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Ramatla T, Ramaili T, Lekota K, Mileng K, Ndou R, Mphuthi M, Khasapane N, Syakalima M, Thekisoe O. Antibiotic resistance and virulence profiles of Proteus mirabilis isolated from broiler chickens at abattoir in South Africa. Vet Med Sci 2024; 10:e1371. [PMID: 38357843 PMCID: PMC10867704 DOI: 10.1002/vms3.1371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/10/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Proteus mirabilis has been identified as an important zoonotic pathogen, causing several illnesses such as diarrhoea, keratitis and urinary tract infections. OBJECTIVE This study assessed the prevalence of P. mirabilis in broiler chickens, its antibiotic resistance (AR) patterns, ESBL-producing P. mirabilis and the presence of virulence genes. METHODS A total of 26 isolates were confirmed as P. mirabilis from 480 pooled broiler chicken faecal samples by polymerase chain reaction (PCR). The disk diffusion method was used to evaluate the antibacterial susceptibility test, while nine virulence genes and 26 AR genes were also screened by PCR. RESULTS All 26 P. mirabilis isolates harboured the ireA (siderophore receptors), ptA, and zapA (proteases), ucaA, pmfA, atfA, and mrpA (fimbriae), hlyA and hpmA (haemolysins) virulence genes. The P. mirabilis isolates were resistant to ciprofloxacin (62%) and levofloxacin (54%), while 8 (30.7%) of the isolates were classified as multidrug resistant (MDR). PCR analysis identified the blaCTX-M gene (62%), blaTEM (58%) and blaCTX-M-2 (38%). Further screening for AMR genes identified mcr-1, cat1, cat2, qnrA, qnrD and mecA, 12%, 19%, 12%, 54%, 27% and 8%, respectively for P. mirabilis isolates. The prevalence of the integron integrase intI1 and intI2 genes was 43% and 4%, respectively. CONCLUSIONS The rise of ciprofloxacin and levofloxacin resistance, as well as MDR strains, is a public health threat that points to a challenge in the treatment of infections caused by these zoonotic bacteria. Furthermore, because ESBL-producing P. mirabilis has the potential to spread to humans, the presence of blaCTX -M -producing P. mirabilis in broilers should be kept under control. This is the first study undertaken to isolate P. mirabilis from chicken faecal samples and investigate its antibiotic resistance status as well as virulence profiles in South Africa.
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Affiliation(s)
- Tsepo Ramatla
- Unit for Environmental Sciences and ManagementNorth‐West UniversityPotchefstroomSouth Africa
- Gastrointestinal Research UnitDepartment of SurgerySchool of Clinical MedicineUniversity of the Free StateBloemfonteinSouth Africa
| | - Taole Ramaili
- Department of Animal Health, School of AgricultureNorth‐West UniversityMmabathoSouth Africa
| | - Kgaugelo Lekota
- Unit for Environmental Sciences and ManagementNorth‐West UniversityPotchefstroomSouth Africa
| | - Kealeboga Mileng
- Unit for Environmental Sciences and ManagementNorth‐West UniversityPotchefstroomSouth Africa
| | - Rendani Ndou
- Department of Animal Health, School of AgricultureNorth‐West UniversityMmabathoSouth Africa
| | - Malekoba Mphuthi
- Department of Animal Health, School of AgricultureNorth‐West UniversityMmabathoSouth Africa
| | - Ntelekwane Khasapane
- Department of Life SciencesCentre for Applied Food Safety and BiotechnologyCentral University of TechnologyBloemfonteinSouth Africa
| | - Michelo Syakalima
- Department of Animal Health, School of AgricultureNorth‐West UniversityMmabathoSouth Africa
- Department of Disease ControlSchool of Veterinary MedicineUniversity of ZambiaLusakaZambia
| | - Oriel Thekisoe
- Unit for Environmental Sciences and ManagementNorth‐West UniversityPotchefstroomSouth Africa
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Regulatory Mechanisms of the LuxS/AI-2 System and Bacterial Resistance. Antimicrob Agents Chemother 2019; 63:AAC.01186-19. [PMID: 31383657 DOI: 10.1128/aac.01186-19] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The quorum-sensing (QS) system is an intercellular cell-cell communication mechanism that controls the expression of genes involved in a variety of cellular processes and that plays critical roles in the adaption and survival of bacteria in their environment. The LuxS/AI-2 QS system, which uses AI-2 (autoinducer-2) as a signal molecule, has been identified in both Gram-negative and Gram-positive bacteria. As one of the important global regulatory networks in bacteria, it responds to fluctuations in the numbers of bacteria and regulates the expression of a number of genes, thus affecting cell behavior. We summarize here the known relationships between the LuxS/AI-2 system and drug resistance, discuss the inhibition of LuxS/AI-2 system as an approach to prevent bacterial resistance, and present new strategies for the treatment of drug-resistant pathogens.
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3
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Kato K, Matsumura Y, Yamamoto M, Nagao M, Takakura S, Ichiyama S. Regional Spread of CTX-M-2-ProducingProteus mirabiliswith the Identical Genetic Structure in Japan. Microb Drug Resist 2017; 23:590-595. [DOI: 10.1089/mdr.2016.0148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Affiliation(s)
- Karin Kato
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Anesthesia, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yasufumi Matsumura
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masaki Yamamoto
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Miki Nagao
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Shunji Takakura
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Satoshi Ichiyama
- Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Eguale T, Birungi J, Asrat D, Njahira MN, Njuguna J, Gebreyes WA, Gunn JS, Djikeng A, Engidawork E. Genetic markers associated with resistance to beta-lactam and quinolone antimicrobials in non-typhoidal Salmonella isolates from humans and animals in central Ethiopia. Antimicrob Resist Infect Control 2017; 6:13. [PMID: 28105330 PMCID: PMC5240271 DOI: 10.1186/s13756-017-0171-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 01/05/2017] [Indexed: 11/21/2022] Open
Abstract
Background Beta-lactam and quinolone antimicrobials are commonly used for treatment of infections caused by non-typhoidal Salmonella (NTS) and other pathogens. Resistance to these classes of antimicrobials has increased significantly in the recent years. However, little is known on the genetic basis of resistance to these drugs in Salmonella isolates from Ethiopia. Methods Salmonella isolates with reduced susceptibility to beta-lactams (n = 43) were tested for genes encoding for beta-lactamase enzymes, and those resistant to quinolones (n = 29) for mutations in the quinolone resistance determining region (QRDR) as well as plasmid mediated quinolone resistance (PMQR) genes using PCR and sequencing. Results Beta-lactamase genes (bla) were detected in 34 (79.1%) of the isolates. The dominant bla gene was blaTEM, recovered from 33 (76.7%) of the isolates, majority being TEM-1 (24, 72.7%) followed by TEM-57, (10, 30.3%). The blaOXA-10 and blaCTX-M-15 were detected only in a single S. Concord human isolate. Double substitutions in gyrA (Ser83-Phe + Asp87-Gly) as well as parC (Thr57-Ser + Ser80-Ile) subunits of the quinolone resistance determining region (QRDR) were detected in all S. Kentucky isolates with high level resistance to both nalidixic acid and ciprofloxacin. Single amino acid substitutions, Ser83-Phe (n = 4) and Ser83-Tyr (n = 1) were also detected in the gyrA gene. An isolate of S. Miami susceptible to nalidixic acid but intermediately resistant to ciprofloxacin had Thr57-Ser and an additional novel mutation (Tyr83-Phe) in the parC gene. Plasmid mediated quinolone resistance (PMQR) genes investigated were not detected in any of the isolates. In some isolates with decreased susceptibility to ciprofloxacin and/or nalidixic acid, no mutations in QRDR or PMQR genes were detected. Over half of the quinolone resistant isolates in the current study 17 (58.6%) were also resistant to at least one of the beta-lactam antimicrobials. Conclusion Acquisition of blaTEM was the principal beta-lactamase resistance mechanism and mutations within QRDR of gyrA and parC were the primary mechanism for resistance to quinolones. Further study on extended spectrum beta-lactamase and quinolone resistance mechanisms in other gram negative pathogens is recommended.
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Affiliation(s)
- Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, P.O. Box 1176, Addis Ababa, Ethiopia
| | - Josephine Birungi
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, P O Box 30709, Nairobi, Kenya
| | - Daniel Asrat
- Department of Microbiology, Immunology & Parasitology, School of Medicine, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 9086, Addis Ababa, Ethiopia
| | - Moses N Njahira
- ICIPE-African Insect Science for Food and Health, P.O. Box 30772-00100, Nairobi, Kenya
| | - Joyce Njuguna
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, P O Box 30709, Nairobi, Kenya
| | - Wondwossen A Gebreyes
- Department of Veterinary Preventive Medicine, The Ohio State University, 1920 Coffey Rd., Columbus, OH 43210 USA
| | - John S Gunn
- Department of Microbial Infection and Immunity, Center for Microbial Interface Biology, The Ohio State University, Biomedical Research Tower, 460 West 12th, Columbus, OH 432101214 USA
| | - Appolinaire Djikeng
- Biosciences Eastern and Central Africa-International Livestock Research Institute (BecA-ILRI) Hub, P O Box 30709, Nairobi, Kenya
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Churchill Avenue, P.O. Box 1176, Addis Ababa, Ethiopia
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5
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Xue T, Yu L, Shang F, Li W, Zhang M, Ni J, Chen X. Short communication: The role of autoinducer 2 (AI-2) on antibiotic resistance regulation in an Escherichia coli strain isolated from a dairy cow with mastitis. J Dairy Sci 2016; 99:4693-4698. [PMID: 27060825 DOI: 10.3168/jds.2015-10543] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Accepted: 03/02/2016] [Indexed: 12/27/2022]
Abstract
Extended spectrum β-lactamase (ESBL)-positive Escherichia coli is a major etiological organism responsible for bovine mastitis. The autoinducer 2 (AI-2) quorum sensing system is widely present in many species of gram-negative and gram-positive bacteria and has been proposed to be involved in interspecies communication. In E. coli model strains, the functional mechanisms of AI-2 have been well studied; however, in clinical antibiotic-resistant E. coli strains, whether AI-2 affects the expression of antibiotic resistance genes has not been reported. In this study, we report that exogenous AI-2 increased the antibiotic resistance of a clinical E. coli strain isolated from a dairy cow with mastitis by upregulating the expression of TEM-type enzyme in an LsrR (LuxS regulated repressor)-dependent manner.
