scholarly journals Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Community and Private Health Care Centers

2003 ◽  
Vol 47 (11) ◽  
pp. 3506-3514 ◽  
Author(s):  
Corinne Arpin ◽  
Véronique Dubois ◽  
Laure Coulange ◽  
Catherine André ◽  
Isabelle Fischer ◽  
...  
Keyword(s):  
Nursing Home ◽  
Dna Typing ◽  
Enterobacter Aerogenes ◽  
Pcr Analysis ◽  
Extended Spectrum ◽  
The Family ◽  
Ambulatory Patients ◽  
Providencia Stuartii ◽  
Plasmid Dissemination ◽  
Esbl Producers

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.

scholarly journals PREVALENCE OF EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING ENTEROBACTERIACEAE MEMBERS ISOLATED FROM CLINICALLY SUSPECTED PATIENTS

2018 ◽  
Vol 11 (5) ◽  
pp. 364 ◽  
Author(s):  
Moorthy Kannaiyan ◽  
Gedif Meseret Abebe ◽  
Chinnasamy Kanimozhi ◽  
Punitha Thambidurai ◽  
Saranya Ashokapuram Selvam ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Antibiotic Sensitivity ◽  
Enterobacter Aerogenes ◽  
Clinical Problem ◽  
Clinical Samples ◽  
Extended Spectrum Beta Lactamase ◽  
E Coli ◽  
Extended Spectrum ◽  
Genotypic Identification ◽  
Esbl Producers

 Objective: Emergence of extended-spectrum beta-lactamases (ESBLs) production poses another clinical problem with Gram-negative bacterial infections. The present study was aimed to evaluate the ESBL producers among various clinical samples of clinically suspected patients.Methods: A total of 1279 samples (urine [918], pus [207] and stool [154]) were collected and 465 isolates (Escherichia coli [320], Enterobacter aerogenes [119] and Klebsiella pneumoniae [26]) were isolated and screened for the presence of ESBL producers using combination disc method and double disc synergy test.Results: Of the 465 culture positive isolates, 130 (E. coli 93 [29.06%], E. aerogenes 35 [29.41%] and K. pneumoniae 2 [7.69%]) were identified as ESBL producers. Among the three Enterobacteriaceae members, E. coli 93 (29.06%) was found to be predominant ESBL producer next in order E. aerogenes 35 (29.41%) and K. pneumoniae 2 (7.69%). Maximum number of ESBL producers were recovered from urine (n=111) followed by pus (n=14) and stool (n=5). All the ESBL-producing isolates were subjected to antibiotic sensitivity test using 10 different antibiotics. ESBL producers were chiefly resistance to ceftriaxone followed by ceftazidime and cefotaxime. Of 130 ESBL producers, 15 (E. coli (8), E. aerogenes (6) and K. pneumoniae (1)] strains were selected for genotypic identification. Among, only two strains of E. aerogenes were positive isolates for CTX-M type ESBL in polymerase chain reaction.Conclusion: This study concluded that among Enterobacteriaceae members, E. coli was the predominant ESBL producers and urine was noted as the prime source for the ESBL positive isolates when compared to other source. Genotypic identification was the best method to differentiate ESBL types which were essential to provide proper treatment.

scholarly journals Ceftazidime-Resistant EnterobacteriaceaeIsolates from Three Polish Hospitals: Identification of Three Novel TEM- and SHV-5-Type Extended-Spectrum β-Lactamases

1998 ◽  
Vol 42 (3) ◽  
pp. 514-520 ◽  
Author(s):  
Marek Gniadkowski ◽  
Ines Schneider ◽  
Renate Jungwirth ◽  
Waleria Hryniewicz ◽  
Adolf Bauernfeind
Keyword(s):  
Escherichia Coli ◽  
Amino Acid ◽  
Klebsiella Pneumoniae ◽  
Detailed Analysis ◽  
Amino Acid Substitutions ◽  
New Combinations ◽  
Extended Spectrum ◽  
The Family ◽  
Genetic Events ◽  
Esbl Producers

