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Woodford, N., Ward, M. E., Kaufmann, M. E., Turton, J., Fagan, E. J., James, D., Johnson, A. P., Pike, R., Warner, M., Cheasty, T., Pearson, A., Harry, S., Leach, J. B., Loughrey, A., Lowes, J. A., Warren, R. E. and Livermore, D. M. 
ORCID: https://orcid.org/0000-0002-9856-3703
(2004)
Community and hospital spread of Escherichia coli producing CTX-M extended-spectrum β-lactamases in the UK.
Journal of Antimicrobial Chemotherapy, 54 (4).
pp. 735-743.
ISSN 0305-7453
Abstract
Objectives: During 2003, the Health Protection Agency's Antibiotic Resistance Monitoring and Reference Laboratory began to receive isolates of Escherichia coli for confirmation of extended-spectrum ß-lactamase production with a phenotype implying a CTX-M-type ß-lactamase, i.e. MICs of cefotaxime =8-fold higher than MICs of ceftazidime. Many were referred as being from community patients. We examined 291 CTX-M-producing isolates from the UK and investigated the genetic basis of their phenotype. Methods: PCR was used to detect alleles encoding CTX-M enzymes and to assign these to their blaCTX-M phylogenetic groups. Selected alleles were sequenced. Producers were compared by analysis of banding patterns generated by pulsed-field gel electrophoresis of XbaI-digested genomic DNA. MICs were determined by an agar dilution method or by Etest. Results: Of 291 CTX-M-producing E. coli isolates studied from 42 UK centres, 70 (24%) were reportedly from community patients, many of whom had only limited recent hospital contact. Community isolates were referred by 12 centres. Two hundred and seventy-nine (95.9%) producers contained genes encoding group 1 CTX-M enzymes and 12 contained blaCTX-M-9-like alleles. An epidemic CTX-M-15-producing strain was identified, with 110 community and inpatient isolates referred from six centres. Representatives of four other major strains also produced CTX-M-15, as did several sporadic isolates examined. Most producers were multi-resistant to fluoroquinolones, trimethoprim, tetracycline and aminoglycosides as well as to non-carbapenem ß-lactams. Conclusions: CTX-M-producing E. coli are a rapidly developing problem in the UK, with CTX-M-15 particularly common. The diversity of producers and geographical scatter of referring laboratories indicates wide dissemination of blaCTX-M genes. Because of the public health implications, including for the treatment of community-acquired urinary tract infections, the spread of these strains—and CTX-M-15 ß-lactamase in particular—merits close monitoring.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | sdg 3 - good health and well-being ,/dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Groups > Epidemiology and Public Health Faculty of Medicine and Health Sciences > Research Groups > Public Health and Health Services Research (former - to 2023) |
| Depositing User: | Rhiannon Harvey |
| Date Deposited: | 12 Jul 2011 10:06 |
| Last Modified: | 12 Mar 2024 17:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/33526 |
| DOI: | 10.1093/jac/dkh424 |
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