MICROBIOLOGY LETTERS. Introduction RESEARCH LETTER

Size: px
Start display at page:

Download "MICROBIOLOGY LETTERS. Introduction RESEARCH LETTER"

Transcription

1 RESEARCH LETTER Predominant characteristics of CTX-M-producing Klebsiella pneumoniae isolates from patients with lower respiratory tract infection in multiple medical centers in China Shuchang An 1, Jichao Chen 2, Zhanwei Wang 3, Xiaorong Wang 1, Xixin Yan 4, Jihong Li 5, Yusheng Chen 6,QiWang 7, Xiaoling Xu 8, Jiabin Li 9, Jingping Yang 10, Hui Wang 3 & Zhancheng Gao 1 1 Department of Respiratory and Critical Care Medicine, Peking University People s Hospital, Beijing, China; 2 Department of Respiratory Medicine, the Central Hospital of China Aerospace Corporation, Beijing, China; 3 Department of Clinical Laboratory, Peking University People s Hospital, Beijing, China; 4 Department of Respiratory Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang, China; 5 Department of Clinical Laboratory, the Second Hospital of Hebei Medical University, Shijiazhuang, China; 6 Department of Respiratory Medicine, Fujian Province Hospital, Fuzhou, China; 7 Department of Respiratory Medicine, the Second Affiliated Hospital of Dalian Medical University, Dalian, China; 8 Department of Respiratory Medicine, Anhui Province Hospital, Hefei, China; 9 Department of Infectious Diseases, the First Affiliated Hospital of Anhui Medical University, Hefei, China; and 10 Department of Respiratory Medicine, the Third Affiliated Hospital of the Inner Mongolia Medical College, Baotou, China MICROBIOLOGY LETTERS Correspondence: Zhancheng Gao, Department of Respiratory & Critical Care Medicine, Peking University People s Hospital, No. 11 Xizhimen South Street, Beijing , China. Tel.: ; fax: ; zcgao@bjmu.edu.cn Received 7 January 2012; revised 23 April 2012; accepted 23 April Final version published online 28 May DOI: /j x Editor: Mark Schembri Keywords extended-spectrum b-lactamase; CTX-M; Klebsiella pneumoniae; multilocus sequence typing. Introduction Abstract Extended-spectrum Β-lactamase (ESBL)-producing Enterobacteriaceae, especially Klebsiella pneumoniae and Escherichia coli, have been shown to have a significant impact on treatment options and clinical outcome in inpatients and outpatients (Tumbarello et al., 2007; Meier et al., 2011). Further, ESBL-producing bacteria have been shown to cause higher morbidity, mortality, and fiscal burden (Jean & Hsueh, 2011; Dhillon & Clark, 2012). The typical characteristic of ESBLs is their ability to hydrolyze oxyiminocephalosporins and aztreonam while From February 2010 to July 2011, 183 of 416 presumptive Klebsiella pneumoniae isolates with reduced susceptibility to third-generation cephalosporins from patients with lower respiratory tract infection were collected from seven tertiary hospitals in China. Phenotypic and genotypic methods were employed to characterize 158 extended-spectrum b-lactamase (ESBL)-producers. Among the 158 isolates analyzed, 134 (84.8%) harbored bla CTX-M, within which the most predominant ESBL gene was CTX-M-14 (49.4%), followed by CTX-M-15 (12.0%) and CTX-M-27 (10.8%). Also, 120 (75.9%) harbored bla SHV. One novel SHV variant, bla SHV-142 with T18A and L35Q substitutions, was identified. Ninety-one isolates carried bla TEM-1. An isolate containing bla TEM-135 was first identified in Klebsiella spp. bla KPC-2 was detected in 5 isolates. More than one ESBL combination was detected in 18 isolates (11.4%). Fifty-four (34.2%) isolates demonstrated the multidrug resistant (MDR) phenotype. Seventy-four sequence types (STs) were identified, which showed large genetic background diversity in ESBL-producing K. pneumoniae isolates from the six areas. This is the first report on the high prevalence of CTX-M-27 in China with the possible transmission of a single clone (ST48). The correlated surveillance of organisms with MDR phenotype should be investigated in future. being inhibited by b-lactamase inhibitors (Paterson & Bonomo, 2005). As the first types of ESBL derived from the non-esbl bla SHV-1 and bla TEM-1 were reported, CTX-M-type ESBLs are now actually the most frequent types worldwide and are clustered in five subgroups (Falagas & Karageorgopoulos, 2009). Furthermore, some ESBLs exhibiting inhibitor resistance properties have also been identified in gram-negative bacteria (Nüesch- Inderbinen et al., 1997). So far, there are 124 CTX-M variants, 143 SHV variants, and 196 TEM variants, and many other types of ESBLs have been reported worldwide (

