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  • Title: Escherichia coli producing SHV-type extended-spectrum beta-lactamase is a significant cause of community-acquired infection.
    Author: Rodríguez-Baño J, Alcalá J, Cisneros JM, Grill F, Oliver A, Horcajada JP, Tórtola T, Mirelis B, Navarro G, Cuenca M, Esteve M, Peña C, Llanos AC, Cantón R, Pascual A.
    Journal: J Antimicrob Chemother; 2009 Apr; 63(4):781-4. PubMed ID: 19223299.
    Abstract:
    OBJECTIVES: Extended-spectrum beta-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.
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