Resumo: Dentre os agentes bacterianos amplamente distribuídos no ecossistema aquático, destacam-se as famílias Aeromonadaceae e Enterobactereaceae. Os peixes são importantes veículos de infecções humanas causadas por essas bactérias. Com este enfoque, o estudo foi realizado com o objetivo de verificar a ocorrência de Aeromonas sp., coliformes termotolerantes e bactérias heterotróficas mesófilas em pisciculturas da Região da Baixada Ocidental Maranhense. Para tal, foram selecionadas no período de outubro de 2008 a março de 2009, doze propriedades nos municípios de Pinheiro, Palmeirândia e Perimirim e colhidas amostras de água dos viveiros e peixes de cada piscicultura, totalizando 96 amostras. Em 100% das amostras analisadas foi confirmada a presença de Aeromonas sp., classificadas em quatro espécies, A. hydrophila (87,03%), A. caviae (8,02%), A. veronii sobria (3,70%), A. schubertii (1,23%). Essas ainda apresentaram elevados percentuais de resistência e multiresistência a 12 antimicrobianos testados. As populações de bactérias heterotróficas mesófilas nas pisciculturas variaram de 102 UFC/mL a 104 UFC/mL de água. Das pisciculturas avaliadas, sete apresentaram pelo menos uma amostra em desacordo com o padrão para coliformes termotolerantes. As amostras analisadas revelaram - se como possíveis vias de transmissão de aeromonas potencialmente patogênicas para peixes e ser humano, representando risco para a saúde da população consumidora dos organismos cultivados nessas propriedades / Abstract: Among widely distributed agents in the aquatic ecosystem can be outstanding the families Aeromonadaceae and Enterobacteriaceae. The fishs are very important vehicles of human infections caused for these bacteria. With the approach the study intended to verify the occurrence of Aeromonas sp., thermotolerant coliforms and heterotrophic mesophilic bacteria in fish farms located in Occidental Baixada Maranhense Region. Twelve properties in the Pinheiro, Palmeirândia and Perimirim' s cities were selected in the period from October of 2008 to March of 2009, and harvested water pond and fish samples of each fish farm, with the total of 96 samples. Aeromonas sp. was confirmed in 100% of samples, classified in four species, A. hydrophila (87,03%), A. caviae (8,02%), A. veronii sobria (3,70%), A.schubertii (1,23%). These bacteria showed high resistance and multiple resistance to the 12 antibiotics tested. The populations of heterotrophic mesophilic bacteria varied between 1,4 x 102 UFC/mL to 7,2 x 103 UFC/mL/. Seven fish farms showed at least one sample in disagreement with the standard to termotholerant coliforms. The samples of water and fish revealed the possible sources of potentially pathogenic contamination of aeromonas for fish and human being representing risk for health of the population healthy that consume the organisms cultivated in these properties / Orientador: Oswaldo Durival Rossi Junior / Coorientadora: Francisca Neide Costa / Banca: Henrique Cesar Pereira Figueiredo / Banca: Naiá Carla Marchi de Rezende Lago / Banca: Fabiana Pilarski / Banca: Luiz Augusto do Amaral / Doutor

Antibiotic resistance has emerged as one of the World's leading public health challenges. The inexorable emergence of drug resistant pathogens, combined with a steep decline in antibacterial drug discovery, has led to a major crisis. One of the most common drug resistance mechanisms involves bacteria adapting to reduce intracellular drug accumulation. To understand these resistance mechanisms, one needs quantitative information about the membrane permeability of drugs. In this Thesis, we develop a novel optofluidic permeability assay that allows us to quantify the permeability coefficient of drugs crossing lipid membranes. Lipid vesicles are used as model systems and drug molecules are tracked directly using their autofluorescence in the ultraviolet. The permeability coefficient of the drug is inferred by studying the increase in drug autofluorescence intensity within vesicles as they traverse a microfluidic network while exposed to the drug for well defined times. This provides a novel platform from which we can develop membrane models for understanding drug permeability. We incorporate the Escherichia coli outer membrane protein OmpF in vesicles and quantify its role in the transport of fluoroquinolone antibiotics. We provide direct visualisation of OmpF mediated fluoroquinolone transport. We study the pH dependence of antibiotic transport both through pure phospholipid membranes and through OmpF, and present a physical mechanism to explain the pH dependence of E. coli fluoroquinolone susceptibility. We also show the importance of lipid composition on drug permeability - changing the lipid composition of the membrane is shown to change antibiotic permeability by over an order of magnitude. Finally, we report on the discovery of a novel signalling mechanism in E. coli that relies on the transport of small drug-like molecules, and discuss the role it plays in stress response in the microbial community.

