Nationwide study of Escherichia coli producing extended-spectrum β-lactamases TEM, SHV and CTX-M in Turkey.

Four hundred and forty extended-spectrum β-lactamase (ESBL)-producing Escherichia coli isolates were collected from 10 different hospitals in Turkey between 2011 and 2012. Clinical specimens consisted of urine (80.45%), blood (6.59%), cerebrospinal fluid (1.13%), pleural fluid (2.95%), wound (4.31%) and sputum (4.54%). ESBL-coding genes (CTX-M1, CTX-M2, TEM, SHV) were detected by PCR. According to the PCR and sequencing results, CTX-M1 was the most prevalent β-lactamase 83.18% (366/440), followed by TEM 44.09% (194/440), CTX-M2 31.81% (140/440) and SHV 1.81% (8/440). Sequencing results showed that TEM and SHV types were TEM-1b and SHV-11, respectively. Rate of the strains harboring only CTX-M1, CTX-M2, TEM-1b and SHV-11 were 30.90%, 3.63%, 2.27% and 0.23%, respectively. Rate of the strains harboring the combinations of CTX-M1-CTX-M2, CTX-M1-CTX-M2-TEM-1b, CTX-M2-TEM-1b, CTX-M1-TEM-1b, CTX-M1-CTX-M2-TEM-1b-SHV-11, CTX-M1-TEM-1b-SHV-11, CTX-M1-SHV-11, CTX-M1-CTX-M2-SHV-11, CTX-M2-SHV-11, CTX-M2-TEM-1b-SHV-11, TEM-1b-SHV-11 were 12.95%, 11.59%, 2.95%, 26.13%, 0.45%, 0.68%, 0.22%, 0.22%, 0%, 0% and 0%, respectively. This is a nationwide study of ESBL-producing E. coli in Turkey. These results shows that CTX-M1 group is the most common type of class A β-lactamases among ESBL-producing E. coli strains in Turkey.