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Affiliation(s)
- Ting Xue
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China.
| | - Lumin Yu
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Fei Shang
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Wenchang Li
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Ming Zhang
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Jingtian Ni
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China
| | - Xiaolin Chen
- School of Life Sciences, Anhui Agricultural University, Hefei, Anhui 230036, China.
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TEM-187, a new extended-spectrum β-lactamase with weak activity in a Proteus mirabilis clinical strain. Antimicrob Agents Chemother 2013; 57:2410-2. [PMID: 23478954 DOI: 10.1128/aac.01761-12] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A Proteus mirabilis clinical strain (7001324) was isolated from urine sample of a patient hospitalized in a long-term-care facility. PCR and cloning experiments performed with this strain identified a novel TEM-type β-lactamase (TEM-187) differing by four amino acid substitutions (Leu21Phe, Arg164His, Ala184Val, and Thr265Met) from TEM-1. This characterization provides further evidence for the diversity of extended-spectrum β-lactamases (ESBL) produced by P. mirabilis and for their potential spread to other Enterobacteriaceae due to a lack of sensitive detection methods used in daily practice.
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7
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Nakano R, Nakano A, Abe M, Inoue M, Okamoto R. Regional outbreak of CTX-M-2 β-lactamase-producing Proteus mirabilis in Japan. J Med Microbiol 2012; 61:1727-1735. [DOI: 10.1099/jmm.0.049726-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ryuichi Nakano
- Department of Microbiology and Immunology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8605, Japan
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Akiyo Nakano
- School of Veterinary Medicine Azabu University, 1-17-71 Fuchinobe, Chuoh-ku, Sagamihara, Kanagawa 252-5201, Japan
| | - Michiko Abe
- Department of Medical Laboratory Sciences, School of Allied Health Sciences, Kitasato University, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0373, Japan
| | - Matsuhisa Inoue
- Department of Microbiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
| | - Ryoichi Okamoto
- Department of Microbiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
- Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami-ku, Sagamihara, Kanagawa 252-0374, Japan
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8
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Rubtsova MY, Ulyashova MM, Bachmann TT, Schmid RD, Egorov AM. Multiparametric determination of genes and their point mutations for identification of beta-lactamases. BIOCHEMISTRY (MOSCOW) 2011; 75:1628-49. [PMID: 21417998 DOI: 10.1134/s0006297910130080] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
More than half of all currently used antibiotics belong to the beta-lactam group, but their clinical effectiveness is severely limited by antibiotic resistance of microorganisms that are the causative agents of infectious diseases. Several mechanisms for the resistance of Enterobacteriaceae have been established, but the main one is the enzymatic hydrolysis of the antibiotic by specific enzymes called beta-lactamases. Beta-lactamases represent a large group of genetically and functionally different enzymes of which extended-spectrum beta-lactamases (ESBLs) pose the greatest threat. Due to the plasmid localization of the encoded genes, the distribution of these enzymes among the pathogens increases every year. Among ESBLs the most widespread and clinically relevant are class A ESBLs of TEM, SHV, and CTX-M types. TEM and SHV type ESBLs are derived from penicillinases TEM-1, TEM-2, and SHV-1 and are characterized by several single amino acid substitutions. The extended spectrum of substrate specificity for CTX-M beta-lactamases is also associated with the emergence of single mutations in the coding genes. The present review describes various molecular-biological methods used to identify determinants of antibiotic resistance. Particular attention is given to the method of hybridization analysis on microarrays, which allows simultaneous multiparametric determination of many genes and point mutations in them. A separate chapter deals with the use of hybridization analysis on microarrays for genotyping of the major clinically significant ESBLs. Specificity of mutation detection by means of hybridization analysis with different detection techniques is compared.
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Affiliation(s)
- M Yu Rubtsova
- Chemical Faculty, Lomonosov Moscow State University, Russia.
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Tonkić M, Mohar B, Šiško-Kraljević K, Meško-Meglič K, Goić-Barišić I, Novak A, Kovačić A, Punda-Polić V. High prevalence and molecular characterization of extended-spectrum β-lactamase-producing Proteus mirabilis strains in southern Croatia. J Med Microbiol 2010; 59:1185-1190. [DOI: 10.1099/jmm.0.016964-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The aim of this study was to determine the prevalence and antibiotic resistance rates of extended-spectrum β-lactamase (ESBL)-producing Proteus mirabilis strains isolated from inpatients at the Split University Hospital (southern Croatia) during a survey performed between 2005 and 2008. A total of 2152 consecutive isolates of P. mirabilis were isolated. The prevalence was 0.5 % in 2005 and increased significantly to 20.9 % by 2008. Strains were most frequently isolated from urine (36.5 %) and bronchial aspirates and wound swabs (11.3 %). ESBL-producing P. mirabilis isolates showed very high resistance rates to the majority of non-β-lactam antibiotics and were susceptible to a β-lactam/β-lactamase inhibitor and carbapenems. The isolates were genotyped and their ESBLs were molecularly characterized. Strains originating from the intensive care unit and the surgery and neurosurgery wards were clonally related. All P. mirabilis isolates produced the TEM-52 type of ESBL. To the best of our knowledge, our work detailed here and summarized in an earlier communication is the first report of such isolates from southern Croatia. Increased monitoring and screening for ESBL production in this species at our hospital is mandatory.
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Affiliation(s)
- Marija Tonkić
- Department of Medical Microbiology, School of Medicine, University of Split, Šoltanska 2, Split, Croatia
- Department of Clinical Microbiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Bojana Mohar
- Department of Medical Microbiology, School of Medicine, University of Split, Šoltanska 2, Split, Croatia
| | - Katarina Šiško-Kraljević
- Public Health Institute of Split–Dalmatia County, Vukovarska 46, Split, Croatia
- Department of Medical Microbiology, School of Medicine, University of Split, Šoltanska 2, Split, Croatia
| | - Karmen Meško-Meglič
- Institute of Microbiology and Immunology, Medical Faculty, University of Ljubljana, Zaloška 4, 1105 Ljubljana, Slovenia
| | - Ivana Goić-Barišić
- Department of Medical Microbiology, School of Medicine, University of Split, Šoltanska 2, Split, Croatia
- Department of Clinical Microbiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Anita Novak
- Department of Medical Microbiology, School of Medicine, University of Split, Šoltanska 2, Split, Croatia
- Department of Clinical Microbiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Ana Kovačić
- Public Health Institute of Split–Dalmatia County, Vukovarska 46, Split, Croatia
| | - Volga Punda-Polić
- Department of Medical Microbiology, School of Medicine, University of Split, Šoltanska 2, Split, Croatia
- Department of Clinical Microbiology, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
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International spread and persistence of TEM-24 is caused by the confluence of highly penetrating enterobacteriaceae clones and an IncA/C2 plasmid containing Tn1696::Tn1 and IS5075-Tn21. Antimicrob Agents Chemother 2009; 54:825-34. [PMID: 19995930 DOI: 10.1128/aac.00959-09] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
TEM-24 remains one of the most widespread TEM-type extended-spectrum beta-lactamases (ESBLs) among Enterobacteriaceae. To analyze the reasons influencing its spread and persistence, a multilevel population genetics study was carried out on 28 representative TEM-24 producers from Belgium, France, Portugal, and Spain (13 Enterobacter aerogenes isolates, 6 Escherichia coli isolates, 6 Klebsiella pneumoniae isolates, 2 Proteus mirabilis isolates, and 1 Klebsiella oxytoca isolate, from 1998 to 2004). Clonal relatedness (XbaI pulsed-field gel electrophoresis [PFGE] and E. coli phylogroups) and antibiotic susceptibility were determined by standard procedures. Plasmid analysis included determination of the incompatibility group (by PCR, hybridization, and/or sequencing) and comparison of restriction fragment length polymorphism (RFLP) patterns. Characterization of genetic elements conferring antibiotic resistance included integrons (classes 1, 2, and 3) and transposons (Tn3, Tn21, and Tn402). Similar PFGE patterns were identified among E. aerogenes, K. pneumoniae, and P. mirabilis isolates, while E. coli strains were diverse (phylogenetic groups A, B2, and D). Highly related 180-kb IncA/C2 plasmids conferring resistance to kanamycin, tobramycin, chloramphenicol, trimethoprim, and sulfonamides were identified. Each plasmid contained defective In0-Tn402 (dfrA1-aadA1, aacA4, or aacA4-aacC1-orfE-aadA2-cmlA1) and In4-Tn402 (aacA4 or dfrA1-aadA1) variants. These integrons were located within Tn21, Tn1696, or hybrids of these transposons, with IS5075 interrupting their IRtnp and IRmer. In all cases, blaTEM-24 was part of an IS5075-DeltaTn1 transposon within tnp1696, mimicking other genetic elements containing blaTEM-2 and blaTEM-3 variants. The international dissemination of TEM-24 is fuelled by an IncA/C2 plasmid acquired by different enterobacterial clones which seem to evolve by gaining diverse genetic elements. This work highlights the risks of a confluence between highly penetrating clones and highly promiscuous plasmids in the spread of antibiotic resistance, and it contributes to the elucidation of the origin and evolution of TEM-2 ESBL derivatives.
