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Genomic analysis revealing the resistance mechanisms of extended-spectrum β-lactamase-producing Klebsiella pneumoniae isolated from pig and humans in Malaysia. Int Microbiol 2021; 24:243-250. [PMID: 33469786 DOI: 10.1007/s10123-021-00161-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/26/2020] [Accepted: 01/07/2021] [Indexed: 02/06/2023]
Abstract
Extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae has been associated with a wide range of infections in humans and animals. The objective of this study was to determine the genomic characteristics of two multiple drug resistant, ESBLs-producing K. pneumoniae strains isolated from a swine in 2013 (KP2013Z28) and a hospitalized patient in 2014 (KP2014C46) in Malaysia. Genomic analyses of the two K. pneumoniae strains indicated the presence of various antimicrobial resistance genes associated with resistance to β-lactams, aminoglycosides, colistin, fluoroquinolones, phenicols, tetracycline, sulfonamides, and trimethoprim, corresponding to the antimicrobial susceptibility profiles of the strains. KP2013Z28 (ST25) and KP2014C46 (ST929) harbored 5 and 2 genomic plasmids, respectively. The phylogenomics of these two Malaysian K. pneumoniae, with other 19 strains around the world was determined based on SNPs analysis. Overall, the strains were resolved into five clusters that comprised of strains with different resistance determinants. This study provided a better understanding of the resistance mechanisms and phylogenetic relatedness of the Malaysian strains with 19 strains isolated worldwide. This study also highlighted the needs to monitor the usage of antibiotics in hospital settings, animal husbandry, and agricultural practices due to the increase of β-lactam, aminoglycosides, tetracycline, and colistin resistance among pathogenic bacteria for better infection control.
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Mobasseri G, Teh CSJ, Ooi PT, Tan SC, Thong KL. Molecular Characterization of Multidrug-Resistant and Extended-Spectrum Beta-Lactamase-Producing Klebsiella pneumoniae Isolated from Swine Farms in Malaysia. Microb Drug Resist 2019; 25:1087-1098. [PMID: 30844323 DOI: 10.1089/mdr.2018.0184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Aims: The high prevalence of multidrug resistance (MDR) and extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae associated with nosocomial infections has caused serious therapeutic challenges. The objectives of this study were to determine the genotypic and phenotypic characteristics of K. pneumoniae strains isolated from Malaysian swine farms and the transferability of ESBL genes by plasmids. Results: A total of 50 K. pneumoniae strains were isolated from 389 samples, which were collected from healthy and unhealthy pigs (swine rectum and oral cavities), healthy farmers (human rectum, urine, and nasal cavities), farm's environment, and animal feeds from seven Malaysian swine farms. Antimicrobial susceptibility analysis of these 50 K. pneumoniae strains showed that the majority (86%) were resistant to tetracycline, while 44% and 36% of these strains were MDR and ESBL producers, respectively. PCR and DNA sequencing of the amplicons showed the occurrence of blaTEM (15/18), blaSHV (15/18), blaCTX-M-1 group (7/18), and blaCTX-M-2 group (2/18), while only class 1 integron-encoded integrase was detected. Conjugation experiments and plasmid analysis indicated that the majority of the ESBL genes were plasmid encoded and the plasmids in 11 strains were conjugative. Genotyping by pulsed-field gel electrophoresis and repetitive extragenic palindrome-polymerase chain reaction (REP-PCR) showed that these 50 strains were genetically diverse with 44 pulsotypes and 43 REP-PCR subtypes. Conclusions: ESBL-producing K. pneumoniae strains showed high resistance to tetracycline as this antibiotic is used for prophylaxis and therapeutic purposes at the swine farms. The findings in this study have drawn attention to the issue of increasing MDR in animal husbandry and it should be taken seriously to prevent the spread and treatment failure due to antimicrobial resistance.
