Prevalence of extended-spectrum β-lactamases in South America

Villegas, María Virginia; Kattan, Juan Nicolas; Quinteros, Mirta; Casellas, José María

doi:10.1111/j.1469-0691.2007.01869.x

Cited by 110 publications

(96 citation statements)

References 40 publications

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“…22 CTX-M-2, CTX-M-8 and CTX-M-9 groups were the most frequently detected CTX-M-type enzymes among ESBL-producing Enterobacteriaceae isolates from South American countries. 4,9,23 In the present study, CTX-M 2 (61%) was the predominant cluster. CTX-M-2 was first characterized and appears to be dominant in Argentina.…”

Section: Resultssupporting

confidence: 55%

“…[5][6][7][8] In some of those settings, rates of CTX-M-production as high as 58.5% in K. pneumoniae have been reported, 7 and South America appears as an important source of CTX-M type ESBL. 9,10 In the present study we describe the molecular characterization of CTX-M-producing K. pneumoniae clinical strains isolated from six different hospitals in three cities of Brazil.…”

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confidence: 99%

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Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

Chagas¹,

Alves²,

Vallim³

et al. 2011

Braz J Infect Dis

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Objective: The present study was undertaken to characterize CTX-M ESBL-producing Klebsiella pneumoniae collected from hospitals in different cities of Brazil. Material and Methods: Eighty-five K. pneumoniae strains isolated from hospitalized patients in six different hospitals of three cities of Brazil were analyzed. ESBL production was confirmed by the standard double-disk synergy test and the Etest®. The MIC 50 and MIC 90 for ESBL-producing isolates were determined by the Etest® method. The antimicrobial susceptibilities of bacterial isolates were determined using the agar diffusion method according to the CLSI. Screening for bla TEM, bla SHV, bla CTX-M genes and class 1 integron was performed by PCR amplification. To determine the genomic diversity of CTX-M-producers, isolates were analyzed by macrorestriction profile analysis following PFGE. Results and Discussion: Seventy-one K. pneumoniae isolates were ESBL-producing. PCR and sequencing experiments detected 38 CTX-M-producing K. pneumoniae belonged to groups CTX-M 1, CTX-M 2, CTX-M 8 and CTX-M 9. The association of different types ESBL (CTX-M, SHV and TEM) was frequent. All K. pneumoniae isolates carried class 1 integron. PFGE analysis revealed thirty-one clonal types among CTX-M-producing isolates. The data presented herein illustrate the diversity of genotypes of CTX-M producing K. pneumoniae among Brazilians hospitals.

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Section: Resultssupporting

confidence: 55%

mentioning

confidence: 99%

Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

Chagas¹,

Alves²,

Vallim³

et al. 2011

Braz J Infect Dis

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“…The prevalence of SHV, TEM and CTX-M among the ESBL-producers was 91, 71 and 36.4 %, respectively. In the SHV group, the variants SHV-12 and SHV-5 were the most prevalent, as is the case worldwide (Paterson et al, 2003;Villegas et al, 2008;Ryoo et al, 2005). Other non-ESBL SHVs were also detected at lower rates, including SHV-1, SHV-11 and SHV-85, found in six, four and two isolates, respectively.…”