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Molecular and biochemical characterization of the natural chromosome-encoded class A beta-lactamase from Pseudomonas luteola. Antimicrob Agents Chemother 2009; 54:45-51. [PMID: 19884377 DOI: 10.1128/aac.00427-09] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Pseudomonas luteola (formerly classified as CDC group Ve-1 and named Chryseomonas luteola) is an unusual pathogen implicated in rare but serious infections in humans. A novel beta-lactamase gene, bla(LUT-1), was cloned from the whole-cell DNA of the P. luteola clinical isolate LAM, which had a weak narrow-spectrum beta-lactam-resistant phenotype, and expressed in Escherichia coli. This gene encoded LUT-1, a 296-amino-acid Ambler class A beta-lactamase with a pI of 6 and a theoretical molecular mass of 28.9 kDa. The catalytic efficiency of this enzyme was higher for cephalothin, cefuroxime, and cefotaxime than for penicillins. It was found to be 49% to 59% identical to other Ambler class A beta-lactamases from Burkholderia sp. (PenA to PenL), Ralstonia eutropha (REUT), Citrobacter sedlakii (SED-1), Serratia fonticola (FONA and SFC-1), Klebsiella sp. (KPC and OXY), and CTX-M extended-spectrum beta-lactamases. No gene homologous to the regulatory ampR genes of class A beta-lactamases was found in the vicinity of the bla(LUT-1) gene. The entire bla(LUT-1) coding region was amplified by PCR and sequenced in five other genetically unrelated P. luteola strains (including the P. luteola type strain). A new variant of bla(LUT-1) was found for each strain. These genes (named bla(LUT-2) to bla(LUT-6)) had nucleotide sequences 98.1 to 99.5% identical to that of bla(LUT-1) and differing from this gene by two to four nonsynonymous single nucleotide polymorphisms. The bla(LUT) gene was located on a 700- to 800-kb chromosomal I-CeuI fragment, the precise size of this fragment depending on the P. luteola strain.
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Yuan L, Liu JH, Hu GZ, Pan YS, Liu ZM, Mo J, Wei YJ. Molecular characterization of extended-spectrum β-lactamase-producing Escherichia coli isolates from chickens in Henan Province, China. J Med Microbiol 2009; 58:1449-1453. [DOI: 10.1099/jmm.0.012229-0] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli has spread rapidly worldwide and poses a serious threat to human and animal health. This study collected 51 non-replicate E. coli isolates from 14 different chicken farms in Henan Province in China from December 2007 to August 2008. The prevalence of ESBL-producing E. coli, molecular characterization of the ESBL-related bla genes, including bla
TEM, bla
SHV and bla
CTX-M, and the susceptibilities of these bacteria to various antimicrobial agents were determined. Thirty-one of the 51 isolates were positive for an ESBL phenotype and 29 of these isolates carried one or more bla genes. Twenty-two isolates harboured bla
TEM genes and 15 isolates carried bla
CTX-M genes (one CTX-M-14, three CTX-M-24 and 11 CTX-M-65). One isolate carried bla
TEM
-57; the remaining bla
TEM isolates carried bla
TEM-1 with one silent nucleotide base variation (T18C). We believe that this is the first study to report TEM-57 in E. coli isolates. All isolates harbouring bla
CTX-M-24 and bla
CTX-M-14 and five of the bla
CTX-M-65 isolates also harboured the bla
TEM-1 gene. To our knowledge, this study is the first to describe detection of CTX-M-65-producing E. coli isolated from chickens. None of the isolates contained the bla
SHV gene. Conjugation experiments demonstrated that bla
CTX-M and bla
TEM genes could be transferred to E. coli DH5α. The results indicate that ESBL frequency has reached an alarming level in chicken isolates in China, with TEM-1 and CTX-M-65 enzymes being the two predominant β-lactamases detected.
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Affiliation(s)
- Li Yuan
- Department of Pharmacology and Toxicology, College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou 450002, PR China
| | - Jian-Hua Liu
- Department of Pharmacology and Toxicology, College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou 450002, PR China
| | - Gong-Zheng Hu
- Department of Pharmacology and Toxicology, College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou 450002, PR China
| | - Yu-Shan Pan
- Department of Pharmacology and Toxicology, College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou 450002, PR China
| | - Zhi-Ming Liu
- Henan Bureau of Animal Husbandry, Zhengzhou 450002, PR China
| | - Juan Mo
- Department of Pharmacology and Toxicology, College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou 450002, PR China
| | - Yong-Jun Wei
- Department of Pharmacology and Toxicology, College of Animal Husbandry and Veterinary Science, Henan Agricultural University, Zhengzhou 450002, PR China
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Extended Spectrum beta-Lactamases among Gram-Negative Bacterial Isolates from Clinical Specimens in Three Major Hospitals in Northern Jordan. Int J Microbiol 2009; 2009:513874. [PMID: 19936109 PMCID: PMC2777014 DOI: 10.1155/2009/513874] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Accepted: 07/25/2009] [Indexed: 11/17/2022] Open
Abstract
Background and Objectives. Extended spectrum β-lactamase (ESBL) production is increasing all over the world, and organisms other than E. coli and K. pneumoniae are acquiring this character. ESBL production is detectable by automation, E-test, double disk diffusion (DDD), and PCR. This study aimed to determine the prevalence of ESBL production among clinical isolates of gram-negative rods, and to evaluate the effectiveness of augmentation of clavunate with Cefotaxime, Ceftazoxime, Aztreonam, Ceftriaxone, and Cefpodoxime in detecting ESBL production.
Methods. 472 clinical gram-negative isolates identified by standard methods were tested for ESBL-production by (DDD) method using six cephalosporins and amoxicillin-clavulinate discs.
Results. 108/472 (22.9%) of the isolates were ESBL producers, and were prevalent in tertiary care hospitals. 88.2% of E. cloacae, 71.4% of K. pneumoniae, 28.6% of K. oxytoca, 12.5% of C. freundii, 11.1% of A. calcoacceticus, and 10.8% of E. coli were ESBL producers. The DDD test demonstrated some variations in the efficacy of the different cephalosporins in detecting all the ESBL producers. The inclusion of ceftizoxime discs increased the efficacy of the test. It is concluded that ESBL-producing bacteria were prevalent among our hospitalized patients, and involved genera other than Klebsiella and Escherichia, and the inclusion of ceftizoxime increased the efficacy of ESBL detection by the DDD test.
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Mahrouki S, Ben–Achour N, Chouchani C, Ben–Moussa M, Belhadj O. Identification of plasmid-encoded extended spectrum β-lactamases produced by a clinical strain of Proteus mirabilis. ACTA ACUST UNITED AC 2009; 57:e55-9. [DOI: 10.1016/j.patbio.2008.02.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2008] [Accepted: 02/28/2008] [Indexed: 11/30/2022]
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15
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Novel plasmid-encoded ceftazidime-hydrolyzing CTX-M-53 extended-spectrum beta-lactamase from Salmonella enterica serotypes Westhampton and Senftenberg. Antimicrob Agents Chemother 2009; 53:1944-51. [PMID: 19273683 DOI: 10.1128/aac.01581-08] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We describe the characterization of a novel CTX-M beta-lactamase from Salmonella enterica. Four S. enterica isolates (three of serotype Westhampton and one of serotype Senftenberg) resistant to extended-spectrum cephalosporins (cefotaxime and ceftazidime) were recovered in 2004 from living cockles in three supermarkets located in distant geographic areas in France, which got their supplies from the same fishery. The isolates were found to produce a novel extended-spectrum beta-lactamase (ESBL) belonging to the CTX-M-1 phylogenetic group and named CTX-M-53. The CTX-M-53 beta-lactamase harbored the substitution Asp240Gly, like the CTX-M-15 enzyme, which is specifically implicated in a higher catalytic efficiency against ceftazidime. The bla(CTX-M-53) gene was located on a mobilizable 11-kb plasmid, pWES-1. The complete sequence of pWES-1 revealed the presence of a novel insertion sequence, ISSen2, and an IS26 element upstream and downstream of the bla(CTX-M-53) gene, respectively; however, transposition assays of the bla(CTX-M-53) gene were unsuccessful. IS26 elements may have contributed to the acquisition of the bla(CTX-M-53) gene. Interestingly, the mobilization module of the pWES-1 plasmid was similar to that of quinolone resistance plasmids (carrying the qnrS2 gene) from aquatic sources. Although belonging to two serotypes differentiated on the basis of the O-antigen structure (E1 or E4 groups), the isolates were found to be genetically indistinguishable by pulsed-field gel electrophoresis. Multilocus sequence typing showed that the isolates of serotype Westhampton had a sequence type, ST14, common among isolates of serotype Senftenberg. This is the first characterization of the CTX-M-53 ESBL, which represents an additional ceftazidime-hydrolyzing CTX-M enzyme.
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16
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Quantifying nonspecific TEM beta-lactamase (blaTEM) genes in a wastewater stream. Appl Environ Microbiol 2008; 75:203-11. [PMID: 18997031 DOI: 10.1128/aem.01254-08] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
To control the antibiotic resistance epidemic, it is necessary to understand the distribution of genetic material encoding antibiotic resistance in the environment and how anthropogenic inputs, such as wastewater, affect this distribution. Approximately two-thirds of antibiotics administered to humans are beta-lactams, for which the predominant bacterial resistance mechanism is hydrolysis by beta-lactamases. Of the beta-lactamases, the TEM family is of overriding significance with regard to diversity, prevalence, and distribution. This paper describes the design of DNA probes universal for all known TEM beta-lactamase genes and the application of a quantitative PCR assay (also known as Taqman) to quantify these genes in environmental samples. The primer set was used to study whether sewage, both treated and untreated, contributes to the spread of these genes in receiving waters. It was found that while modern sewage treatment technologies reduce the concentrations of these antibiotic resistance genes, the ratio of bla(TEM) genes to 16S rRNA genes increases with treatment, suggesting that bacteria harboring bla(TEM) are more likely to survive the treatment process. Thus, beta-lactamase genes are being introduced into the environment in significantly higher concentrations than occur naturally, creating reservoirs of increased resistance potential.
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17
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Savini V, Catavitello C, Talia M, Di Berardino F, Manna A, Balbinot A, Febbo F, Carlino D, Fioritoni F, Di Bonaventura G, D'Antonio D. Ulcer Infection by ESβL-Producing Proteus mirabilis: A Case Report. INT J LOW EXTR WOUND 2008; 7:99-101. [DOI: 10.1177/1534734608316107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this article, a case of decubitus ulcer infection caused by an extended-spectrum β-lactamase-producing Proteus mirabilis strain, successfully treated with oral amoxicillin-clavulanate (1-month therapy) is described. This article focuses on diffusion and clinical effect of extended-spectrum β-lactamases-producing Proteus mirabilis on treatment of gram negative lower extremity infections.
