P1857 Molecular epidemiology of extended–spectrum β–lactamases-producing organisms of the family Enterobacteriaceae in Sofia, Bulgaria

ABSTRACT In 1999, 39 of 2,599 isolates of the family Enterobacteriaceae (1.5%) collected by eight private laboratories in the Aquitaine region in France produced an extended-spectrum β-lactamase (ESBL). Among these were 19 Enterobacter aerogenes isolates; 8 Klebsiella pneumoniae isolates; 6 Escherichia coli isolates; 3 Proteus mirabilis isolates; and 1 isolate each of Serratia marcescens, Morganella morganii, and Providencia stuartii. ESBL producers were isolated from 38 patients, including 33 residents of 11 clinics or nursing homes and 5 ambulatory patients. Seven different ESBLs were characterized. These mainly consisted of TEM-24 (25 isolates) and TEM-21 (9 isolates), but TEM-15 (2 isolates) and TEM-3, TEM-19, SHV-4, and CTX-M-1 (1 isolate each) were also characterized. Seven strains showed the coexistence of different TEM- and/or SHV-encoding genes, including a new SHV-1 variant, SHV-44, defined by the substitution R205L previously reported for SHV-3 in association with S238G. The epidemiology of the ESBL producers was investigated by random amplification of polymorphic DNA, typing by enterobacterial repetitive intergenic consensus PCR, analysis of resistance cotransferred with the ESBL, and analysis of the restriction profiles of the ESBL-encoding plasmids. Of the TEM-24-expressing strains, 18 were E. aerogenes isolates, including 9 from the same clinic, that were representatives of the epidemic clone disseminating in France. Of the TEM-21-producing strains that belonged to different species of the family Enterobacteriaceae (E. coli, K. pneumoniae, and P. mirabilis), 8 were isolated in the same nursing home. Outbreaks due to strain and/or plasmid dissemination in these clinic and nursing home were demonstrated. The presence of ESBL producers in five ambulatory patients probably resulted from nosocomial acquisition. Our data highlight the serious need to monitor patients for ESBL-producing Enterobacteriaceae in general practice.

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Concurrent outbreaks of extended-spectrum β-lactamase-producing organisms of the family Enterobacteriaceae in a Warsaw hospital

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/44.4.489 ◽

1999 ◽

Vol 44 (4) ◽

pp. 489-499 ◽

Cited By ~ 66

Author(s):

Andrzej Palucha ◽

Barbara Mikiewicz ◽

Waleria Hryniewicz ◽

Marek Gniadkowski

Keyword(s):

Extended Spectrum ◽

The Family

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Risk factors and molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in Xiamen, China

Journal of Global Antimicrobial Resistance ◽

10.1016/j.jgar.2017.04.015 ◽

2017 ◽

Vol 11 ◽

pp. 23-27 ◽

Cited By ~ 1

Author(s):

Jie Deng ◽

Yan-Ting Li ◽

Xu Shen ◽

Yi-Wen Yu ◽

Hui-Ling Lin ◽

...

Keyword(s):

Risk Factors ◽

Klebsiella Pneumoniae ◽

Molecular Epidemiology ◽

Extended Spectrum

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Using Nucleic Acid Microarrays To Perform Molecular Epidemiology and Detect Novel -Lactamases: a Snapshot of Extended-Spectrum -Lactamases throughout the World

Journal of Clinical Microbiology ◽

10.1128/jcm.06115-11 ◽

2012 ◽

Vol 50 (5) ◽

pp. 1632-1639 ◽

Cited By ~ 50

Author(s):

C. Lascols ◽

M. Hackel ◽

A. M. Hujer ◽

S. H. Marshall ◽

S. K. Bouchillon ◽

...

Keyword(s):

Nucleic Acid ◽

Molecular Epidemiology ◽

Extended Spectrum ◽

The World

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β-Lactamases Responsible for Resistance to Expanded-Spectrum Cephalosporins in Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis Isolates Recovered in South Africa

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.42.6.1350 ◽

1998 ◽

Vol 42 (6) ◽

pp. 1350-1354 ◽

Cited By ~ 137

Author(s):

J. D. D. Pitout ◽

K. S. Thomson ◽

N. D. Hanson ◽

A. F. Ehrhardt ◽

E. S. Moland ◽

...

