Document Detail


Clonal spread of both oxyimino-cephalosporin- and cefoxitin-resistant Klebsiella pneumoniae isolates co-producing SHV-2a and DHA-1 beta-lactamase at a burns intensive care unit.
MedLine Citation:
PMID:  17095195     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Over a 1-month period, a total of 16 ceftriaxone- and cefoxitin-resistant Klebsiella pneumoniae isolates were isolated from 15 patients hospitalised at a burns intensive care unit (ICU). These isolates showed negative results for extended-spectrum beta-lactamase (ESBL) by the Vitek system and were highly resistant to ceftazidime, aztreonam and cefoxitin (minimum inhibitory concentrations > or =128 microg/mL). The bla(SHV-2a) and bla(DHA-1) genes were detected by polymerase chain reaction and sequence analysis. Pulsed-field gel electrophoresis profiles of the isolates were identical. AmpC disk tests for AmpC enzymes as well as double-disk tests and Clinical and Laboratory Standards Institute (CLSI) confirmatory disk tests for ESBLs yielded positive results for all the isolates. However, only three isolates (18.8%) were shown to produce ESBL by CLSI confirmatory tests using broth microdilution. We report the first outbreak of colonisations and infections due to K. pneumoniae isolates co-producing an SHV-2a ESBL and a DHA-1 AmpC beta-lactamase in a Korean hospital, which were suggested to represent a single clonal spread at a burns ICU. In addition, this report presents problems associated with ESBL detection using broth microdilution in isolates that co-produce an ESBL and an AmpC beta-lactamase.
Authors:
Wonkeun Song; Kyu Man Lee; Han-Sung Kim; Jae-Seok Kim; Jonghyun Kim; Seok Hoon Jeong; Kyoung Ho Roh
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Publication Detail:
Type:  Journal Article     Date:  2006-11-13
Journal Detail:
Title:  International journal of antimicrobial agents     Volume:  28     ISSN:  0924-8579     ISO Abbreviation:  Int. J. Antimicrob. Agents     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-11-27     Completed Date:  2007-02-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9111860     Medline TA:  Int J Antimicrob Agents     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  520-4     Citation Subset:  IM    
Affiliation:
Department of Laboratory Medicine, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, 948-1 Daelim-dong, Youngdeungpo-gu, Seoul 150-950, South Korea. swonkeun@hallym.or.kr
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / pharmacology
Burn Units*
Cefoxitin / pharmacology
Cephalosporin Resistance*
Cephalosporins / pharmacology
Disease Outbreaks*
Humans
Klebsiella Infections / epidemiology*,  microbiology
Klebsiella pneumoniae / drug effects,  enzymology,  genetics*
Korea / epidemiology
Microbial Sensitivity Tests
Polymerase Chain Reaction
beta-Lactamases / biosynthesis*,  genetics
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Cephalosporins; 35607-66-0/Cefoxitin; EC 3.5.2.-/beta-lactamase SHV-2a; EC 3.5.2.6/beta-Lactamases

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