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Affiliation(s)
- Vincenzo Savini
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo,
| | - Chiara Catavitello
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
| | - Marzia Talia
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
| | - Fabio Di Berardino
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
| | - Assunta Manna
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
| | - Andrea Balbinot
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
| | - Fabio Febbo
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
| | - Daniela Carlino
- Dipartimento di Ematologia, Ospedale Civile Spirito
Santo, Universita degli Studi Gabriele D'Annunzio, Pescara
| | - Francesca Fioritoni
- Dipartimento di Ematologia, Ospedale Civile Spirito
Santo, Universita degli Studi Gabriele D'Annunzio, Pescara
| | - Giovanni Di Bonaventura
- Laboratorio di Microbiologia Clinica, Centro Studi Invecchiamento
(Ce.S.I.), Università degli Studi Gabriele D'Annunzio, Chieti Italy
| | - Domenico D'Antonio
- Unità Operativa Complessa di Microbiologia e Virologia
Clinica, Dipartimento di Medicina Trasfusionale, Ospedale Civile Spirito Santo
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18
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Si H, Hu J, Liu Z, Zeng ZL. Antibacterial effect of oregano essential oil alone and in combination with antibiotics against extended-spectrum beta-lactamase-producing Escherichia coli. ACTA ACUST UNITED AC 2008; 53:190-4. [PMID: 18435748 DOI: 10.1111/j.1574-695x.2008.00414.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In this paper, we studied the antibacterial effects of oregano essential oil (OEO) both alone, using a twofold dilution method, and combined with antibiotics, using a checkerboard microtitre assay, against extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli. The result indicated that multiple drug-resistant E. coli was very sensitive to OEO and polymycin; their minimal inhibitory concentration values are 0.5 microL mL(-1) and 0.8 microg mL(-1). The antibacterial effects of OEO in combination with kanamycin were independent against E. coli, with fractional inhibitory concentration (FIC) indices of 1.5. The antibacterial effects of OEO combined with amoxicillin, polymycin, and lincomycin showed an additive effect against E. coli, with FIC indices in the range of 0.625-0.750. The antibacterial effects of OEO in combination with fluoroquinolones, doxycycline, lincomycin, and maquindox florfenicol displayed synergism against E. coli, with FIC indices ranging from 0.375 to 0.500. The combination of OEO with fluoroquinolones, doxycycline, lincomycin, and maquindox florfenicol to treat infections caused by ESBL-producing E. coli may lower, to a great extent, the effective dose of these antibiotics and thus minimize the side effects of antibiotics. This is the first report on OEO against ESBL-producing E. coli.
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Affiliation(s)
- Hongbin Si
- Guangdong Provincial Key Laboratory of Veterinary Pharmaceutics Development and Safety Evaluation, College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
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19
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Wagenlehner F, Weidner W, Naber K. Antibiotics in Urology – New Essentials. Urol Clin North Am 2008; 35:69-79; vi. [DOI: 10.1016/j.ucl.2007.09.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Mahamat A, Lavigne JP, Bouziges N, Daurès JP, Sotto A. [Antimicrobial susceptibility of Proteus mirabilis urinary tract isolates from 1999 to 2005 at Nîmes University Hospital]. ACTA ACUST UNITED AC 2006; 54:456-61. [PMID: 17030456 DOI: 10.1016/j.patbio.2006.07.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2006] [Accepted: 07/21/2006] [Indexed: 11/25/2022]
Abstract
AIM OF THE STUDY To analyse antimicrobial resistance trends of Proteus mirabilis urinary tract isolates from 1999 to 2005 at the Nîmes University hospital. MATERIALS AND METHODS We retrospectively collected non-duplicate urinary tract infections and colonization isolates from inpatients between 1 January 1999 and 31 December 2005. RESULTS One thousand and eight non-duplicate urinary tract isolates were studied, 63.1% were from females and the mean age was 76 years. The mean resistance rate was 59.0% for amoxicillin (AMX), 48.0% for piperacillin (PIP), 3.9% for cefotaxim, 33.9% for amoxicillin plus clavulanic acid (AMC) and 2.8% for piperacillin plus tazobactam (TZP). A significant increase in resistance was observed for AMC and TZP. The mean resistance rate was 35.0% for norfloxacin, 34.8% for ofloxacin and 23.5% for ciprofloxacin. No significant increase in resistance to fluoroquinolones was seen except for ciprofloxacin whereas a significant increase was observed for aminoglycosides. The mean rate resistance for cotrimoxazole was 33.2% with a significant decrease in the resistance during the study period. CONCLUSION P. mirabilis stilled sensitive to cefotaxim or ceftazidim and to TZP. The significant increase in the rate resistance to AMC and TZP could be explained by production of beta-lactamases and in particular extended-spectrum beta-lactamases. The increase in resistance observed for fluoroquinolones become a major concern. Amikacine was the most active aminoglycosides. These data suggested for the re-enforcement of the antimicrobial susceptibility surveillance in order to optimise the rational use of antibiotics.
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Affiliation(s)
- A Mahamat
- Recherche clinique et épidémiologie, DIM, groupe hospitalo-universitaire Carémeau, CHU de Nîmes, place du Professeur-Debré, 30900 Nîmes, France.
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21
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Wu LT, Wu HJ, Chung JG, Chuang YC, Cheng KC, Yu WL. Dissemination of Proteus mirabilis isolates harboring CTX-M-14 and CTX-M-3 β-lactamases at 2 hospitals in Taiwan. Diagn Microbiol Infect Dis 2006; 54:89-94. [PMID: 16406185 DOI: 10.1016/j.diagmicrobio.2005.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Revised: 09/09/2005] [Accepted: 09/12/2005] [Indexed: 11/17/2022]
Abstract
From February to June 2003, 111 clinical isolates of Proteus mirabilis were mainly isolated from patients with respiratory or urinary tract infections hospitalized at 3 district hospitals (A, B, C) in central Taiwan. Among them, 34 (30.6%) strains, isolated within 2 hospitals (A and B), exhibited nonsusceptibility to cefotaxime with significant reduction of MIC (> or = 3 log2 dilution) by the effect of clavulanic acid, which confirmed the phenotype of extended-spectrum beta-lactamases (ESBLs). These ESBL producers were coresistant to gentamicin, isepamicin, and amikacin, but remained susceptible to ceftazidime (MIC, < or = 0.5 microg/mL) and meropenem (MIC, <0.5 microg/mL). By isoelectric focusing analysis, polymerase chain reaction, and nucleotide sequencing, we detected the presence of CTX-M-14 in 33 strains and CTX-M-3 in 6 strains (5 strains harboring both CTX-M-14 and CTX-M-3 enzymes). These beta-lactamase genes can be successfully transferred by the conjugative plasmid. Molecular epidemiology of the 34 ESBL-producing P. mirabilis strains by pulsed-field gel electrophoresis using SfiI restriction enzyme revealed 9 different genotypes, suggesting epidemic clones with intra- and interhospital spread. In conclusion, the broadly extended clonal spreading of CTX-M-type P. mirabilis was first discovered at the district hospitals in Taiwan.
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Affiliation(s)
- Lii-Tzu Wu
- The Institute of Medical Science and Department of Microbiology, China Medical University, Taichung 404, Taiwan
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22
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Giamarellou H. Multidrug resistance in Gram-negative bacteria that produce extended-spectrum beta-lactamases (ESBLs). Clin Microbiol Infect 2005; 11 Suppl 4:1-16. [PMID: 15953019 DOI: 10.1111/j.1469-0691.2005.01160.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In 1983, just two years after the introduction of the oxymino-beta-lactams to the market , the first extended-spectrum beta-lactamases were isolated in Germany from Klebsiella pneumoniae strains. Since then several outbreaks have been reported in many European countries and the USA, and nowadays in several places worldwide the problem seems to reach endemic dimensions, with rates exceeding 50% in some countries, such as Portugal and Turkey. On the other hand not only K. pneumoniae but also Escherichia coli strains, with Enterobacter aerogenes predominating among the other enterobacteriaceal species, are increasingly reported as ESBL producers. In this review types, molecular characteristics, detection methods, epidemiology as well as interventions for therapy and antibiotic strategies to prevent and control infections caused by ESBL-producing microorganisms, are presented and discussed.
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Affiliation(s)
- H Giamarellou
- 4th Department of Internal Medicine, Athens University Medical School, University General Hospital Attikon, Greece.
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23
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Endimiani A, Luzzaro F, Brigante G, Perilli M, Lombardi G, Amicosante G, Rossolini GM, Toniolo A. Proteus mirabilis bloodstream infections: risk factors and treatment outcome related to the expression of extended-spectrum beta-lactamases. Antimicrob Agents Chemother 2005; 49:2598-605. [PMID: 15980325 PMCID: PMC1168714 DOI: 10.1128/aac.49.7.2598-2605.2005] [Citation(s) in RCA: 109] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Bloodstream infection (BSI) due to Proteus mirabilis strains is a relatively uncommon clinical entity, and its significance has received little attention. This study was initiated to evaluate risk factors and treatment outcome of BSI episodes due to P. mirabilis producing extended-spectrum beta-lactamases (ESBLs). Twenty-five BSI episodes caused by P. mirabilis occurred at our hospital (Ospedale di Circolo e Fondazione Macchi, Varese, Italy) over a 7.5-year period. Phenotypic and molecular methods were used to assess ESBL production. Clinical records of BSI patients were examined retrospectively. Demographic data, underlying diseases (according to McCabe and Jackson classification and Charlson weighted index), risk factors, and treatment outcome were investigated by comparing cases due to ESBL-positive strains to cases due to ESBL-negative strains. Eleven isolates were found to express ESBLs (TEM-52 or TEM-92). The remaining 14 isolates were ESBL negative and were uniformly susceptible to extended-spectrum cephalosporins and monobactams. Comparison of the two groups showed that previous hospitalization in a nursing home (P = 0.04) and use of bladder catheter (P = 0.01) were significant risk factors for infections due to ESBL-positive strains. In addition, cases due to ESBL-positive strains showed a significantly higher mortality attributable to BSI (P = 0.04). BSI cases due to ESBL-negative isolates uniformly responded to therapy, whereas 5/11 cases due to ESBL-positive isolates failed to respond (P < 0.01). Use of carbapenems was associated with complete response independently of ESBL production. Therapeutic failure and mortality may occur in BSI episodes caused by ESBL-positive P. mirabilis isolates. Thus, recognition of ESBL-positive strains appears to be critical for the clinical management of patients with systemic P. mirabilis infections.