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Affiliation(s)
- Golnaz Mobasseri
- Faculty of Science, Institute of Biological Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Cindy Shuan Ju Teh
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Peck Toung Ooi
- Department of Veterinary Clinical Studies, Faculty of Veterinary Medicine, Universiti Putra Malaysia, Serdang, Malaysia
| | - Shiang Chiet Tan
- Faculty of Science, Institute of Biological Science, University of Malaya, Kuala Lumpur, Malaysia
| | - Kwai Lin Thong
- Faculty of Science, Institute of Biological Science, University of Malaya, Kuala Lumpur, Malaysia
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Sidjabat HE, Paterson DL. Multidrug-resistantEscherichia coliin Asia: epidemiology and management. Expert Rev Anti Infect Ther 2015; 13:575-91. [DOI: 10.1586/14787210.2015.1028365] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Koczura R, Semkowska A, Mokracka J. Integron-bearing Gram-negative bacteria in lake waters. Lett Appl Microbiol 2014; 59:514-9. [DOI: 10.1111/lam.12307] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Revised: 07/10/2014] [Accepted: 07/16/2014] [Indexed: 11/28/2022]
Affiliation(s)
- R. Koczura
- Department of Microbiology; Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań Poland
| | - A. Semkowska
- Department of Microbiology; Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań Poland
| | - J. Mokracka
- Department of Microbiology; Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań Poland
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Sato N, Kawamura K, Nakane K, Wachino JI, Arakawa Y. First Detection of Fosfomycin Resistance Gene fosA3 in CTX-M-Producing Escherichia coli Isolates from Healthy Individuals in Japan. Microb Drug Resist 2013; 19:477-82. [DOI: 10.1089/mdr.2013.0061] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Natsumi Sato
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kumiko Kawamura
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kunihiko Nakane
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan
- Okazaki City Public Health Center, Okazaki, Japan
| | - Jun-Ichi Wachino
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshichika Arakawa
- Department of Bacteriology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Mokracka J, Oszyńska A, Kaznowski A. Increased frequency of integrons and β-lactamase-coding genes among extraintestinal Escherichia coli isolated with a 7-year interval. Antonie Van Leeuwenhoek 2012; 103:163-74. [PMID: 22945863 PMCID: PMC3528966 DOI: 10.1007/s10482-012-9797-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 08/10/2012] [Indexed: 11/28/2022]
Abstract
We analyzed the level of antimicrobial resistance, and the presence of integrons and β-lactamase-coding genes in 69 clinically relevant Escherichia coli strains originating from extraintestinal infections isolated in 1999–2001 and 2008–2010. Comparison of the two groups showed significant differences in drug resistance frequency, and the presence of integron and β-lactamase-coding genes. The frequency of resistance to all antimicrobials beside imipenem, streptomycin, piperacillin/tazobactam, and sulfamethoxazole increased significantly, especially towards aminoglycosides, β-lactams and fluoroquinolones. Similarly, we noticed an increase in the number of strains with integrons from 31.6 to 80.7 %. The presence of integrase genes was associated with elevated frequency of resistance to each antimicrobial tested besides imipenem, piperacillin/tazobactam and ceftazidime. The presence of integrons was also associated with multidrug resistance phenotype. The genetic content of integrons comprised genes determining resistance toward aminoglycosides, sulfonamides and trimethoprim. Moreover, we noticed a significant increase in the frequency of blaCTX-M β-lactamases, with appearance of blaCTX-M-15 variant and newer plasmid-encoded β-lactamases like CMY-15 and DHA. The emergence of strains resistant to several classes of antimicrobials and carrying integrons, ESBL and AmpC β-lactamase-coding genes may predict the spread of isolates with limited treatment options.
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Affiliation(s)
- Joanna Mokracka
- Faculty of Biology, Department of Microbiology, Adam Mickiewicz University in Poznań, ul. Umultowska 89, 61-614, Poznań, Poland.