Submitted by Celso Magalhaes (celsomagalhaes@ufrrj.br) on 2017-07-26T14:34:03Z No. of bitstreams: 1 2012 - Elaine Concei??o Liporage de Mendon?a.pdf: 3515906 bytes, checksum: ebf489151f2cd6961ddeeb292cd910a7 (MD5) / Made available in DSpace on 2017-07-26T14:34:03Z (GMT). No. of bitstreams: 1 2012 - Elaine Concei??o Liporage de Mendon?a.pdf: 3515906 bytes, checksum: ebf489151f2cd6961ddeeb292cd910a7 (MD5) Previous issue date: 2012-03-16 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / The use of antibiotic in the control of intramammary infections and in the elimination of its possible sources in dairy farms is an important control measure. However, the inappropriate use of antibiotics can result in the appearance of resistant strains and compromise the efficiency of the treatment. Besides Staphylococcus spp. are among the main pathogens of bovine mastitis, they are often resistant to antibiotics, especially beta-lactamics, mainly by two distinct mechanisms: the production of extracellular enzyme beta-lactamase, encoded by the blaZ gene, and production of PBP2a or PBP2 ' a penicillin-binding protein with low affinity, encoded by the mecA gene. The expression of mecA gene is constitutive or induced by beta-lactamic antibiotics, such as oxacillin and cefoxitin. The mecA gene is inserted into the chromosome through a staphylococcal mobile genetic element, called staphylococcal cassette chromosome mec (SCCmec). The present study evaluated the phenogenotypical resistance profile to betalactam antibiotics of 250 Staphylococcus spp. isolates, using oxacillin and cefoxitin as markers in order to produce data to the knowledge of resistance in dairy farms located in the South-Fluminense and the Metropolitan regions of the State of Rio de Janeiro to support the implementation of measures to control this disease. The assessment of resistance was made through 8 different phenotypic tests and yielded 54 profiles. Disk diffusion and agar screen with oxacillin were used as "gold standard" for the calculation of sensitivity, specificity and prediction once they are recommended by the CLSI veterinarian as standardized tests. Disk diffusion with cefoxitin achieved the best performance in the prediction of oxacillin resistance. Genotypic detection of mecA do not provided any positive isolate, otherwise mecI and mecRI genes were also detected in 11.6% (29/250) of the studied Staphylococcus spp. Four cassette mec types were detected (I, II, III and IV), being type I the most disseminated one. Gene blaZ was detected in 5.2% (13/250) isolates. From these 13 blaZ positive isolates, the whole system comprising blaR1-blaI-blaZ was detected in 23.1% (3/13) isolates / MENDON?A, Elaine Concei??o Liporage. Caracteriza??o fenogenot?pica da resist?ncia antimicrobiana em Staphylococcus spp. isolados de mastites cl?nicas e subcl?nicas em unidades leiteiras de munic?pios do Rio de Janeiro como subs?dio para implementa??o de medidas de controle. 89 p. Disserta??o (Mestrado em Ci?ncias Veterin?rias). Instituto de Veterin?ria, Departamento de Parasitologia Animal, Universidade Federal Rural do Rio de Janeiro, Serop?dica, RJ, 2012. A utiliza??o de antibi?ticos no controle das infec??es intramam?rias e na elimina??o de prov?veis fontes de infec??o nas fazendas leiteiras se constitui em importante medida de controle. No entanto, o uso inadequado de antibi?ticos no tratamento da doen?a pode gerar o aparecimento de cepas resistentes e comprometer a efici?ncia do tratamento. Bact?rias do g?nero Staphylococcus spp. est?o entre os principais agentes etiol?gicos da mastite bovina e s?o freq?entemente resistentes aos antimicrobianos, em especial