Sub-typing of extended-spectrum-β-lactamase-producing isolates from a nosocomial outbreak: application of a 10-loci generic Escherichia coli multi-locus variable number tandem repeat analysis

PLoS One. 2013 Dec 31;8(12):e83030. doi: 10.1371/journal.pone.0083030. eCollection 2013.

Abstract

Extended-spectrum β-lactamase producing Escherichia coli (ESBL-E. coli) were isolated from infants hospitalized in a neonatal, post-surgery ward during a four-month-long nosocomial outbreak and six-month follow-up period. A multi-locus variable number tandem repeat analysis (MLVA), using 10 loci (GECM-10), for 'generic' (i.e., non-STEC) E. coli was applied for sub-species-level (i.e., sub-typing) delineation and characterization of the bacterial isolates. Ten distinct GECM-10 types were detected among 50 isolates, correlating with the types defined by pulsed-field gel electrophoresis (PFGE), which is recognized to be the 'gold-standard' method for clinical epidemiological analyses. Multi-locus sequence typing (MLST), multiplex PCR genotyping of bla CTX-M, bla TEM, bla OXA and bla SHV genes and antibiotic resistance profiling, as well as a PCR assay specific for detecting isolates of the pandemic O25b-ST131 strain, further characterized the outbreak isolates. Two clusters of isolates with distinct GECM-10 types (G06-04 and G07-02), corresponding to two major PFGE types and the MLST-based sequence types (STs) 131 and 1444, respectively, were confirmed to be responsible for the outbreak. The application of GECM-10 sub-typing provided reliable, rapid and cost-effective epidemiological characterizations of the ESBL-producing isolates from a nosocomial outbreak that correlated with and may be used to replace the laborious PFGE protocol for analyzing generic E. coli.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child, Preschool
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • DNA, Bacterial / genetics
  • Disease Outbreaks*
  • Drug Resistance, Bacterial / genetics
  • Electrophoresis, Gel, Pulsed-Field
  • Escherichia coli / classification
  • Escherichia coli / enzymology*
  • Escherichia coli / genetics*
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology
  • Humans
  • Infant
  • Infant, Newborn
  • Microbial Sensitivity Tests
  • Minisatellite Repeats*
  • Multilocus Sequence Typing
  • Sweden / epidemiology
  • beta-Lactamases / biosynthesis*

Substances

  • DNA, Bacterial
  • beta-Lactamases

Grants and funding

The study described in this manuscript was supported by funding from Västra Götaland Region projects: ALFGBG-11574; ALFGBG-210591; VGFOUREG-30781; VGFOUREG-157801; and from STRAMA (the Swedish Strategic Programme against Antibiotic Resistance). http://www.fou.nu/is/alfgbg/. http://www.fou.nu/is/vgregion. http://en.strama.se/dyn/,84,,.html. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.