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Affiliation(s)
- Andrea Endimiani
- Laboratorio di Microbiologia, Ospedale di Circolo e Università dell'Insubria, Viale Borri 57, 21100 Varese, Italy
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24
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Kim SH, Wei CI, An H. Molecular characterization of multidrug-resistant Proteus mirabilis isolates from retail meat products. J Food Prot 2005; 68:1408-13. [PMID: 16013378 DOI: 10.4315/0362-028x-68.7.1408] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Sixty-four multidrug-resistant isolates of Proteus mirabilis were collected from retail meat products in Oklahoma. The isolates showed four different patterns of antibiotic resistance based on their resistant phenotype and genotypes. Most of these isolates were resistant to ampicillin, tetracycline, gentamycin, and kanamycin. Class 1 integrons were detected as a common carrier of the antibiotic-resistant genes, such as aadA1, aadB, and aadA2. A few isolates (9%) contained class 2 integrons with three gene cassettes included: dhfr1, sat1, and aadA1. These isolates were even resistant to nalidixic acid due to mutations in gyrA and parC. All ampicillin-resistant isolates contained blaTEM-1. Plasmids that contained class 1 or 2 integrons and blaTEM-1 were able to be transferred from P. mirabilis isolates into Escherichia coli by conjugation, indicating that conjugal transfer could contribute to the dissemination of antibiotic resistance genes between the Enterobacteriaceae species.
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Affiliation(s)
- Shin-Hee Kim
- Department of Nutritional Sciences, College of Human Environmental Sciences, Oklahoma State University, Stillwater, Oklahoma 74078, USA.
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25
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Rodríguez C, Radice M, Perazzi B, Castro S, Juárez J, Santini P, Vay C, Famiglietti A, Gutkind G. [Enzymatic resistance to beta lactam antibiotics within the genus Proteus and evaluation of Proteus mirabilis phenotypes and genotypes for resistance to third- and fourth-generation cephalosporins]. Enferm Infecc Microbiol Clin 2005; 23:122-6. [PMID: 15757582 DOI: 10.1157/13072160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate betalactam resistance within the genus Proteus and characterize the betalactamases responsible for this resistance. METHODS We analyzed 99 strains (87, P. mirabilis; 10 P. vulgaris, and 2, P. penneri) isolated from patients at one University Hospital. Antibiotic susceptibility tests were performed according to NCCLS recommendations. Presence of extended spectrum betalactamases (ESBL) was inferred by both double disk diffusion tests and minimum inhibitory concentration (MIC) of third and fourth generation cephalosporins alone and in the presence of clavulanic acid. Isoelectric points (pI) of the enzymes were estimated by isoelectrofocusing and the presence of the encoding genes was confirmed by polymerase chain reaction (PCR). RESULTS A broad spectrum betalactamase could be detected in those isolates (28%) resistant to penicillin and first generation cephalosporins while CTX-M-2 enzyme could be detected in P. mirabilis isolates resistant to third and fourth generation cephalosporins (18%). One of the P. vulgaris displayed reduced susceptibility to cefotaxime due to an enzyme of pI 7.4, while resistance to cefotaxime in one P. penneri was related to an enzyme of pI 6.8. Both enzymes were active on cefotaxime (1,000 mg/l) in the iodometric assay. CONCLUSION The broad extended spectrum betalactamase within genus Proteus was TEM-1, while CTX-M-2 was the ESBL responsible for the third and fourth generation cephalosporins in P. mirabilis. In P. vulgaris and P. penneri this resistance was associated with the hyperproduction of the chromosomal encoded betalactamase.
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Affiliation(s)
- Cynthia Rodríguez
- Cátedra de Análisis Clínicos I, Laboratorio de Bacteriología, Hospital de Clínicas, Universidad de Buenos Aires, Argentina
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26
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Wagenlehner FME, Weidner W, Naber KG. Emerging drugs for bacterial urinary tract infections. Expert Opin Emerg Drugs 2005; 10:275-98. [PMID: 15934867 DOI: 10.1517/14728214.10.2.275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Bacterial urinary tract infections (UTIs) are frequent infections in the outpatient as well as in the nosocomial setting. The stratification into uncomplicated and complicated UTIs has proven to be clinically useful. Bacterial virulence factors on the one side and the integrity of the host defence mechanisms on the other side determine the course of the infection. In uncomplicated UTIs, Escherichia coli is the leading organism, whereas in complicated UTIs, the bacterial spectrum is much broader, including Gram-negative, Gram-positive and often multiresistant organisms. The therapy of uncomplicated UTIs is almost exclusively antibacterial, whereas in complicated UTIs the complicating factors also have to be treated. There are two predominant aims in the antimicrobial treatment of both uncomplicated and complicated UTIs: i) rapid and effective response to therapy and prevention of recurrence of the individual patient treated; and ii) prevention of emergence of resistance to chemotherapy in the microbial environment. The aim of this review is to highlight the existing, and to describe emerging, treatment options for UTIs.
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Affiliation(s)
- Florian M E Wagenlehner
- Urologic Clinic, Hospital St. Elisabeth, St. Elisabeth Street. 23, D-94315 Straubing, Germany.
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Biendo M, Thomas D, Laurans G, Hamdad-Daoudi F, Canarelli B, Rousseau F, Castelain S, Eb F. Molecular diversity of Proteus mirabilis isolates producing extended-spectrum β-lactamases in a French university hospital. Clin Microbiol Infect 2005; 11:395-401. [PMID: 15819867 DOI: 10.1111/j.1469-0691.2005.01147.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Between February 1997 and December 2002, 3340 hospitalised patients yielded samples positive for Proteus mirabilis, of whom 45 (1.3%) were colonised/infected by P. mirabilis producing extended-spectrum beta-lactamases (ESBLs). The gross incidence of patients colonised/infected by ESBL-producing P. mirabilis was 1.61/10(5) days of hospitalisation, with 20% of isolates being collected from patients in urology wards, most frequently (53.3%) from urine samples. Seventeen (37.7%) of the 43 isolates were obtained from samples collected within 48 h of hospitalisation, indicating that they were community-acquired. Isoelectric focusing assays and sequencing identified the TEM-24, TEM-92 and TEM-52 ESBLs. Pulsed-field gel electrophoresis revealed eight pulsotypes (I-VIII), with the two most common pulsotypes, IV and VI, comprising ten (23.3%) and 12 (26.6%) isolates, respectively. These pulsotypes were considered to represent epidemic strains and spread in various wards of the hospital.
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Affiliation(s)
- M Biendo
- Laboratoire de Bactériologie et Hygiène, CHU Nord, France.
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28
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Ho PL, Ho AYM, Chow KH, Wong RCW, Duan RS, Ho WL, Mak GC, Tsang KW, Yam WC, Yuen KY. Occurrence and molecular analysis of extended-spectrum β-lactamase-producing Proteus mirabilis in Hong Kong, 1999–2002. J Antimicrob Chemother 2005; 55:840-5. [PMID: 15857942 DOI: 10.1093/jac/dki135] [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: 11/14/2022] Open
Abstract
OBJECTIVES A study was conducted to evaluate the occurrence and characterization of extended-spectrum beta-lactamases (ESBLs) among blood isolates of Proteus mirabilis collected over a 4 year period in Hong Kong. METHODS Production of ESBLs among 99 consecutive and non-duplicate isolates was evaluated by the double-disc synergy test. The ESBLs were characterized by isoelectric focusing and PCR sequencing using specific primers. The epidemiological relationship of the isolates was studied by the Dienes test and PFGE. RESULTS ESBLs were identified in 13 isolates, from none in 1999-2000 and up to 18.5% (5/27) in 2001 and 25.8% (8/31) in 2002. The ESBL-producing isolates were more resistant to ceftriaxone than to ceftazidime, and were more likely than non-ESBL-producers to have resistance to ciprofloxacin (76.9% versus 14%) and gentamicin (38.5% versus 9.3%). The ESBL content included CTX-M-13 (n=8), CTX-M-14 (n=3), SHV-5 (n=2), TEM-11 (n=1), and an unidentified ESBL with a pI of 7.5. The Dienes test revealed that the genetic background in the 99 isolates was highly heterogeneous, with 54 distinct types among 92 isolates and seven were non-typeable. Among the 13 ESBL-producing isolates, five different backgrounds, including one cluster (Dienes-pulsotype A) with nine isolates, were identified by both Dienes test and PFGE, thus suggesting both clonal and multi-clonal spread of the CTX-M enzymes. CONCLUSIONS Our findings indicate the emergence of CTX-M enzymes among P. mirabilis in Hong Kong. More ESBL screening of this species is required to improve their recognition.
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Affiliation(s)
- P L Ho
- Division of Infectious Diseases, Department of Microbiology and Centre of Infection, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Pokfulam, Hong Kong Special Administrative Region, China.
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Literacka E, Empel J, Baraniak A, Sadowy E, Hryniewicz W, Gniadkowski M. Four variants of the Citrobacter freundii AmpC-Type cephalosporinases, including novel enzymes CMY-14 and CMY-15, in a Proteus mirabilis clone widespread in Poland. Antimicrob Agents Chemother 2004; 48:4136-43. [PMID: 15504832 PMCID: PMC525428 DOI: 10.1128/aac.48.11.4136-4143.2004] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Twenty-nine Proteus mirabilis isolates from 17 Polish hospitals were analyzed. The isolates were resistant to a variety of antimicrobials, and their patterns of resistance to beta-lactams resembled those of the constitutive class C cephalosporinase (AmpC) producers. Indeed, beta-lactamases with a pI of approximately 9.0 were found in all of the isolates, and they were subsequently identified as four AmpC-type cephalosporinases, CMY-4, -12, -14, and -15, of which the two last ones were novel enzyme variants. The enzymes were of Citrobacter freundii origin and were closely related to each other, with CMY-4 likely being the evolutionary precursor of the remaining ones. The bla(CMY) genes were located exclusively in chromosomal DNA, within EcoRI restriction fragments of the same size of approximately 10 kb. In the CMY-12- and -15-producing isolates, an additional fragment of approximately 4.5 kb hybridized with the bla(CMY) probe as well, which could have arisen from a duplication event during the evolution of the genes. In all of the isolates, the ISEcp1 mobile element, which most probably is involved in mobilization of the C. freundii ampC gene, was placed at the same distance from the 5' ends of the bla(CMY) genes, and sequences located between them were identical in isolates carrying each of the four genes. These data suggested that a single chromosome-to-chromosome transfer of the ampC gene from C. freundii to P. mirabilis could have initiated the spread and evolution of the AmpC-producing P. mirabilis in Poland. The hypothesis seems to be confirmed by pulsed-field gel electrophoresis typing, which revealed several cases of close relatedness between the P. mirabilis isolates from distant centers and showed an overall similarity between the majority of the multiresistant isolates.
