blaCTX-M-15 carried by IncF-type plasmids is the dominant ESBL gene in Escherichia coli and Klebsiella pneumoniae at a hospital in Ghana

Alex Agyekum; Alicia Fajardo-Lubián; Daniel Ansong; Sally R Partridge; Tsiri Agbenyega; Jonathan R Iredell

doi:10.1016/j.diagmicrobio.2015.12.010

blaCTX-M-15 carried by IncF-type plasmids is the dominant ESBL gene in Escherichia coli and Klebsiella pneumoniae at a hospital in Ghana

Diagn Microbiol Infect Dis. 2016 Apr;84(4):328-33. doi: 10.1016/j.diagmicrobio.2015.12.010. Epub 2015 Dec 17.

Authors

Alex Agyekum¹, Alicia Fajardo-Lubián², Daniel Ansong³, Sally R Partridge², Tsiri Agbenyega³, Jonathan R Iredell⁴

Affiliations

¹ Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia; Malaria Research Centre, Agogo Presbyterian Hospital, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
² Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia.
³ Malaria Research Centre, Agogo Presbyterian Hospital, Komfo Anokye Teaching Hospital, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
⁴ Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, The University of Sydney, Westmead Hospital, Westmead, NSW, Australia. Electronic address: jonathan.iredell@sydney.edu.au.

PMID: 26830052
DOI: 10.1016/j.diagmicrobio.2015.12.010

Abstract

Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases (ESBLs) are among the most multidrug-resistant pathogens in hospitals and are spreading worldwide. Horizontal gene transfer and spread of high-risk clones are involved in ESBL dissemination. Investigation of the resistance phenotypes of 101 consecutive clinical E. coli (n=58) and K. pneumoniae (n=43) isolated at the Komfo Anokye Teaching Hospital in Ghana over 3 months revealed 63 (62%) with an ESBL phenotype. All 63 had a blaCTX-M gene, and sequence analysis showed that 62 of these were blaCTX-M-15. blaCTX-M-15 was linked to ISEcp1 and orf477Δ in all isolates, and most isolates also carried blaTEM, aac(3)-II, aacA4cr, and/or blaOXA-30 genes on IncF plasmids. XbaI/pulsed-field electrophoresis showed heterogeneity among isolates of both species, suggesting that blaCTX-M-15 dissemination is caused by horizontal gene transfer rather than clonal spread of these species in Ghana.

Keywords: Antibiotic resistance; CTX-M enzymes; ESBLs; Enterobacteriaceae; Ghana; PFGE.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Electrophoresis, Gel, Pulsed-Field
Escherichia coli / classification
Escherichia coli / enzymology*
Escherichia coli / genetics
Escherichia coli / isolation & purification
Escherichia coli Infections / microbiology*
Gene Transfer, Horizontal
Genes, Bacterial
Genetic Variation
Ghana
Hospitals
Humans
Klebsiella Infections / microbiology*
Klebsiella pneumoniae / classification
Klebsiella pneumoniae / enzymology*
Klebsiella pneumoniae / genetics
Klebsiella pneumoniae / isolation & purification
Molecular Typing
Plasmids / classification
Plasmids / isolation & purification*
Sequence Analysis, DNA
beta-Lactamases / genetics*

Substances

beta-lactamase CTX-M-15
beta-Lactamases