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

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 ␤-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.

Molecular Characterization of ESBL-Producing Escherichia Coli Isolated from Healthy Cattle and Sheep

“…DNA from E. coli isolates with confi rmed ESBL production was extracted using a genomic DNA purifi cation kit (Thermo Fisher Scientifi c Inc., Massachusetts, USA) and tested by PCR with specifi c primers for the bla TEM , bla SHV and bla CTX-M genes as described elsewhere [22][23][24][25][26][27] E. coli ATCC 35218 (bla TEM-1 ) and K. pneumoniae ATCC 700603 (bla SHV-18 ) were used as positive control strains for bla TEM and bla SHV encoding genes. E. coli NCTC 13461, E. coli NCTC 13462, E. coli NCTC 13463, Enterobacter cloacae NCTC 13464 and K. pneumoniae NCTC 13465 were used as positive controls for the detection of bla CTX-M group 1, group 2, group 8, group 9 and group 25 genes, respectively.…”

Enterobactérias produtoras de ESBL em Passo Fundo, estado do Rio Grande do Sul, Brasil

“…É sabido que a diminuição na permeabilidade da bactéria aos antimicrobianos e a produção de outras β-lactamases induzíveis podem mascarar a presença de ESBL 19,20 . Airpin e cols 21 relataram que 49% dos isolados produtores de ESBL eram E. aerogenes, seguidos de 21% de K. pneumoniae e 15% de E. coli. O presente estudo mostrou diferença significativa quanto ao tipo de microrganismo isolado e a produção de ESBL (p<0,05).…”

Phenotypic Cofirmatory Disc Diffusion Test (PCDDT), Double Disc Synergy Test (DDST), E-Test Os Diagnostic Tool for Detection of Extended Spectrum Beta Lactamase (ESΒL) Producing Uropathogens

“…ESBLs were discovered in 1980, nursing homes and hospitals are found as main reservoirs of extended spectrum beta-lactamase (ESBL) producing bacteria. Hospital patients serve as a reservoir for these resistant organisms [3][4][5]. Enterobacteriacae produce ESBL sand are globally serious nosocomial pathogens [6,7].…”