Molecular characterization of extended-spectrum β-lactamases in clinical Escherichia coli and Klebsiella pneumoniae isolates from Surabaya, Indonesia

• Published in: Journal of antimicrobial chemotherapy Vol. 65; no. 3; pp. 465 - 469
• Main Authors: Severin, Juliëtte A., Mertaniasih, Ni Made, Kuntaman, Kuntaman, Lestari, Endang S., Purwanta, Marijam, Lemmens-Den Toom, Nicole, Duerink, D. Offra, Hadi, Usman, van Belkum, Alex, Verbrugh, Henri A., Goessens, Wil H.
• Format: Journal Article
• Language: English
• Published: Oxford Oxford University Press 01.03.2010
• Subjects: antibiotic resistance; Antibiotics. Antiinfectious agents. Antiparasitic agents; Asia; Bacterial Typing Techniques; beta-Lactamases - chemistry; beta-Lactamases - genetics; Biological and medical sciences; Cluster Analysis; CTX-M-15; DNA Fingerprinting; Electrophoresis, Gel, Pulsed-Field; Escherichia coli - classification; Escherichia coli - enzymology; Escherichia coli - genetics; Escherichia coli - isolation & purification; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Genotype; Hospitals, University; Humans; Indonesia - epidemiology; Klebsiella Infections - epidemiology; Klebsiella Infections - microbiology; Klebsiella pneumoniae - classification; Klebsiella pneumoniae - enzymology; Klebsiella pneumoniae - genetics; Klebsiella pneumoniae - isolation & purification; Medical sciences; Molecular Epidemiology; O25b-ST131; PFGE; Pharmacology. Drug treatments; Asia; Indonesia; CTX-M-15; PFGE; O25b-ST131; antibiotic resistance; Asia; Nucleotide sequence; Escherichia coli; Extended-spectrum β-lactamase; Resistance; Antibiotic; Pulsed field electrophoresis; Bacteria; Isolate; Antibacterial agent; Klebsiella pneumoniae; Enterobacteriaceae
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkp471

Background No detailed reports regarding extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae are currently available from Indonesia, the fourth most populous country in the world. Methods A survey was carried out to investigate the molecular epidemiology and genetic characteristics of clinical ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates originating from the Dr. Soetomo Academic Hospital in Surabaya, Indonesia, over a 4 month period (January to April 2005). ESBLs were characterized by isoelectric focusing and PCR assays. Clonality of the isolates was assessed by PFGE and repetitive-sequence-based PCR (rep-PCR). Phylogenetic grouping was performed among CTX-M-15-producing E. coli. Results In total, 73 consecutive non-duplicate ESBL-positive E. coli and 72 K. pneumoniae strains were isolated. The blaCTX-M-15 gene was found to be highly prevalent (69/73 strains, 94.5%) among the 73 ESBL-positive E. coli isolates. The gene was detected in both clonal and non-clonal isolates, as defined by PFGE and rep-PCR. Sixteen CTX-M-15-positive E. coli could be assigned to a single rep-PCR type and phylogenetic group B2 and belonged to the well-known O25b-ST131 clone. Among the 72 ESBL-positive K. pneumoniae isolates, blaCTX-M-15 was again the most prevalent ESBL (40/72, 55.6%). Several SHV-type enzymes were also frequently detected: SHV-5 (n = 28); SHV-12 (n = 13); and SHV-2 (n = 6). TEM-type ESBLs were not detected in any of the isolates. Conclusions Indonesia is another developing country affected by the emergence and spread of bacterial strains harbouring ESBL genes, including the CTX-M-15-producing B2-E. coli O25b-ST131 clone.