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This study was supported by a grant from the Federation Ministry of Education and Science (No. 03-39-5980-58-1/08), Bosnia and Herzegovina.

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High prevalence of CTX-M-15 and first report of CTX-M-3, CTX-M-22, CTX-M-28 and plasmid-mediated AmpC beta-lactamase producing Enterobacteriaceae causing urinary tract infections in Bosnia and Herzegovina in hospital and community settings

Publicated to:Journal Of Infection And Chemotherapy. 21 (5-6): 363-369 - 2015-01-01 21(5-6), DOI: 10.1016/j.jiac.2015.01.003

Authors: Ibrahimagic, Amir; Bedenic, Branka; Kamberovic, Farah; Uzunovic, Selma;

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Abstract

Aim: To investigate molecular epidemiology of extended-spectrum beta-lactamase/ESBL and plasmid-mediated AmpC beta-lactamase/pAmpC producing Gram-negative bacteria causing urinary tract infections (UTIs) in Zenica-Doboj Canton, Bosnia and Herzegovina, in the period Decembar 2009 May 2010. Methods: Antibiotic susceptibility was determined by disc diffusion and broth microdilution according to CLSI guidelines. Double-disk synergy test was performed in order to screen for ESBLs/pAmpC beta-lactamases. PCR was used to detect bla(ESBL)/bla(ampC)/bla(carb) genes. Genetic relatedness of the strains was determined by pulsed-field-gel-electrophoresis (PFGE). Results: Among 85 patients with UT's caused by ESBL producing isolates, 44 (51.8%) were from inpatients and 41 (48.2%) from outpatients. Klebsiella spp. was the most frequently isolated from inpatients, in 28 (63.6%) cases. Among outpatients, Klebsiella spp./Escherichia coli were the most frequently isolated, in 19 (46.3%)/16 (39.0%) cases. Twenty-one (75.0%) from hospital and nine (47.4%) from outpatient Klebsiella spp. isolates were positive for bla(TEM), whereas 27 (96.4%) from in-patients and 6 (31.6%) from outpatient were bla(CTX-M) positive (18 hospital and five outpatient isolates were encoding bla(CTX-M-15)). One Klebsiella oxytoca and one Enterobacter cloacae inpatient isolates were positive for bla(CTX-M-28). One Klebsiella pneumoniae outpatient isolate were positive for bla(CTX-M-22) and one E. coli for bla(CTX-M-3). One hospital Proteus mirabilis strain was positive for bla(CMY-2) and two Klebsiella spp. strains for bla(DHA-1), whereas two E. coil, one K. oxytoca and one Proteus vulgaris outpatient strains were positive for bla(CMY-2). Conclusion: Identification of bla(CTX-M-3), bla(CTX-M-22) and bla(CTX-M-28) among Enterobacteriaceae is uncommon. In this study we report the emergency of CMY-2 and DHA-1 plasmid-mediated beta-lactamases. (C) 2015, Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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