2 138 S. An et al. The prevalence of ESBL-producing bacteria and their antimicrobial resistance profiles vary worldwide (Dhillon & Clark, 2012). Further, the widespread use of broadspectrum antibacterial agents is an independent risk factor for infection with ESBL-producers (Pfaller & Segreti, 2006). Because of various antibiotic prescription patterns in different regions and increasing internal travel and trade in China, continuous surveillance studies and epidemiologic data on the prevalence of genotypes of ESBLs in different areas are of great needs. To date, the predominant ESBLs in Enterobacteriaceae are CTX-M- and SHV-type, with other ESBL enzymes were less often encountered (Chanawong et al., 2002; Yu et al., 2007; Liu et al., 2009; Zhang et al., 2009). The aim of this investigation was to clarify the current phenotypes, genotypes, and the genetic characteristics of bla CTX-M/SHV/TEM -producing K. pneumoniae isolates originating from patients with lower respiratory tract infection in seven tertiary hospitals in China. Materials and methods Clinical strains From February 2010 to July 2011, 416 consecutive nonduplicate clinical K. pneumoniae isolates were collected from seven tertiary hospitals in Beijing Xicheng District (n = 109), Beijing Haidian District (n = 45), Fujian Province (n = 71), Anhui Province (n = 64), Hebei Province (n = 52), Liaoning Province (n = 40), and Inner Mongolia Autonomous Region (n = 35) in China. The lower respiratory tract infection was defined as described elsewhere (Li et al., 2011). Species identification was initially carried out by each of the hospital microbiological laboratories using their own protocols. The presumptive ESBL phenotype was screened by reduced susceptibility to ceftriaxone, cefotaxime, and aztreonam with automated systems or the disk diffusion methods using the Clinical and Laboratory Standards Institute (CLSI) criteria (Clinical & Laboratory Standards Institute, 2010). Upon arrival at the referral laboratory, the identification of all isolates was confirmed by sequencing analysis of the rpob gene coding for the b-subunit of K. pneumonia RNA polymerase (Diancourt et al., 2005). The patients clinical data such as demographics (age, sex) and the hospital units where they had received medical service were also reviewed. This study was approved by Peking University People s Hospital Ethics Committee (Federal-wide Assurance ). Confirmation of ESBL production and antimicrobial susceptibility testing All presumptive ESBL-producing isolates were subjected to the confirmation test for ESBL production by the double-disk synergy test (Clinical & Laboratory Standards Institute, 2010). Minimum inhibitory concentrations (MICs) to 21 antimicrobial agents (ampicillin, ampicillin/ sulbactam, piperacillin, piperacillin/tazobactam, cefazolin, cefuroxime, cefuroxime axetil, ceftriaxone, ceftazidime, cefepime, cefotetan, aztreonam, imipenem, meropenem, amikacin, gentamicin, tobramycin, ciprofloxacin, levofloxacin, nitrofurantoin, and trimethoprim-sulfamethoxazole) were performed using the VITEK 2 system (biome rieux, France) with the AST-GN09 card. The susceptibility to cefotaxime refers to the confirmation test. All results were interpreted based on the CLSI guidelines (Clinical & Laboratory Standards Institute, 2010). Multidrug resistant (MDR) phenotype was determined as described previously (Tumbarello et al., 2007). The disks used for confirmation test were obtained from Beijing Tiantan Biological Products Corporation (China). Escherichia coli (ATCC 25922) and K. pneumoniae (ATCC ) were used as quality control strains. PCR amplification of b-lactamase genes and sequence analysis Plasmid DNA was extracted and purified by the alkaline lysis method using a commercial plasmid DNA purification kit (Tiangen Biotech Co., Ltd, China). Detection of genes encoding bla SHV/TEM/CTX-M groupi/ctx-m groupiv enzymes was performed by PCR with the primers listed in Table S1, Supporting information. The specific PCR assay of CTX-M group II, III, and V was implemented with the relevant primers (Nagano et al., 2003; Pitout et al., 2004; Chmelnitsky et al., 2005). Further amplification for K. pneumoniae carbapenemase (KPC) in speculative isolates (MIC of imipenem or meropenem of 2 lg ml 1 ), another pair of primers was used (Yigit et al., 2001). PCR products were subjected to bidirectional nucleotide sequencing using an automated DNA sequencer (ABI 3730XL, Weiterstadt, Germany). The nucleotide sequences or deduced protein sequences were analyzed via both Basic Local Alignment Search Tool (BLAST) program ( BLAST) and web site on the nomenclature of ESBLs ( Multilocus sequence typing (MLST) The genetic relationship between all qualified K. pneumoniae isolates was determined by MLST with seven housekeeping genes (Diancourt et al., 2005). Chromosomal DNA was obtained by the alkaline lysis method using a commercial genomic DNA purification kit (Tiangen Biotech Co., Ltd) according to the manufacturer s instructions. Allele sequences and sequence types (STs) were