Section: Enterobacteriaceaementioning

confidence: 87%

The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

Yezli

Shibl

Memish

2015

Journal of Medical Microbiology

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Resistance to b-lactams among Gram-negative bacteria is a worldwide issue. Increased prevalence of extended-spectrum b-lactamase (ESBL)-producers and the dissemination of carbapenem-resistance genes are particularly concerning. ESBL-producing strains are common in the Kingdom of Saudi Arabia, particularly among the Enterobacteriaceae, and carbapenem resistance is on the increase, especially among the non-fermenters. b-lactamase production is a major mechanism of resistance to these agents and although b-lactamase-producing strains have been documented in the Kingdom, relatively few reports characterized the molecular basis of this production. Nevertheless, available data suggest that CTX-M (CTX-M-15 in particular) is the predominant ESBL in the Enterobacteriaceae, with SHV also being prevalent in Klebsiella pneumoniae. Carbapenem resistance in the latter is mainly due to OXA-48 and NDM-1. In Pseudomonas aeruginosa, VEB-like enzymes are the most common ESBLs, and VIM is the prevalent metallo-b-lactamase. OXA-10 extended-spectrum enzymes are also frequent. PER and GES ESBLs have been reported in Acinetobacter baumannii, and oxacillinases (OXA-23 in particular) are the dominant carbapanamases in this species. IntroductionInfections due to Gram-negative bacteria are a leading cause of morbidity and mortality worldwide (Giske et al., 2008). Antimicrobial agents are a major therapeutic tool in the treatment of such infections. However, antimicrobial resistance among Gram-negative bacteria, particularly among the Enterobacteriaceae and the non-fermenters, has become one of the most serious public health concerns worldwide (Giske et al., 2008;Livermore, 2012). The global dissemination of resistance has recently received much attention, especially following reports of the international spread of multi-resistant Enterobacteriaceae, particularly strains resistant to cephalosporins due to the production of CTX-M-type extended-spectrum b-lactamases (ESBLs) and strains producing carbapenemases such as KPC and NDM (Nordmann et al., 2011;Johnson & Woodford, 2013). The spread of resistance determinants is facilitated by a number of factors, including presence on genetic mobile elements, antibiotic misuse, poor infection control practices, and increased international travel. In this context Saudi Arabia is particularly relevant as it is annually a host for more than 4 million Muslim pilgrims from over 180 countries worldwide in the Hajj and Umra seasons. In addition, up to 6 million of the Kingdom's population are expatriates, mainly from south and east Asia, where antimicrobial resistance is rife, including to carbapenems (Yong et al., 2009). These factors could potentially make Saudi Arabia a hot spot for the collection of multidrug-resistant strains and the spread of antibiotic resistance around the world.We previously reported on the antimicrobial resistance among the key Gram-negative bacteria in Saudi Arabia and found increased prevalence of b-lactam-resistant strains, including ESBL-producers, and carbapenem resistance (Y...

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“…Among ESBL families, TEM, SHV, and CTX-M are the most reported around the world, and in Latin America, SHV and CTX-M variants are the most frequent [2][3][4]. In Brazil, there is no report of TEM enzymes that express an ESBL phenotype, while some SHV ESBLs are frequently reported (SHV-5, SHV-12) [5][6].…”

Section: Introductionmentioning

confidence: 99%

Complex class 1 integrons harboring CTX-M-2-encoding genes in clinical Enterobacteriaceae from a hospital in Brazil

Dropa

Balsalobre

Lincopán

et al. 2015

J Infect Dev Ctries

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Introduction: CTX-M enzymes are the most prevalent extended-spectrum beta-lactamases (ESBLs) in Brazil and around the world. The spread of CTX-M lies in their ability to be mobilized by insertion sequences and integrons. This study aimed to identify the mobile genetic structures associated with bla CTX-M genes from clinical Enterobacteriaceae strains. Methodology: Twenty-eight clinical non-clonal Enterobacteriaceae were screened by PCR for the presence of bla CTX-M genes and class 1 integrase (int1), and for the association of bla CTX-M with class 1 integrons. Plasmid incompatibility groups were assessed by PBRT. Wild-type plasmids were transformed into electrocompetent E. coli, and the S1-PFGE technique was used to verify the presence of high-molecularweight plasmids in both wild-type strains and E. coli transformants. Results: Sequencing showed that strains carried bla CTX-M-2 (n = 25) and bla CTX-M-59 (n = 3) genes inserted into the 3'-end of complex class 1 integrons. Thirteen strains also carried bla TEM and bla SHV genes. CTX-M-2/59-containing complex class 1 integrons were also present in E. coli transformants. The most frequent Inc groups were IncA/C (n = 10) and IncF (n = 8). Heavy plasmids were observed in both wild-type strains and E. coli transformants. Conclusions: The presence of the same bla CTX-M-2-group -containing genetic structure in seven Enterobacteriaceae species isolated at seven hospital wards shows the great mobility potential of complex class 1 integrons. Also, this is the first report of TEM-15, SHV-45, and SHV-55 in Latin America. The genetic environment of bla CTX-M-2 accounts for their maintenance and spread among Gram-negative bacteria.

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Prevalence of extended-spectrum β-lactamases in South America

Cited by 110 publications

References 40 publications

Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

Diversity of genotypes in CTX-M-producing Klebsiella pneumoniae isolated in different hospitals in Brazil

The molecular basis of β-lactamase production in Gram-negative bacteria from Saudi Arabia

Complex class 1 integrons harboring CTX-M-2-encoding genes in clinical Enterobacteriaceae from a hospital in Brazil

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