ABSTRACT Twelve ceftazidime-resistant isolates of the familyEnterobacteriaceae (11 Klebsiella pneumoniaeisolates and 1 Escherichia coli isolate) were collected in 1995 from three Polish hospitals located in different cities. All were identified as producers of extended-spectrum β-lactamases (ESBLs). Detailed analysis of their β-lactamase contents revealed that six of them expressed SHV-5-like ESBLs. The remaining six were found to produce three different TEM enzymes, each characterized by a pI value of 6.0 and specified by new combinations of amino acid substitutions. The amino acid substitutions compared to the TEM-1 β-lactamase sequence were Gly238Ser, Glu240Lys, and Thr265Met for TEM-47; Leu21Phe, Gly238Ser, Glu240Lys, and Thr265Met for TEM-48; and Leu21Phe, Gly238Ser, Glu240Lys, Thr265Met, and Ser268Gly for TEM-49. The new TEM β-lactamases, TEM-47, TEM-48, and TEM-49, belong to a subfamily of TEM-2-related enzymes. Genes coding for TEM-47 and TEM-49 could have originated from the TEM-48-encoding sequence by various single genetic events. The new TEM derivatives probably document the already advanced microevolution of ESBLs ongoing in Polish hospitals, in a majority of which no monitoring of ESBL producers was performed before 1996.

scholarly journals Extended-Spectrum β-Lactamases in Ireland, Including a Novel Enzyme, TEM-102

2003 ◽  
Vol 47 (8) ◽  
pp. 2572-2578 ◽  
Author(s):  
Dearbháile Morris ◽  
Colette O'Hare ◽  
Maura Glennon ◽  
Majella Maher ◽  
Geraldine Corbett-Feeney ◽  
...  
Keyword(s):  
Molecular Typing ◽  
Clinical Laboratory ◽  
Enterobacter Cloacae ◽  
Disk Diffusion ◽  
National Committee ◽  
Esbl Production ◽  
Esbl Gene ◽  
Extended Spectrum ◽  
The Family ◽  
Esbl Producers

ABSTRACT Organisms producing extended-spectrum β-lactamases (ESBLs) have been reported in many countries, but there is no information on the prevalence of ESBL-producing members of the family Enterobacteriaceae in Ireland. A total of 925 isolates of ampicillin-resistant members of the Enterobacteriaceae were received from six hospitals in Ireland over a 3-year period from September 1996 to September 1999. Isolates were screened for ESBL production by the double-disk diffusion (DDD) method. DDD-positive isolates that were (i) confirmed as ESBL producers by National Committee for Clinical Laboratory Standards (NCCLS) confirmatory testing and (ii) susceptible to cefoxitin by disk diffusion were considered ESBL producers. By these criteria, 27 (3%) of the ampicillin-resistant members of the Enterobacteriaceae studied were categorized as ESBL producers. Molecular typing suggested that some intra- and interhospital spread of ESBL-producing isolates had occurred. DNA sequencing of amplified bla TEM and bla SHV genes resulted in the detection of a novel bla TEM ESBL gene, bla TEM-102 in two isolates (Klebsiella pneumoniae and Enterobacter cloacae) received from the same hospital but isolated from different patients. The study suggests dissemination of ESBL-producing bacteria within the health care system in Ireland and emphasizes the need for measures to control such spread.

scholarly journals Molecular Identification of Extended-Spectrum-β-Lactamase Genes from Enterobacteriaceae Isolated from Healthy Human Carriers in Switzerland

2011 ◽  
Vol 56 (3) ◽  
pp. 1609-1612 ◽  
Author(s):  
Nadine Geser ◽  
Roger Stephan ◽  
Bozena M. Korczak ◽  
Lothar Beutin ◽  
Herbert Hächler
Keyword(s):  
Escherichia Coli ◽  
Pcr Analysis ◽  
Healthy Human ◽  
Fecal Samples ◽  
Content Type ◽  
Healthy Humans ◽  
Extended Spectrum ◽  
High Degree ◽  
Esbl Producers ◽  
M 14

ABSTRACTIn this study, fecal samples from 586 healthy humans were investigated to determine the occurrence of extended-spectrum-β-lactamase (ESBL)-producingEnterobacteriaceaein Swiss people. A total of 5.8% of the human fecal samples yielded ESBL producers, and all of the 34 isolated strains wereEscherichia coli. PCR analysis revealed that 14 strains produced CTX-M-15, 10 produced CTX-M-1, 7 strains produced CTX-M-14, and 2 strains produced CTX-M-2 ESBLs. One strain produced SHV-12 ESBL. Of the 34 isolates, 15 produced additional TEM-1 broad-spectrum β-lactamases. By serotyping, a high degree of diversity among the strains was found.

