coli (containing bla CTX-M-15 and bla TEM-1 genes) isolated from

coli (containing bla CTX-M-15 and bla TEM-1 genes) isolated from a Belgian patient with ventilator-associated pneumonia selleck compound travelling back from Egypt [21]. To date reports from the Middle East has been focused on the sporadic and selective E. coli O25b-B2-ST131 cases [22] and a comprehensive study on the epidemiology of this lineage was lacking. Therefore we aimed to address this issue by systematically characterising the multi-drug resistant (MDR) isolates of E. coli O25b-B2-ST131 recovered from https://www.selleckchem.com/products/mm-102.html patients in order to use these findings as a source

for future reference studies and surveillances. Methods Bacterial isolates A survey of Extended Spectrum β-lactamase (ESBL)-producing Enterobacteriaceae was undertaken from January 2010 to December 2012. A subset of 832 MDR E. coli strains was collected from the microbiology laboratories of three major hospitals that serve the six governorates of Kuwait. All the three hospitals are tertiary health care providers with bed capacities of 300 for Ahmadi, 500 for Amiri and 600 for Yiaco-Adan. The average number of specimens processed each day varies from 500 to 700 which includes samples from out-patient and in-patient specialists units. 832 original isolates represent a subset of the isolates submitted to the clinical diagnostic laboratories

of these centres. Each patient was included only once in this study. A database ARS-1620 research buy was created based on the patient’s records that contained information; such as age, sex, hospital, location of care on each site, type of specimen and date of sampling. Specimens were

processed by clinical ALOX15 staff members of the diagnostic laboratories using standard protocols. Cultures were performed on blood agar, MacConkey, Cystine lactose electrolyte deficient agar (CLED) and incubated aerobically and anaerobically as required. All isolates were identified at the species level based on colony morphology, biochemical analysis and by using Vitek2 (Vitek AMS; bioMérieux Vitek Systems Inc., Hazelwood, MO, USA). The isolates were stored in 10% skim milk and at -70°C. To confirm the phylogenic grouping of E. coli O25b-B2-ST131, PCR amplification of the pabB, trpA, chuA, yjaA genes [23] and DNA fragment of TSPE4.C2 were carried out as described before [24]. The products were sequenced from both directions and analysed. Antimicrobial susceptibility testing Antimicrobial susceptibility testing was determined by automated broth microdilution method (Vitek2) (Vitek AMS; BioMérieux Vitek Systems Inc., Durham, NC, USA) and the results were analysed according to the Clinical and Laboratory Standards Institute, CLSI (2012) guidelines [25].

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