Importation of organisms producing broad-spectrum SHV-group β-lactamases into the United Kingdom

Shannon, Kevin; King, Anna; Phillips, Ian; Nicolas, M. H.; Philippon, A.

doi:10.1093/jac/25.3.343

Cited by 45 publications

(26 citation statements)

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“…Another notable dissemination has been of a TEM-24-producing Enterobacter aerogenes clone in France, Spain, and Belgium (68,108,119). Intercontinental transfer has also been described (365).…”

Section: Molecular Epidemiology Of Nosocomial Infections With Esbl-prmentioning

confidence: 97%

“…Transfer of genotypically related ESBLs from hospital to hospital within a single city (40,256,351,439), from city to city (439), and from country to country (128,147,365,439) has been documented. A notable clone has been an SHV-4-producing, serotype K-25 isolate of Klebsiella pneumoniae which has spread to multiple hospitals in France and Belgium (439).…”

Section: Molecular Epidemiology Of Nosocomial Infections With Esbl-prmentioning

confidence: 99%

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Extended-Spectrum β-Lactamases: a Clinical Update

2005

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SUMMARY Extended-spectrum β-lactamases (ESBLs) are a rapidly evolving group of β-lactamases which share the ability to hydrolyze third-generation cephalosporins and aztreonam yet are inhibited by clavulanic acid. Typically, they derive from genes for TEM-1, TEM-2, or SHV-1 by mutations that alter the amino acid configuration around the active site of these β-lactamases. This extends the spectrum of β-lactam antibiotics susceptible to hydrolysis by these enzymes. An increasing number of ESBLs not of TEM or SHV lineage have recently been described. The presence of ESBLs carries tremendous clinical significance. The ESBLs are frequently plasmid encoded. Plasmids responsible for ESBL production frequently carry genes encoding resistance to other drug classes (for example, aminoglycosides). Therefore, antibiotic options in the treatment of ESBL-producing organisms are extremely limited. Carbapenems are the treatment of choice for serious infections due to ESBL-producing organisms, yet carbapenem-resistant isolates have recently been reported. ESBL-producing organisms may appear susceptible to some extended-spectrum cephalosporins. However, treatment with such antibiotics has been associated with high failure rates. There is substantial debate as to the optimal method to prevent this occurrence. It has been proposed that cephalosporin breakpoints for the Enterobacteriaceae should be altered so that the need for ESBL detection would be obviated. At present, however, organizations such as the Clinical and Laboratory Standards Institute (formerly the National Committee for Clinical Laboratory Standards) provide guidelines for the detection of ESBLs in klebsiellae and Escherichia coli. In common to all ESBL detection methods is the general principle that the activity of extended-spectrum cephalosporins against ESBL-producing organisms will be enhanced by the presence of clavulanic acid. ESBLs represent an impressive example of the ability of gram-negative bacteria to develop new antibiotic resistance mechanisms in the face of the introduction of new antimicrobial agents.

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Section: Molecular Epidemiology Of Nosocomial Infections With Esbl-prmentioning

confidence: 97%

Section: Molecular Epidemiology Of Nosocomial Infections With Esbl-prmentioning

confidence: 99%

Extended-Spectrum β-Lactamases: a Clinical Update

2005

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“…Plasmid transfer of cefotaxime or ceftazidime resistance markers was performed by a broth culture conjugation method (26). E. coli J53 Azi r was used as a recipient.…”

Section: Methodsmentioning

confidence: 99%

Occurrence of Extended-Spectrum β-Lactamases in Members of the Genus Shigella in the Republic of Korea

Kim

Kang

et al. 2004

J Clin Microbiol

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A nationwide survey was carried out in Korea to assess the prevalence of Shigella strains producing extended-spectrum ␤-lactamases (ESBLs). From 1991 to 2002, 5,911 clinical strains were isolated and screened for resistance to extended-spectrum cephalosporins. Twenty of the Shigella isolates were ESBL positive, based on the synergistic effects between clavulanate and selected ␤-lactams (ceftazidime and cefotaxime). Nucleotide sequence analysis of these isolates revealed that they harbored bla TEM-19 (eight isolates), bla TEM-15 (five isolates), bla TEM-52 (six isolates), bla TEM-17 (one isolate), bla TEM-20 (one isolate), and bla CTX-M-14 (three isolates). All the ESBL-encoding genes in this study were carried in conjugable plasmids. Thus, TEM-19, TEM-15, TEM-52, and CTX-M-14 ␤-lactamases can be considered common Korean ESBL types in Shigella sonnei and are probably transmitted through interspecies spread between medical facilities and the community in Korea. This is the first report of the presence of TEM-17, TEM-19, and TEM-20 in Korea and in S. sonnei.