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Affiliation(s)
- Elzbieta Literacka
- National Institute of Public Health, ul. Chełmska 30/34, 00-725 Warsaw, Poland
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30
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Stürenburg E, Lang M, Horstkotte MA, Laufs R, Mack D. Evaluation of the MicroScan ESBL plus confirmation panel for detection of extended-spectrum beta-lactamases in clinical isolates of oxyimino-cephalosporin-resistant Gram-negative bacteria. J Antimicrob Chemother 2004; 54:870-5. [PMID: 15471997 DOI: 10.1093/jac/dkh449] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE We aimed to assess the performance of the MicroScan ESBL plus confirmation panel using a series of 87 oxyimino-cephalosporin-resistant Gram-negative bacilli of various species. METHODS Organisms tested included 57 extended-spectrum beta-lactamase (ESBL) strains comprising Enterobacter aerogenes (3), Enterobacter cloacae (10), Escherichia coli (11), Klebsiella pneumoniae (26), Klebsiella oxytoca (3) and Proteus mirabilis (4). Also included were 30 strains resistant to oxyimino cephalosporins but lacking ESBLs, which were characterized with other resistance mechanisms, such as inherent clavulanate susceptibility in Acinetobacter spp. (4), hyperproduction of AmpC enzyme in Citrobacter freundii (2), E. aerogenes (3), E. cloacae (3), E. coli (4), Hafnia alvei (1) and Morganella morganii (1), production of plasmid-mediated AmpC beta-lactamase in K. pneumoniae (3) and E. coli (3) or hyperproduction of K1 enzyme in K. oxytoca (6). RESULTS The MicroScan MIC-based clavulanate synergy correctly classified 50 of 57 ESBL strains as ESBL-positive and 23 of 30 non-ESBL strains as ESBL-negative (yielding a sensitivity of 88% and a specificity of 76.7%, respectively). False negatives among ESBL producers were highest with Enterobacter spp. due to masking interactions between ESBL and AmpC beta-lactamases. False-positive classifications occurred in two Acinetobacter spp., one E. coli producing plasmid-mediated AmpC beta-lactamase and two K. oxytoca hyperproducing their chromosomal K1 beta-lactamase. CONCLUSION The MicroScan clavulanate synergy test proved to be a valuable tool for ESBL confirmation. However, this test has limitations in detecting ESBLs in Enterobacter spp. and in discriminating ESBL-related resistance from the K1 enzyme and from inherent clavulanate susceptibility in Acinetobacter spp.
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Affiliation(s)
- Enno Stürenburg
- Institut für Infektionsmedizin, Zentrum für Klinisch-Theoretische Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany.
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31
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Nagano N, Shibata N, Saitou Y, Nagano Y, Arakawa Y. Nosocomial outbreak of infections by Proteus mirabilis that produces extended-spectrum CTX-M-2 type beta-lactamase. J Clin Microbiol 2004; 41:5530-6. [PMID: 14662935 PMCID: PMC308985 DOI: 10.1128/jcm.41.12.5530-5536.2003] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
Nineteen multidrug-resistant Proteus mirabilis strains were isolated from 19 patients suffering from infections probably caused by P. mirabilis. These strains were recovered from urine or other urogenital specimens of 16 inpatients and three outpatients with a hospitalization history in a urology ward of Funabashi Medical Center, from July 2001 to August 2002. These strains demonstrated resistance to cefotaxime, ceftriaxone, cefpodoxime, and aztreonam, while they were highly susceptible to ceftazidime (MIC, </=0.5 micro g/ml). The resistance level of these strains to cefotaxime was decreased by the presence of clavulanic acid. Therefore, the strains were speculated to produce extended-spectrum class A beta-lactamases. These strains were later found to carry bla(CTX-M-2) genes by both PCR and sequencing analyses. The profiles of SmaI-digested genomic DNA of 19 isolates were distinguished into five different clusters by biased sinusoidal field gel electrophoresis. Four of them, consisting of 18 isolates, were suggested to be a clonal expansion. These findings suggested that a nosocomial outbreak of infections by CTX-M-2-producing P. mirabilis had occurred in our medical center. Most patients suffered from urogenital malignancies with long-term catheterization. Cefazolin, cefoperazone-sulbactam, and/or levofloxacin were mostly administered to the patients, but these agents seemed ineffective for eradication of CTX-M-2 producers. Early recognition and rapid identification of colonizing antimicrobial-resistant bacteria, including CTX-M-2-producing P. mirabilis, would be the most effective measures to cope with further spread of this kind of hazardous microorganism in clinical environments.
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Affiliation(s)
- Noriyuki Nagano
- Medical Microbiology Laboratory, Funabashi Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba, Japan.
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Mutnick AH, Kirby JT, Jones RN. CANCER resistance surveillance program: initial results from hematology-oncology centers in North America. Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance. Ann Pharmacother 2003; 37:47-56. [PMID: 12503932 DOI: 10.1345/aph.1c292] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The CANCER (Chemotherapy Alliance for Neutropenics and the Control of Emerging Resistance) surveillance program was initiated to collect culture data on antimicrobial and antifungal agents in hospitals treating neutropenic patients in North America, as a means to monitor the development of microbial resistance. METHODS A total of 2042 isolates from bloodstream, respiratory, urinary, and cutaneous infections in 2000-2001 were submitted by 33 oncology centers, clinics, and hospitals in North America, sent to a central laboratory, and tested by National Committee for Clinical Laboratory Standards methods against 42 different antimicrobials. RESULTS Staphylococcus aureus, Escherichia coli, coagulase-negative staphylococci, Enterococcus spp., and Klebsiella spp. represented the most frequently isolated pathogens during the initial benchmark year. The incidence of extended-spectrum beta-lactamase-producing phenotypes ranged from 1.6% to 4.6% among E. coli and Klebsiella spp. Amikacin, tobramycin, polymyxin B, and piperacillin/tazobactam provided the highest susceptibility rates against Pseudomonas aeruginosa isolates. Yeast bloodstream isolates demonstrated complete susceptibility to amphotericin B, but 14% of strains were considered to have high-level fluconazole resistance. CONCLUSIONS Elevated resistance rates when compared to general hospital strains were not observed in the CANCER program during the baseline year of this novel longitudinal, resistance surveillance program. The prevalence of gram-positive pathogens, although representing more than 50% of all bacterial isolates, was slightly lower than that reported previously by other investigators. Continued evaluation for antimicrobial resistance as well as changes in the prevalence of gram-positive pathogens requires the use of longitudinal surveillance programs such as the CANCER program. Such initiatives allow the development of therapeutic strategies for coping with changes in resistance and pathogen prevalence in this dynamic at-risk patient environment.
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Affiliation(s)
- Alan H Mutnick
- Pharmacology, The JONES Group/JMI Laboratories, North Liberty, IA 52317-9258, USA.
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Naas T, Zerbib M, Girlich D, Nordmann P. Integration of a transposon Tn1-encoded inhibitor-resistant beta-lactamase gene, bla(TEM-67) from Proteus mirabilis, into the Escherichia coli chromosome. Antimicrob Agents Chemother 2003; 47:19-26. [PMID: 12499163 PMCID: PMC148959 DOI: 10.1128/aac.47.1.19-26.2003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2002] [Revised: 06/04/2002] [Accepted: 09/21/2002] [Indexed: 01/09/2023] Open
Abstract
Proteus mirabilis NEL-1 was isolated from a urine sample of a patient hospitalized in a long-term care facility. Strain NEL-1 produced a beta-lactamase with a pI of 5.2 conferring resistance to amoxicillin and amoxicillin-clavulanic acid. Sequencing of a PCR amplicon by using TEM-specific primers revealed a novel bla(TEM) gene, bla(TEM-67). TEM-67 was an IRT-1-like TEM derivative related to TEM-65 (Lys39, Cys244) with an additional Leu21Ile amino acid substitution in the leader peptide. The biochemical properties of TEM-67 were equivalent to those described for TEM-65. Analysis of sequences surrounding bla(TEM-67) revealed that it was located on a transposon, Tn1, which itself was located on a 48-kb non-self-transferable plasmid, pANG-1. Electroporation of plasmid pANG-1 into Escherichia coli DH10B resulted in the integration of bla(TEM-67) into the chromosome, whereas it remained episomal in the P. mirabilis CIP103181 reference strain. Further characterization of pANG-1 revealed the presence of two identical sequences on both sides of Tn1 that contained an IS26 insertion sequence followed by a novel colicin gene, colZ, which had 20% amino acid identity with other colicin genes. The characterization of this novel TEM derivative provides further evidence for the large diversity of plasmid-encoded beta-lactamases produced in P. mirabilis and for their spread to other enterobacterial species through transposable-element-mediated events.
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Affiliation(s)
- Thierry Naas
- Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 94275 Le Kremlin-Bicêtre, France.
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Bonnet R, Chanal C, Ageron E, Sirot D, De Champs C, Grimont P, Sirot J. Inducible AmpC beta-lactamase of a new member Enterobacteriaceae. Antimicrob Agents Chemother 2002; 46:3316-9. [PMID: 12234870 PMCID: PMC128800 DOI: 10.1128/aac.46.10.3316-3319.2002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Extensive biochemical testing and 16S rRNA and rpoB sequence analysis revealed that clinical strain CF01Ent1, initially identified as Buttiauxella agrestis by the use of Api 32 biochemical strips, is a new organism in the Enterobacteriaceae family. It produced an inducible AmpC-type beta-lactamase whose sequence shares 69 to 72% identity with those of the other AmpC-type beta-lactamases of ENTEROBACTERIACEAE: This enzyme exhibits an atypical high affinity for all beta-lactams tested.
