Research paperIdentification and molecular characterization of Escherichia coli blaSHV genes in a Chinese teaching hospital
Introduction
Enterobacteriaceae bacteria (Escherichia coli or Klebsiella pneumoniae, etc.) are the most common nosocomial pathogens in human being and can cause the purulent diseases, such as pneumonia, meningitis, bacteremia, or the urinary tract and intestinal infection, while others are the important pathogens in nosocomial infection (Abreu et al., 2011). For example, E. coli commonly reside peacefully in human intestine because most E. coli strains are harmless, but some serotypes cause serious food poisoning (Vogt and Dippold, 2005). Moreover, some non-virulent bacteria could obtain exgenous virulent genes and become pathogens to human beings. However, the resistant mechanism of Enterobacteriaceae bacteria is very complex and one of the main mechanism of drug resistance is their production of beta-lactamase, an enzyme to hydrolyze β-lactam antibiotics and lead to their deactivation (Jones and Wilson, 1982). Among the large family of the β-lactamases, the extended-spectrum β-lactamases (ESBLs), AmpC enzyme and carbapenemase are the most common and there are numerous variants existing in clinical isolates (Gutkind et al., 2013, Vasoo et al., 2015).
In recent decades, the global over- and misuse of antimicrobial agents has caused the rapid spread of multiple-risistance genes in Europe (Coque et al., 2008), Asia (Hawkey, 2008), and the USA (Bush, 2008). E. coli is an important cause of community- and health care-associated infection, and frequently associated with ESBL carriage (Vasoo et al., 2015). The ESBLs consist of three major genetic groups, including blaTEM, blaSHV and blaCTX-M types (Chong et al., 2011). In the 1990s, blaTEM or blaSHV type of the ESBLs was generally found in Klebsiella pneumonia (K. pneumonia) and most isolates were from nosocomial infection spread (Yano et al., 2013), although there were reports about E. coli and other bacteria (Yezli et al., 2015). Nevertheless, currently available data indicate that the main ESBL identified in E. coli was blaCTX-M (blaCTX-M-15 in particular). But in K. pneumoniae, the predominant β-lactamases are blaSHV (especially, blaSHV-12, blaSHV-5, and blaSHV-1), blaCTX-M (mainly blaCTX-M-15) and blaTEM (Yezli et al., 2015). In 1983, blaSHV-1 gene was first discovered on the chromosome of K. pneumoniae in Germany and considered as the ancestor of blaSHV-ESBLs (Bedenic et al., 2005). Antibiotics misuse in clinic and agriculture led rapid emergence of genotypes of blaSHV ESBLs due to point mutations to blaSHV variants (Gutkind et al., 2013). For example, E. coli strains isolated from clinical samples showed the characteristics of multidrug resistance and contained multiple antibiotics-resistant genes, especially those of β-lactamases, which are normally carried on the plasmids. The plasmid could transfer among the same and different species of bacteria to induce dissemination of drug resistance (Rice et al., 1990). The previous studies on β-lactamase genes have mainly focused on blaSHVs in K. pneumonia (Gutmann et al., 1989, Nuesch-Inderbinen et al., 1997) and blaSHV genes were globally disseminated by plasmids not only among genera of E. coli and K. pneumoniae, but also among other hospital-acquired or community infection microorganisms (Gutkind et al., 2013). Even though blaSHV-type ESBLs were originally found in K. pneumonia; thus, case reports and outbreaks involving different Enterobacteriaceae and non-fermenting gram negative bacilli producing blaSHV-ESBLs are well documented (Ben-Hamouda et al., 2004, Gundes et al., 2005, Mansour et al., 2009, Mazzariol et al., 2007, Naiemi et al., 2005, Palasubramaniam et al., 2009, Poirel et al., 2004).
One of the early reports of blaSHV-2 enzymes was from China (Cheng and Chen, 1994); however, before a study of blaCTX-M-13 and blaCTX-M-14 from Guangzhou, China was published, there were very few reports of ESBL genotypes from China (Hawkey, 2008). To date, the ESBLs-producing E. coli and K. pneumonia in China become serious and blaCTX-M ESBLs were among the most common genotypes (Gao et al., 2015, Liu et al., 2013a, Liu et al., 2009, Ma et al., 2012, Shi et al., 2015, Sun et al., 2010, Wang et al., 2003, Yu et al., 2007), but a few studies focused on blaSHV. Thus, in this study, we identified and molecularly characterized blaSHV genes in 490 E. coli strains isolated from a hospital in Wenzhou, China to access blaSHV genotypes and their dissemination in this hospital population.
Section snippets
Bacterial strains
In this study, we first isolated a total of 490 non-duplicate clinically significant E. coli strains from the First Affiliated Hospital of Wenzhou Medical University (Zhejiang, China) between 2009 and 2011. Among these 490 E. coli strains, 137 were isolated in 2009, 175 in 2010, and 178 in 2011. The strains were identified by the Vitek-60 microorganism auto-analysis system (BioMerieux Corporate, Lyon, France). Bacteria and plasmids used in this study were listed in Table 1.
Screening, sequence structure and phylogenetic analysis of the blaSHV genes
Genomic DNA was
Identification of blaSHV genes in multidrug-resistant E. coli strains and their antibiotic-resistant activities
Among these 490 clinical E. coli strains isolated from a Chinese hospital between 2009 and 2011, we only detected 0.8% (4/490) that harbored blaSHV genes (two isolated from urine samples in 2010 and the other two isolated from ascites and pus, respectively in 2011). The MICs of 13 antimicrobial agents tests against these four strains were shown in Table 2. In particular, EC D2485 and EC D2487 (both were isolated in 2010) and EC D2616 and EC D2684 (both were isolated in 2011) showed the similar
Discussion
In the current study, we screened and identified four different blaSHV genes from the 490 E. coli strains isolated from a teaching hospital in South China. Their resistance activities and molecular characteristics showed they were related but did have differences in resistance to different antibiotics. Our current data revealed a novel sub-genotype of blaSHV gene (blaSHV-195), and a clonal dissemination related blaSHV-5. It suggests that the novel blaSHV and clonal dissemination may be
Conflict of interest statement
The authors declared that there is no conflict of interest in this work.
Acknowledgements
This work was supported by the Natural Science Foundation of Zhejiang Province, China (LY14C060005); the Science and Technology Foundation of National Health and Family Planning Commission of China (WKJ2012-2-032); the Science and Technology Foundation of Zhejiang Province, China (2008C23074); the National Natural Science Foundation of China (81171614, 31100917, 81401702); Science and Technology Foundation of Wenling City, China (W201195, W201075, 2016C31BE0029).
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