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Mokracka J, Gruszczyńska B, Kaznowski A. Integrons, β-lactamase andqnrgenes in multidrug resistant clinical isolates ofProteus mirabilisandP. vulgaris. APMIS 2012; 120:950-8. [DOI: 10.1111/j.1600-0463.2012.02923.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 05/01/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Joanna Mokracka
- Department of Microbiology, Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań; Poland
| | - Beata Gruszczyńska
- Department of Microbiology, Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań; Poland
| | - Adam Kaznowski
- Department of Microbiology, Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań; Poland
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The role of horizontal gene transfer in the dissemination of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolates in an endemic setting. Diagn Microbiol Infect Dis 2012; 74:34-8. [PMID: 22722012 DOI: 10.1016/j.diagmicrobio.2012.05.020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 03/27/2012] [Accepted: 05/16/2012] [Indexed: 11/23/2022]
Abstract
The contribution of horizontal gene transmission (HGT) in the emergence and spread of extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria during periods of endemicity is unclear. Over a 12-month period, rectal colonization with SHV-5- and SHV-12-producing Escherichia coli and Klebsiella pneumoniae was quantified among a cohort of residents in a long-term care facility. Demographic and clinical data were collected on colonized residents. Transferability of SHV-encoding plasmids and pulsed-field gel electrophoresis were performed to quantify the contribution of HGT and cross-transmission, respectively. A total of 25 (12%) of 214 enrolled patients were colonized with 11 SHV-5- and 17 SVH-12-producing E. coli and K. pneumoniae. Clonally related isolates were detected among multiple residents residing on the same and different wards. Among 12 clonally distinct isolates, HGT of SHV-5- and SHV-12-encoding plasmids was identified among 6 (50%) isolates. HGT among clonally distinct strains contributes to the transmission dynamics of these ESBL-producing Gram-negative bacteria and should be considered when evaluating the spread of these pathogens.
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An S, Chen J, Wang Z, Wang X, Yan X, Li J, Chen Y, Wang Q, Xu X, Li J, Yang J, Wang H, Gao Z. Predominant characteristics of CTX-M-producing Klebsiella pneumoniae isolates from patients with lower respiratory tract infection in multiple medical centers in China. FEMS Microbiol Lett 2012; 332:137-45. [PMID: 22537112 DOI: 10.1111/j.1574-6968.2012.02586.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2012] [Revised: 04/23/2012] [Accepted: 04/23/2012] [Indexed: 11/26/2022] Open
Affiliation(s)
- Shuchang An
- Department of Respiratory and Critical Care Medicine; Peking University People's Hospital; Beijing; China
| | - Jichao Chen
- Department of Respiratory Medicine; the Central Hospital of China Aerospace Corporation; Beijing; China
| | - Zhanwei Wang
- Department of Clinical Laboratory; Peking University People's Hospital; Beijing; China
| | - Xiaorong Wang
- Department of Respiratory and Critical Care Medicine; Peking University People's Hospital; Beijing; China
| | - Xixin Yan
- Department of Respiratory Medicine; the Second Hospital of Hebei Medical University; Shijiazhuang; China
| | - Jihong Li
- Department of Clinical Laboratory; the Second Hospital of Hebei Medical University; Shijiazhuang; China
| | - Yusheng Chen
- Department of Respiratory Medicine; Fujian Province Hospital; Fuzhou; China
| | - Qi Wang
- Department of Respiratory Medicine; the Second Affiliated Hospital of Dalian Medical University; Dalian; China
| | - Xiaoling Xu
- Department of Respiratory Medicine; Anhui Province Hospital; Hefei; China
| | - Jiabin Li
- Department of Infectious Diseases; the First Affiliated Hospital of Anhui Medical University; Hefei; China
| | - Jingping Yang
