The purpose of this study was to investigate the prevalence and mechanisms of extended-spectrum cephalosporin- (ESC) and carbapenem-resistance in Escherichia coli from the GTA. A total of 526 non-duplicate E. coli clinical isolates were collected during March 1-5, 2010 from 13 participant hospitals. Among these, 71 isolates showed reduced susceptibility (rS, intermediate, and/or resistant phenotype) to cefoxitin (FOX) and/or ESC. No carbapenem resistance was detected. Extended-spectrum ß-lactamase genes detected (n=37; 52.1%) belong to the CTX-M-family, including blaCTX-M-15 (78.4%), blaCTX-M-23 (2.7%), blaCTX-M-14 (18.9%). The only plasmid-mediated ampC gene identified among FOXrS isolates (n=49; 69%) was blaCMY-2 (n=7; 14.3%). Seventeen strains (24%) were negative for all ß-lactamase genes tested. Analysis of the chromosomal ampC promoter revealed mutations associated with AmpC hyperproduction. Other mechanisms of resistance (e.g. impermeability and/or unidentified ß-lactamases) cannot be discarded. The most prevalent clone detected was ST131. IncFIA, FIB and Frep were the most common plasmid replicon types detected.

The purpose of this study was to investigate the prevalence and mechanisms of extended-spectrum cephalosporin- (ESC) and carbapenem-resistance in Escherichia coli from the GTA. A total of 526 non-duplicate E. coli clinical isolates were collected during March 1-5, 2010 from 13 participant hospitals. Among these, 71 isolates showed reduced susceptibility (rS, intermediate, and/or resistant phenotype) to cefoxitin (FOX) and/or ESC. No carbapenem resistance was detected. Extended-spectrum ß-lactamase genes detected (n=37; 52.1%) belong to the CTX-M-family, including blaCTX-M-15 (78.4%), blaCTX-M-23 (2.7%), blaCTX-M-14 (18.9%). The only plasmid-mediated ampC gene identified among FOXrS isolates (n=49; 69%) was blaCMY-2 (n=7; 14.3%). Seventeen strains (24%) were negative for all ß-lactamase genes tested. Analysis of the chromosomal ampC promoter revealed mutations associated with AmpC hyperproduction. Other mechanisms of resistance (e.g. impermeability and/or unidentified ß-lactamases) cannot be discarded. The most prevalent clone detected was ST131. IncFIA, FIB and Frep were the most common plasmid replicon types detected.