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Extended-spectrum beta-lactamases and plasmid diversity in urinary isolates of Escherichia coli in Croatia: a nation-wide, multicentric, retrospective study

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Abstract

In recent years, a dramatic increase in the prevalence of Escherichia coli strains producing extended-spectrum β-lactamases (ESBLs) has been observed — both in the community and in healthcare settings. This multicentric study aimed to characterize ESBLs produced by E. coli isolates causing hospital-onset and community urinary tract infections, as well as to compare their antimicrobial sensitivity patterns, β-lactamase content and plasmid types. Phenotypic tests for the detection of ESBLs and plasmid-mediated AmpC β-lactamases were initially pursued, followed by molecular detection of resistance genes, plasmid characterization, genotyping with pulsed-field gel electrophoresis and whole genome sequencing (WGS). The isolates exhibited high level of resistance to expanded-spectrum cephalosporins (ESC) and carried CTX-M (cefotaximase-Munich) or TEM (Temoniera) β-lactamases. All six representative isolates subjected to WGS belonged to the widespread clone ST131. In conclusion, our study demonstrated dissemination of group 1 CTX-M positive E. coli in different geographic regions of Croatia, but also different components of the health care systems (hospitals, nursing homes and the community) and confirmed the switch from SHV-2 (suphydril variant) and SHV-5 ESBLs to the nation-wide predominance of group 1 CTX-M β-lactamases. Different plasmids were shown to be associated with the dissemination of blaCTX-M genes in different geographic regions of Croatia.

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Acknowledgements

We would like to thank Dr. Maja Anušić for technical assistance with serotyping.

Funding

This work was partly supported by Horizon 2020 project FAPIC (Fast Assay for Pathogen Identification and Characterization). Grant agreement ID: 634137 (funded under H2020-EU.3.1.3).

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Authors and Affiliations

  1. Public Health Institute of Dubrovnik-Neretva County, Dubrovnik, Croatia

    Marija Krilanović

  2. Public Health Institute of Brod-Posavina County, Slavonski Brod, Croatia

    Maja Tomić-Paradžik

  3. Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia

    Maja Tomić-Paradžik

  4. Polyclinic “Dr. Zora Profozić”, Zagreb, Croatia

    Tomislav Meštrović

  5. School of Medicine, University of Zagreb, Zagreb, Croatia

    Nataša Beader, Jasmina Vraneš, Vesna Elveđi-Gašparović & Branka Bedenić

  6. University Hospital Centre Zagreb, Zagreb, Croatia

    Nataša Beader, Zoran Herljević, Vesna Elveđi-Gašparović & Branka Bedenić

  7. Austrian Institute for Technology, Vienna, Austria

    Rick Conzemius & Ivan Barišić

  8. Teaching Institute of Public Health “Dr. Andrija Štampar”, Zagreb, Croatia

    Jasmina Vraneš

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  1. Marija Krilanović
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Krilanović, M., Tomić-Paradžik, M., Meštrović, T. et al. Extended-spectrum beta-lactamases and plasmid diversity in urinary isolates of Escherichia coli in Croatia: a nation-wide, multicentric, retrospective study. Folia Microbiol 65, 649–667 (2020). https://doi.org/10.1007/s12223-019-00769-1

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