- Department of Respiratory Medicine; the Third Affiliated Hospital of the Inner Mongolia Medical College; Baotou; China
| | - Hui Wang
- Department of Clinical Laboratory; Peking University People's Hospital; Beijing; China
| | - Zhancheng Gao
- Department of Respiratory and Critical Care Medicine; Peking University People's Hospital; Beijing; China
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Dropa M, Balsalobre LC, Lincopan N, Mamizuka EM, Murakami T, Cassettari VC, Franco F, Guida SM, Balabakis AJ, Passadore LF, Santos SR, Matté GR, Matté MH. Extended-spectrum beta-lactamases among Enterobacteriaceae isolated in a public hospital in Brazil. Rev Inst Med Trop Sao Paulo 2009; 51:203-9. [PMID: 19739000 DOI: 10.1590/s0036-46652009000400005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Accepted: 06/18/2009] [Indexed: 11/21/2022] Open
Abstract
Extended-spectrum beta-lactamases (ESBL) in enterobacteria are recognized worldwide as a great hospital problem. In this study, 127 ESBL-producing Enterobacteriaceae isolated in one year from inpatients and outpatients at a public teaching hospital at São Paulo, Brazil, were submitted to analysis by PCR with specific primers for bla SHV, bla TEM and bla CTX-M genes. From the 127 isolates, 96 (75.6%) Klebsiella pneumoniae, 12 (9.3%) Escherichia coli, 8 (6.2%) Morganella morganii, 3 (2.3%) Proteus mirabilis, 2 (1.6%) Klebsiella oxytoca, 2 (1.6%) Providencia rettgeri, 2 (1.6%) Providencia stuartti, 1 (0.8%) Enterobacter aerogenes and 1 (0.8%) Enterobacter cloacae were identified as ESBL producers. Bla SHV, bla TEM and bla CTX-M were detected in 63%, 17.3% and 33.9% strains, respectively. Pulsed field gel eletrophoresis genotyping of K. pneumoniae revealed four main molecular patterns and 29 unrelated profiles. PCR results showed a high variety of ESBL groups among strains, in nine different species. The results suggest the spread of resistance genes among genetically different strains of ESBL-producing K. pneumoniae in some hospital wards, and also that some strongly related strains were identified in different hospital wards, suggesting clonal spread in the institutional environment.
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Affiliation(s)
- Milena Dropa
- Public Health Laboratory, School of Public Health, University of São Paulo, São Paulo, SP, Brazil.
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Characterization of multidrug resistant ESBL-producing Escherichia coli isolates from hospitals in Malaysia. J Biomed Biotechnol 2009; 2009:165637. [PMID: 19672454 PMCID: PMC2721974 DOI: 10.1155/2009/165637] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2009] [Accepted: 06/11/2009] [Indexed: 11/17/2022] Open
Abstract
The emergence of Escherichia coli that produce extended spectrum beta-lactamases (ESBLs) and are multidrug resistant (MDR) poses antibiotic management problems. Forty-seven E. coli isolates from various public hospitals in Malaysia were studied. All isolates were sensitive to imipenem whereas 36 were MDR (resistant to 2 or more classes of antibiotics). PCR detection using gene-specific primers showed that 87.5% of the ESBL-producing E. coli harbored the blaTEM gene. Other ESBL-encoding genes detected were blaOXA, blaSHV, and blaCTX-M. Integron-encoded integrases were detected in 55.3% of isolates, with class 1 integron-encoded intI1 integrase being the majority. Amplification and sequence analysis of the 5'CS region of the integrons showed known antibiotic resistance-encoding gene cassettes of various sizes that were inserted within the respective integrons. Conjugation and transformation experiments indicated that some of the antibiotic resistance genes were likely plasmid-encoded and transmissible. All 47 isolates were subtyped by PFGE and PCR-based fingerprinting using random amplified polymorphic DNA (RAPD), repetitive extragenic palindromes (REPs), and enterobacterial repetitive intergenic consensus (ERIC). These isolates were very diverse and heterogeneous. PFGE, ERIC, and REP-PCR methods were more discriminative than RAPD in subtyping the E. coli isolates.
