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Journal of Clinical Microbiology, November 2006, p. 4049-4056, Vol. 44, No. 11
0095-1137/06/$08.00+0     doi:10.1128/JCM.01076-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Emergence and Outbreaks of CTX-M ß-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Strains in a Tunisian Hospital

Laboratoire Résistance aux Antibiotiques, Département de Microbiologie, Faculté de Medecine, Tunis, Tunisia,¹ Laboratoire de Microbiologie, Hôpital Charles Nicolle, Boulevard du 9 Avril, 1006 Tunis, Tunisia,² Laboratoire de Bactériologie, UPRES EA 2392, Faculté de Médecine Pierre et Marie Curie, Université Paris VI, 27 rue de Chaligny, 75012 Paris, France,³ Service de Bactériologie-Hygiène, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, 4 rue de la Chine, 75970 Paris Cedex 20, France,⁴ Service de Microbiologie, Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris, Bobigny, France⁵

Received 24 May 2006/ Returned for modification 10 July 2006/ Accepted 23 August 2006

Sixty-two isolates of Enterobacteriaceae (35 Escherichia coli and 27 Klebsiella pneumoniae isolates) producing CTX-M-type ß-lactamases were collected between March 2000 and June 2003 in different wards of Charles Nicolle Hospital in Tunis (Tunisia). Sequencing identified the bla_CTX-M-15 determinant in 55 isolates and bla_CTX-M-16 in 7 isolates. The CTX-M-15-producing strains were isolated in several wards and consisted mainly of two successive clonal groups of E. coli and a major clonal group of K. pneumoniae. The second clonal group of E. coli belonged to phylogenetic group B2 and harbored more virulence factors than the first clonal group. Among the 22 transconjugants or electroporants obtained with selected E. coli and K. pneumoniae CTX-M-15-producing strains, a predominant plasmid restriction pattern was obtained with 17 isolates. The four CTX-M-16-producing strains of E. coli yielded the same pulsed-field gel electrophoresis (PFGE) pattern, while the three CTX-M-16-producing strains of K. pneumoniae yielded two different PFGE patterns. All of the CTX-M-16-producing isolates were recovered in the pediatric ward and had the same plasmid restriction pattern.

Published ahead of print on 6 September 2006.

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