Emergence and risk factors of β-lactamase–mediated resistance to oxyimino-β-lactams in Enterobacteriaceae isolates

Manageiro, Vera; Ferreira, Eugénia; Jones-Dias, Daniela; Louro, Deolinda; Pinto, Margarida; Diogo, José; Caniça, Manuela

doi:10.1016/j.diagmicrobio.2011.11.009

Cited by 8 publications

(5 citation statements)

References 26 publications

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“…This finding is in accordance with a recent work that states that age over 65 years old is a risk factor for β -lactamase-mediated resistance to oxyimino- β -lactams in patients infected with enterobacteria [30]. …”

Section: Discussionsupporting

confidence: 93%

Molecular Characterization of ESBL-Producing Enterobacteriaceae in Northern Portugal

Fernandes

Amador

Oliveira

et al. 2014

The Scientific World Journal

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Extended-spectrum β-lactamases (ESBLs) prevalence was studied in the north of Portugal, among 193 clinical isolates belonging to citizens in a district in the boundaries between this country and Spain from a total of 7529 clinical strains. In the present study we recovered some members of Enterobacteriaceae family, producing ESBL enzymes, including Escherichia coli (67.9%), Klebsiella pneumoniae (30.6%), Klebsiella oxytoca (0.5%), Enterobacter aerogenes (0.5%), and Citrobacter freundii (0.5%). β-lactamases genes blaTEM, blaSHV, and blaCTX-M were screened by polymerase chain reaction (PCR) and sequencing approaches. TEM enzymes were among the most prevalent types (40.9%) followed by CTX-M (37.3%) and SHV (23.3%). Among our sample of 193 ESBL-producing strains 99.0% were resistant to the fourth-generation cephalosporin cefepime. Of the 193 isolates 81.3% presented transferable plasmids harboring bla ESBL genes. Clonal studies were performed by PCR for the enterobacterial repetitive intragenic consensus (ERIC) sequences. This study reports a high diversity of genetic patterns. Ten clusters were found for E. coli isolates and five clusters for K. pneumoniae strains by means of ERIC analysis. In conclusion, in this country, the most prevalent type is still the TEM-type, but CTX-M is growing rapidly.

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Section: Discussionsupporting

confidence: 93%

Molecular Characterization of ESBL-Producing Enterobacteriaceae in Northern Portugal

Fernandes

Amador

Oliveira

et al. 2014

The Scientific World Journal

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“…Inclusion criteria for the clinical isolates were 1) non–wild-type susceptibility to cefotaxime, 2) presumptive phenotypic ESBL production, and 3) genetic similarity by pulsed-field gel electrophoresis. Analysis of the genetic relatedness of human and dolphin isolates, determined by pulsed-field gel electrophoresis that used Xba I digested DNA ( 7 ), revealed 1 major cluster, which included 22 (35%) clinical isolates from 3 regions in Portugal and the isolate from the dolphin ( Figure ).…”

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confidence: 99%

“…The genetic characterization of the 1 dolphin and 22 clinical isolates was performed by PCR and sequencing selective for the most prevalent ESBL-mediated genes ( bla TEM , bla SHV , bla OXA-G1 , bla CTX-M ) and genes encoding plasmid-mediated quinolone resistance ( qnrA , qnrB , qnrC , qnrD , qnrS , qepA , aac(6’)Ib-cr ), as previously described ( 7 ). Specifically, the strain recovered from the dolphin contained bla CTX-M-15 , bla TEM-1 , and bla OXA-30 , associated with a plasmid-mediated quinolone resistance gene, aac(6’)-Ib-cr ( Figure ).…”

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confidence: 99%

“…Multilocus sequence typing (MLST) was performed for 9 of the 23 E. coli isolates. According to E. coli MLST website ( http://mlst.ucc.ie/mlst/dbs/Ecoli ), clones from the dolphin and from the humans exhibited the same combination of alleles across the 7 sequenced loci, corresponding to the epidemic ST131, associated with CTX-M-15 and widely disseminated among hospitals in Portugal ( 2 , 7 ). Within-ST subclones were analyzed on the basis of sequence variation of the E. coli fimbrial adhesin gene fimH , as previously described ( 10 ).…”

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confidence: 99%

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CTX-M-15–ProducingEscherichia coliin Dolphin, Portugal

Manageiro¹,

Clemente²,

Jones-Dias³

et al. 2015

Emerg. Infect. Dis.

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“…The carbapenemase-producing strains were subjected to pulsed-field gel electrophoresis (PFGE) at the National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal, as previously described. 31 …”

Section: Methodsmentioning

confidence: 99%

Outbreak of KPC-producing Klebsiella pneumoniae at a Portuguese university hospital: Epidemiological characterization and containment measures

Peres¹,

Figueiredo²,

Andrade³

et al. 2022

Porto Biomedical Journal

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Background: KPC-producing K pneumoniae (KPC-Kp) is a public health problem with important clinical and epidemiological implications. We describe an outbreak of KPC-Kp at vascular surgery and neurosurgery wards in a central hospital in Porto, Portugal. Methods: A case of KPC-Kp was considered to be a patient positive for KPC-Kp with strong epidemiological plausibility of having acquired this microorganism in the affected wards and/or with genetic relationship ≥92% between KPC-Kp isolates. Active surveillance cultures (ASCs) and real-time polymerase chain reaction were used for the detection of carbapenemase genes through rectal swab in a selected population. Molecular analysis was performed using pulsed-field gel electrophoresis at the National Reference Laboratory. Patient risk factors were collected from the electronic medical record system. Information regarding outbreak containment strategy was collected from the Infection Control Unit records. Results: Of the 16 cases, 11 (69%) were identified through active screening, representing 1.4% of the total 766 ASCs collected. The most frequent risk factors identified were previous admission (63%), antibiotic exposure in the past 6 months (50%), and immunodepression (44%). The length of stay until KPC-Kp detection was high (0–121 days, mean 35.6), as was the total length of stay (5–173 days, mean 56.6). Three patients (19%) were infected by KPC-Kp, 2 of whom died. One previously colonized patient died later because of KPC-Kp infection. Conclusions: Multifactorial strategy based on contact precautions (with patient and healthcare professional cohorts) and ASC, as well as Antibiotic Stewardship Program reinforcement, allowed to contain this KPC-Kp outbreak.

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Emergence and risk factors of β-lactamase–mediated resistance to oxyimino-β-lactams in Enterobacteriaceae isolates

Cited by 8 publications

References 26 publications

Molecular Characterization of ESBL-Producing Enterobacteriaceae in Northern Portugal

Molecular Characterization of ESBL-Producing Enterobacteriaceae in Northern Portugal

CTX-M-15–ProducingEscherichia coliin Dolphin, Portugal

Outbreak of KPC-producing Klebsiella pneumoniae at a Portuguese university hospital: Epidemiological characterization and containment measures

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