aos beta-lact?micos, principalmente por dois mecanismos distintos: a produ??o da enzima extracelular beta-lactamase, codificada pelo gene blaZ, e a produ??o de PBP2a ou PBP2?, uma prote?na ligante de penicilina de baixa afinidade, codificada pelo gene mecA. A express?o do gene mecA ? constitutiva ou induzida por antibi?ticos betalact?micos, como a oxacilina e cefoxitina. O gene mecA est? inserido no cromossomo estafiloc?cico atrav?s de um elemento gen?tico m?vel, denominado cassete estafiloc?cico cromoss?mico mec (SCCmec). O presente estudo avaliou o perfil fenogenot?pico de resist?ncia aos beta-lact?micos em 250 isolados de Staphylococcus spp, utilizando os marcadores oxacilina e cefoxitina, de modo a produzir dados que possam contribuir para o conhecimento da resist?ncia antimicrobiana em algumas propriedades leiteiras das regi?es Sul-Fluminense e Metropolitana do Estado do Rio de Janeiro com o objetivo de subsidiar a implementa??o de medidas de controle dessa enfermidade. A avalia??o da resist?ncia foi feita a partir de 8 diferentes testes fenot?picos, sendo obtidos 54 perfis. Os testes de difus?o em disco simples e ?gar screen com oxacilina foram utilizados como ?padr?o ouro? para os c?lculos dos valores de sensibilidade, especificidade e predi??o por serem preconizados pelo CLSI veterin?rio. O teste de difus?o em disco simples com cefoxitina foi o de melhor desempenho na predi??o da resist?ncia a oxacilina. Na avalia??o genot?pica, n?o foi detectado qualquer isolado positivo para o gene mecA, j? os genes mecI e mecRI foram detectados igualmente em 11,6% (29/250) dos Staphylococcus spp avaliados. Foram detectados os quatro tipos de cassete mec analisados (I, II, III e IV), sendo o tipo I o que teve mais ampla distribui??o entre as regi?es estudadas. Gene blaZ foi detectado em 5,2% (13/250) dos isolados, sendo que nestes, todo o sistema blaZ-blaI- blaR1 foi detectado em 23,1% (3/13) dos isolados.

Bacterial antibiotic resistance is an increasing global health problem, leaving few therapeutic options available for the treatment of pathogenic infections. The development of new antibiotics has been slow since their discovery more than 8 decades, therefore, monitoring the extent and distribution of antibiotic resistance is of great importance. The aim of this study was to determine the presence of antibiotic resistance genes in sludge samples obtained from three wastewater treatment plants (WWTPs) in Sweden. Samples were collected and analyzed for the presence of nalidixic acid (NA), chloramphenicol (CHL), and tetracycline (TC) resistance genes using polymerase chain reaction (PCR). The DNA extracted from Eskilstuna and MälarEnergi sludge showed the presence of NA and TC resistance genes, whereas Örebro sludge was found to have resistance for TC antibiotic genes. To validate the results, PCR detection for resistance genes was performed on Escherichia coli isolates from the sludge samples. Antibiotic susceptibility testing was used to confirm the genetic analysis for antibiotic resistance genes detection in these E. coli. The PCR results for TC resistance genes correlated between sludge PCR analysis and bacterial isolates for all 3 WWTPs. Based on the results obtained from the genotypic analysis of sludge and E coli, incomplete compatibility in regards to NA, and CHL were observed. However on the basis of antibiotic susceptibility testing, E coli isolates from MälarEnergi sludge samples unveiled the majority presence for antibiotic resistance genes. The results suggest that extra monitoring for the wastewater treatment facilities are vital to minimize the rising incidence of antibiotic resistant bacteria.