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“…ESBLs have spread widely and have become a major cause of nosocomial infections associated with high mortality rates, particularly in serious infections such as septicemia (12). In Africa, ESBLs have been reported in Egypt (19), Tunisia (4,5), Morocco (2), Senegal (18,20), Nigeria (1), South Africa (9), and Kenya (11) but not previously from Tanzania. In the present study, we investigated the prevalence and clinical implications of ESBL production in E. coli, Klebsiella pneumoniae, and salmonellae causing septicemia in infants and children admitted to a tertiary teaching hospital in Tanzania.…”

Section: Resistance To Beta-lactam Antibiotics Was Demonstrated Inmentioning

confidence: 99%

High Rate of Fatal Cases of Pediatric Septicemia Caused by Gram-Negative Bacteria with Extended-Spectrum Beta-Lactamases in Dar es Salaam, Tanzania

Blomberg

Jureen

Manji³

et al. 2005

J Clin Microbiol

189

176

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Extended-spectrum beta-lactamases (ESBLs) were present in high proportions of Escherichia coli (25% [9 of 36]) and Klebsiella pneumoniae isolates (17% [9 of 52]) causing pediatric septicemia at a tertiary hospital in Tanzania. Patients with septicemia due to ESBL-producing organisms had a significantly higher fatality rate than those with non-ESBL isolates (71% versus 39%, P ‫؍‬ 0.039). This is the first report of the CTX-M-15 genotype of ESBLs on the African continent and the first observation of SHV-12 genotype in an isolate of Salmonella enterica serotype Newport. Resistance to beta-lactam antibiotics was demonstrated inEscherichia coli even before penicillin was released for clinical use. In the 1960s, the first plasmid-transferable beta-lactamase was discovered and named TEM-1 after Temoniera, the Greek girl who harbored the E. coli isolate from which the enzyme was obtained. Since the 1980s, a large number of plasmid-transferable extended-spectrum beta-lactamases (ESBLs) capable of inactivating extended-spectrum cephalosporins has been discovered (6). Most of the ESBLs are derived from TEM-1 and SHV-1 (sulfhydryl variable) by mutations. ESBLs have spread widely and have become a major cause of nosocomial infections associated with high mortality rates, particularly in serious infections such as septicemia (12). In Africa, ESBLs have been reported in Egypt (19), Tunisia (4, 5), Morocco (2), Senegal (18,20), Nigeria (1), South Africa (9), and Kenya (11) but not previously from Tanzania. In the present study, we investigated the prevalence and clinical implications of ESBL production in E. coli, Klebsiella pneumoniae, and salmonellae causing septicemia in infants and children admitted to a tertiary teaching hospital in Tanzania. MATERIALS AND METHODSFrom August 2001 to August 2002, blood cultures were obtained from 1,798 children aged 0 to 7 years with a fever of Ն38°C or other signs of severe infections admitted to the Pediatric Department at Muhimbili National Hospital, a tertiary referral hospital in Dar es Salaam, Tanzania. We included in the present study 113 children who had growth in blood culture of one or more isolates of E. coli, Klebsiella spp., or salmonellae.Blood specimens (1 ml from neonates and 5 ml from older children) were inoculated in BACTEC Myco/F lytic blood culturing vials (Becton Dickinson, Franklin Lakes, N.J). Positive blood cultures were subcultured on Columbia II agar base (Oxoid Ltd, Basingstoke, United Kingdom) with 5% human blood, chocolate agar, and MacConkey agar (Difco/BD Diagnostic Systems, Sparks, Mich.). The isolates were identified according to established procedures (7).Klebsiella spp. were identified with the API 20E system (bioMérieux SA, Marcy l'Etoile, France). Susceptibilities against antimicrobial agents were tested by the disk diffusion method according to NCCLS guidelines (15). Isolates of E. coli, Klebsiella spp., and salmonellae with reduced susceptibilities to cefotaxime (zone diameter of Յ27 mm) and/or ceftazidime (zone diameter of Յ22 mm) according to guidel...

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Importation of organisms producing broad-spectrum SHV-group β-lactamases into the United Kingdom

Cited by 45 publications

References 0 publications

Extended-Spectrum β-Lactamases: a Clinical Update

Extended-Spectrum β-Lactamases: a Clinical Update

Occurrence of Extended-Spectrum β-Lactamases in Members of the Genus Shigella in the Republic of Korea

High Rate of Fatal Cases of Pediatric Septicemia Caused by Gram-Negative Bacteria with Extended-Spectrum Beta-Lactamases in Dar es Salaam, Tanzania

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