibiogram types 32% of the PCR positive isolates. Epidemiological data supported a nosocomial transmission in a limited number of cases, suggesting an endemic rather than an epidemic situation. In conclusion, the genetic complexity of ESBL-producing E. coli has become a challenge for any microbiology laboratory. Although the defining O25b-ST131 PCR assay was the most efficient method to identify this epidemic clone, PCR methods cannot be applied on genetically uncharacterized E. coli strains. To rely on a single epidemiological typing method to identify strains or mobile genetic elements with epidemic potential might be insufficient.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Mikrobiologi inom det medicinska området (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Microbiology in the medical area (hsv//eng)
Keyword
- Escherichia coli
- extended-spectrum beta-lactamase
- ESBL
- epidemiological typing
- typningsmetoder
- ESBL
- extended-spectrum beta-lactamase
- Clinical bacteriology
- Klinisk bakteriologi
- Clinical Bacteriology
- Klinisk bakteriologi
Publication and Content Type
- vet (subject category)
- ovr (subject category)
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