Escherichia coli producing SHV-type extended-spectrum  -lactamase is a significant cause of community-acquired infection

• Published in: Journal of antimicrobial chemotherapy 2009-04, Vol.63 (4), p.781-784
• Main Authors: Rodriguez-Bano, J., Alcala, J., Cisneros, J. M., Grill, F., Oliver, A., Horcajada, J. P., Tortola, T., Mirelis, B., Navarro, G., Cuenca, M., Esteve, M., Pena, C., Llanos, A. C., Canton, R., Pascual, A.
• Format: Article
• Language: English
• Subjects: Drug resistance; E coli; Epidemiology; Infections
• ISSN: 0305-7453; 1460-2091
• DOI: 10.1093/jac/dkp028

Objectives Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli (ESBLEC) is an increasingly significant cause of community-acquired infection worldwide. The epidemiological features of CTX-M- and SHV-producing ESBLEC causing community-acquired infections are compared. Methods A multicentre cohort study including all community-acquired infections caused by ESBLEC in four geographical areas of Spain was carried out. ESBL characterization was by isoelectric focusing, PCR and sequencing. Demographics, previous healthcare contact, co-morbidity, use of antimicrobials, invasive procedures and type of infection were collected for all patients. Patients with CTX-M- and SHV-producing isolates were compared using logistic regression. Results One hundred and twenty-two cases (95% urinary tract infections) were included. ESBLs were characterized in 112 isolates; 77 isolates (69%) produced CTX-M, 36 (32%) produced SHV and 7 (6%) produced TEM enzymes (8 produced >1 ESBL). Patients with isolates producing CTX-M enzymes only (CTX-M group, n = 70) and SHV enzymes only (SHV group, n = 31) were compared. There were no differences in terms of underlying disease, previous healthcare contact, invasive procedures, antibiotic use or type of infection. Multivariate analysis including geographical area showed that a Charlson Index score of >2 (OR = 4.0; 95% CI = 1.2-12.6) was associated with SHV isolates, while age >60 (4.7; 1.7-12.5) was associated with CTX-M isolates. Conclusions SHV-producing ESBLEC is a significant cause of community-acquired infection in Spain; the clinical epidemiology of such isolates seems very similar to that of CTX-M-producing E . coli . [PUBLICATION ABSTRACT]