3 Characteristics of CTX-M-producing K. pneumoniae in China 139 verified at the PF8/mlst/Kpneumoniae.html web site. The phylogenetic relationships among the different STs were established according to a dendrogram generated using the unweighted pair group method with arithmetic mean (UPGMA) algorithms and eburst analysis ( mlstanalyse). Statistical analysis Categorical variables were evaluated by the chi-square test. Values are expressed as percentages of the group from which they were derived (categorical variables). Two-tailed tests were used to determine statistical significance. P value of < 0.05 was considered significant. All statistical analysis was performed by the SPSS statistics program, version 16.0, for Windows (SPSS Inc., IBM). Results Identification of the K. pneumoniae isolates In total, 183 ESBL-producers were screened. Of the 183 study isolates, seven isolates were negative for ESBL production by the double-disk synergy test and 18 isolates were excluded by the rpob confirmatory test. Thus, 158 K. pneumoniae was included for further characterization. The frequency of occurrence of ESBLproducers in the six areas ranges from 28.8% to 64.4% (Fig. S1). Clinical characteristics of the K. pneumoniae isolates Complete medical records were available for review from 133 of 158 patients. As shown in Table S2, 107 (80.5%) isolates were collected from the general wards except for 26 (19.5%) of which were collected from the intensive care units (ICU). Most of the patients (84/133) were over 60 years old and were predominantly male (90 males vs. 43 females). Ninety percent isolates were collected more than 48 h after hospitalization. Antibiotic susceptibility tests All isolates were resistant to ampicillin, cefazolin (MICs 64 lg ml 1 ), and manifested 100% resistance to ceftriaxone (MIC range 8 64 lg ml 1 ) (Table 1). The resistance rates to drugs with lower overall resistance rate were 26.6%, 22.2%, 10.1%, 8.2%, and 3.8%, to amikacin, cefepime, piperacillin/tazobactam, cefotetan, and imipenem, respectively. All isolates were resistant to cefotaxime with the zone diameters of 22 mm except for one of 24 mm. A total of 54 of the 158 isolates (34.2%) were classified as MDR (Table 2). b-lactamase genes characterization All 158 isolates yielded purified plasmids and harbored b-lactamase genes by PCR. Sequence analysis revealed that bla CTX-M, bla SHV, and bla TEM were present in 134, 120, and 92 isolates, respectively. A total of 149 (94.3%) isolates harbored one or more ESBL genes. Of 134 CTX-M producers, 78 carried the bla CTX-M-14, which was the most common type of ESBLs in seven hospitals, 19 isolates carried bla CTX-M-15, 17 bla CTX-M-27, 12 bla CTX-M-3, 4 bla CTX-M-55,2bla CTX-M-65,2bla CTX-M-24,2bla CTX-M-24a,1 bla CTX-M-38, and 1 bla CTX-M-98. No group II, III, and V bla CTX-M have been detected. Sequencing of bla SHV PCR products indicated that 15 of 120 clinical isolates had bla SHV-12 and 7 bla SHV-5. Other ESBL genes were bla SHV2a (n = 3), bla SHV-2 (n = 2), bla SHV-27 (n = 2), and bla SHV-38 (n = 1). The most prevalent non-esbl bla SHV was SHV-11 (n = 45, 28.5%), which commonly coexisted with other ESBLs except for 2 isolates. Other non-esbl bla SHV were bla SHV-1 (n = 23), bla SHV-108 (n = 5), bla SHV-28 (n = 4), bla SHV-36 (n = 3), bla SHV-1a (n = 1), bla SHV-26 (n = 1), bla SHV-32 (n = 1), bla SHV-33 (n = 1), bla SHV-60 (n = 1), bla SHV-103 (n = 1), bla LEN (n = 1), and bla LEN-22 (n = 1). One novel SHV variant, of which the deduced protein sequence showed the combination of T18A and L35Q (according to the ABL numbering scheme) substitution in relation to bla SHV-1, named SHV-142, was detected (Fig. 1). Nearly, all of the bla TEM encoded TEM-1 except for one isolate carrying SHV-2a and TEM-135 with a single point mutation in CDS, T396G (data not shown). Seventeen (10.8%) isolates were detected to have two ESBL genes, and 1 (0.6%) isolate was detected to have three ESBL genes (Fig. 1). Five of 6 isolates with resistances to carbapenems also coded the bla KPC-2. Antimicrobial susceptibilities of representative bla CTX-M -harboring K. pneumoniae isolates An analysis of MICs and resistance patterns of the predominant bla CTX-M-14 (49.4%), bla CTX-M-15 (12%), and bla CTX-M-27 (10.8%) subtypes is shown in Table 2. With non-esbl bla, the subgroups CTX-M-15 and CTX-M-27 exhibited higher proportion of resistance to aztreonam and ceftazidime than that of subgroup CTX-M-14 (P < 0.05). The MIC ranges to aztreonam and ceftazidime among 12 isolates in subgroup CTX-M-15 were lg ml 1 and 4 64 lg ml 1, respectively. Also, the MIC ranges to aztreonam and ceftazidime in subgroup CTX-M-27 were 2 64 lg ml 1 and 4 64 lg ml 1, respectively, while both of which among 54

