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JAC Advance Access originally published online on May 2, 2008
Journal of Antimicrobial Chemotherapy 2008 62(2):284-288; doi:10.1093/jac/dkn181
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Turkey: a further country concerned by community-acquired Escherichia coli clone O25-ST131 producing CTX-M-15

Zeki Yumuk1, Gokhan Afacan2, Marie-Hélène Nicolas-Chanoine3, Albert Sotto4,* and Jean-Philippe Lavigne4,5

1 Department of Clinical Microbiology, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey 2 Clinical Microbiology Laboratory, Hifzissihha Institute, Izmir, Turkey 3 Institut National de la Santé et de la Recherche Médicale, U-773, Faculté de Médecine D. Diderot, Université Paris 7, Paris, France 4 Institut National de la Santé et de la Recherche Médicale, ESPRI 26, Université Montpellier 1, UFR de Médecine, Nîmes, France 5 Laboratoire de Bactériologie, Virologie, Parasitologie, CHU Carémeau, Nîmes, France

Received 7 January 2008; returned 8 February 2008; revised 29 March 2008; accepted 31 March 2008

* Corresponding author. Tel: +33-4-66-68-32-31; Fax: +33-4-66-68-38-24; E-mail: albert.sotto{at}chu-nimes.fr

Objectives: The aim of this study was to assess the frequency and diversity of extended-spectrum β-lactamases (ESBLs) produced by exclusively community-acquired Escherichia coli isolates in Izmir (Turkey) and to search for isolates producing CTX-M-15 and belonging to the pandemic clone E. coli O25-ST131.

Methods: The patients with E. coli urinary tract infections (UTIs) and no hospitalization in the last 12 months, and no transfer from hospital, no stay in nursing home and no antimicrobial treatment in the previous 3 months were prospectively included over a 1 year period. Those E. coli detected positive for ESBL were characterized and compared with a representative of E. coli clone O25-ST131 with regard to bla genes, antibiotic resistance, phylogenetic groups, PFGE profiles and virulence factor genes (n = 17). O serotyping, multilocus sequence typing (MLST) and AmpC typing were performed to confirm that the Turkish isolate belonged to the clone O25-ST131.

Results: Among the 3108 UTIs diagnosed, 82 (2.6%) were due to community E. coli isolates and followed the strict inclusion criteria. Seventeen of them (21%) produced an ESBL, of which CTX-M-15 was predominant (53%). These ESBL-positive isolates, distributed equally into three phylogenetic groups, displayed 13 PFGE profiles and three clusters. A Turkish CTX-M-15-producing isolate as a member of the clone ST131 was suggested by a high similarity of its PFGE profile to that of the clone representative and was confirmed by O serotyping, AmpC typing and MLST.

Conclusions: This study describes the community emergence of CTX-M-15-producing E. coli isolates, including an isolate of clone O25-ST131, in Turkey.

Keywords: enterobacteria , epidemiology , extended-spectrum β-lactamases


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