HIGHER CTX-M, TEM, AND SHV EXTENDED-SPECTRUM BETA-LACTAMASE PLASMID GENE COMBINATION FREQUENCY IN ESBL PRODUCING KLEBSIELLA PNEUMONIAE COMPARED WITH ESBL PRODUCING ESCHERICHIA COLI

Abstract

Introduction:Extended-spectrum beta-lactamase (ESBL) producing Enterobacteriaceae confer antibiotic resistance to broad-spectrum penicillins, cephalosporins, using ESBL genes CTX-M, TEM, SHV, which are encoded in bacterial plasmid genome. Methods: We compared plasmid CTX-M, TEM, and SHV ESBL gene combinations in ESBL producing Escherichia coliand Klebsiella pneumoniae. Altogether, 136 ESBL producing Enterobacteriaceae isolation cases were analyzed. Results:The ESBL producing Enterobacteriaceae, mostly K. pneumoniae (n = 66; 48.53%), E. coli (n = 36; 26.47%), were isolated from 52 (38.2%) female and 84 (61.8%) male patients from Riga East Clinical University Hospital. Overall,132 isolates (97.06%) registered positive for the plasmid CTX-M gene, 97 isolates (71.32%) for the plasmid TEM gene, and 87 isolates (63.97%) for the plasmid SHV gene.Patients with the three ESBL plasmid gene (CTX-M+ TEM+ SHV+) combination were significantly older (67.11 ± 14.16 years) than patients with other gene combinations (59.63 ± 18.14 years; p = 0.047). Plasmid SHV gene frequency was higher in K. pneumoniae (p < 0.001). The K. pneumoniae mostly presented with the three plasmid ESBL gene (CTX-M+ TEM+ SHV+) combination, whereas E. coli presented with other gene combinations (p = 0.014). Conclusions: Klebsiella Pneumoniae, more often, presented with the plasmid SHV ESBL gene and the three ESBL gene (CTX-M+ TEM+ SHV+) combination, compared to E. coli. Older patients with ESBL producing Enterobacteriaceae infection, more often, presented with the three ESBL gene (CTX-M+ TEM+ SHV+) combination, compared to younger patients with the infection.