Nosocomial and community-acquired Enterobacter cloacae bloodstream infection: risk factors for and prevalence of SHV-12 in multiresistant isolates in a medical centre

Liu, C.-P.; Wang, N.-Y.; Lee, C.-M.; Weng, Li-Chuan; Tseng, Hsiang-Kuang; Liu, C.-W.; Chiang, Chuen‐Sheue; Huang, Fu Yuan

doi:10.1016/j.jhin.2004.04.019

Cited by 38 publications

(33 citation statements)

References 34 publications

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“…>2, which further illustrated that infection with E. cloacae is closely associated with external factors; this is consistent with other investigations (10)(11)(12). Notably, antibiotic abuse has been considered an essential reason for antibiotic resistance and the wide spread of antibiotic-resistant strains; however, no significant effect of antibiotic usage for >30 days was found in groups 1-4.…”

Section: No Of Resistant Isolatessupporting

confidence: 90%

“…Currently, central venous catheters, malignant tumors, history of antibiotic usage and Pitt bacteremia score are regarded as the risk factors for bacterial infection (9); however, associated risk factors are distinct based on differences in hospital settings, practitioners, usage of medications and the condition of the patient, suggesting that additional external factors may be at play in the evolution of antibiotic resistance for E. cloacae (10)(11)(12).…”

Section: Over Recent Decades the Enterobacter Cloacae Complex (Consimentioning

confidence: 99%

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Association of antibiotic resistance with SHV-12 extended-spectrum β-lactamase in Enterobacter cloacae

Liu

Lin

et al. 2015

Experimental and Therapeutic Medicine

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Abstract.The association between antibiotic resistance and SHV-12 extended-spectrum β-lactamase (ESBL) in Enterobacter cloacae remains unknown. The aim of the present study was to investigate the prevalence of both chromosome-and plasmid-borne SHV-12 ESBL genes in Enterobacter cloacae. Transmission of the SHV-12 ESBL gene was explored, and the risk factors for antibiotic resistance in E. cloacae were analyzed. Polymerase chain reaction (PCR) results showed that 58 out of the 100 isolates carried the SHV-12 ESBL gene: 34.48% of them occurred in the chromosome, 48.28% were plasmid-borne and 17.24% appeared in both. Enterobacterial repetitive intergenic consensus-PCR tests detected 82 chromosomal genotypes. Conjugation assays showed that 70.00% of plasmid-borne SHV-12 ESBL genes were successfully transconjugated into E. coli C600 and that the antibiotic resistance phenotype of E. cloacae was partially (84%) or completely (10%) transferred. A significantly higher SHV-12 ESBL detection rate was found in patients with underlying conditions and/or complications compared with those without (P<0.05). The detection of SHV-12 ESBL-producing E. cloacae from vertical transmission varied significantly across clinical departments and age groups (P<0.05), with the highest rates in the intensive care unit and the group of patients aged ≥60 years. The present results indicate that the location and transmission efficiency of SHV-12 ESBL are closely correlated with the antibiotic resistance of E. cloacae.

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Section: No Of Resistant Isolatessupporting

confidence: 90%

Section: Over Recent Decades the Enterobacter Cloacae Complex (Consimentioning

confidence: 99%

Association of antibiotic resistance with SHV-12 extended-spectrum β-lactamase in Enterobacter cloacae

Liu

Lin

et al. 2015

Experimental and Therapeutic Medicine

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“…Southern blotting was performed as previously described (23). The chromosomal or plasmid DNA in agarose gels was transferred to N ϩ Hybond nylon membranes, followed by UV light cross-linking.…”

Section: Methodsmentioning

confidence: 99%

Ceftriaxone Resistance of Nontyphoidal Salmonella enterica Isolates in Northern Taiwan Attributable to Production of CTX-M-14 and CMY-2 β-Lactamases

Huang

Liu

et al. 2005

J Clin Microbiol

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. Sixteen of these isolates belonged to Salmonella serogroup B, nine belonged to serogroup C, four belonged to serogroup D, and two belonged to serogroup E. The majority were from stool cultures. The mechanism of resistance was investigated for eight isolates, including three S. enterica serovar Typhimurium, one S. enterica serovar Wagenia, one S. enterica serovar Senftenberg, one S. enterica serovar Derby, one S. enterica serovar Panama, and one S. enterica serovar Duesseldorf isolate. All eight patients from whom these isolates were recovered had community-acquired infections. All eight isolates were resistant to ampicillin, ceftriaxone, and cefotaxime but susceptible to imipenem and ciprofloxacin. Ceftriaxone resistance was due to the production of the CMY-2 AmpC ␤-lactamase by seven isolates and the CTX-M-14 ␤-lactamase by the remaining isolate. Both ␤-lactamase genes were carried on conjugative plasmids. In a 2.5-kb region encompassing the bla CMY-2 gene, at nucleotide 49 upstream of the start codon of bla CMY-2 , three of the seven bla CMY-2 -positive isolates had an A nucleotide and four had a G nucleotide. In conclusion, the ceftriaxone resistance of nontyphoidal Salmonella isolates in our hospital was attributed to the CTX-M-14 and CMY-2 ␤-lactamases.

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“…Not detecting ESBLs in these pathogens may have a significant adverse impact on patients, especially those treated with extended-spectrum cephalosporins [68,69]. ESBLs are more difficult to detect in these organisms because AmpC enzymes may be induced by clavulanate (which inhibits them poorly) and may increase resistance to cephalosporins, overcoming the synergy arising from inhibition of the ESBL [70].…”

Section: Phenotypic Confirmatory Tests For Esbl Productionmentioning

confidence: 99%

The continuing challenge of ESBLs

Pérez

Endimiani

Hujer

et al. 2007

Current Opinion in Pharmacology

252

209

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Summary of recent advancesSince their first description more than twenty years ago, Escherichia coli and Klebsiella pneumoniae possessing extended-spectrum class A beta-lactamases (ESBLs) continue to thwart our best clinical efforts. In the "early years" the most common beta-lactamases were of the TEM and SHV varieties. Now, CTX-M enzymes are being discovered though out the world and are becoming the most prevalent beta-lactamases found in clinical isolates. The Klebsiella pneumoniae carbapenemases (KPC) (ESBL type enzymes that confer resistance to extended spectrum cephalosporins and carbapenems) present the most significant challenge to date. Structural studies of ESBLs indicate that active site expansion and remodeling are responsible for this extended hydrolytic activity. Continuing questions still exist regarding the optimal detection method for ESBLs. Most relevant are the increasing concerns regarding the status of carbapenems as "best therapy" for ESBL producing bacteria in light of the emergence of carbapenemases.

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Nosocomial and community-acquired Enterobacter cloacae bloodstream infection: risk factors for and prevalence of SHV-12 in multiresistant isolates in a medical centre

Cited by 38 publications

References 34 publications

Association of antibiotic resistance with SHV-12 extended-spectrum β-lactamase in Enterobacter cloacae

Association of antibiotic resistance with SHV-12 extended-spectrum β-lactamase in Enterobacter cloacae

Ceftriaxone Resistance of Nontyphoidal Salmonella enterica Isolates in Northern Taiwan Attributable to Production of CTX-M-14 and CMY-2 β-Lactamases

The continuing challenge of ESBLs

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