Neonatal intensive care unit outbreak caused by a strain of Klebsiella oxytoca resistant to aztreonam due to overproduction of chromosomal β-lactamase

Jeong, Seok Hoon; Kim, W. M.; Chang, Chin-Hsiang; Kim, J. M.; Lee, Kyungwon; Chong, Yunsop; Hwang, Hyunyong; Baek, Yunju; Chung, Hun-Sik; Woo, I. G.; Ku, Ja-Ran

doi:10.1053/jhin.2001.1018

Cited by 39 publications

(21 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Klebsiella oxytoca is an opportunistic pathogen responsible for causing health care-associated infections (14,15,17). These species possess chromosomal genes encoding ␤-lactamases that are constitutively expressed at low levels and that confer resistance to amino-and carboxypenicillins but not to other ␤-lactams (4).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Outbreak of OXY-2-Producing Klebsiella oxytoca in a Renal Transplant Unit

et al. 2008

View full text Add to dashboard Cite

We describe a Klebsiella oxytoca infection outbreak in a renal transplant unit that involved seven patients. All strains belonged to a single pulsed-field gel electrophoresis pattern and were resistant to amoxicillin-clavulanate, cefuroxime, piperacillin-tazobactam, and aztreonam but susceptible to ceftriaxone, ceftazidime, cefepime, and imipenem. Chromosomal ␤-lactamase hyperproduction was caused by a point mutation in the bla OXY-2 gene promoter region.

show abstract

mentioning

confidence: 99%

“…oxytoca infection outbreaks have been documented in multiple settings (4,15,18,19,21). However, K. oxytoca infection outbreaks in transplantation units have not yet been reported.…”

mentioning

confidence: 99%

Outbreak of OXY-2-Producing Klebsiella oxytoca in a Renal Transplant Unit

et al. 2008

View full text Add to dashboard Cite

show abstract

“…In wild-type K. oxytoca, a penicillinase is produced at low levels and confers resistance to aminopenicillins, ticarcillin, and piperacillin. Clinical isolates of K. oxytoca resistant to expanded-spectrum cephalosporins and aztreonam have been reported (13,14). Two mechanisms of resistance to these expanded-spectrum ␤-lactams have been reported for K. oxytoca.…”

mentioning

confidence: 99%

In Vivo Selection of a Chromosomally Encodedβ-Lactamase Variant Conferring Ceftazidime Resistance in Klebsiellaoxytoca

Mammeri

Poirel

Nordmann

2003

Antimicrob Agents Chemother

View full text Add to dashboard Cite

Klebsiella oxytoca clinical isolate A was recovered from the urine of a 55-year-old man with prostatic and urinary tract infections. This isolate displayed a ␤-lactam resistance phenotype consistent with overproduction of a chromosomally encoded class A ␤-lactamase and had decreased susceptibilities to all ␤-lactams except ceftazidime, cephamycins, and carbapenems. Four weeks after treatment with an antibiotic regimen that included ceftazidime, K. oxytoca isolate B, which had a high level of resistance to ceftazidime, was isolated from the urine of the same patient. Isoelectric focusing analysis of the culture extracts of these isolates gave a pI of 5.4 for both isolates. Cloning experiments with the PCR products of the bla OXY gene resulted in two Escherichia coli DH10B recombinant clones with resistance phenotypes mirroring those of the parental isolates. Sequencing analysis revealed that the bla OXY-2-5 gene from K. oxytoca B had a single nucleotide substitution compared to the sequence of the bla OXY-2 gene from K. oxytoca A, leading to a proline-to-serine substitution at position 167, according to the numbering of Ambler. Biochemical analysis of purified OXY-2-5 showed that it had the ability to hydrolyze ceftazidime. This is the first report of in vivo selection of a K. oxytoca isolate that produced a chromosomally encoded ␤-lactamase conferring resistance to ceftazidime.Klebsiella oxytoca is a gram-negative rod of the family Enterobacteriaceae that is responsible for nosocomial infections, mainly located in the urinary tract. In wild-type K. oxytoca, a penicillinase is produced at low levels and confers resistance to aminopenicillins, ticarcillin, and piperacillin. Clinical isolates of K. oxytoca resistant to expanded-spectrum cephalosporins and aztreonam have been reported (13,14). Two mechanisms of resistance to these expanded-spectrum ␤-lactams have been reported for K. oxytoca. Overproduction of the chromosomally encoded penicillinase due to mutation in the promoter region of the gene may appear (9), whereas production of a plasmidmediated extended-spectrum ␤-lactamase has also been reported (19). The former mechanism confers resistance to most penicillins and reduced susceptibility to most cephalosporins but does not confer resistance to either cephamycins (such as cefoxitin) or ceftazidime. DNA sequencing shows that K. oxytoca chromosomal ␤-lactamase genes may be divided into two main groups, the bla OXY-1 and bla OXY-2 genes (11). These two types of ␤-lactamase genes share 89.7% DNA identity and confer the same phenotype of resistance to ␤-lactams. Biochemical study of the purified chromosomally encoded ␤-lactamase OXY-2 showed that this enzyme exhibits an extended spectrum of activity (2), leading to its classification in functional group 2be of the extended-spectrum ␤-lactamases (6).In this study, we report on the biochemical analysis of an OXY-2 variant that conferred resistance to ceftazidime and that was obtained after in vivo selection. MATERIALS AND METHODSBacterial strains and plasmids. Cli...