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12
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Pournaras S, Tsakris A, Ikonomidis A, Markogiannakis A, Kristo I, Maniatis AN. Detection of a novel variantblaCTX-M-3extended spectrum β-lactamase gene in a community-acquired Escherichia coli isolate. ACTA ACUST UNITED AC 2009; 38:213-6. [PMID: 16500785 DOI: 10.1080/00365540500322361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A highly cefotaxime- and cefepime-resistant but ceftazidime-sensitive Escherichia coli isolate was recovered from a community-acquired urinary infection of a Greek patient. Susceptibility testing, transfer assays, plasmid analysis as well as PCR and sequencing techniques were used to investigate the underlying mechanism of resistance. The isolate carried a new variant of the bla(CTX-M-3) gene that possessed a T instead of A at nt position 663. Cefotaxime resistance was transferable and carried on a 60 kb plasmid. The bla(CTX-M-3) variant was located downstream of an ISEcp1B element. The emergence of this new derivative indicates further evolution of the worldwide-distributed bla(CTX-M-3) gene.
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Affiliation(s)
- Spyros Pournaras
- Department of Medical Microbiology, University of Thessalia, Mezourlo, Larissa, Greece
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Xiao YH, Wang J, Li Y. Bacterial resistance surveillance in China: a report from Mohnarin 2004-2005. Eur J Clin Microbiol Infect Dis 2008; 27:697-708. [PMID: 18563461 DOI: 10.1007/s10096-008-0494-6] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2007] [Accepted: 02/15/2008] [Indexed: 10/21/2022]
Abstract
The aim of this study was to establish a nationwide antimicrobial resistant surveillance network and obtain information on bacterial resistance in China. A total of 4075 clinical bacterial isolates were collected from 17 hospitals in 15 cities throughout China. Antibacterial minimal inhibitory concentrations (MICs) were determined by the standard agar dilution method recommended by Clinical and Laboratory Standards Institute. The results of the MICs revealed the following bacterial resistance characteristics. Oxacillin resistance was shown by 62.9% of Staphylococcus aureus and 82.89% of Staphylococcus epidermidis strains. Penicillin non-sensitivity was show by 40.7% of the Streptococcus pneumoniae strains, which included 10.5% penicillin-resistant strains and 30.2% penicillin-intermediate strains. Five strains of Enterococci were vancomycin-intermediate, but all Enterococci strains were sensitive to teicoplanin. All Staphylococci were susceptible to glycopeptides. A high resistance to macrolides was a predominant characteristic of the Gram-positive cocci. Enterobacteriaceae strains were clearly resistant to the third generation cephalosporins, with the exception of ceftazidime, and the resistance rates ranged from 20 to 70%. About 65% of the Escherichia coli strains were resistant to fluoroquinolones. Carbapenems remained highly active against all the target bacteria. Latamoxef, piperacillin/tazobactam, cefoperazone/sulbactam and cefepime were all active against Enterobacteriaceae, which showed resistant rates of less than 10%. Imipenem resistance was found in 10.6% of Pseudomonas aeruginosa and 10.4% of Acinetobacter baumannii strains, most of which were multidrug resistant isolates. Combinations of beta-lactam/beta-lactamase inhibitor and fluoroquinolones also had potent antibacterial activity against non-fermenters. Amikacin was active against Enterobacteriaceae and P. aeruginosa. In conclusion, methicillin-resistant Staphylococci, penicillin-insensitive S. pneumoniae, macrolides-resistant Gram-positive cocci, cephalosporin-resistant Enterobacteriaceae, multidrug-resistant nonfermenters and fluoroquinolone-resistant E. coli were revealed to be the most serious problems in terms of bacteria resistance in China. No glycopeptides-resistant Staphylococcus strains were isolated, and the appearance of glycopeptides-resistant Enterococci was seldom.
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Affiliation(s)
- Y H Xiao
- Institute of Clinical Pharmacology, First Hospital, Peking University, 38#, Xueyuan Road, Haidian District, Beijing, 100083, China.