Keyword(s):

Escherichia Coli ◽

South Africa ◽

Klebsiella Pneumoniae ◽

Proteus Mirabilis ◽

Dna Amplification ◽

Medical Centers ◽

Extended Spectrum ◽

The Family ◽

Agar Dilution ◽

Related Enzyme

ABSTRACT Although resistance to the expanded-spectrum cephalosporins among members of the family Enterobacteriaceae lacking inducible β-lactamases occurs virtually worldwide, little is known about this problem among isolates recovered in South Africa. Isolates of Klebsiella pneumoniae, Escherichia coli, and Proteus mirabilis resistant to expanded-spectrum cephalosporins recovered from patients in various parts of South Africa over a 3-month period were investigated for extended-spectrum β-lactamase production. Antibiotic susceptibility was determined by standard disk diffusion and agar dilution procedures. Production of extended-spectrum β-lactamases was evaluated by using the double-disk test, and the β-lactamases were characterized by spectrophotometric hydrolysis assays and an isoelectric focusing overlay technique which simultaneously determined isoelectric points and general substrate or inhibitor characteristics. DNA amplification and sequencing were performed to confirm the identities of these enzymes. The P. mirabilis and E. coliisolates were found to produce TEM-26-type, SHV-2, and SHV-5 extended-spectrum β-lactamases. An AmpC-related enzyme which had a pI of 8.0 and which conferred resistance to cefoxitin as well as the expanded-spectrum cephalosporins was found in a strain of K. pneumoniae. This is the first study which has identified organisms producing different extended-spectrum β-lactamases from South Africa and the first report describing strains of P. mirabilis producing a TEM-26-type enzyme. The variety of extended-spectrum β-lactamases found among members of the familyEnterobacteriaceae isolated from major medical centers in South Africa is troubling and adds to the growing list of countries where these enzymes pose a serious problem for antimicrobial therapy.

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Characterization of beta-lactamase gene blaPER-2, which encodes an extended-spectrum class A beta-lactamase.

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.40.3.616 ◽

1996 ◽

Vol 40 (3) ◽

pp. 616-620 ◽

Cited By ~ 82

Author(s):

A Bauernfeind ◽

I Stemplinger ◽

R Jungwirth ◽

P Mangold ◽

S Amann ◽

...

Keyword(s):

Amino Acid ◽

Amino Acid Sequence ◽

Beta Lactamase ◽

Reading Frame ◽

Beta Lactamases ◽

Class A ◽

Extended Spectrum ◽

The Family ◽

Extended Spectrum Beta Lactamases ◽

Lactamase Gene

Plasmidic extended-spectrum beta-lactamases of Ambler class A are mostly inactive against ceftibuten. Salmonella typhimurium JMC isolated in Argentina harbors a bla gene located on a plasmid (pMVP-5) which confers transferable resistance to oxyiminocephalosporins, aztreonam, and ceftibuten. The beta-lactamase PER-2 (formerly ceftibutenase-1; CTI-1) is highly susceptible to inhibition by clavulanate and is located at a pI of 5.4 after isoelectric focusing. The blaPER-2 gene was cloned and sequenced. The nucleotide sequence of a 2.2-kb insert in vector pBluescript includes an open reading frame of 927 bp. Comparison of the deduced amino acid sequence of PER-2 with those of other beta-lactamases indicates that PER-2 is not closely related to TEM or SHV enzymes (25 to 26% homology). PER-2 is most closely related to PER-1 (86.4% homology), an Ambler class A enzyme first detected in Pseudomonas aeruginosa. An enzyme with an amino acid sequence identical to that of PER-1, meanwhile, was found in various members of the family Enterobacteriaceae isolated from patients in Turkey. Our data indicate that PER-2 and PER-1 represent a new group of Ambler class A extended-spectrum beta-lactamases. PER-2 so far has been detected only in pathogens (S. typhimurium, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis) isolated from patients in South America, while the incidence of PER-1-producing strains so far has been restricted to Turkey, where it occurs both in members of the family Enterobacteriaceae and in P. aeruginosa.

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