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Affiliation(s)
- Richard Bonnet
- Laboratoire de Bactériologie, Faculté de Médecine, 63001 Clermont-Ferrand Cedex, France.
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36
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Wagenlehner FME, Niemetz A, Dalhoff A, Naber KG. Spectrum and antibiotic resistance of uropathogens from hospitalized patients with urinary tract infections: 1994-2000. Int J Antimicrob Agents 2002; 19:557-64. [PMID: 12135848 DOI: 10.1016/s0924-8579(02)00100-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
During the period 1994-2000 all uropathogens cultured from urine of hospitalized urological patients were identified and susceptibility was tested against 11 antibacterials. Duplicated isolates were eliminated. There was no general trend of increased of resistance apart from E. coli to ciprofloxacin (10.4% in 2000). Vancomycin-resistant staphylococci or enterococci was not significant. The lowest overall rates of resistance were found with piperacillin/tazobactam followed by ciprofloxacin and trimethoprim/sulphamethoxazole. Ciprofloxacin was the best oral antibiotic for the empirical treatment of urinary tract infection (UTI) due to Gram-negative rods and ampicillin/sulbactam for the treatment of UTI with Gram-positive cocci.
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37
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Mutnick AH, Turner PJ, Jones RN. Emerging antimicrobial resistances among Proteus mirabilis in Europe: report from the MYSTIC Program (1997-2001). Meropenem Yearly Susceptibility Test Information Collection. J Chemother 2002; 14:253-8. [PMID: 12120879 DOI: 10.1179/joc.2002.14.3.253] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Resistance patterns that are currently problematic in Europe can vary greatly within the same species over time, among various patient populations and among geographic regions on the same continent. The results from the Meropenem Yearly Susceptibility Test Information Collection (MYSTIC) Program, which monitors carbapenem resistance rates in institutions using meropenem, were used to determine resistance differences among Proteus mirabilis. MIC results from 688 P. mirabilis strains were classified into 4 patient care groups: ICU (n=426), neutropenia patients (NP; n=145), general wards (n=97) and cystic fibrosis patients (CF; n=20). A total of 40 centers from 12 European countries have participated since 1997, divided into 3 geographic regions (East, North, South). All testing was performed by NCCLS reference methods and interpretive criteria, including screening of extended-spectrum beta-lactamase (ESBL) phenotypes. Over the monitored interval the resistance rates varied for each agent without a clear trend toward a greater rate. Rank order of susceptibility was: meropenem (99%) > piperacillin/tazobactam (TAZ; 96%) > cefepime (95%) > ceftazidime (CAZ; 94%) > imipenem (IPM; 92%). Ciprofloxacin (CIP) was the least active agent tested (MIC90 4 microg/ml; 86% susceptible). Unexpectedly, 3.6% of P. mirabilis were imipenem-resistant (MIC, > or = 16 microg/ml). Greater rates of resistance were found for strains from NP and CF patients, and from eastern or southern European sites, usually associated with epidemic clusters. Generally susceptible species such as P. mirabilis have recently emerged as therapeutic problems in European medical centers following mutations that compromise CIP, CAZ and aminoglycoside use. Imipenem also showed decreased susceptibility of greater than 7% compared to less than 1% for meropenem. Continued surveillance by the MYSTIC Program appears to be a prudent practice to focus effective empiric treatment regimens.
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Affiliation(s)
- A H Mutnick
- The JONES Group/JMI Laboratories, North Liberty, Iowa 52317, USA.
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38
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Dumarche P, De Champs C, Sirot D, Chanal C, Bonnet R, Sirot J. TEM derivative-producing Enterobacter aerogenes strains: dissemination of a prevalent clone. Antimicrob Agents Chemother 2002; 46:1128-31. [PMID: 11897606 PMCID: PMC127085 DOI: 10.1128/aac.46.4.1128-1131.2002] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TEM-24 (CAZ-6) extended-spectrum beta-lactamase (ESBL) was detected in 1988 in Clermont-Ferrand, France, in Klebsiella pneumoniae (bla(TEM-24)) and Enterobacter aerogenes (bla(TEM-24b)), and since 1994, a TEM-24-producing E. aerogenes clonal strain has been observed elsewhere in the country. To determine if the spread of this clonal strain was restricted to TEM-24-producing E. aerogenes strains, 84 E. aerogenes strains (non-TEM/SHV-producing strains, TEM-1- or -2-producing strains, and different ESBL-producing strains), isolated from 1988 to 1999 in Clermont-Ferrand (n = 59) and in 11 other French hospitals in 1998 (n = 25), were studied. A clonal strain was found for TEM-24- but also for TEM-3- and TEM-1- or 2-producing isolates. This study shows that there is a clonal strain dependent on acquisition of the TEM-type enzyme (TEM-24 and other TEM types).
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Affiliation(s)
- P Dumarche
- Faculté de Médecine, Laboratoire de Bactériologie, 63001 Clermont-Ferrand Cedex, France
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Pagani L, Migliavacca R, Pallecchi L, Matti C, Giacobone E, Amicosante G, Romero E, Rossolini GM. Emerging extended-spectrum beta-lactamases in Proteus mirabilis. J Clin Microbiol 2002; 40:1549-52. [PMID: 11923394 PMCID: PMC140357 DOI: 10.1128/jcm.40.4.1549-1552.2002] [Citation(s) in RCA: 75] [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
Beta-lactamase production was detected in 147 (52%) of 282 consecutive nonduplicate Proteus mirabilis isolates obtained over a 1-year period from the S. Matteo Hospital of Pavia (northern Italy). Seventy isolates (48% of the beta-lactamase producers) were found to produce extended-spectrum beta-lactamases (ESBLs), identified as PER-1 (first report in this species) and TEM-52 in 52 and 18 isolates, respectively. Analysis of clonal diversity of the ESBL producers suggested different spreading patterns for the two ESBL determinants.
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Affiliation(s)
- Laura Pagani
- Dipartimento di Scienze Morfologiche, Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia, Italy
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40
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Perilli M, Segatore B, De Massis MR, Franceschini N, Bianchi C, Rossolini GM, Amicosante G. Characterization of a new extended-spectrum beta-lactamase (TEM-87) isolated in Proteus mirabilis during an Italian survey. Antimicrob Agents Chemother 2002; 46:925-8. [PMID: 11850290 PMCID: PMC127476 DOI: 10.1128/aac.46.3.925-928.2002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A new natural TEM derivative, named TEM-87, was identified in a Proteus mirabilis isolate from an Italian hospital. Compared to TEM-1, TEM-87 contains the following mutations: E104K, R164C, and M182T. Kinetic analysis of TEM-87 revealed extended-spectrum activity against oxyimino cephalosporins (preferentially ceftazidime) and aztreonam. Expression of blaTEM-87 in Escherichia coli decreased the host susceptibility to these drugs.
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Affiliation(s)
- Mariagrazia Perilli
- Dipartimento di Scienze e Tecnologie Biomediche, Università di L'Aquila, L'Aquila, Italy
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41
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Dutour C, Bonnet R, Marchandin H, Boyer M, Chanal C, Sirot D, Sirot J. CTX-M-1, CTX-M-3, and CTX-M-14 beta-lactamases from Enterobacteriaceae isolated in France. Antimicrob Agents Chemother 2002; 46:534-7. [PMID: 11796372 PMCID: PMC127047 DOI: 10.1128/aac.46.2.534-537.2002] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Six clinical CTX-M-producing isolates of the family Enterobacteriaceae were detected between 1999 and 2000 in different French hospitals. Two strains produced CTX-M-1 and CTX-M-3 and four strains produced CTX-M-14, a mutant Ala-231-->Val of CTX-M-9. A putative transposable element, ISEcp-1, was located 43 bp upstream of all the bla(CTX-M) genes. Two CTX-M-14-encoding plasmids exhibited similar restriction patterns. The CTX-M-1- and CTX-M-3-encoding plasmids were related to the CTX-M-1- and CTX-M-3-encoding plasmids previously reported in 1990 in France and in 1998 in Poland, respectively.
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Affiliation(s)
- C Dutour
- Laboratoire de Bactériologie, Faculté de Médecine, 63001 Clermont-Ferrand Cedex, France
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42
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Mammeri H, Gilly L, Laurans G, Vedel G, Eb F, Paul G. Catalytic and structural properties of IRT-21 beta-lactamase (TEM-77) from a co-amoxiclav-resistant Proteus mirabilis isolate. FEMS Microbiol Lett 2001; 205:185-9. [PMID: 11750800 DOI: 10.1111/j.1574-6968.2001.tb10945.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Proteus mirabilis strain MAG1, a clinical isolate that is resistant to broad-spectrum penicillins and co-amoxiclav, produces inhibitor-resistant TEM (IRT)-21, a novel mutant of TEM beta-lactamase. This enzyme has a pI of 5.2 and is derived from the bla(TEM-1a) gene ancestor. It contains two major amino acid substitutions specific for co-amoxiclav resistance (Leu-69 for Met and Ser-244 for Arg) that have never been found together previously. The dramatic loss of sensitivity to clavulanic acid, the enhancement of K(m) for all beta-lactams and markedly for ticarcillin, and the decrease in the catalytic efficiency makes IRT-21 comparable to the other IRTs with substitutions at position 244 or double substitutions.
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Affiliation(s)
- H Mammeri
- Laboratoire de Bactériologie, CHU, Amiens, France
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43
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Pai H, Lee HJ, Choi EH, Kim J, Jacoby GA. Evolution of TEM-related extended-spectrum beta-lactamases in Korea. Antimicrob Agents Chemother 2001; 45:3651-3. [PMID: 11709362 PMCID: PMC90891 DOI: 10.1128/aac.45.12.3651-3653.2001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2001] [Accepted: 08/21/2001] [Indexed: 11/20/2022] Open
Abstract
TEM-52, differing from TEM-1 by having the substitutions Glu-104-->Lys, Met-182-->Thr, and Gly-238-->Ser, has previously been described as the most prevalent extended-spectrum beta-lactamase (ESBL) in Korea. In a further survey, we discovered the ESBLs TEM-15, which is like TEM-52 but lacks the substitution at residue 182, and TEM-88, which is like TEM-52 with an additional Gly-196-->Asp substitution. TEM-88 retained the activity of TEM-52 against moxalactam. Otherwise, the kinetic properties of the three ESBLs failed to show an advantage to this evolution.
