CTX-M-2 and a New CTX-M-39 Enzyme Are the Major Extended-Spectrum Beta-Lactamases in Multiple Escherichia coli Clones Isolated in Tel Aviv, Israel

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Abstract
The rate of occurrence of the extended-spectrum beta-lactamase (ESBL)-producing phenotype among Escherichia coli isolates in Tel Aviv is 12% (22). The aim of this study was to understand the molecular epidemiology of E. coli ESBL producers and to identify the ESBL genes carried by them. We studied 20 single-patient ESBL-producing E. coli clinical isolates. They comprised 11 distinct nonrelated pulsed-field gel electrophoresis (PFGE) genotypes: six isolates belonged to the same PFGE clone, four other clones included two isolates each, and six unrelated clones included only one isolate. All isolates produced various beta-lactamases with pIs ranging from 5.2 to 8.2, varying within similar PFGE clones. The most prevalent ESBL gene was bla CTX-M ; 16 isolates carried bla CTX-M-2 and three carried a new ESBL gene designated bla CTX-M-39 . Three strains carried bla SHV (two bla SHV-12 and one bla SHV-5 ), and two strains carried inhibitor-resistant ESBL genes, bla TEM-33 and bla TEM-30 ; 18 strains carried bla TEM-1 and eight strains carried bla OXA-2 . Plasmid mapping and Southern blot analysis with a CTX-M-2 probe demonstrated that bla CTX-M-2 is plasmid borne. The wide dissemination of ESBLs among E. coli isolates in our institution is partly related to clonal spread, but more notably to various plasmid-associated ESBL genes, occurring in multiple clones, wherein the CTX-M gene family appears almost uniformly. We report here a new CTX-M gene, designated bla CTX-M-39 , which revealed 99% homology with bla CTX-M-26 , with a substitution of arginine for glutamine at position 225.

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