Year Urine Blood Wound Pus Catheter tip Ascetic Fluid Eye Pleural Fluid Sputum Amiri (ADA) 9 2010                   2011           1       2012 8                 Ahamdi (KOC) 57 2010 38 5 2 2 2       1 2011 3                 2012 3     1           Yiaco-Adan (Y) 17 2010                   2011                   2012 13   2       1 1   PCR amplification and sequencing Table 3 shows the distribution of the bla genes among the 83 isolates of E. coli O25b-ST131. Four (4.8%) did not contain any of the β-lactamase

click here enzymes while the majority (95.2%) harboured at least one β-lactamase GSK2118436 cost resistance gene. Two isolates harboured bla CTX-M-2 and bla CTX-M-56. bla NDM, bla IMP and bla VIM genes were not found. ISEcp1 was detected upstream region of 25 (33%) of the bla CTX-M-15 positive isolates. bla CMY-2 was only detected in four isolates (4.8%). IS elements were detected in 2 bla CMY-2 positive isolates, 1 contained class 1 integrons and 1 class II integrons. Table 3 Molecular characterization of bla genes among E. coli O25b-B2-ST131in Kuwait Profiles of the antibiotic resistance genes No.

of isolates (%) bla TEM-1 2 (2.4) bla SHV-12 1 (1.2) bla CTX-M-2 1 (1.2) bla CTX-M-15 32 (38.6) bla CTX-M-56 1 (1.2) bla TEM-1, bla SHV-12 1 (1.2) bla CTX-M-15, bla SHV-12 9 (10.8) bla CTX-M-15, bla TEM-1 21 (25.3) bla CTX-M-15, bla TEM-1, bla SHV-12 12 (14.5) Class 1 integrons were identified in 30 (36.1%) isolates

and only 5 (6%) AZ 628 contained class II integrons. None of the isolates contained both classes of integrons. Quinolone resistance determinants All but two isolates were resistant or had intermediate resistance to ciprofloxacin (MIC > 2 mg/l). Two sensitive isolates did not contain aac(6’)-Ib Ib-cr (isolates Y-116 and Y-159). We did not detect qnrA gene in any of the isolates tested. Three isolates harboured qnrB1 and 4 harboured qnrS1. qnrB1 and qnrS1 coexisted in only 2 isolates (Table 4). Table 4 Dolichyl-phosphate-mannose-protein mannosyltransferase The profile of quinolone resistant E. coli O25b-B2-ST131isolates Profiles of the antibiotic resistance genes No. of Isolates bla CTX-M-56, bla cmy-2, qnrB1 1 bla CTX-M-15, aac(6’)-Ib-cr, bla TEM-1, qnrB1 1 bla CTX-M-15, aac(6’)-Ib-cr, bla OXA-1, bla TEM-1, qnrB1, ISEcp1 1 bla CTX-M-15, aac(6’)-Ib-cr, bla OXA-1,, bla TEM-1, qnrS1, ISEcp1 1 bla CTX-M-15, aac(6’)-Ib-cr, bla OXA-1,, qnrB1, qnrS1 2 bla CTX-M-15, aac(6’)-Ib-cr, bla OXA-1,, qnrS1, ISEcp1 2 bla CTX-M-15, qnrS1, bla OXA-1,, ISEcp1 1 Total 9 Fifty six (67.5%) isolates carried aac(6’)-Ib Ib-cr. Among the aac(6’)-Ib Ib-cr negative strains (27/83) 32.5%, 1 isolate carried qnrB1 and bla CTX-M-56 (KOC-10) and 1 isolate carried qnrS1 (ADA-234).