4 140 S. An et al. Table 1. Antimicrobial resistances in 158 ESBL-producing Klebsiella pneumoniae isolates from seven tertiary hospitals in China No. of isolates (%) Total AMP SAM PIP TZP CFZ CXM FUR CTT CRO CAZ Genotype of ESBLs bla CTX-M * 116 (73.4) 116 (100) 91 (78.4) 106 (91.4) 9 (7.8) 116 (100) 116 (100) 116 (100) 9 (7.8) 116 (100) 43 (37.1) blashv 15 (9.5) 15 (100) 15 (100) 15 (100) 2 (13.3) 15 (100) 12 (80) 12 (80) 0 (0) 15 (100) 13 (86.7) bla CTX-M14+CTX-M15 3 (1.9) 3 (100) 3 (100) 3 (100) 0 (0) 3 (100) 3 (100) 3 (100) 0 (0) 3 (100) 2 (66.7) blactx-m + bla SHV 15 (9.5) 15 (100) 14 (93.3) 14 (93.3) 4 (26.7) 15 (100) 15 (100) 15 (100) 1 (6.7) 15 (100) 12 (80) Not detect genotype 9 (5.7) 9 (100) 6 (66.7) 7 (77.8) 1 (11.1) 9 (100) 7 (77.8) 7 (77.8) 3 (33.3) 9 (100) 4 (44.4) Total (%) 158 (100) 158 (100) 129 (81.6) 145 (91.8) 16 (10.1) 158 (100) 153 (96.8) 153 (96.8) 13 (8.2) 158 (100) 74 (46.8) Total FEP ATM IMP AMK GEN TOB CIP LEV FT SXT blactx-m* 116 (73.4) 20 (17.2) 56 (48.3) 4 (3.4) 25 (21.6) 81 (69.8) 35 (30.2) 55 (47.4) 45 (38.8) 66 (56.9) 78 (67.2) bla SHV 15 (9.5) 2 (13.3) 11 (73.3) 0 (0) 7 (46.7) 10 (66.7) 10 (66.7) 9 (60) 9 (60) 9 (60) 14 (93.3) blactx-m14+ctx-m15 3 (1.9) 3 (100) 3 (100) 0 (0) 0 (0) 2 (66.7) 0 (0) 1 (33.3) 1 (33.3) 1 (33.3) 3 (100) bla CTX-M + bla SHV 15 (9.5) 9 (60) 12 (80) 1 (6.7) 7 (46.7) 15 (100) 7 (46.7) 11 (73.3) 11 (73.3) 6 (54.5) 9 (60) Not detect genotype 9 (5.7) 1 (11.1) 6 (66.7) 1 (11.1) 3 (33.3) 8 (88.9) 3 (33.3) 4 (44.4) 4 (44.4) 7 (77.8) 8 (88.9) Total (%) 158 (100) 35 (22.2) 88 (55.7) 6 (3.8) 42 (26.6) 116 (73.4) 55 (34.8) 80 (50.6) 70 (44.3) 89 (56.3) 112 (70.9) AMP, ampicillin; SAM, ampicillin/sulbactam; PIP, piperacillin; TZP, piperacillin/tazobactam; CFZ, cefazolin; CXM, cefuroxime; FUR, cefuroxime axetil; CRO, ceftriaxone; CAZ, ceftazidime; FEP, cefepime; CTT, cefotetan; ATM, aztreonam; IMP, imipenem; AMK, amikacin; GEN, gentamicin; TOB, tobramycin; CIP, ciprofloxacin; LEV, levofloxacin; FT, nitrofurantoin; SXT, trimethoprimsulfamethoxazole. The antimicrobial resistances to meropenem were similar to imipenem. *Three isolates harboring blakpc-2 were included. One isolate harboring bla KPC-2 was included. isolates in subgroup CTX-M-14 were 1 64 lg ml 1. The subgroup CTX-M-15 exhibited higher level of resistance to cefepime than that of subgroup CTX-M-14 (P < 0.01), and the MIC range in subgroup CTX-M-15 was 2 64 lg ml 1. As for subgroup CTX-M-27, it exhibited higher proportion of resistance to ciprofloxacin and levofloxacin than that of subgroup CTX-M-14 (P < 0.01), and the MIC range to ciprofloxacin in subgroup CTX-M-27 was 1 4 lg ml 1, while it was lg ml 1 in subgroup CTX- M-14. The proportion of MDR in subgroup CTX-M-27 was higher than that in subgroup CTX-M-14 (P < 0.01). Nevertheless, when other ESBL bla (except for bla KPC-2 ) were present, subgroup CTX-M-14 showed significant increase in resistance to aztreonam and ceftazidime (P < 0.05). MLST To investigate the genetic relationship between the 158 clinical isolates, MLST was performed for all isolates. ST patterns for three isolates were not obtained because of the deletion or insertion of oligonucleotide in the gene (tonb) sequence coding for periplasmic energy transducer. Of the 155 isolates, 74 STs were identified, and the most prevalent ST was ST11 (n = 19), followed by ST48 (n = 9), ST37 (n = 7), ST17 (n = 7), ST15 (n = 6), ST340 (n = 6), ST23 (n = 5), and so forth (Fig. 1). The UPGMA dendrogram showed that there were only a few bla CTX-M-14 -producing isolates exhibiting genetic relationships (Fig. 1). Analysis of STs by eburst showed three clonal complexes (CCs) CC11 (n = 34), CC709 (n = 32), CC37 (n = 18), and other singletons (data not shown). This result also indicated the majority of 155 isolates were unrelated among the six geographical areas. Twenty-nine new STs in six hospitals except for Inner Mongolia were identified. The MLST results showed a large genetic background diversity in these ESBL-producing K. pneumoniae isolates from the six geographical areas in China. Interestingly, five isolates producing bla CTX-M-27 with the same patterns (ST48) were originated from patients in the same hospital. Nucleotide sequence accession number The nucleotide sequences of the novel bla SHV-142 and bla TEM-135 have been deposited in the GenBank nucleotide database under accession number JQ and JQ060998, respectively. Discussion ESBL-producing K. pneumoniae strains are frequently associated with nosocomial outbreaks, especially in ICU

5 Characteristics of CTX-M-producing K. pneumoniae in China 141 Table 2. Antimicrobial resistances in representative bla CTX-M -harboring Klebsiella pneumoniae isolates No. of isolates (MIC range lg ml 1 ) CTX-M-14 CTX-M-15 CTX-M-27 Antimicrobial agents No other bla (n = 11) With other non-esbl bla (n = 54)* With other ESBL bla (n = 9) No other bla (n = 0) With other non- ESBL bla (n = 12) With other ESBL bla (n = 7) No other bla (n = 1) With other non- ESBL bla (n = 15) With other ESBL bla (n = 1) TZP 0 ( 4 8) 1 ( 4 128) 0 ( 4 8) 0( 4 8) 1 ( 4 128) 0 (8) 2 ( 4 128) 1 ( 128) ATM 3 ( 1 64) 12 ( 1 64) 6 ( 1 64) 12 (16 64) 7( 64) 1 (16) 13 (2 64) 1( 64) CRO 11 (8 64) 54 (8 64) 9 (8 64) 12 ( 64) 7 ( 64) 1 (32) 15 (16 128) 1 ( 64) CAZ 2 ( 1 64) 10 ( 1 64) 5 ( 1 64) 7(4 64) 6(8 64) 0 (4) 12 (4 64) 1( 64) FEP 1 ( 1 64) 5 ( 1 64) 3 ( 1 64) 6(2 64) 7 (32 64) 0 (2) 2 ( 1 64) 1 ( 64) CIP 2 ( ) 19 ( ) 4 ( 0.5 4) 6( ) 5 (0.5 4) 1 ( 4) 13 (1 4) 1( 4) LVX 2 ( ) 18 (1 8) 4 (1 8) 4( ) 5 (1 8) 0 (1) 12 (1 8) 1( 8) GEN 8 ( 1 16) 41 ( 1 16) 8 ( 1 16) 5( 1 16) 6 ( 1 16) 0 ( 1) 10 ( 1 16) 1 ( 16) TOB 0 ( 1 4) 16 ( 1 16) 3 ( 1 16) 1( 1 16) 0 ( 1 8) 0 (8) 4 ( 1 16) 0 (4) AMK 0 ( 2) 13 ( 2 64) 3 ( 2 64) 0( 2 4) 0 ( 2) 0 (4) 2 ( 2 64) 0 ( 2) IMP 0 ( 1) 0 ( 1) 0 ( 1) 0( 1) 0 ( 1) 0 ( 1) 0 ( 1) 0 ( 1) No. of MDR 2 (18.2%) 14 (25.9%) 4 (44.4%) 4 (33.3%) 5 (71.4%) 1 (100%) 10 (66.7%) 1 (100%) phenotype TZP, piperacillin/tazobactam; ATM, aztreonam; CRO, ceftriaxone; CAZ, ceftazidime; FEP, cefepime; CIP, ciprofloxacin; LEV, levofloxacin; GEN, gentamicin; TOB, tobramycin; AMK, amikacin; IMP, imipenem. *Four isolates showing carbapenems resistance were not included. P < 0.05 vs. subgroup CTX-M-14 with other non-esbl bla. P < 0.01 vs. subgroup CTX-M-14 with other non-esbl bla.