show abstract

“…Of the bacteria cultured from the necropsy-sampled lung specimen, Klebsiella oxytoca, a Gram-negative rod belonging to the Enterobacteriaceae, is known to cause neonatal septicaemia 16 and haemorrhagic colitis in antibiotic-treated humans 14 , and may have genetic over-expression of Ä-lactamases giving rise to resistance to certain antibiotics; its origin is either environmental such as in water sources 16 , or from the intestinal tract. It has also been reported as an opportunistic pathogen causing severe suppurative otitis media, urogenital tract infections and pneumonia in laboratory rodents, especially those prone to diabetes mellitus or known immune deficiency, as well as in vole moles 2 .…”

Section: Discussionmentioning

confidence: 99%

Barbiturate ingestion in three adult captive tigers (Panthera tigris) and concomitant fatal botulism of one : clinical communication

Williams¹,

Bester²,

Venter³

et al. 2011

J. S. Afr. Vet. Assoc.

View full text Add to dashboard Cite

Zoo animals, including tigers, have been reported to suffer from barbiturate intoxication, with pentabarbitone being most commonly recorded. Clinical signs range from mild ataxia to general anaesthesia with recovery over hours to days with several factors affecting hepatic barbiturate metabolism and tissue partitioning. Botulism is an often fatal intoxication in man, animals, birds and certain fish. The occurrence in carnivores is uncommon to rare, with only 2 reports found of botulism in felids. This report relates to 3 adult captive cohabiting tigers that simultaneously developed signs of abdominal discomfort, progressive ataxia, recumbency and comatose sleep resembling stage 2 anaesthesia, alternating with periods of distracted wakefulness and ataxic movements. These signs occurred 4 days after being fed the carcass of a horse that had ostensibly died of colic and not been euthanased. The male tiger that was the dominant animal in the feeding hierarchy was worst affected and had to be given intravenous fluids. The female that was lowest in hierarchy was unaffected. After 48-72 hours of treatment at the Onderstepoort Veterinary Academic Hospital the females could eat and made an uneventful recovery. The male tiger showed partial recovery but died during the night a few hours after drinking water on his return to the owner. Necropsy revealed severe oesophageal dilation and impaction with decaying grass; some of this material and water were present in the pharynx and trachea, and had been aspirated causing acute widespread bronchopneumonia. Colon content tested negative for common pesticides but, together with liver, tested positive for barbiturate. Serum taken on the day of admission had tested negative for barbiturate and the residual serum from the 3 animals later tested negative for botulinum toxin. Colon and oesophageal content from the male at necropsy were positive for Clostridium botulinum toxin type C by the mouse bioassay neutralisation test, confirming that this male had had concomitant barbiturate toxicity and botulism, and had succumbed to aspiration bronchopneumonia secondary to pharyngeal, laryngeal and oesophageal paralysis and oesophageal impaction

show abstract

Neonatal intensive care unit outbreak caused by a strain of Klebsiella oxytoca resistant to aztreonam due to overproduction of chromosomal β-lactamase

Cited by 39 publications

References 14 publications

Outbreak of OXY-2-Producing Klebsiella oxytoca in a Renal Transplant Unit

Outbreak of OXY-2-Producing Klebsiella oxytoca in a Renal Transplant Unit

In Vivo Selection of a Chromosomally Encodedβ-Lactamase Variant Conferring Ceftazidime Resistance in Klebsiellaoxytoca

Barbiturate ingestion in three adult captive tigers (Panthera tigris) and concomitant fatal botulism of one : clinical communication

Contact Info

Product

Resources

About