Interspecies plasmid transfer appears rare in sequential infections with extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae

Diagn Microbiol Infect Dis. 2019 Apr;93(4):380-385. doi: 10.1016/j.diagmicrobio.2018.10.014. Epub 2018 Nov 1.


From a cohort of 1836 Swedish patients infected with ESBL-producing Enterobacteriaceae (EPE) during 2004-2014, 513 patients with recurrent EPE infection were identified. Only in 14 of the 513 patients was a change of species (ESBL-E. coli to ESBL-K. pneumoniae or vice versa) found between the index and subsequent infection. Eleven sequential urine isolates from 5 of the 14 patients were available for further analysis of possible transfer of ESBL-carrying plasmids. The plasmid content was studied using optical DNA mapping (ODM), PCR-based replicon typing, and ESBL gene sequencing. ODM allowed us to directly compare whole plasmids between isolates and found similar ESBL-carrying plasmids in 3 out of the 5 patients. The ODM results and the rarity in shift of species between ESBL-E. coli and ESBL-K. pneumoniae imply that in recurrent EPE infections interspecies plasmid transfer is uncommon.

Keywords: E coli; Extended-spectrum β-lactamase (ESBL); K. pneumoniae; Optical DNA mapping; Plasmid; Recurrent infection; Transfer.

MeSH terms

  • Enterobacteriaceae / enzymology*
  • Enterobacteriaceae / genetics
  • Enterobacteriaceae / isolation & purification*
  • Enterobacteriaceae Infections / microbiology*
  • Gene Transfer, Horizontal*
  • Humans
  • Plasmids / analysis*
  • Polymerase Chain Reaction
  • Sequence Analysis, DNA
  • Sweden
  • Urine / microbiology*
  • beta-Lactamases / genetics*


  • beta-Lactamases