6 142 S. An et al. Fig. 1. The UPGMA dendrogram, sequence types (STs), and genotypes of 155 ESBL-producing Klebsiella pneumoniae isolates from the seven tertiary hospitals in China. Dendrogram shows the majority of 155 isolates were un-related. The black vertical line shows the cut-off (similarity >70%). Letters in the strain IDs correspond to the source hospitals. The seven tertiary hospitals were Peking University People s Hospital (X), the First Affiliated Hospital of Anhui Medical University (A), the Second Hospital of Hebei Medical University (H), the Second Affiliated Hospital of Dalian Medical University (D), Fujian Province Hospital (F), the Central Hospital of China Aerospace Corporation (C), and the Third Affiliated Hospital of the Inner Mongolia Medical College (Baotou, B). Three isolates were non-typeable (the isolate H5 coding CTX-M-14+SHV-11+TEM-1, the isolate F4 coding CTX-M-27, and the isolate X2 coding TEM-1). Five isolates producing bla CTX-M-27+SHV-1 in the pane were collected from the same hospital (C). ACTT was as the referral strain.

7 Characteristics of CTX-M-producing K. pneumoniae in China 143 settings (Falagas & Karageorgopoulos, 2009; Shu et al., 2010). Senior, critical, or immunocompromised statuses are important risk factors for such infections (Falagas & Karageorgopoulos, 2009). In the present study, nearly two-thirds of the patients were over 60 years old, and the majority of isolates came from patients in common wards, where the respiratory expectoration was of significance contributing to the dissemination of ESBLproducing organisms. Since the first report of ESBLs in 2002 (Chanawong et al., 2002), bla CTX-M has been predominant in mainland (Yu et al., 2007; Liu et al., 2009). In this multicentre study, the prevalence of ESBL production in K. pneumoniae has been demonstrated to be about 40%. Of 158 ESBL-producers, the isolates harboring ESBL genes and bla CTX-M-14 were 94.3% and 49.4%, respectively, and were shown to increase 10% and 9% to those in another large-scale study (Yu et al., 2007), respectively. The proportion of bla CTX-M increased 12% compared to the percentage (72.3%) described in a report of southern China three years ago (Liu et al., 2009) and doubled the percentage reported nine years ago (Li et al., 2003). Because the usage of plasmid-based amplification method in this study and the potential false-negative products owing to the unbinding on some novel bla, the detection of b-lactamase genes may have been underestimated. Although there are some differences in the source of the isolates in our study as compared to the studies mentioned above, our results clearly suggest the increasing prevalence of bla CTX-M in K. pneumoniae in China. CTX-M-type ESBLs exhibit powerful activity against cefotaxime and ceftriaxone but generally not against ceftazidime, and several variants with enhanced ceftazidimase activity have been reported (Poirel et al., 2002; Bonnet et al., 2003; Rossolini et al., 2008). In this study, it was observed that the isolates harboring CTX-M-15 or CTX- M-27 alone exhibited higher resistance rates to ceftazidime and aztreonam than that in subgroup CTX-M-14 without other ESBLs (Table 2). Further, a high percentage of isolates harboring bla CTX-M-27 demonstrated the MDR phenotype. To our knowledge, this is the first study about the high prevalence of CTX-M-27 in Enterobacteriaceae in China. This warrants for an active surveillance to monitor these resistant bacteria. The overall resistance rates to the tested b-lactam antimicrobial agents were over 30% except for cefepime, piperacillin/tazobactam, and cefotetan in this study. As shown in Table 2, only 9.3% isolates harboring CTX- M-14 alone showed resistance to cefepime, but 50% isolates harboring CTX-M-15 exhibited resistance (P < 0.01), and a 100% resistance rate when CTX-M-15 coexisted with other ESBLs. Nevertheless, piperacillin/ tazobactam show only 10.1% resistance rate in vitro, although the proportion increased to 26.7% when the isolates contained two types of ESBLs(bla CTX-M + bla SHV ) (Table 1). Several clinical intervention studies also supported that piperacillin/tazobactam may contribute to preventing the ESBL-producing K. pneumoniae outbreaks (Lee et al., 2007; Tangden et al., 2011). These properties highlight the value of piperacillin/tazobactam as empirical therapy for infections by suspected organisms possessing a single ESBL (especially the bla CTX-M ). Although the overall sensitivity to cefotetan was nearly 90% in this study, its clinical utility has been limited because of its severe adverse events (Martin & Laber, 2006). There were 34.2% isolates that met the MDR criteria in our study. The lowest resistance rate among 158 isolates to non-b-lactam agents was still as high as 26.6% (to amikacin). Therefore, therapeutic options for ESBL-producing K. pneumoniae infections will become increasingly limited. In this survey, the most prominent non-esbl bla SHV was identified to be SHV-11 (28.5%). Interestingly, a survey in Korea indicated that the incidence of bla SHV-12 was more predominant in K. pneumoniae strains carrying the chromosomal bla SHV-11 (19.3%) than in strains carrying the bla SHV-1 (2.0%) (Lee et al., 2006). SHV-12 is classified as group 2be and sometimes shows high-level resistance to third-generation cephalosporins and resistance to b-lactamase inhibitors (Nüesch-Inderbinen et al., 1997). It is currently not known why this overabundance of SHV-12 had occurred, but the high prevalence of bla SHV- 11 in our study certainly warrants further surveillance. Two isolates carrying the novel SHV-142 together with CTX-M-14 were detected. Both isolates showed slight MICs increase to gentamicin and ciprofloxacin to isolates harboring CTX-M-14 alone (data not shown). Five isolates coding bla SHV-108 were detected, and they all showed the MDR phenotype (data not shown). The data indicated the isolates co-harboring SHV-108 showed high MIC values to non-b-lactam antibiotics. This is the first report of the occurrence of SHV-60, SHV-103, and SHV- 108 in China. bla TEM-1 was detected in 91 isolates but one encoding TEM-135, which was sporadically reported in Neisseria gonorrhoeae strains (Ohnishi et al., 2010). In this study, 6 (3.8%) carbapenem-resistant isolates were detected and five of them were with bla KPC-2. Lower breakpoints of the carbapenems do not completely exclude the possibility of resistant KPC isolate to be called susceptible (Bulik et al., 2010). This suggests that KPC producers have been underestimated in this study. Nine (5.7%) isolates no bla CTX-M/SHV/TEM ESBL was detected (Table 1). These isolates may have produced another ESBL, which was not determined in this study or might have given positive results for ESBL activity. Among 155 isolates, only a small number of isolates showed clonal relationships (> 70% similarity) by the MLST methods. ST-11 and CC11 were the most

