Clinical features and molecular epidemiology of CMY-type β-lactamase-producing Escherichia coli

Hanna E. Sidjabat, David L. Paterson, Zubair A. Qureshi, Jennifer M. Adams-Haduch, Alexandra O'Keefe, Alvaro Pascual, Jesús Rodríguez-Bão, Yohei Doi

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42 Citations (Scopus)

Abstract

Background. Knowledge of the clinical features of infections caused by Escherichia coli strains that produce plasmid-mediated AmpC β-lactamase is limited. Of the several groups of plasmid-mediated AmpC β-lactamases, CMY-type β-lactamase is the most common in the United States. Methods. We prospectively identified patients infected or colonized with E. coli strains that produce CMY-type β-lactamase, and we collected clinical data over a 7-month period. A retrospective cohort study was performed to identify features associated with these cases. Patients with extended-spectrum β-lactamase-producing E. coli were used as a control group. Pulsed-field gel electrophoresis, plasmid analysis, and phylogenetic typing were performed. Results. Twenty-two patients with infection or colonization due to CMY-type β-lactamase-producing E. coli and 25 patients with infection or colonization due to extended-spectrum β-lactamase-producing E. coli were identified. The demographic characteristics of the patients were similar in both cohorts. Patients with CMY-type β-lactamase-producing E. coli were significantly more likely to have symptomatic infection than were patients with extended-spectrum β-lactamase-producing E. coli (P = .028). The CMY-type β-lactamase was identified as CMY-2 or its variants. Ninety-four percent of the CMY-type β-lactamase-producing isolates belonged to E. coli phylogenetic groups B2 and D, which are associated with virulence. Many of the isolates shared similar plasmid profiles, whereas the pulsed-field gel electrophoresis profiles were diverse. Co-resistance to non-β-lactam antimicrobials was common. Conclusion. In Pittsburgh, Pennsylvania, CMY-type β-lactamase-producing E. coli strains are almost as common as extended-spectrum β-lactamase-producing E. coli strains, and they cause symptomatic infection in the majority of cases.

Original languageEnglish
Pages (from-to)739-744
Number of pages6
JournalClinical Infectious Diseases
Volume48
Issue number6
DOIs
Publication statusPublished - 15-03-2009
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

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    Sidjabat, H. E., Paterson, D. L., Qureshi, Z. A., Adams-Haduch, J. M., O'Keefe, A., Pascual, A., Rodríguez-Bão, J., & Doi, Y. (2009). Clinical features and molecular epidemiology of CMY-type β-lactamase-producing Escherichia coli. Clinical Infectious Diseases, 48(6), 739-744. https://doi.org/10.1086/597037