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Affiliation(s)
- H Pai
- Department of Internal Medicine, College of Medicine, Dankook University, Chonan, Korea
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Neuwirth C, Madec S, Siebor E, Pechinot A, Duez JM, Pruneaux M, Fouchereau-Peron M, Kazmierczak A, Labia R. TEM-89 beta-lactamase produced by a Proteus mirabilis clinical isolate: new complex mutant (CMT 3) with mutations in both TEM-59 (IRT-17) and TEM-3. Antimicrob Agents Chemother 2001; 45:3591-4. [PMID: 11709345 PMCID: PMC90874 DOI: 10.1128/aac.45.12.3591-3594.2001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
TEM-89 (CMT-3) is the first complex mutant beta-lactamase produced by a clinical strain of Proteus mirabilis (strain Pm 631). This new enzyme, which has a pI of 6.28, is derived from TEM-3 and has a single amino acid substitution also encountered in TEM-59 (inhibitor-resistant TEM beta-lactamase IRT-17): Ser-130 to Gly. TEM-89 hydrolyzed penicillins to the same extent that TEM-3 did but lost almost all hydrolytic activity for cephalosporins and, like TEM-59, was highly resistant to inhibitors.
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Affiliation(s)
- C Neuwirth
- Laboratoire de Bactériologie, Hôpital Universitaire du Bocage, 21034 Dijon Cedex, France.
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45
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Bradford PA. Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001; 14:933-51, table of contents. [PMID: 11585791 PMCID: PMC89009 DOI: 10.1128/cmr.14.4.933-951.2001] [Citation(s) in RCA: 1573] [Impact Index Per Article: 68.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Beta-lactamases continue to be the leading cause of resistance to beta-lactam antibiotics among gram-negative bacteria. In recent years there has been an increased incidence and prevalence of extended-spectrum beta-lactamases (ESBLs), enzymes that hydrolyze and cause resistance to oxyimino-cephalosporins and aztreonam. The majority of ESBLs are derived from the widespread broad-spectrum beta-lactamases TEM-1 and SHV-1. There are also new families of ESBLs, including the CTX-M and OXA-type enzymes as well as novel, unrelated beta-lactamases. Several different methods for the detection of ESBLs in clinical isolates have been suggested. While each of the tests has merit, none of the tests is able to detect all of the ESBLs encountered. ESBLs have become widespread throughout the world and are now found in a significant percentage of Escherichia coli and Klebsiella pneumoniae strains in certain countries. They have also been found in other Enterobacteriaceae strains and Pseudomonas aeruginosa. Strains expressing these beta-lactamases will present a host of therapeutic challenges as we head into the 21st century.
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Affiliation(s)
- P A Bradford
- Wyeth-Ayerst Research, Pearl River, New York 10965, USA.
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Abstract
The NPS-1 and TLE-1 beta-lactamase genes were cloned and sequenced. NPS-1 differed from LCR-1 beta-lactamase in 8 of 260 amino acids. TLE-1 differed from TEM-1 by a single Asp(115)-->Gly substitution and has been renamed TEM-90.
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Affiliation(s)
- H Pai
- Division of Infectious Disease, College of Medicine, Dankook University, Chonan, Korea
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47
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Bonnet R, Dutour C, Sampaio JL, Chanal C, Sirot D, Labia R, De Champs C, Sirot J. Novel cefotaximase (CTX-M-16) with increased catalytic efficiency due to substitution Asp-240-->Gly. Antimicrob Agents Chemother 2001; 45:2269-75. [PMID: 11451684 PMCID: PMC90641 DOI: 10.1128/aac.45.8.2269-2275.2001] [Citation(s) in RCA: 124] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Three clinical strains (Escherichia coli Rio-6, E. coli Rio-7, and Enterobacter cloacae Rio-9) collected in 1996 and 1999 from hospitals in Rio de Janeiro (Brazil) were resistant to broad-spectrum cephalosporins and gave a positive double-disk synergy test. Two bla(CTX-M) genes encoding beta-lactamases of pl 7.9 and 8.2 were implicated in this resistance: the bla(CTX-M-9) gene observed in E. coli Rio-7 and E. cloacae Rio-9 and a novel CTX-M-encoding gene, designated bla(CTX-M-16), observed in E. coli strain Rio-6. The deduced amino acid sequence of CTX-M-16 differed from CTX-M-9 only by the substitution Asp-240-->Gly. The CTX-M-16-producing E. coli transformant exhibited the same level of resistance to cefotaxime (MIC, 16 microg/ml) but had a higher MIC of ceftazidime (MIC, 8 versus 1 microg/ml) than the CTX-M-9-producing transformant. Enzymatic studies revealed that CTX-M-16 had a 13-fold higher affinity for aztreonam and a 7.5-fold higher k(cat) for ceftazidime than CTX-M-9, thereby showing that the residue in position 240 can modulate the enzymatic properties of CTX-M enzymes. The two bla(CTX-M-9) genes and the bla(CTX-M-16) gene were located on different plasmids, suggesting the presence of mobile elements associated with CTX-M-encoding genes. CTX-M-2 and CTX-M-8 enzymes were found in Brazil in 1996, and two other CTX-M beta-lactamases, CTX-M-9 and CTX-M-16, were subsequently observed. These reports are evidence of the diversity of CTX-M-type extended-spectrum beta-lactamases in Brazil.
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Affiliation(s)
- R Bonnet
- Laboratoire de Bactériologie, Faculté de Médecine, 63001 Clermont-Ferrand Cedex, France.
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48
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de Champs C, Monne C, Bonnet R, Sougakoff W, Sirot D, Chanal C, Sirot J. New TEM variant (TEM-92) produced by Proteus mirabilis and Providencia stuartii isolates. Antimicrob Agents Chemother 2001; 45:1278-80. [PMID: 11257046 PMCID: PMC90455 DOI: 10.1128/aac.45.4.1278-1280.2001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2000] [Accepted: 01/01/2001] [Indexed: 11/20/2022] Open
Abstract
The sequences of the bla(TEM) genes encoding TEM-92 in Proteus mirabilis and Providencia stuartii isolates were determined and were found to be identical. Except for positions 218 (Lys-6) and 512 (Lys-104), the nucleotide sequence of bla(TEM-92) was identical to that of bla(TEM-20), including the sequence of the promoter region harboring a 135-bp deletion combined with a G-162-->T substitution. The deduced amino acid sequence of TEM-92 differed from that of TEM-52 by the presence of a substitution (Gln-6-->Lys) in the peptide signal.
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Affiliation(s)
- C de Champs
- Laboratoire de Bactériologie, Faculté de Médecine, 63001 Clermont-Ferrand Cedex, France.
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Luzzaro F, Perilli M, Amicosante G, Lombardi G, Belloni R, Zollo A, Bianchi C, Toniolo A. Properties of multidrug-resistant, ESBL-producing Proteus mirabilis isolates and possible role of beta-lactam/beta-lactamase inhibitor combinations. Int J Antimicrob Agents 2001; 17:131-5. [PMID: 11165117 DOI: 10.1016/s0924-8579(00)00325-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
At our institution, isolation rates of clinical strains of ESBL-producing Proteus mirabilis increased to 8.8% of all P. mirabilis isolates during the period 1997-1999. To evaluate the susceptibility of ESBL-producing P. mirabilis strains against commonly used drugs, we studied 50 non-duplicated isolates selected on the basis of synergy between clavulanate and beta-lactams (ceftazidime, aztreonam, cefotaxime, and ceftriaxone). The presence of ESBL-coding genes was confirmed by colony hybridization with bla(TEM-1) and bla(SHV-1) probes. Minimum inhibitory concentrations of several antimicrobial agents for each isolate were obtained using the Etest method. All strains were encoding for TEM-derived enzymes. Gene sequencing showed that at least three different genes (TEM-15, TEM-20, and TEM-52) were present. These enzymes have not been previously reported in P. mirabilis. Isolates were characterized by: (a) reduced susceptibility or resistance to third- and fourth-generation cephalosporins (MIC > or = 2 mg/l), (b) resistance to piperacillin that was abolished by tazobactam (MIC > or = 256 vs. < or = 2 mg/l, respectively), (c) multiple antibiotic resistance that included gentamicin, fluoroquinolones and co-trimoxazole. Therapeutic failure and lack of eradication of ESBL-positive P. mirabilis by third-generation cephalosporins has been repeatedly observed both at our Institution and elsewhere. Piperacillin-tazobactam, as well as amikacin and meropenem appear to be important therapeutic options for infections due to multidrug-resistant, ESBL-producing P. mirabilis isolates.
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Affiliation(s)
- F Luzzaro
- Laboratory of Medical Microbiology, Ospedale di Circolo e Fondazione Macchi and University of Insubria, Varese, Italy.
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50
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De Champs C, Sirot D, Chanal C, Bonnet R, Sirot J. A 1998 survey of extended-spectrum beta-lactamases in Enterobacteriaceae in France. The French Study Group. Antimicrob Agents Chemother 2000; 44:3177-9. [PMID: 11036046 PMCID: PMC101626 DOI: 10.1128/aac.44.11.3177-3179.2000] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In a 3-month period in 1998, 79 consecutive isolates of Enterobacteriaceae producing an extended-spectrum beta-lactamase (ESBL) were collected. ESBLs were predominantly TEM derivatives (74 of 79): TEM-24-like (40 isolates), TEM-3-like (29 isolates), TEM-21 (3 isolates), and TEM-4 and TEM-52 (1 isolate each). Four isolates produced SHV derivatives SHV-4 (three isolates) and SHV-5 (one isolate), and one strain produced a CTX-M-3 enzyme. The high proportion of TEM-24-like-producing Enterobacter aerogenes isolates (36 of 79) suggests the occurrence of an epidemic strain in France.
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Affiliation(s)
- C De Champs
- Laboratoire de Bactériologie, Faculté de Médecine, Université d'Auvergne, 63001 Clermont-Ferrand Cedex, France.
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