scholarly journals Use of Microdilution Panels with and without β-Lactamase Inhibitors as a Phenotypic Test for β-Lactamase Production among Escherichia coli, Klebsiella spp.,Enterobacter spp., Citrobacter freundii, andSerratia marcescens

1999 ◽  
Vol 43 (6) ◽  
pp. 1393-1400 ◽  
Author(s):  
Kenneth S. Thomson ◽  
Christine C. Sanders ◽  
Ellen Smith Moland
Keyword(s):  
Escherichia Coli ◽  
Klebsiella Oxytoca ◽  
Enterobacter Aerogenes ◽  
Citrobacter Freundii ◽  
Extended Spectrum ◽  
The Family ◽  
Convenient Approach ◽  
Susceptibility Tests ◽  
Klebsiella Spp ◽  
Maximum Separation

ABSTRACT Over the past decade, a number of new β-lactamases have appeared in clinical isolates of Enterobacteriaceaethat, unlike their predecessors, do not confer β-lactam resistance that is readily detected in routine antibiotic susceptibility tests. Because optimal methodologies are needed to detect these important new β-lactamases, a study was designed to evaluate the ability of a panel of various β-lactam antibiotics tested alone and in combination with β-lactamase inhibitors to discriminate between the production of extended-spectrum β-lactamases, AmpC β-lactamases, high levels of K1 β-lactamase, and other β-lactamases in 141 isolates of Escherichia coli,Klebsiella pneumoniae, Klebsiella oxytoca,Enterobacter cloacae, Enterobacter aerogenes,Citrobacter freundii, and Serratia marcescens possessing well-characterized β-lactamases. The microdilution panels studied contained aztreonam, cefpodoxime, ceftazidime, cefotaxime, and ceftriaxone, with and without 1, 2, and 4 μg of clavulanate per ml or 8 μg of sulbactam per ml and cefoxitin and cefotetan with and without 8 μg of sulbactam per ml. The results indicated that a minimum panel of five tests would provide maximum separation of extended-spectrum β-lactamase high AmpC, high K1, and other β-lactamase production in Enterobacteriaceae. These included cefpodoxime, cefpodoxime plus 4 μg of clavulanate per ml, ceftazidime, ceftriaxone, and ceftriaxone plus 8 μg of sulbactam per ml. Ceftriaxone plus 2 μg of clavulanate per ml could be substituted for cefpodoxime plus 4 μg of clavulanate per ml without altering the accuracy of the tests. This study indicated that tests with key β-lactam drugs, alone and in combination with β-lactamase inhibitors, could provide a convenient approach to the detection of a variety of β-lactamases in members of the family Enterobacteriaceae.

scholarly journals Phenotypic and Genotypic Study of Klebsiella species with Reference to Extended Spectrum Beta-Lactamase

2021 ◽  
Author(s):  
Rakesh Prasad Sah ◽  
Rakesh Kumar Mukhia ◽  
AD Urhekar ◽  
Kshitija Rane
Keyword(s):  
Drug Resistance ◽  
Multi Drug Resistance ◽  
Pcr Analysis ◽  
Beta Lactamase ◽  
Klebsiella Species ◽  
Single Strain ◽  
Antimicrobial Drug Resistance ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Esbl Producers