Bacteria are one of the largest causes of human disease, with millions of deaths every year attributed to bacterial infections, and they have become more difficult to tackle with the widespread emergence of antibiotic resistance. In this thesis, I describe my studies that pursued two approaches: one focus was on using antimicrobial histones as an alternative to treatment for antibiotic resistant bacteria; in another approach the recombinant version of an eggshell cuticle protein was expressed and purified for testing against food-safety pathogens. One major pathogen that is contributing to this challenge of antibiotic resistance is Staphylococcus aureus. The methicillin-resistant strain of S. aureus leads to increased hospital stays and increased mortality in patients. The impact of such pathogens is worsened when bacteria form surface-attached aggregates known as biofilms. Development of new approaches to eradicate antibiotic- resistant biofilms will benefit human health. This study looked at an alternative method to eradicate bacteria compared to traditional antibiotics. Histones with antimicrobial activity were extracted from chicken blood and tested against methicillin-sensitive and methicillin-resistant strains of Staphylococcus aureus biofilm (MSSA and MRSA). The histone mixture completely eradicated both strains in biofilm form at relatively low concentrations. In addition, the histone mixture also displayed fast kill kinetics against planktonic forms of the two strains. Finally, the interaction of the histone mixture with the bacterial membrane in MRSA biofilms was observed by scanning electron microscopy (SEM). Bacteria treated with the histone mixture showed clear morphological changes, including pore formation and cell collapse. Therefore, the histone mixture purified from chicken red blood cells could prove to be a good alternative to traditional antibiotics for protection against antibiotic-resistant strains of bacteria in their planktonic and biofilm forms. Reduction of food-borne illness is another important aspect in the promotion of human health. A significant contributor to food-borne illness is contaminated table eggs. The unfertilized egg can be contaminated by a variety of pathogens including Salmonella spp. and Bacillus spp. The egg is protected by the eggshell which is traversed by respiratory pores that are normally covered by a cuticle plug to restrict pathogen entry. This cuticle consists of several proteins including ovocaxlyin-32 (OCX-32). OCX-32 has a large number of naturally occurring haplotypes due non-synonymous single nucleotide polymorphisms (SNPs). In this study, the goal was to express five of the most common haplotypes of OCX-32 in Escherichia coli and purify the recombinant protein for assay of its antimicrobial activity. Five constructs that contain the cDNA of common OCX-32 haplotypes (A, B, C, D, and O) with a histidine tag at the C-terminus were generated. The constructs were subcloned into pGEX4T-1 vector which encodes Glutathione-S-transferase (GST) upstream of the multiple cloning site. My study developed methods to optimize the expression conditions, and to increase the solubility of the recombinant protein. Various expression strains of E. coli and solubility buffers were tested. In addition, the construct was subcloned into a plasmid containing the small ubiquitin-like modifier (SUMO) fusion tag; the solubility of the new SUMO-OCX-32 haplotype A recombinant fusion protein was evaluated. The best results were obtained by slow dialysis refolding of denatured SUMO-OCX-32 fusion protein. This recombinant protein showed almost complete solubility with minimal precipitation and was tested against the egg-related pathogen, Bacillus cereus. Unfortunately, the SUMO-OCX-32 recombinant protein did not inhibit growth of B. cereus. In my studies reported in this thesis, two very different approaches were taken. A histone mixture was isolated from an abundant starting material, which proved to be highly effective and promising in the eradication of S. aureus biofilms at relatively low concentrations. Alternatively, expression of a soluble recombinant protein for functional activity assay was very challenging and required the optimization of a number of methods to prepare soluble protein for testing. One of the methods tested proved effective in obtaining large amounts of soluble protein. However, further developmental work will be essential to determine if this approach is a viable strategy in acquiring functional protein.

La résistance aux antibiotiques chez les bactéries est un problème majeur mondial du fait de son augmentation. Récemment, la transmission des bactéries résistantes aux humains, aux animaux et à l’environnement sont de plus en plus décrits dans la littérature. Ces dernières années, les voyages internationaux ont augmenté massivement ce qui a permis aux bactéries résistantes de se propager d’un lieu à un autre. Les voyageurs internationaux sont les principaux acteurs de l’acquisition et de la propagation des gènes de résistance aux antibiotiques. Le plus grand rassemblement annuel de personnes comme le pèlerinage à la Mecque est connu pour être un réservoir pour la transmission des maladies infectieuses telles que la grippe, les épidémies méningococciques ou la tuberculose. Par conséquent, les voyageurs en particulier les pèlerins représentent une source importante de propagation de bactéries multi-résistantes. Les études sur la transmission et l'acquisition de gènes de résistance pendant le Hajj sont rares. Par conséquent, ce projet de thèse a trois objectifs principaux permettant de mieux comprendre la prévalence des gènes de résistance et des bactéries multi-résistantes au cours du Hajj:(i)l’étude de la surveillance épidémiologique des gènes de résistance chez les pèlerins avant et après le Hajj,(ii)l’étude des facteurs de risque d'acquisition de gènes de résistance aux antibiotiques chez les pèlerins,(iii)les études épidémiologiques moléculaires des bactéries résistantes chez les pèlerins et d'autres sources, tels que les patients, les animaux et l’environnement en utilisant des techniques comme le typage des séquences multi-locus et le séquençage du génome complet. / Antibiotic resistance in bacteria is increasing and become a worldwide problem. Newresistance bacteria or mechanisms are emerging and spreading rapidly. Recently, thetransmission of antibiotic-resistant (AR) bacteria among humans, animals, and the variousenvironments are vastly recognized. With the growth of international travels over the pastdecades, this provides opportunities for AR bacteria to be spread rapidly from one geographiclocation to another. During trips, travelers changed diets, lifestyles, and their environmentsresulting in the alteration of AR patterns of bacteria residing in the gut. Thus, internationaltravelers are one of the most important modes for the acquisition and spread of AR genes.The largest annual mass gathering, the Hajj (pilgrimage to Mecca) is well known as a sourcefor infectious diseases transmission such as influenza, meningococcal outbreaks ortuberculosis. Thus, travelers, especially pilgrims, are one of the most significant sources forspreading AR bacteria. However, studies of the transmission and acquisition of AR genesduring Hajj in pilgrims are scarce. Therefore, this research thesis was carried out with threemain objectives to better understanding the prevalence of AR genes and bacteria during Hajj:(i) epidemiological surveillance of AR genes in pilgrims before and after Hajj, (ii) risk factorsanalysis concerning AR genes acquisition in pilgrims, (iii) molecular epidemiological studiesof AR bacteria in pilgrims, including patients, animals, and environment with the use ofmulti-locus sequence typing and whole genome sequencing.

