Genes Encoding TEM-4, SHV-2, and CTX-M-10 Extended-Spectrum β-Lactamases Are Carried by MultipleKlebsiella pneumoniaeClones in a Single Hospital (Madrid, 1989 to 2000)

Abstract

Over a 12-year period (1989 to 2000), 159 Klebsiella pneumoniae isolates harboring extended-spectrum ␤-lactamases (ESBLs) (4.8% of the total number of K. pneumoniae isolates obtained) were recovered from 58 patients, who were mainly hospitalized in intensive care and surgery units. For 62 representative isolates from 58 patients, 31 clonal types harboring TEM-4 (n ‫؍‬ 5), SHV-2 (n ‫؍‬ 7), SHV2a (n ‫؍‬ 4), SHV-5 (n ‫؍‬ 1), CTX-M-10 (n ‫؍‬ 13), or CTX-M-9 (n ‫؍‬ 1) ␤-lactamases were identified by pulsed-field gel electrophoresis. This is the first report to document the presence of the CTX-M-10 or the CTX-M-9 ␤-lactamase in K. pneumoniae. These ␤-lactamases were previously identified in Escherichia coli isolates from Spain. Only two of five K. pneumoniae TEM-4 clones caused more than a single case of infection, with one of them spreading for 9 months. A single plasmid was detected among these TEM-4 clones. Only two of seven K. pneumoniae clones containing SHV-2 and three of four strains harboring SHV-2a were detected in more than one case of infection. Plasmids encoding SHV-2 or SHV-2a were unrelated. Four of 13 K. pneumoniae CTX-M-10 clones were found in more than one patient, with two of them recovered 2 and 5 years apart. As in the case of the SHV-2 isolates, we were unable to document a common transmissible genetic element that could explain the polyclonal structure of our isolates. Nevertheless, the spread of a single gene may be suggested by the presence of a conserved set of noncoding polymorphisms in the sequences. Most ESBL-producing K. pneumoniae clones were ephemeral, being poorly selected and maintained in the hospital setting, but the genes encoding ESBL persisted successfully over the years that the strains were recovered, probably as a minority gene population in the hospital metagenome.

Prevalence and Molecular Epidemiology of CTX-MExtended-Spectrum β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae in RussianHospitals

“…The first organisms producing ␤-lactamases of this type were identified both as single and epidemic clinical isolates in very distant geographic regions (Germany and France and Argentina) in the early 1990s (3, 5, 7). More recently, a rapid increase in the proportion of multiple CTX-M variants to the TEM-and SHV-derived ESBLs has been reported in many hospitals in Spain (9,12,15,35) (14), and Korea (28). Furthermore, CTX-M ␤-lactamases, mainly types CTX-M-2 and CTX-M-3, were found to be widespread or even predominant ESBL types in several countries, including Argentina (31, 34; M. Galas, F. Pasteran, R. Melano, A. Petroni, G. Lopez, A. Corso, A. Rossi, et al, Abstr.…”

Bakterielle Erreger von Krankenhausinfektionen mit besonderen Resistenzen und Multiresistenzen

“…Beispielhaft dafür sind Ergebnisse aus einem spanischen Krankenhaus. Hier traten ESBL der Typen TEM-4, SHV-2 und CTX 10 in genotypisch verschiedenen Stämmen der Spezies E. coli und K. pneumoniae auf [29].…”

Kuşbaşı Dana Etlerinde GSBL-Üreten Enterobacteriaceae Suşlarının Varlıkları

“…The disc-inserted plates were incubated at 37ºC for 18-24 h. The zones of inhibition was evaluated according to the criteria by CLSI (2013) [16,17] . A difference of ≥5 mm between the zone measurements of the identical discs ± CV were considered to be ESBL-producing species [15,17,18] .…”

“…The isolate was spiked in a sterile saline physiological solution to get a density expressed as 0.5 McFarland standard. Using a cotton swap, it was spreaded over Mueller Hinton Agar (MHA) (Merck, Germany) [15,16] . The ESBL screening was performed by cefotaxime (CTX; 30 μg), ceftazidime (CAZ; 30 μg), and cefpodoxime (CPD; 10 μg) discs (TurkLab, Turkey).…”