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Fernández Vecilla D, Zugazaga Inchaurza K, Lombide Aguirre I, Díaz de Tuesta Del Arco JL. Phenotypic and genotypic characterization of Shigella sonnei carrying the extended-spectrum beta-lactamase CTX-M-27. A report of two cases in Spain in men who have sex with men. ENFERMEDADES INFECCIOSAS Y MICROBIOLOGIA CLINICA (ENGLISH ED.) 2023; 41:248-250. [PMID: 36868981 DOI: 10.1016/j.eimce.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/07/2022] [Accepted: 06/12/2022] [Indexed: 03/05/2023]
Affiliation(s)
- Domingo Fernández Vecilla
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain.
| | - Kristina Zugazaga Inchaurza
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain.
| | - Itxaso Lombide Aguirre
- Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain; Servicio de Enfermedades Infecciosas, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain.
| | - José Luis Díaz de Tuesta Del Arco
- Servicio de Microbiología y Parasitología Clínica, Hospital Universitario de Basurto, Bilbao, Vizcaya, Spain; Instituto de Investigación Sanitaria Biocruces, Barakaldo, Vizcaya, Spain.
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Kocsis E, Díaz de Tuesta JL, Sánchez J, Santamaría R, Moragas M, Herrera-León S, Cisterna R. Cluster of cases due to Shigella flexneri producing CTX-M-15 in Spain. Acta Microbiol Immunol Hung 2022; 69:345-350. [PMID: 36454544 DOI: 10.1556/030.2022.01902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/15/2022] [Indexed: 12/03/2022]
Abstract
The aim of our study was to delineate an outbreak of gastroenteritis caused by Shigella flexneri and affecting sixteen persons between May and June 2014 in Bilbao, Spain. All patients exhibited symptoms after consuming kebab in the same kebab shop.The outbreak is described through the clinical cases, the microbiological and molecular genetic diagnosis, and the epidemiologic investigation. Minimum inhibitory concentrations for ampicillin, amoxicillin plus clavulanic acid, third and fourth generation cephalosporins, carbapenems, monobactams, aminoglycosides, fluoroquinolones, co-trimoxazole, colistin and tigecycline were measured. The S. flexneri strains were screened by PCR for TEM, SHV, CTX-M beta-lactamases and plasmidic AmpCs and aac(6')-Ib gene. Serotyping, pulsed field gel-electrophoresis, conjugation assay, plasmid sizing by S1 enzyme digestion and Southern blot hybridization were accomplished.All the S. flexneri isolates proved to be serotype 2 and produced extended-spectrum beta-lactamase (ESBL). Carbapenems, fluoroquinolones, tigecycline, colistin, and co-trimoxazole remained active antibiotics. All the strains harboured blaCTX-M-15 and blaOXA-1 genes. The strains hosted two high-molecular weight plasmids of 100 and 230 kb, respectively. According to the hybridization assay blaCTX-M-15 was located on the plasmid of 230 kb. The identical pulsotype verified the presence of outbreak.Remarkable, that one of the food handlers has travelled recently to Pakistan, where ESBL-producing Shigella strains had been reported previously. To the best of our knowledge, this is the first outbreak caused by CTX-M-15-expressing S. flexneri in Spain and as well as in Europe.
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Affiliation(s)
- Erika Kocsis
- 1Clinical Microbiology and Infection Control, Basurto University Hospital, Avenida Montevideo 18, 48013, Bilbao, Spain.,2Medical Mycology Laboratory, Department of Plant Production and Microbiology, Campus of Sant Joan d'Alacant, University Miguel Hernández, Ctra. Alicante-Valencia N 332, 03550, Alicante, Spain
| | - José Luis Díaz de Tuesta
- 1Clinical Microbiology and Infection Control, Basurto University Hospital, Avenida Montevideo 18, 48013, Bilbao, Spain
| | - Juan Sánchez
- 1Clinical Microbiology and Infection Control, Basurto University Hospital, Avenida Montevideo 18, 48013, Bilbao, Spain
| | - Rosaura Santamaría
- 3Unit of Epidemiology of Bizkaia, Public Health, Basque Government, Alameda de Rekalde 39 A, 48008, Bilbao, Spain
| | - Manuel Moragas
- 4Department of Health and Consumer Affairs, Council of Bilbao, Calle Ugalde 7, 48012, Bilbao, Spain
| | - Silvia Herrera-León
- 5Unit of Enterobacteria, National Centre of Microbiology, Instituto de Salud Carlos III, Carretera de Majadahonda a Pozuelo km 2, 28220, Majadahonda, Madrid, Spain
| | - Ramón Cisterna
- 1Clinical Microbiology and Infection Control, Basurto University Hospital, Avenida Montevideo 18, 48013, Bilbao, Spain
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Fernández Vecilla D, Zugazaga Inchaurza K, Lombide Aguirre I, Díaz de Tuesta del Arco JL. Caracterización fenotípica y genotípica de Shigella sonnei portadora de la betalactamasa de espectro extendido CTX-M-27. A propósito de dos casos en España en hombres que tienen sexo con hombres. Enferm Infecc Microbiol Clin 2022. [DOI: 10.1016/j.eimc.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rosales-Castillo A, Pedrosa-Corral I, Gutiérrez-Fernández J. A propos of a new case of shigellosis by a non-imported multiresistant strain. REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 2020; 112:244. [PMID: 31960688 DOI: 10.17235/reed.2020.6399/2019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We present the case corresponding to a shigellosis produced by multiresistant S. flexneri in a patient with no recent history of tourism or travel to exotic countries. This case exposes the need to know the distribution of resistant strains, and their emergence not imported in our environment, in the face of choosing the most appropriate type of antibiotic, when appropriate.
