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Klebsiella pneumoniae CH0905 strain exhibiting high-level cefotaxime resistance was isolated from a stool culture in the intensive care unit. The resistance gene responsible was shown to be located on a conjugative 60-kb plasmid designated pCH0905. The minimum inhibitory concentration (MIC) values for cefotaxime and ceftazidime of the original isolate and the transconjugates were 256 mug/ml. Isoelectric focusing of a protein preparation from the K. pneumoniae strain showed beta-lactamases with the pI values of 7.6 and 6.3. A 1,080-bp fragment amplified with PCR was cloned into the pGEM-T Easy vector. The nucleotide sequence of the complete 1,080 bp was determined. Sequence analysis revealed that the bla(TEM) gene of pCH0905 differed from bla(TEM-1) by two mutations, leading to the following amino acid substitutions: the glutamic acid residue at position 104 by lysine and the glycine residue at position 238 by serine (Ambler numbering). The association of these two mutations was described previously in TEM-15 beta-lactamase, but this is the first detection of this enzyme in Tunisia.

A clinical isolate of Escherichia coli LBT04 was found to have a high-level resistance to broad-spectrum β-lactams. Analysis of this strain by the disk diffusion test revealed synergies between clavulanic acid and ceftazidime, cefotaxime. Clavulanic acid decreased the MICs of ceftazidime, cefotaxime, and ceftriaxone, which suggested that LBT04 produced an extended-spectrum β-lactamase. These resistances were carried by a 1080-bp chromosomal gene that encoded a β-lactamase with a pI of 6.3. Cloning and sequencing experiments showed that this β-lactamase revealed identity with the bla TEM-1 gene encoding the TEM-1 β-lactamase, except for a replacement of the Glu residue at position 104 by Lys, and of the Gly residue at position 238 by Ser. These two mutations were encountered in TEM-15 β-lactamase, but this is the first description of this enzyme in the E. coli species in Tunisian hospitals.

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