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Wang A, Yang Y, Lu Q, Wang Y, Chen Y, Deng L, Ding H, Deng Q, Wang L, Shen X. Occurrence of qnr-positive clinical isolates in Klebsiella pneumoniae producing ESBL or AmpC-type β-lactamase from five pediatric hospitals in China. FEMS Microbiol Lett 2008; 283:112-6. [DOI: 10.1111/j.1574-6968.2008.01163.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Ko KS, Yeom JS, Lee MY, Peck KR, Song JH. Clonal dissemination of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates in a Korean hospital. J Korean Med Sci 2008; 23:53-60. [PMID: 18303199 PMCID: PMC2526503 DOI: 10.3346/jkms.2008.23.1.53] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
In this study, we investigated the molecular characteristics of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates that were recovered from an outbreak in a Korean hospital. A new multilocus sequence typing (MLST) scheme for K. pneumoniae based on five housekeeping genes was developed and was evaluated for 43 ESBL-producing isolates from an outbreak as well as 38 surveillance isolates from Korea and also a reference strain. Overall, a total of 37 sequence types (STs) and six clonal complexes (CCs) were identified among the 82 K. pneumoniae isolates. The result of MLST analysis was concordant with that of pulsedfield gel electrophoresis. Most of the outbreak isolates belonged to a certain clone (ST2), and they produced SHV-1 and CTX-M14 enzymes, which was a different feature from that of the K. pneumoniae isolates from other Korean hospitals (ST20 and SHV-12). We also found a different distribution of CCs between ESBL-producing and -nonproducing K. pneumoniae isolates. The MLST method we developed in this study could provide unambiguous and well-resolved data for the epidemiologic study of K. pneumoniae. The outbreak isolates showed different molecular characteristics from the other K. pneumoniae isolates from other Korean hospitals.
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Affiliation(s)
- Kwan Soo Ko
- Department of Molecular Cell Biology, Sungkyunkwan University School of Medicine, Suwon, Korea
- Asian-Pacific Research Foundation for Infectious Diseases (ARFID), Seoul, Korea
| | - Joon-Sup Yeom
- Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Mi Young Lee
- Asian-Pacific Research Foundation for Infectious Diseases (ARFID), Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hoon Song
- Asian-Pacific Research Foundation for Infectious Diseases (ARFID), Seoul, Korea
- Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Bin C, Hui W, Renyuan Z, Yongzhong N, Xiuli X, Yingchun X, Yuanjue Z, Minjun C. Outcome of cephalosporin treatment of bacteremia due to CTX-M–type extended-spectrum β-lactamase–producing Escherichia coli. Diagn Microbiol Infect Dis 2006; 56:351-7. [PMID: 16934430 DOI: 10.1016/j.diagmicrobio.2006.06.015] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Revised: 06/13/2006] [Accepted: 06/16/2006] [Indexed: 11/16/2022]
Abstract
The aim of the study was to analyze the outcome of different antibiotic treatments for bacteremia due to CTX-M-type extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. In a prospective controlled clinical study from October 2002 to April 2005, 22 consecutive cases of bacteremia due to ESBL-producing E. coli with a ceftazidime-inhibition zone diameter of > or =18 mm were studied. The Etest method was used to determine the MIC values of cefotaxime, ceftazidime, imipenem, gentamicin, and ciprofloxacin against 22 isolates of E. coli. The polymerase chain reaction and sequencing analyses were used to determine the genotypes of the ESBLs. Of these 22 episodes, 7 were treated with ceftazidime, 8 were treated with imipenem/cilastatin, and 7 were treated with cefoperazone/sulbactam after detection of bacteremia. The demographic characteristics were comparable between the 3 groups. The treatment success ratio was similar (ceftazidime 85.7%, imipenem/cilastatin 87.5%, cefoperazone/sulbactam 71.4%, P = 0.637). Difficulties arose during treatment of peritonitis caused by CTX-M-producing E. coli bacteremia. Patients with bacteremia associated with urinary tract infection or biliary tract infection had a better chance of survival. All the 22 strains of E. coli produced CTX-M ESBLs (CTX-M-3, CTX-M-14, or CTX-M-27). The MICs of ceftazidime for 22 strains of E. coli were < or =8 microg/mL. All 7 patients who received ceftazidime survived, 6 of them were cured. Treatment in one patient with a ceftazidime MIC of 2 mug/mL failed because of abdominal abscess. Treatment with ceftazidime in vivo was effective against cases of CTX-M ESBL-producing E. coli bacteremia due to urinary tract infections and biliary tract infection when the MICs of ceftazidime were < or =8 microg/mL.
