Molecular epidemiology of Klebsiella pneumoniae strains that produce SHV-4 beta-lactamase and which were isolated in 14 French hospitals

Arlet, Guillaume; Rouveau, M.; Casin, I.; Bouvet, Philippe; Lagrange, Philippe; Philippon, A.

doi:10.1128/jcm.32.10.2553-2558.1994

Cited by 128 publications

(56 citation statements)

References 42 publications

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“…Such a spread of an ESBL variant can occur due to the dissemination of a single clone of an ESBL-producing organism in numerous centers of a region, which seems to strongly indicate frequent occurrences of strain transmission from one center to another. This was well documented in France, with an SHV-4-producing Klebsiella pneumoniae clone being found in 14 hospitals by the end of 1988 [140], and the previously mentioned TEM-24-producing Enterobacter aerogenes clone spreading into 21 hospitals by 1997 [141]. Recently, a single clone of CTX-M-type ESBL-producing Salmonella typhimurium has been identified in Russia, Hungary and Greece [115].…”

Section: E Sbl Ep Idemiologymentioning

confidence: 77%

“…An ESBL variant (ESBL producer strain) may appear in a center due to de novo selection, which may result in a novel type of enzyme [17,57,60,89,130] or in one that has been previously identified in another institution (convergent evolution) [67][68][69]137]. It may also be imported by a patient from another center, even though that may be located in another city or country [31,57,[138][139][140][141]. Once selected, the ESBL variant may spread in the center by different means, including clonal dissemination of the producer strain [14,92,93,142,143] or horizontal transmission of the ESBL gene-carrying plasmid among non-related strains [29,144].…”

Section: E Sbl Ep Idemiologymentioning

confidence: 99%

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Evolution and epidemiology of extended-spectrum β-lactamases (ESBLs) and ESBL-producing microorganisms

Gniadkowski

2001

Clinical Microbiology and Infection

211

166

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The rapid and irrepressible increase in antimicrobial resistance of pathogenic bacteria that has been observed over the last two decades is widely accepted to be one of the major problems of human medicine today. Several aspects of this situation are especially worrying. There are resistance mechanisms that eliminate the use of last-choice antibiotics in the treatment of various kinds of infection. Many resistance mechanisms that emerge and spread in bacterial populations are those of wide activity spectra, which compromise all or a majority of drugs belonging to a given therapeutic group. Some mechanisms of great clinical importance require specific detection procedures, as they may not confer clear resistance in vitro on the basis of the interpretive criteria used in standard susceptibility testing. Finally, multiple mechanisms affecting the same and/or different groups of antimicrobials coexist and are even co-selected in more and more strains of pathogenic bacteria. The variety of beta-lactamases with wide spectra of substrate specificity illustrates very well all the phenomena mentioned above. Being able to hydrolyze the majority of beta-lactams that are currently in use, together they constitute the most important resistance mechanism of Gram-negative rods. Three major groups of these enzymes are usually distinguished, class C cephalosporinases (AmpC), extended-spectrum beta-lactamases (ESBLs) and different types of beta-lactamases with carbapenemase activity, of which the so-called class B metallo-beta-lactamases (MBLs) are of the greatest concern. This review is focused on various aspects of the evolution and epidemiology of ESBLs; it does not cover the problems of ESBL detection and clinical relevance of infections caused by ESBL-producing organisms.

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Section: E Sbl Ep Idemiologymentioning

confidence: 77%

Section: E Sbl Ep Idemiologymentioning

confidence: 99%

Evolution and epidemiology of extended-spectrum β-lactamases (ESBLs) and ESBL-producing microorganisms

Gniadkowski

2001

Clinical Microbiology and Infection

211

166

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“…ESBLs, such as TEM-52 and SHV-12, among human pathogens were first reported in Europe (Knothe et al, 1983;Arlet et al, 1994;Babini & Livermore, 2000;De Gheldre et al, 2001;Vahaboglu et al, 2001;Saladin et al, 2002;Arpin et al, 2003;Weill et al, 2004a, b;Politi et al, 2005;Livermore et al, 2007). Later on, TEM-type ESBLs were described in the United States (Jacoby et al, 1988;Rice et al, 1996).…”

