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Background  Blood stream infections (BSI) caused by Extended Spectrum Beta-Lactamases (ESBLs) producing  Enterobacteriaceae  is a clinical challenge leading to high mortality, especially in developing countries. In this study, we sought to describe the epidemiology of ESBL-producing  Escherichia coli  strains isolated from Vietnamese individuals with BSI, to investigate the concordance of genotypic-phenotypic resistance, and clinical outcome of ESBL  E. coli  BSI.    Methods  A total of 459 hospitalized patients with BSI were screened between October 2014 and May 2016. 115  E. coli  strains from 115 BSI patients were isolated and tested for antibiotic resistance using the VITEK®2 system. The ESBL phenotype was determined by double disk diffusion method following the guideline of Clinical and Laboratory Standards Institute. Screening for beta-lactamase (ESBL and carbapenemase) genes was performed using a multiplex-PCR assay.    Results  58% (67/115) of the  E. coli  strains were ESBL-producers and all were susceptible to both imipenem and meropenem. Resistance to third-generation cephalosporin was common, 70% (81/115) were cefotaxime-resistant and 45% (52/115) were ceftazidime-resistant.  bla  CTX-M  was the most common ESBL gene detected (70%; 80/115) The sensitivity and specificity of  bla  CTX-M -detection to predict the ESBL phenotype was 87% (76–93% 95% CI) and 54% (39–48% 95% CI), respectively. 28%% (22/80) of  bla  CTX-M  were classified as non-ESBL producers by phenotypic testing for ESBL production. The detection of  bla  CTX-M  in ESBL-negative  E. coli  BSI was associated with fatal clinical outcome (27%; 6/22 versus 8%; 2/26, p = 0.07).    Conclusion  A high prevalence of ESBL-producing  E. coli  isolates harbouring  bla  CTX-M  was observed in BSI patients in Vietnam. The genotypic detection of  bla  CTX-M  may have added benefit in optimizing and guiding empirical antibiotic therapy of  E. coli  BSI to improve clinical outcome.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12941-021-00466-3.

annals of clinical microbiology and antimicrobials

Molecular detection of blaCTX-M gene to predict phenotypic cephalosporin resistance and clinical outcome of Escherichia coli bloodstream infections in Vietnam