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When Carbapenem-Hydrolyzing -Lactamase KPC Meets Escherichia coli ST131 in France

Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris-Sud, Université Paris XI, 94275 Le Kremlin-Bicêtre, France.
Antimicrobial Agents and Chemotherapy (Impact Factor: 4.48). 07/2011; 55(10):4933-4. DOI: 10.1128/AAC.00719-11
Source: PubMed

ABSTRACT

Carbapenem-resistance in E. coli isolates even though rare, can be attributed to outer-membrane protein deficiency coupled with plasmid-mediated ESBLs or class C ß-lactamases (2, 10, 11) or to carbapenemases.…

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    • "The KPC-2-containing isolate also produced TEM-1, CMY-2, and CTX-M-3/CTX-M-22 β-lactamases and was classified as MLST sequence type 410 (ST410). To date, KPC-producing E. coli has only been reported in Israel, the USA, China, Brazil, France, Greece, and Ireland [10,12,22,28-31], and two major sequence types containing KPC-carbapenemases have been reported. ST131 was reported in France [31], the USA [27], and Ireland [30]; ST410 was reported in Greece [10] and Israel [1] (ST471 in the Pasteur Institute typing system is the same as ST410 in the UCC typing system). "
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    ABSTRACT: The global spread and increasing incidence of carbapenem-resistant Enterobacteriaceae have resulted in treatment and public health concerns. Here, we present an investigation of the molecular mechanisms and clonality of carbapenem-non-susceptible Escherichia coli (CnSEC) based on a nationwide survey in Taiwan. We collected 32 and 43 carbapenem-non-susceptible E. coli isolates in 2010 and 2012, respectively. The genes encoding cabapenemases and plasmidic AmpC-type and extended-spectrum beta-lactamases (EBSLs) were analyzed by polymerase chain reaction (PCR). The major porin channels OmpF and OmpC were evaluated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Molecular typing was performed with pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST). The resistance rates of CnSEC isolates to cefazolin, cefotaxime, cefoxitin, ceftazidime, and ertapenem were all 100%, and most (94.7%) isolates were CMY producers. The main mechanism of CnSEC in Taiwan is via plasmidic AmpC beta-lactamase CMY-2 and DHA-1 in combination with the loss of OmpC/F. In 2010, one isolate was confirmed to harbor blaIMP-8; a KPC-2 producer and an NDM-1 producer were detected in 2012. No isolate had VIM- or OXA-carbapenemases. ST131 was the predominant ST type (33.3%). PFGE revealed no large cluster in CnSEC isolates in Taiwan. The co-existence of plasmidic AmpC beta-lactamase and outer membrane protein loss is the main mechanism for CnSEC in Taiwan. The emergence of KPC-2 and NDM-1 in 2012 and the predominance of ST131 warrant close monitoring and infection control.
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    • "The presence of the bla NDM-1 gene and other carbapenemhydrolyzing -lactamase genes, including bla KPC-2 [133], in a widely disseminated and virulent E. coli clone is of great concern to public health. In addition, novel NDM-1 variants with enhanced carbapenamase activity, such as NDM-4 and NDM-5, have been very recently identified in E. coli [134] [135], suggesting that these enzymes are continuously and rapidly evolving. "

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    • "The presence of the bla NDM-1 gene and other carbapenemhydrolyzing -lactamase genes, including bla KPC-2 [133], in a widely disseminated and virulent E. coli clone is of great concern to public health. In addition, novel NDM-1 variants with enhanced carbapenamase activity, such as NDM-4 and NDM-5, have been very recently identified in E. coli [134] [135], suggesting that these enzymes are continuously and rapidly evolving. "
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