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BMC Microbiol. 2015 Feb 4;15:15. doi: 10.1186/s12866-015-0348-1.

Dissemination of IncF-type plasmids in multiresistant CTX-M-15-producing Enterobacteriaceae isolates from surgical-site infections in Bangui, Central African Republic.

Author information

1
Institut Pasteur, Laboratory of Bacteriology, Avenue de l'Independance, BP 923, Bangui, Central African Republic. clotairerafai@yahoo.fr.
2
Institut Pasteur, Laboratory of Bacteriology, Avenue de l'Independance, BP 923, Bangui, Central African Republic. thierryfrank@yahoo.fr.
3
Institut Pasteur, Unit of Epidemiology, Avenue de l'Independance, BP 923, Bangui, Central African Republic. amanirak@yahoo.fr.
4
Complexe Pédiatrique, Department of Paediatric Surgery, Avenue de l'Independance, Bangui, Central African Republic. agaudeuille2@yahoo.fr.
5
Institut Pasteur, Laboratory of Bacteriology, Avenue de l'Independance, BP 923, Bangui, Central African Republic. mbecko2003@yahoo.fr.
6
Hôpital de l'Amitié, Department of General Surgery, Avenue de l'Independance, Bangui, Central African Republic. lucnghario@yahoo.fr.
7
Hôpital de l'Amitié, Department of Gynaecology and Obstetrics, Avenue de l'Independance, Bangui, Central African Republic. serdouma@yahoo.fr.
8
Hôpital Communautaire, Department of Orthopaedic Surgery, Avenue des Martyrs, Bangui, Central African Republic. tekpabertrand@yahoo.fr.
9
Institut Pasteur, Laboratory of Bacteriology, BP 1274, Antananarivo, Madagascar. benoitgarin@gmail.com.
10
Institut Pasteur, Laboratory of Bacteriology, Avenue de l'Independance, BP 923, Bangui, Central African Republic. sbreurec@gmail.com.
11
University of Antilles, Faculty of Medecine, Pointe-à-Pitre, French West Indies. sbreurec@gmail.com.

Abstract

BACKGROUND:

Surgical-site infection is the most frequent health care-associated infection in the developing world, with a strikingly higher prevalence than in developed countries We studied the prevalence of resistance to antibiotics in Enterobacteriaceae isolates from surgical-site infections collected in three major tertiary care centres in Bangui, Central African Republic. We also studied the genetic basis for antibiotic resistance and the genetic background of third-generation cephalosporin-resistant (3GC-R) Enterobacteriaceae.

RESULTS:

Between April 2011 and April 2012, 195 patients with nosocomial surgical-site infections were consecutively recruited into the study at five surgical departments in three major tertiary care centres. Of the 165 bacterial isolates collected, most were Enterobacteriaceae (102/165, 61.8%). Of these, 65/102 (63.7%) were 3GC-R, which were characterized for resistance gene determinants and genetic background. The bla CTX-M-15 and aac(6')-Ib-cr genes were detected in all strains, usually associated with qnr genes (98.5%). Escherichia coli, the most commonly recovered species (33/65, 50.8%), occurred in six different sequence types, including the pandemic B2-O25b-ST131 group (12/33, 36.4%). Resistance transfer was studied in one representative strain of the resistance gene content in each repetitive extragenic palindromic and enterobacterial repetitive intergenic consensus sequence-PCR banding pattern. Plasmids were characterized by PCR-based replicon typing and sub-typing schemes. In most isolates (18/27, 66.7%), bla CTX-M-15 genes were found in incompatibility groups F/F31:A4:B1 and F/F36:A4:B1 conjugative plasmids. Horizontal transfer of both plasmids is probably an important mechanism for the spread of bla CTX-M-15 among Enterobacteriaceae species and hospitals. The presence of sets of antibiotic resistance genes in these two plasmids indicates their capacity for gene rearrangement and their evolution into new variants.

CONCLUSIONS:

Diverse modes are involved in transmission of resistance, plasmid dissemination probably playing a major role.

PMID:
25648151
PMCID:
PMC4326526
DOI:
10.1186/s12866-015-0348-1
[Indexed for MEDLINE]
Free PMC Article

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