Introduction: Klebsiella species is an important nosocomial pathogen with the emergence of Multi Drug Resistance (MDR). MDR in Klebsiella species is increasing worldwide with the production Extended Spectrum Beta-Lactamase (ESBL). The emergence of ESBL is a critical concern in Klebsiella species due to resistance to ceftazidime and other cephalosporins which compromise the efficacy of life saving antibiotics against these infections. Aim: To know the factors responsible for antimicrobial drug resistance in Klebsiella species with respect to ESBL and their responsible genes. Materials and Methods: A prospective and experimental study was carried out over a period of three years (August 2013 to July 2016). Total 200 isolates of Klebsiella species were screened for cefotaxime and ceftazidime. The resistant strains (cefotaxime/ ceftazidime) were subjected to ESBL agar, Phenotypic Confirmatory Disc Diffusion Test (PCDDT) and Modified Three Dimensional Test (M3DT). Genetic analysis by Polymerase Chain Reaction (PCR) was done for the detection of beta-lactamase (bla) genes i.e., blaTEM, blaSHV & blaCTX-M in 58 isolates of Klebsiella species. The data was presented using frequency and percentage. The proportion was compared using Z-test for the proportions. Results: Out of 200 isolates, 135 (67.5%) were found resistant to cefotaxime and 125 (62.5%) were resistant to ceftazidime. Among which 110 (55%), 75 (37.5%) and 95 (47.5%) Klebsiella species were found positive for production of ESBL by ESBL agar, PCDDT and M3DT respectively. PCR analysis in 48 isolates were positive by PCDDT/M3DT or both were also positive for beta- lactamase genes i.e., 43 (89.58%) blaTEM; 44 (91.67%) blaSHV and 48 (100%) blaCTX-M. Ten negative isolates either by PCDDT/M3DT or both were also negative by PCR. Co-existence of (blaTEM+blaSHV +blaCTX-M), (blaTEM+blaSHV), (blaTEM+blaCTX-M) and (blaSHV+blaCTX-M) were found 81.25%, 0%, 8.33% and 10.42%, respectively. Conclusion: The M3DT is the best phenotypic method for the confirmation of ESBL producer in Klebsiella species which is not included by CLSI while inclusion with PCDDT enhances the detection of ESBL producers. Co-existence of all three genes (blaTEM, blaSHV and blaCTX-M) in a single strain is a serious concern for us. So it is important to include M3DT and PCDDT in routine basis for the detection and management of ESBL producers which will help clinician to prescribe proper antibiotics.

scholarly journals Extended-Spectrum β-Lactamases in Enterobacteriaceae in Buenos Aires, Argentina, Public Hospitals

2003 ◽  
Vol 47 (9) ◽  
pp. 2864-2867 ◽  
Author(s):  
M. Quinteros ◽  
M. Radice ◽  
N. Gardella ◽  
M. M. Rodriguez ◽  
N. Costa ◽  
...  
Keyword(s):  
Buenos Aires ◽  
Clinical Laboratory ◽  
Pcr Amplification ◽  
Enterobacter Aerogenes ◽  
Public Hospitals ◽  
National Committee ◽  
Extended Spectrum ◽  
Confirmatory Tests ◽  
Resistant Strains ◽  
Providencia Stuartii

ABSTRACT Resistance to extended-spectrum cephalosporins is often associated with plasmid encoded extended spectrum β-lactamases (ESBL). In order to evaluate the prevalence and diversity of ESBLs in enterobacteria in our city, a 1-month-period survey was carried out from April to May 2000. Extended-spectrum-cephalosporin-resistant strains, isolated from inpatient clinical specimens other than stools, were collected among 17 participating hospitals. From a total of 427 enterobacterial strains that were collected during this period, 39 were extended-spectrum cephalosporin resistant. The National Committee for Clinical Laboratory Standards' Screening and Confirmatory Tests for ESBL production were performed using cefotaxime and ceftazidime; cefepime and cefepime-clavulanic acid-containing disks were included. β-Lactamases were characterized by isoelectric focusing and PCR amplification using specific primers. Three different ESBLs were detected: SHV-related (4 isolates), PER-2-type (9 isolates), and CTX-M-2-related (26 isolates). Sequencing of the corresponding genes confirmed CTX-M-2 in 19 of 21 and CTX-M-31 (an allelic variant) in the remaining 2 of 21. CTX-M-2 (or its variant) was detected in all Escherichia coli, Enterobacter aerogenes, Serratia marcescens, Proteus mirabilis, and Providencia stuartii strains, while PER-2 was detected in Enterobacter cloacae, E. aerogenes, and Klebsiella pneumoniae; SHV-related ESBL were found only in K. pneumoniae. These results clearly show that CTX-M-2 is the most prevalent ESBL produced by enterobacterial species isolated from public hospitals in Buenos Aires.

scholarly journals Countrywide Spread of CTX-M-3 Extended-Spectrum β-Lactamase-Producing Microorganisms of the Family Enterobacteriaceae in Poland