8 144 S. An et al. predominant, present in 19 (12.3%) and 34 (21.9%) isolates, respectively. As for the predominate ESBL, CTX-M-14-producing K. pneumoniae strains of the main STs 37, 5, 505, 11, 23, 1, 22, and 48 were scattered in six geographical areas, exhibiting a multiclonal distribution. ST340 and ST15 as two major CTX-M-15-producing K. pneumoniae epidemic clones were dispersed in three independent areas. Three SHV-12 clones, ST722, ST340, and ST709 were also dispersed in three areas. These data indicate that the predominant ESBL-producing K. pneumoniae isolates from lower respiratory tract might acquire ESBL genes independently. Several different clones might contribute to the horizontal transfer of ESBL genes among K. pneumoniae in China. It is worthy of note that clone ST-48 harboring CTX-M-27 coupled with SHV-1 was detected in one hospital, especially that 4 isolates were detected from the same ward, suggesting the possible single clone dissemination. These findings confer the concern of various multiresistant pathogens and present new epidemiological and clinical challenges. In conclusion, although some ESBL genes may be missed by this basically plasmid encoded method, our study clearly indicates the high prevalence of bla CTX-M and large phylogenetic diversity in ESBL-producing K. pneumoniae. The consequent surveillance of multiple ESBL-producing organisms with MDR phenotype is of paramount importance. Acknowledgements This project was supported by the National Science and Technology Major Project of the Ministry of Science and Technology of China (Grant No. 2009ZX ) and National High-Tech R&D program (Grant No. 2006AA02Z4A9). We would like to gratefully appreciate Dr Dakun Wang, Senior Scientist, Precision Therapeutics, for kindly helping the English version. References Bonnet R, Recule C, Baraduc R et al. (2003) Effect of D240G substitution in a novel ESBL CTX-M-27. J Antimicrob Chemother 52: Bulik CC, Fauntleroy KA, Jenkins SG, Abuali M, LaBombardi VJ, Nicolau DP & Kuti JL (2010) Comparison of meropenem MICs and susceptibilities for carbapenemaseproducing Klebsiella pneumoniae isolates by various testing methods. J Clin Microbiol 48: Chanawong A, M Zali FH, Heritage J, Xiong JH & Hawkey PM (2002) Three cefotaximases, CTX-M-9, CTX-M-13, and CTX-M-14, among Enterobacteriaceae in the People s Republic of China. Antimicrob Agents Chemother 46: Chmelnitsky I, Carmeli Y, Leavitt A, Schwaber MJ & Navon- Venezia S (2005) CTX-M-2 and a new CTX-M-39 enzyme are the major extended-spectrum beta-lactamases in multiple Escherichia coli clones isolated in Tel Aviv, Israel. Antimicrob Agents Chemother 49: Clinical and Laboratory Standards Institute (2010) Performance Standards for Antimicrobial Susceptibility Testing, 20th edn. Informational supplement M100-S20. Clinical and Laboratory Standards Institute, Wayne, PA. Dhillon RH & Clark J (2012) ESBLs: a clear and present danger. Crit Care Res Pract 2012: Diancourt L, Passet V, Verhoef J, Grimont PA & Brisse S (2005) Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates. J Clin Microbiol 43: Falagas ME & Karageorgopoulos DE (2009) Extendedspectrum beta-lactamase-producing organisms. J Hosp Infect 73: Jean SS & Hsueh PR (2011) High burden of antimicrobial resistance in Asia. Int J Antimicrob Agents 37: Lee YH, Cho B, Bae IK, Chang CL & Jeong SH (2006) Klebsiella pneumoniae strains carrying the chromosomal SHV-11 beta-lactamase gene produce the plasmid-mediated SHV-12 extended-spectrum beta-lactamase more frequently than those carrying the chromosomal SHV-1 beta-lactamase gene. J Antimicrob Chemother 57: Lee J, Pai H, Kim YK et al. (2007) Control of extendedspectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a children s hospital by changing antimicrobial agent usage policy. J Antimicrob Chemother 60: Li CR, Li Y & Zhang PA (2003) Dissemination and spread of CTX-M extended-spectrum beta-lactamases among clinical isolates of Klebsiella pneumoniae in central China. Int J Antimicrob Agents 22: Li DZ, Chen YS, Yang JP et al. (2011) Preliminary molecular epidemiology of the Staphylococcus aureus in lower respiratory tract infections: a multicenter study in China. Chin Med J (Engl) 124: Liu W, Chen L, Li H et al. (2009) Novel CTX-M {beta}- lactamase genotype distribution and spread into multiple species of Enterobacteriaceae in Changsha, Southern China. J Antimicrob Chemother 63: Martin ME & Laber DA (2006) Cefotetan-induced hemolytic anemia after perioperative prophylaxis. Am J Hematol 81: Meier SWR, Zbinden RRC & Hasse B (2011) Extendedspectrum b-lactamase-producing Gram-negative pathogens in community-acquired urinary tract infections: an increasing challenge for antimicrobial therapy. Infection 39: Nagano N, Shibata N, Saitou Y, Nagano Y & Arakawa Y (2003) Nosocomial outbreak of infections by Proteus mirabilis that produces extended-spectrum CTX-M-2 type beta-lactamase. J Clin Microbiol 41: Nüesch-Inderbinen MT, Kayser FH & Hächler H (1997) Survey and molecular genetics of SHV beta-lactamases in