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Commensal Escherichia coli are a reservoir for the transfer of XDR plasmids into epidemic fluoroquinolone-resistant Shigella sonnei. Nat Microbiol 2020; 5:256-264. [PMID: 31959970 PMCID: PMC6992430 DOI: 10.1038/s41564-019-0645-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/22/2019] [Indexed: 11/29/2022]
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González Donapetry P, Pescador Martín P, Gómez-Gil Mira R, Ruiz Carrascoso G. Imported infection by CTX-M-15 extended-spectrum beta-lactamase-producing Shigella sonnei. Enferm Infecc Microbiol Clin 2019; 37:141. [PMID: 29691072 DOI: 10.1016/j.eimc.2018.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 02/26/2018] [Accepted: 03/02/2018] [Indexed: 10/27/2022]
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Qian H, Liu G, Chen Y, Ma P, Kong X, Zhou L, Hong J, Bao C, Gu B. Increasing clinical resistance rate of Shigella sonnei to cefotaxime in Jiangsu Province, China, between 2012 and 2015. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:207. [PMID: 30023370 DOI: 10.21037/atm.2018.05.43] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background The objective of this study is to evaluate the prevalence of Shigella sonnei (S. sonnei) and characterize the mechanism of its increasing resistance to cefotaxime, a third-generation cephalosporin agent between 2012 and 2015. Methods We investigated the drug resistance in 95 isolates of S. sonnei by K-B dilution method and isolates with the extended-spectrum beta-lactamases (ESBLs)-producing genes were detected by polymerase chain reaction (PCR) and sequencing. Results Over a 4-year period, the resistance rate of S. sonnei to cefotaxime increased from 31.6% to 64.3%, between 2012 and 2015. Molecular characterization of the ESBL genes, comprising 28 strains of CTX-M-1 group: blaCTX-M-55 (n=22), blaCTX-M-3 (n=3) and blaCTX-M-15 (n=3); 11 strains of CTX-M-9 group: blaCTX-M-14 (n=9) and blaCTX-M-65 (n=2), and 36 strains with blaTEM-1 gene. None of S. sonnei isolates carried blaCTX-M-2 group and SHV-type. Conclusions The antimicrobial resistance rate of S. sonnei to cefotaxime significantly increased. Accordingly, regular surveillance of the cephalosporin-resistant S. sonnei should be emphasized. Moreover, exploration of the mechanism underlying the resistance of S. sonnei to cefotaxime contributes to the prophylaxis of further emergence of drug resistance.
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Affiliation(s)
- Huimin Qian
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Guoye Liu
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China
| | - Yin Chen
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China
| | - Ping Ma
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China.,Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Xiaoxiao Kong
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Lu Zhou
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Jie Hong
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Changjun Bao
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Bing Gu
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China.,Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
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González-Torralba A, García-Esteban C, Alós JI. Enteropathogens and antibiotics. Enferm Infecc Microbiol Clin 2015; 36:47-54. [PMID: 26277207 DOI: 10.1016/j.eimc.2015.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Revised: 06/25/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Abstract
Infectious gastroenteritis remains a public health problem. The most severe cases are of bacterial origin. In Spain, Campylobacter and Salmonella are the most prevalent bacterial genus, while Yersinia and Shigella are much less frequent. Most cases are usually self-limiting and antibiotic therapy is not generally indicated, unless patients have risk factors for severe infection and shigellosis. Ciprofloxacin, third generation cephalosporins, azithromycin, ampicillin, cotrimoxazole and doxycycline are the most recommended drugs. The susceptibility pattern of the different bacteria determines the choice of the most appropriate treatment. The aim of this review is to analyse the current situation, developments, and evolution of resistance and multidrug resistance in these 4 enteric pathogens.
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Affiliation(s)
- Ana González-Torralba
- Servicio de Microbiología, Hospital Universitario de Getafe, Getafe, Madrid, España; Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España
| | - Coral García-Esteban
- Servicio de Microbiología, Hospital Universitario de Getafe, Getafe, Madrid, España
| | - Juan-Ignacio Alós
- Servicio de Microbiología, Hospital Universitario de Getafe, Getafe, Madrid, España; Facultad de Ciencias Biomédicas, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, España.