2002 ◽  
Vol 46 (1) ◽  
pp. 151-159 ◽  
Author(s):  
Anna Baraniak ◽  
Janusz Fiett ◽  
Agnieszka Sulikowska ◽  
Waleria Hryniewicz ◽  
Marek Gniadkowski
Keyword(s):  
Pcr Analysis ◽  
Randomly Amplified Polymorphic Dna ◽  
In Vitro Bioassay ◽  
Extended Spectrum ◽  
The Family ◽  
Dna Types ◽  
High Degree ◽  
Very High ◽  
Permeability Alterations

ABSTRACT Eighty-four clinical isolates of the family Enterobacteriaceae, recovered from 1998 to 2000 in 15 hospitals in 10 Polish cities, were analyzed. All the isolates produced β-lactamases with pIs of 8.4 and 5.4, and the pI 8.4 enzymes were demonstrated to hydrolyze cefotaxime but not ceftazidime in the in vitro bioassay. PCR analysis and DNA sequencing have revealed that in all cases the pI 8.4 β-lactamase was probably the CTX-M-3 extended-spectrum β-lactamase (ESBL) variant, which was originally identified in 1996 in Praski Hospital in Warsaw. In the majority of isolates, bla CTX-M-3 genes resided within large conjugative plasmids with similar fingerprints, which, in the context of the high degree of diversity of the randomly amplified polymorphic DNA types of the isolates, suggested that horizontal transfer of plasmids was likely the main mechanism of CTX-M-3 spread. The dissemination of plasmids was probably preceded by the center-to-center transmission of several strains, as indicated by the identification by pulsed-field gel electrophoresis of closely related or possibly related Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii isolates in five different hospitals. CTX-M-3-producing organisms revealed a very high degree of diversity in β-lactam resistance levels and patterns. This was attributed to several factors, such as the production of other β-lactamases including additional ESBLs, possible quantitative variations in CTX-M-3 expression, segregation of AmpC derepressed mutants, and permeability alterations.

Detection of Extended-Spectrum β-Lactamases in Clinical Isolates of Enterobacter cloacae andEnterobacter aerogenes

2000 ◽  
Vol 38 (2) ◽  
pp. 542-546 ◽  
Author(s):  
Eva Tzelepi ◽  
Panagiota Giakkoupi ◽  
Danai Sofianou ◽  
Veneta Loukova ◽  
Anastassia Kemeroglou ◽  
...  
Keyword(s):  
False Positive ◽  
Enterobacter Aerogenes ◽  
Enterobacter Cloacae ◽  
Clinical Isolates ◽  
Screening Methods ◽  
Phenotypic Characteristics ◽  
Extended Spectrum ◽  
Amoxicillin Clavulanate ◽  
Synergy Test ◽  
Esbl Producers

The aim of the present study was to investigate the frequency of extended-spectrum β-lactamases (ESBLs) in a consecutive collection of clinical isolates of Enterobacter spp. The abilities of various screening methods to detect ESBLs in enterobacters were simultaneously tested. Among the 68 consecutive isolates (56Enterobacter cloacae and 12 Enterobacter aerogenes isolates) that were analyzed for β-lactamase content, 21 (25 and 58%, respectively) possessed transferable ESBLs with pIs of 8.2 and phenotypic characteristics of SHV-type enzymes, 8 (14.3%) of the E. cloacae isolates produced a previously nondescribed, clavulanate-susceptible ESBL that exhibited a pI of 6.9 and that conferred a ceftazidime resistance phenotype on Escherichia coli transconjugants, and 2 E. cloacae isolates produced both of these enzymes. Among the total of 31 isolates that were considered ESBL producers, the Vitek ESBL detection test was positive for 2 (6.5%) strains, and the conventional double-disk synergy test (DDST) with amoxicillin-clavulanate and with expanded-spectrum cephalosporins and aztreonam was positive for 5 (16%) strains. Modifications of the DDST consisting of closer application of the disks (at 20 instead of 30 mm), the use of cefepime, and the use of both modifications increased the sensitivity of this test to 71, 61, and 90%, respectively. Of the 37 isolates for which isoelectric focusing failed to determine ESBLs, the Vitek test was false positive for 1 isolate and the various forms of DDSTs were false-positive for 3 isolates.

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