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Affiliation(s)
- Cao Bin
- Department of Pulmonary Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Dongdan, Beijing 100730, People's Republic of China
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Wei ZQ, Chen YG, Yu YS, Lu WX, Li LJ. Nosocomial spread of multi-resistant Klebsiella pneumoniae containing a plasmid encoding multiple beta-lactamases. J Med Microbiol 2005; 54:885-888. [PMID: 16091442 DOI: 10.1099/jmm.0.46151-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Six Klebsiella pneumoniae isolates that exhibited resistance to a wide spectrum of antibiotics were recovered from the intensive care units in the First Affiliated Hospital, Zhejiang University, Hangzhou, China. All isolates contained two plasmids of approximately 95 kb and 200 kb. The 95 kb plasmid was shown to be transferable by conjugation experiments. Isoelectric focusing patterns of the beta-lactamases extracted from the six transconjugants were identical, displaying five pI bands: 5.4, 7.75, 8.0, 8.2 and 8.4. The band corresponding to a pI of 7.75 could be inhibited by cloxacillin but not clavulanic acid, while the other bands could be inhibited by clavulanic acid but not cloxacillin. The 95 kb plasmid was digested with HindIII and a recombinant plasmid pT948 was obtained. The insert was found to contain blaDHA-1, regulatory gene ampR and an insertion element (IS26), which was downstream of blaDHA-1. PCR and DNA sequencing results confirmed that the 95 kb plasmid encoded at least four beta-lactamase genes: blaTEM-1, blaSHV-12), blaCTX-M-3 and blaDHA-1. Epidemiological typing by PFGE of the six clinical isolates of K. pneumoniae demonstrated identical genotypic patterns. In conclusion, all results indicated that the six multi-drug resistant clinical isolates of K. pneumoniae most probably originated from one clone and caused a localized epidemic in the intensive care units.
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Affiliation(s)
- Ze-Qing Wei
- Infectious Disease Dept, The First Affiliated Hospital, Medical School, Zhejiang University, The Key Laboratory of Infectious Diseases of Public Health Ministry, Zhejiang, Hangzhou, China
| | - Ya-Gang Chen
- Infectious Disease Dept, The First Affiliated Hospital, Medical School, Zhejiang University, The Key Laboratory of Infectious Diseases of Public Health Ministry, Zhejiang, Hangzhou, China
| | - Yun-Song Yu
- Infectious Disease Dept, The First Affiliated Hospital, Medical School, Zhejiang University, The Key Laboratory of Infectious Diseases of Public Health Ministry, Zhejiang, Hangzhou, China
| | - Wei-Xin Lu
- Infectious Disease Dept, The First Affiliated Hospital, Medical School, Zhejiang University, The Key Laboratory of Infectious Diseases of Public Health Ministry, Zhejiang, Hangzhou, China
| | - Lan-Juan Li
- Infectious Disease Dept, The First Affiliated Hospital, Medical School, Zhejiang University, The Key Laboratory of Infectious Diseases of Public Health Ministry, Zhejiang, Hangzhou, China
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Hasman H, Mevius D, Veldman K, Olesen I, Aarestrup FM. beta-Lactamases among extended-spectrum beta-lactamase (ESBL)-resistant Salmonella from poultry, poultry products and human patients in The Netherlands. J Antimicrob Chemother 2005; 56:115-21. [PMID: 15941775 DOI: 10.1093/jac/dki190] [Citation(s) in RCA: 269] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The purpose of this work was to study the genetic determinants responsible for extended-spectrum beta-lactamase (ESBL) resistance of Salmonella isolated from Dutch poultry, poultry meat and hospitalized humans. METHODS Thirty-four ESBL-resistant Salmonella isolates from The Netherlands were tested towards 21 antimicrobial agents. PCR and sequencing were used to determine the underlying genetic determinants responsible for the ESBL phenotypes. The