Molecular Genetic Typing of Enterobacteriaceae Producing an Extended Spectrum Beta-Lactamase in Patients with Hemoblastoses
Abstract
The aim of this study was to determine the prevalent path of extended spectrum beta-lactamase (ESBL) producing Enterobacteriaceae transmission in hematological patients. Methods. Prospective study was performed from 2013 to 2015 and included cases of bacteremia caused by Enterobacteriaceae. Rectal swabs were taken within the first three days after positive blood culture. ESBL-production was confirmed by phenotypic tests. The genes of blaTEM, blaSHV and blaCTX-M were determined by PCR. Genotyping was performed by ERIC-PCR. Results. A total of 91 enterobacteria isolates (56% - E.coli, 26% - K.pneumoniae, 18% - other) derived from blood were obtained in 89 cases of bacteremia in 82 patients (median age - 50 years). Production of ESBL was found in 19 (21%) isolates (E.coli - n=11, K.pneumoniae n=8). Beta-lactamase CTX-M type was identified in 95% of isolates. Colonization of gut with the same species was detected in all 19 episodes of bacteremia caused by ESBL positive isolates and only in 8 (11%) of 72 episodes of bacteremia caused ESBL-negative isolates (P<0.0001). Genotyping of 19 ESBL producers from blood culture revealed a genetic identity of only two isolates of E.coli, taken from the same patient within two months. Genetically related isolates from blood and gut in the same patients were identified in 26% of the pairs. Conclusion. The endogenous path of infection caused by ESBL producing Enterobacteriaceae prevailed in patients with hematological malignancies.
About the Authors
A. G. Korobova
Hematology Research Center
Russian Federation
Russian Federation
S. A. Khrulnova
Hematology Research Center
Russian Federation
Russian Federation
V. A. Okhmat
Hematology Research Center
Russian Federation
Russian Federation
G. A. Klyasova
Hematology Research Center
Russian Federation
Russian Federation
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Review
For citations:
Korobova A.G., Khrulnova S.A., Okhmat V.A., Klyasova G.A. Molecular Genetic Typing of Enterobacteriaceae Producing an Extended Spectrum Beta-Lactamase in Patients with Hemoblastoses. Antibiot Khimioter = Antibiotics and Chemotherapy. 2017;62(5-6):26-34. (In Russ.)
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