Les intégrons de multirésistance sont des plateformes génétiques permettant aux bactéries de s’adapter à des pressions antibiotiques . Ils leur permettent de capturer et d’exprimer de s gènes de résistance sous forme de cassettes. La capture et le réarrangement des cassettes sont réalisés par une intégrase dont l’expression est régulée par la réponse SOS chez E. coli . L’expression des cassettes est quant à elle assurée par le promoteur Pc. Les travaux présentés dans ce manuscrit visent à préciser deux aspects liés à la dynamique d’évolution des intégrons . L’étude du coût biologique des intégrons a montré que ceux - ci sont des structures génétiques très peu coûteuses pour E. coli . Ce faible coût est notamment lié à la répression du gène de l’intégrase par la réponse SOS. Dans ces conditions de répression, le coût d’un intégron dépend de l’expression du réseau de cassettes et de son contenu. Ainsi ce coût augmente avec la force du promoteur Pc et le nombre de cassettes dans le réseau. D’autre part, le coût lié à la nature des cassettes est variable. L’étude de la dynamique d’évolution du promoteur Pc visait à vérifier l’hypothèse selon laquelle des pressions antibiotiques auraient conduit à l’émergence de promoteurs forts à partir d’un variant ancestral faible. L’évolution d’une souche de E. coli , contenant un intégron plasmidique portant un variant faible d e Pc, a été réalisée en chemostat sur 200 générations . L’analyse des populations évoluées par deep - sequencing n’a pas permis de mettre en évidence l’émergence de variants forts de Pc . Néanmoins, l ’ étude de ce s populations évoluées révèle une part majoritaire d’évolution chromosomique. Dans ces conditions, l’ absence d’évolution du Pc pourrait atteste r soit d’une réalité biologique ou soit d’un protocole expérimental d’évolution à optimiser . / Resistance integrons are genetic platforms able to catch and express resistance genes embedded within gene cassettes. Capture and reshuffling of gene cassettes are mediated by the integrase whose expression is regulated by the SOS response in E. coli. Gene cassettes are then expressed from the Pc promoter.This work aims to clarify the evolution dynamic of integrons.In a first part, the fitness cost of class 1 integron was assessed in E. coli. Results reveal that integrons are low cost structures and that their cost is reduced by the SOS-mediated repression system. While repressed, the cost of an integron mostly depends on cassettes array expression. The cost of an integron therefore increases with Pc strength and the number of cassettes in the array. Furthermore, different cassettes exhibit different costs.In a second part, the evolution dynamic of Pc promoter was assessed in response to antibiotic pressures. An E. coli strain, carrying a plasmidic integron with a weak Pc promoter, was propagated in chemostat for 200 generations. The deep-sequencing of evolved populations did not reveal any mutations in the promoter region. On the other hand, evolved bacteria presented evidence of chromosomal adaptation. In these conditions, the lack of evolution within the Pc region could reveal either a biological reality or an experimental protocol to optimize.