9 Characteristics of CTX-M-producing K. pneumoniae in China 145 Enterobacteriaceae in Switzerland: two novel enzymes, SHV- 11 and SHV-12. Antimicrob Agents Chemother 41: Ohnishi M, Ono E, Shimuta K, Watanabe H & Okamura N (2010) Identification of TEM-135 beta-lactamase in penicillinase-producing Neisseria gonorrhoeae strains in Japan. Antimicrob Agents Chemother 54: Paterson DL & Bonomo RA (2005) Extended-spectrum b-lactamases: a clinical update. Clin Microbiol Rev 18: Pfaller MA & Segreti J (2006) Overview of the epidemiological profile and laboratory detection of extended-spectrum betalactamases. Clin Infect Dis 42(Suppl 4): S153 S163. Pitout JD, Hossain A & Hanson ND (2004) Phenotypic and molecular detection of CTX-M-beta-lactamases produced by Escherichia coli and Klebsiella spp. J Clin Microbiol 42: Poirel L, Gniadkowski M & Nordmann P (2002) Biochemical analysis of the ceftazidime-hydrolysing extended-spectrum beta-lactamase CTX-M-15 and of its structurally related beta-lactamase CTX-M-3. J Antimicrob Chemother 50: Rossolini GM, D Andrea MM & Mugnaioli C (2008) The spread of CTX-M-type extended-spectrum beta-lactamases. Clin Microbiol Infect 14(Suppl 1): Shu JC, Chia JH, Kuo AJ, Su LH & Wu TL (2010) A 7-year surveillance for ESBL-producing Escherichia coli and Klebsiella pneumoniae at a university hospital in Taiwan: the increase of CTX-M-15 in the ICU. Epidemiol Infect 138: Tangden T, Eriksson BM, Melhus A, Svennblad B & Cars O (2011) Radical reduction of cephalosporin use at a tertiary hospital after educational antibiotic intervention during an outbreak of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. J Antimicrob Chemother 66: Tumbarello M, Sanguinetti M, Montuori E et al. (2007) Predictors of mortality in patients with bloodstream infections caused by extended-spectrum-beta-lactamaseproducing Enterobacteriaceae: importance of inadequate initial antimicrobial treatment. Antimicrob Agents Chemother 51: Yigit H, Queenan AM, Anderson GJ, Domenech-Sanchez A, Biddle JW, Steward CD, Alberti S, Bush K & Tenover FC (2001) Novel carbapenem-hydrolyzing beta-lactamase, KPC- 1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 45: Yu Y, Ji S, Chen Y et al. (2007) Resistance of strains producing extended-spectrum beta-lactamases and genotype distribution in China. J Infect 54: Zhang ZJ, Guo XB & Zhang QX (2009) Prevalence characterization of extended-spectrum beta-lactamases among Escherichia coli isolates collected in Zhengzhou. J Clin Lab Anal 23: Supporting Information Additional Supporting Information may be found in the online version of this article: Fig. S1. Distribution of 158 ESBLs-producing K. pneumoniae isolates from seven tertiary hospitals located in six geographical areas (five red areas and the yellow Beijing area) in China. Table S1. Primers used for PCR amplification of b-lactamase genes. Table S2. The demographics and origination of 133 K. pneumoniae isolates from seven tertiary hospitals in China (no. of patients). Please note: Wiley-Blackwell is not responsible for the content or functionality of any supporting materials supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article.

SUMMARY. Key words: antibioticresistance, Enterobacteriaceae, ESBL, CTX-M,

SUMMARY. Key words: antibioticresistance, Enterobacteriaceae, ESBL, CTX-M, SUMMARY Key words: antibioticresistance, Enterobacteriaceae, ESBL, CTX-M, The doctoral thesis entitled Prevalence of Enterobacteriaceae producing extendedspectrum beta-lactamases (ESBL) isolated from broilers

More information

Detection and characterization of extended spectrum β-lactamase producing Escherichia coli from poultry of eastern India

Detection and characterization of extended spectrum β-lactamase producing Escherichia coli from poultry of eastern India Detection and characterization of extended spectrum β-lactamase producing Escherichia coli from poultry of eastern India Dr. Samiran Bandyopadhyay Scientist Indian Veterinary Research Institute Eastern

More information

Use of Molecular Assays for Resistance Detection

Use of Molecular Assays for Resistance Detection Use of Molecular Assays for Resistance Detection Antimicrobial resistance and susceptibility are complex, and current in vitro methods have been developed to predict a microorganism s response to antibacterial

More information

H. Wu, B.-G. Liu, J.-H. Liu, Y.-S. Pan, L. Yuan and G.-Z. Hu

H. Wu, B.-G. Liu, J.-H. Liu, Y.-S. Pan, L. Yuan and G.-Z. Hu Phenotypic and molecular characterization of CTX-M-14 extended-spectrum β-lactamase and plasmid-mediated ACT-like AmpC β-lactamase produced by Klebsiella pneumoniae isolates from chickens in Henan Province,

More information

INTRODUCTION METHODS Printed in Great Britain. Correspondence Mark A. Fisher

INTRODUCTION METHODS Printed in Great Britain. Correspondence Mark A. Fisher Journal of Medical Microbiology (2009), 58, 774 778 DOI 10.1099/jmm.0.006171-0 Performance of the Phoenix bacterial identification system compared with disc diffusion methods for identifying extended-spectrum

More information

Prevalence and molecular characterization of clinical isolates of Escherichia coli expressing an AmpC phenotype

Prevalence and molecular characterization of clinical isolates of Escherichia coli expressing an AmpC phenotype J Antimicrob Chemother 2010; 65: 460 464 doi:10.1093/jac/dkp484 Advance publication 22 January 2010 Prevalence and molecular characterization of clinical isolates of Escherichia coli expressing an AmpC

More information

Are There Non-Carbapenem β-lactam Options for Treating ESBL Infections?

