An outbreak of a CTX-M-type beta-lactamase-producing Klebsiella pneumoniae: the importance of using cefpodoxime to detect extended-spectrum beta-lactamases

Crude extracts from 115 extended-spectrum beta-lactamase-producing Klebsiella pneumoniae isolates were analyzed biochemically. The TEM-3 type was encountered 108 times, SHV types were encountered 7 times, and the TEM-26 type was encountered only once. For the last one, the gene was identified; an adenine was detected at position 925, as in blaTEM-26B not in blaTEM-26.

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Relationship between isolation of extended spectrum beta-lactamase-producing Klebsiella pneumoniae and course of hospital-acquired pneumonia

Medicina ◽

10.3390/medicina43100099 ◽

2007 ◽

Vol 43 (10) ◽

pp. 778

Author(s):

Astra Vitkauskienė ◽

Agnė Giedraitienė ◽

Vytis Dudzevičius ◽

Raimundas Sakalauskas

Keyword(s):

Klebsiella Pneumoniae ◽

Late Onset ◽

Lavage Fluid ◽

Beta Lactamase ◽

Beta Lactamases ◽

Extended Spectrum Beta Lactamase ◽

Extended Spectrum ◽

Extended Spectrum Beta Lactamases ◽

Hospital Acquired Pneumonia ◽

Hospital Acquired

Aim of the study. To evaluate relationship between isolation of extended spectrum beta-lactamaseproducing Klebsiella pneumoniae strains and course of hospital-acquired pneumonia. Materials and methods. K. pneumoniae strains isolated from bronchial secretions or bronchoalveolar lavage fluid samples of patients hospitalized at an intensive care unit of Kaunas University of Medicine Hospital were analyzed. By means of synergistic two-antibiotics disc method, K. pneumoniae strains producing extended spectrum beta-lactamases were selected for further analysis using E-test (AB Biodisk, Solna, Sweden). Hospitalacquired pneumonia was diagnosed based on standard criteria for the diagnosis of pneumonia if signs of pneumonia occurred after 48 hours following admission. Late-onset hospital-acquired pneumonia was considered if these signs of pneumonia occurred on fifth day of hospitalization or later. Results. Total of 45 strains of K. pneumoniae were isolated during the study period; 18 isolated strains produced ESBL. Thirty-two patients investigated have developed hospital-acquired pneumonia, 20 of which were cases of late-onset hospital-acquired pneumonia. Thirteen cases of K. pneumoniae isolation were classified as airway colonization. Extended spectrum beta-lactamase-producing K. pneumoniae strains were more frequently isolated from patients with hospital-acquired pneumonia (88.9%, n=16 and 11.1%, n=2, P<0.05) in comparison with non-producing strains. Extended spectrum beta-lactamase-producing strains were more prevalent in late-onset pneumonia group (93.8%, n=15) than in early-onset group (6.2%, n=1, P<0.001). Conclusions. Extended spectrum beta-lactamase-producing K. pneumoniae strains were more frequently isolated from patients with hospital-acquired pneumonia as compared to colonized patients. Extended spectrum beta-lactamase-producing K. pneumoniae strains were more frequently isolated from patients with late-onset hospital-acquired pneumonia.

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Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe

Eurosurveillance ◽

10.2807/ese.13.47.19044-en ◽

2008 ◽

Vol 13 (47) ◽

Cited By ~ 27

Author(s):

T M Coque ◽

F Baquero ◽

R Cantón

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Beta Lactamase ◽

Mechanisms Of Resistance ◽

Beta Lactamases ◽

Surveillance Studies ◽

Extended Spectrum ◽

Extended Spectrum Beta Lactamases ◽

M 14

Extended-spectrum beta-lactamases (ESBLs) have been increasingly reported in Europe since their first description in 1983. During the 1990s, they were described mainly as members of the TEM- and SHV-beta-lactamase families in Klebsiella pneumoniae causing nosocomial outbreaks. Nowadays, they are mostly found in Escherichia coli that cause community-acquired infections and with increasing frequency contain CTX-M enzymes. Dissemination of specific clones or clonal groups and epidemic plasmids in community and nosocomial settings has been the main reason for the increase in most of the widespread ESBLs belonging to the TEM (TEM-24, TEM-4, TEM-52), SHV (SHV-5, SHV-12) and CTX-M (CTX-M-9, CTX-M-3, CTX-M-14 or CTX-M-15) families in Europe. Co-selection with other resistances, especially to fluoroquinolones, aminoglycosides and sulfonamides, seems to have contributed to the problem. The emergence of epidemic clones harbouring several beta-lactamases simultaneously (ESBLs, metallo-beta-lactamases or cephamycinases) and of new mechanisms of resistance to fluoroquinolones and aminoglycosides warrants future surveillance studies.

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Comparison of a novel, inhibitor-potentiated disc-diffusion test with other methods for the detection of extended-spectrum beta-lactamases in Escherichia coli and Klebsiella pneumoniae

Journal of Antimicrobial Chemotherapy ◽

10.1093/jac/42.1.49 ◽

1998 ◽

Vol 42 (1) ◽

pp. 49-54 ◽

Cited By ~ 36

Author(s):

P. Ho

Keyword(s):

Escherichia Coli ◽

Klebsiella Pneumoniae ◽

Disc Diffusion ◽

Diffusion Test ◽

Beta Lactamases ◽

Extended Spectrum ◽

Extended Spectrum Beta Lactamases

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Investigation of the clonal dissemination of Klebsiella pneumoniae isolates producing extended-spectrum beta-lactamases in a neonatal ward, Sousse, Tunisia

Pathologie Biologie ◽

10.1016/j.patbio.2004.04.015 ◽

2005 ◽

Vol 53 (2) ◽

pp. 75-80 ◽

Cited By ~ 4

Author(s):

Olfa Bouallègue-Godet ◽

Francine Grimont ◽

Youssef Ben Salem ◽

Mabrouka Saidani ◽

Ridha Mzoughi ◽

...

Keyword(s):

Klebsiella Pneumoniae ◽

Beta Lactamases ◽

Extended Spectrum ◽

Extended Spectrum Beta Lactamases ◽

Neonatal Ward

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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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