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Zong Z, Ginn AN, Dobiasova H, Iredell JR, Partridge SR. Different IncI1 plasmids from Escherichia coli carry ISEcp1-blaCTX-M-15 associated with different Tn2-derived elements. Plasmid 2015; 80:118-26. [PMID: 25929173 DOI: 10.1016/j.plasmid.2015.04.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Revised: 04/20/2015] [Accepted: 04/22/2015] [Indexed: 02/05/2023]
Abstract
The bla(CTX-M-15) gene, encoding the globally dominant CTX-M-15 extended-spectrum β-lactamase, has generally been found in a 2.971-kb ISEcp1-bla(CTX-M-15)-orf477Δ transposition unit, with ISEcp1 providing a promoter. In available IncF plasmid sequences from Escherichia coli, this transposition unit interrupts a truncated copy of transposon Tn2 that lies within larger multiresistance regions. In E. coli, bla(CTX-M-15) is also commonly associated with IncI1 plasmids and here three such plasmids from E. coli clinical isolates from western Sydney 2006-2007 have been sequenced. The plasmid backbones are organised similarly to those of other IncI1 plasmids, but have insertions and/or deletions and sequence differences. Each plasmid also has a different insertion carrying bla(CTX-M-15). pJIE113 (IncI1 sequence type ST31) is almost identical to plasmids isolated from the 2011 E. coli O104:H4 outbreak in Europe, where the typical bla(CTX-M-15) transposition unit interrupts a complete Tn2 inserted directly in the plasmid backbone. In the novel plasmid pJIE139 (ST88), ISEcp1-blaC(TX-M-15)-orf477Δ lies within a Tn2/3 hybrid transposon. Homologous recombination could explain movement of ISEcp1-bla(CTX-M-15)-orf477Δ between copies of Tn2 on IncF and IncI1 plasmids and generation of the Tn2/3 hybrid. pJIE174 (ST37) is almost identical to pESBL-12 from the Netherlands and in these plasmids bla(CTX-M-15) is flanked by two copies of IS26 that truncate the transposition unit within a larger region bounded by the ends of Tn2. bla(CTX-M-15) and the associated ISEcp1-derived promoter may be able to move from this structure by the actions of IS26, independently of both ISEcp1 and Tn2.
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Affiliation(s)
- Zhiyong Zong
- Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, The University of Sydney and Westmead Hospital, Westmead, NSW 2145, Australia; Department of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, China
| | - Andrew N Ginn
- Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, The University of Sydney and Westmead Hospital, Westmead, NSW 2145, Australia
| | - Hana Dobiasova
- Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, The University of Sydney and Westmead Hospital, Westmead, NSW 2145, Australia; Department of Biology and Wildlife Diseases, Faculty of Veterinary Hygiene and Ecology, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic; CEITEC VFU, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Jonathan R Iredell
- Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, The University of Sydney and Westmead Hospital, Westmead, NSW 2145, Australia
| | - Sally R Partridge
- Centre for Infectious Diseases and Microbiology, Westmead Millennium Institute, The University of Sydney and Westmead Hospital, Westmead, NSW 2145, Australia.
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Arvand M, Bettge-Weller G, Fruth A, Uphoff H, Pfeifer Y. Extended-spectrum beta-lactamase-producing Shiga toxin gene (stx1)-positive Escherichia coli O91:H14 carrying blaCTX-M-15 on an IncI1-ST31 plasmid isolated from a human patient in Germany. Int J Med Microbiol 2015; 305:404-7. [PMID: 25801683 DOI: 10.1016/j.ijmm.2015.03.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 03/02/2015] [Accepted: 03/03/2015] [Indexed: 12/15/2022] Open
Abstract
In 2011, the Shiga toxin- and extended-spectrum β-lactamase (ESBL)-producing Escherichia coli O104:H4 caused a serious outbreak of gastroenteritis in Germany. This strain carried bla(CTX-M-15) and bla(TEM-1) on an IncI1-ST31 plasmid. During screening of individuals at risk for acquisition of the epidemic E. coli O104:H4, we isolated another ESBL-producing and Shiga toxin-positive E. coli belonging to serotype O91:H14 from feces of a human patient. Interestingly, the patient also carried a further ESBL-producing but Shiga toxin-negative E. coli. Both strains harbored bla(CTX-M-15) and bla(TEM-1) on an IncI1-ST31 plasmid, which was indistinguishable regarding size and plasmid restriction pattern from the plasmid of the epidemic E. coli O104:H4 strain. The patient had traveled to India 6 months prior to the isolation of the E. coli strains. This is the first report of an ESBL-producing, Shiga toxin-positive E. coli of serogroup O91. Our data suggest a high propensity of the IncI1-ST31 plasmid to spread in the human and/or animal population.
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Affiliation(s)
- Mardjan Arvand
- Hesse State Health Office, Centre for Health Protection, Dillenburg, Germany.
| | | | - Angelika Fruth
- Robert Koch Institute, National Reference Centre for Salmonella and other Bacterial Enterics, Wernigerode, Germany
| | - Helmut Uphoff
- Hesse State Health Office, Centre for Health Protection, Dillenburg, Germany
| | - Yvonne Pfeifer
- Robert Koch Institute, FG13 Nosocomial Pathogens and Antibiotic Resistance, Wernigerode, Germany
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