The global increase of antibiotic resistant bacteria threatens the modern health care and challenges the therapeutic effects of available antibiotics. The b-lactam mecillinam (Mec) is an exception to this due to a stable clinical resistance prevalence resistance of approximately 3%. It is only used to treat uncomplicated urinary tract infections (UTIs), mainly caused by E. coli. Mecillinam resistance (MecR) is easily selected for in laboratory settings and linked to >40 genes, including the mrdA gene encoding the Mec target penicillin-binding protein 2. A majority of the known MecR mutations confer a severe fitness cost. Fitness is important for bacteria to survive in the bladder and clinical isolates have been shown to have high fitness. These isolates contain loss-of-function mutations in the cysB gene, which encode a positive regulator of cysteine biosynthesis. In a previous evolution experiment, fitness cost of cysB and mrdA MecR mutations was compensated and the compensatory mutations were identified. Here the compensatory mutations were reconstructed into wildtype (WT) E. coli strain MG1655, and cysB and mrdA backgrounds to study the impact of the mutations on resistance and fitness, using MIC tests and Bioscreen C assays. Our results show that the mrdA mutants only had partial fitness compensation (significantly lower fitness than WT) for all strains and all strains also increased their MecR. The low fitness is possibly an explanation for the lack of mrdA mutants outside laboratories. Of the clinically relevant cysB mutants the majority lost their resistance when increasing growth rate, some even to levels significantly higher than WT, indicating that DcysB mutations are easier to compensate for. One strain (ydjNmx2) however, had a significantly higher growth rate while remaining clinically MecR.

Master of Science / Department of Civil Engineering / Alok Bhandari / Antibiotics and pharmaceuticals are used to improve the quality of life worldwide. However, incomplete metabolism in humans has resulted in the release of large amounts of pharmaceutical drugs into municipal wastewater treatment plant. Past research has shown the release of antibiotic resistant organisms through wastewater effluents into streams and several studies have reported the occurrence of antibiotic resistant bacteria in major U.S. Rivers. Antibiotic resistant bacteria evolve and are selected by long-term environmental exposure to the low concentrations of antibiotics at the ng /L to g/L range. Infections caused by antibiotic resistant organisms are difficult to treat. The aim of this study was to analyze antibiotic resistance patterns in selected wastewater bacteria that include fecal coliforms, Escherichia coli and enterococci. Microorganisms in municipal wastewater treatment plant influent, secondary clarifier effluent and disinfected effluent were plated in the presence of predetermined concentrations of selected antibiotics. These antibiotics included ciprofloxacin, sulfamethoxazole/ trimethoprim and vancomycin. The diversity of enterococci was further investigated with PCR analysis. Fecal coliforms, E. coli and enterococci were found to be resistant or highly resistant to one or more target antibiotics in the influent and secondary clarifier (SC) effluent. Biological treatment reduced the number of overall and resistant bacteria in the SC effluent sample. UV disinfection was generally very effective and eliminated all fecal indicator organisms.

The increasing number of Extended Spectrum Beta-Lactamase (ESBL) producing Escherichia coli (E. coli) associated with sepsis in China is the reason for designing the current study. During 2014-2016, thirty hospitals representing 10 different provinces in China was involved in collecting E. coli isolates causing blood stream infections. Early treatment with suitable antibiotics have been found to be of lifesaving importance in the case of care for septic patients. Thorough understanding of the pathogens involved is therefore crucial. Using antimicrobial susceptibility testing, PCR and Multi Locus Sequence Typing (MLST), the molecular characteristics of ESBL producing E. coli isolates could be determined. This study can report that the most common ESBL producing genes found were CTX-M-14 (51 isolates, 45,5%), CTX-M-55 (23 isolates, 20,5%) CTX-M-15 (22 isolates, 19,6%). In addition, 2 isolates (1,8%) were found to be SHV-11 positive which is another ESBL producing gene. As a side finding, 5 isolates harbored Metallo-beta-lactamase (MBL) encoding genes such as NDM-5 and NDM-1 which were found to coexist with CTX-M-55 and CTX-M-14 respectively. An MLST analysis resulted in the finding of 25 different and 17 previously unknown (16,2 %) sequence types. The most common sequence types were ST131 (18 isolates, 17,1 %) as reported previously.  No significant differences in antimicrobial susceptibility were identified whether ESBL producing genes such as SHV and CTX-M was present or not. This study indicates that there could be novel resistance mechanisms present among those isolates not encoding the genes of interest. However, this finding requires further research before it can be confirmed.