Section: Sick Humansmentioning

confidence: 99%

Broad-spectrum β-lactamases amongEnterobacteriaceaeof animal origin: molecular aspects, mobility and impact on public health

et al. 2010

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Broad-spectrum β-lactamase genes (coding for extended-spectrum β-lactamases and AmpC β-lactamases) have been frequently demonstrated in the microbiota of food-producing animals. This may pose a human health hazard as these genes may be present in zoonotic bacteria, which would cause a direct problem. They can also be present in commensals, which may act as a reservoir of resistance genes for pathogens causing disease both in humans and in animals. Broad-spectrum β-lactamase genes are frequently located on mobile genetic elements, such as plasmids, transposons and integrons, which often also carry additional resistance genes. This could limit treatment options for infections caused by broad-spectrum β-lactam-resistant microorganisms. This review addresses the growing burden of broad-spectrum β-lactam resistance among Enterobacteriaceae isolated from food, companion and wild animals worldwide. To explore the human health hazard, the diversity of broad-spectrum β-lactamases among Enterobacteriaceae derived from animals is compared with respect to their presence in human bacteria. Furthermore, the possibilities of the exchange of genes encoding broad-spectrum β-lactamases - including the exchange of the transposons and plasmids that serve as vehicles for these genes - between different ecosystems (human and animal) are discussed.

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“…Our simulation data suggest that the increasing prevalence of highly resistant organisms across hospitals may be caused not only by selection pressures within hospitals, but also by interhospital spread of highly resistant HAI between hospitals. The data suggest that detected multihospital outbreaks of Staphylococcus [13,14], Klebsiella [12], Acinetobacter [34,35], and coronavirus [11] may not be isolated incidents. This may happen via interhospital transfer of not only critical care patients, as we have studied here, but also via patients from nursing homes or with brief times between hospital admissions [3].…”

Section: Discussionmentioning

confidence: 98%

“…The most notable recent example was the iatrogenic spread of severe acute respiratory syndrome (SARS) in Toronto [11]. Several other examples have been documented [12][13][14]. Patients may act as vectors if they are colonized by highly resistant organisms even when not actively infected [15,16].…”

Section: Introductionmentioning

confidence: 99%

Limiting the spread of highly resistant hospital-acquired microorganisms via critical care transfers: a simulation study

et al. 2011

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Purpose Hospital-acquired infections with highly resistant organisms are an important problem among critically ill patients. Control of these organisms has largely focused within individual hospitals. We examine the extent to which transfers of critically ill patients could be a vector for wide spread of highly resistant organisms, and compare the efficiency of different approaches to targeting infection control resources. Methods We analyzed the network of interhospital transfers of intensive care unit patients in 2005 U.S. Medicare data and 2004–2006 Pennsylvania all-payer data. We simulated spread of highly resistant hospital-acquired infections by randomly choosing a single hospital to develop a highly resistant organism and following spread of infection or colonization throughout the network under varying strategies of infection control and varying levels of infectivity. Results Critical care transfers could spread a highly resistant organism between any two U.S. hospitals in a median of three years. Hospitals varied substantially in their importance to limiting potential spread. Targeting resources to a small subset of hospitals based on their position in the transfer network was 16 times more efficient than distributing infection control resources uniformly. Within any set of targeted hospitals, the best strategy for infection control heavily concentrated resources at a few particularly important hospitals, regardless of level of infectivity. Conclusions Critical care transfers provide a plausible vector for wide-spread dissemination of highly resistant hospital-acquired microorganisms. Infection control efforts can be made more efficient by selectively targeting hospitals most important for transmission.

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Molecular epidemiology of Klebsiella pneumoniae strains that produce SHV-4 beta-lactamase and which were isolated in 14 French hospitals

Cited by 128 publications

References 42 publications

Evolution and epidemiology of extended-spectrum β-lactamases (ESBLs) and ESBL-producing microorganisms

Evolution and epidemiology of extended-spectrum β-lactamases (ESBLs) and ESBL-producing microorganisms

Broad-spectrum β-lactamases amongEnterobacteriaceaeof animal origin: molecular aspects, mobility and impact on public health

Limiting the spread of highly resistant hospital-acquired microorganisms via critical care transfers: a simulation study

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