transferability of the ESBL phenotypes was tested by conjugation to a susceptible Salmonella enterica serovar Dublin and plasmid purification, restriction fragment length polymorphism (RFLP) and pulsed-field gel electrophoresis (PFGE) were employed to further characterize a subset of the isolates. RESULTS A great genetic diversity was seen among the isolates. The bla(TEM-52) gene was most predominant and was found among Salmonella enterica serovars Blockley, Thomson, London, Enteritidis phage type 14b, Paratyphi B, Virchow and Typhimurium phage types 11 and 507. We also found the bla(TEM-20) gene in S. Paratyphi B var. Java and the bla(TEM-63) gene in S. Isangi. Furthermore, we detected the bla(CTX-M-28) gene in S. Isangi and the bla(CTX-M-3) gene in S. Typhimurium phage type 507. The bla(CTX-M-2) gene was identified in S. Virchow, which also contained a copy of the bla(SHV-2) gene and a copy of the bla(TEM-1) gene. The bla(SHV-12) gene was found alone in S. Concord and together with the bla(TEM-52) gene in S. Typhimurium. Finally, the bla(ACC-1) gene was cloned from a S. Bareilly isolate and was found to be present on indistinguishable plasmids in all S. Bareilly isolates examined as well as in a S. Braenderup isolate and a S. Infantis isolate. CONCLUSIONS Our data underscore the diversity of ESBL genes in Salmonella enterica isolated from animals, food products and human patients.
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Affiliation(s)
- Henrik Hasman
- Danish Institute for Food and Veterinary Research, Copenhagen.
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Pallecchi L, Malossi M, Mantella A, Gotuzzo E, Trigoso C, Bartoloni A, Paradisi F, Kronvall G, Rossolini GM. Detection of CTX-M-type beta-lactamase genes in fecal Escherichia coli isolates from healthy children in Bolivia and Peru. Antimicrob Agents Chemother 2005; 48:4556-61. [PMID: 15561825 PMCID: PMC529195 DOI: 10.1128/aac.48.12.4556-4561.2004] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A survey was carried out from August to November 2002 to evaluate the antimicrobial susceptibilities of fecal Escherichia coli isolates from 3,208 healthy children from four different urban areas of Latin America, two in Bolivia (Camiri and Villa Montes) and two in Peru (Yurimaguas and Moyobamba). Ceftriaxone-resistant E. coli isolates were detected in four children, one from each of the areas sampled. The isolates exhibited a multidrug-resistant phenotype, including resistance to oxyimino-cephalosporins and aztreonam, and the MICs of ceftazidime for the isolates were lower than those of cefotaxime. By PCR and sequencing, the bla(CTX-M-2) determinant was detected in three isolates and the bla(CTX-M-15) determinant was detected in one isolate (from Peru). The CTX-M-2-producing isolates belonged to three different phylogenetic groups (groups A, B2, and D), while the CTX-M-15-producing isolate belonged to phylogenetic group D. The bla(CTX-M-2) determinants were transferable to E. coli by conjugation, while conjugative transfer of the bla(CTX-M-15) determinant was not detectable. Plasmids harboring the bla(CTX-M-2) determinant exhibited similar restriction profiles, and in all of them the gene was located on a 2.2-kb PstI fragment, suggesting a genetic environment similar to that present in In35 and InS21. The findings of the present study confirm the widespread distribution of CTX-M-type beta-lactamases and underscore the role that commensal E. coli isolates could play as a potential reservoir of these clinically relevant resistance determinants. This is the first report of CTX-M-type enzymes in Bolivia and Peru and also the first report of the detection of CTX-M-15 in Latin America.
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Affiliation(s)
- Lucia Pallecchi
- Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena, Italy
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