Are There Non-Carbapenem β-lactam Options for Treating ESBL Infections? CIDEIM Are There Non-Carbapenem β-lactam Options for Treating ESBL Infections? Pranita D. Tamma, M.D., M.H.S. Assistant Professor, Pediatrics Director, Pediatric Antimicrobial Stewardship Program CIDEIM

More information

Molecular epidemiology and drug resistant mechanism in carbapenem-resistant Klebsiella pneumoniae isolated from pediatric patients in Shanghai, China

Molecular epidemiology and drug resistant mechanism in carbapenem-resistant Klebsiella pneumoniae isolated from pediatric patients in Shanghai, China RESEARCH ARTICLE Molecular epidemiology and drug resistant mechanism in carbapenem-resistant Klebsiella pneumoniae isolated from pediatric patients in Shanghai, China Xingyu Zhang 1, Di Chen 2, Guifeng

More information

ESBLs and KPCs: Impact of Revised CLSI Breakpoints on testing and Reporting Algorithms

ESBLs and KPCs: Impact of Revised CLSI Breakpoints on testing and Reporting Algorithms ESBLs and KPCs: Impact of Revised CLSI Breakpoints on testing and Reporting Algorithms Stephen G. Jenkins, Ph.D. Director, Clinical Microbiology Laboratories New York/Presbyterian Hospital Weill Cornell

More information

Ongoing epidemic of bla VIM-1 -positive Klebsiella pneumoniae in Athens, Greece: a prospective survey

Ongoing epidemic of bla VIM-1 -positive Klebsiella pneumoniae in Athens, Greece: a prospective survey Journal of Antimicrobial Chemotherapy (2008) 61, 59 63 doi:10.1093/jac/dkm443 Advance Access publication 13 November 2007 Ongoing epidemic of bla VIM-1 -positive Klebsiella pneumoniae in Athens, Greece:

More information

Supplementary appendix

Supplementary appendix Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Quan J, Li X, Chen Y, et al. Prevalence of

More information

Detection of aac(6 0 )-Ib-cr in KPC-producing Klebsiella pneumoniae isolates from Tel Aviv, Israel

Detection of aac(6 0 )-Ib-cr in KPC-producing Klebsiella pneumoniae isolates from Tel Aviv, Israel Journal of Antimicrobial Chemotherapy (2009) 64, 718 722 doi:10.1093/jac/dkp272 Advance Access publication 4 August 2009 Detection of aac(6 0 )-Ib-cr in KPC-producing Klebsiella pneumoniae isolates from

More information

OXA-type beta-lactamases among extended-spectrum cephalosporin-resistant Pseudomonas aeruginosa isolates in a university hospital in southern Taiwan

OXA-type beta-lactamases among extended-spectrum cephalosporin-resistant Pseudomonas aeruginosa isolates in a university hospital in southern Taiwan OXA-type J Microbiol ESBLs Immunol in P. Infect aeruginosa 2006;39:130-134 OXA-type beta-lactamases among extended-spectrum cephalosporin-resistant Pseudomonas aeruginosa isolates in a university hospital

More information

Beta-lactamase inhibition: A potted history of beta lactamase and lessons from recent development of betalactamase inhibiter combinations

Beta-lactamase inhibition: A potted history of beta lactamase and lessons from recent development of betalactamase inhibiter combinations Beta-lactamase inhibition: A potted history of beta lactamase and lessons from recent development of betalactamase inhibiter combinations Dr Shampa Das, Senior Lecturer, Molecular and Clinical Pharmacology,

More information

Department of Microbiology, University College of Medical Sciences & Guru Tegh Bahadur Hospital & *

Department of Microbiology, University College of Medical Sciences & Guru Tegh Bahadur Hospital & * Indian J Med Res 122, October 2005, pp 330-337 Phenotypic characteristics of clinical isolates of Klebsiella pneumoniae & evaluation of available phenotypic techniques for detection of extended spectrum

More information

IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 10 Ver. VII (Oct. 2017), PP 76-81 www.iosrjournals.org Molecular Characterization of TEM, SHV

More information

CRE Laboratory Testing and CRE Lab Testing Recommendations in-depth recommendations on CRE laboratory detection

CRE Laboratory Testing and CRE Lab Testing Recommendations in-depth recommendations on CRE laboratory detection December 2014 Dear Laboratory Director, The Illinois Department of Public Health (IDPH) amended the Control of Communicable Diseases Code (77 Ill. Adm. Code 690) to require reporting of Carbapenem-Resistant

More information

Molecular susceptibility testing

Molecular susceptibility testing Molecular susceptibility testing Dr Andrew Ginn Supervising Scientist Antimicrobial Resistance Reference Laboratory ICPMR, Westmead Hospital Resistance genes Gram negatives Transmissible; e.g. ESBLs, MBLs,

More information

64 Mukherjee et al. Int. J. Biosci. 2011

64 Mukherjee et al. Int. J. Biosci. 2011 RESEARCH PAPER OPEN ACCESS Detection of blatem and blactx-m genes by multiplex polymerase chain reaction amongst uropathogenic Escherichia coli strains isolated from hospitalized patients in Kolkata, India

More information

NEXT STEP TO STOP THE SPREAD OF ANTIMICROBIAL RESISTANCE. Patricia Ruiz Garbajosa Servicio de Microbiología Hospital Universitario Ramón y Cajal

NEXT STEP TO STOP THE SPREAD OF ANTIMICROBIAL RESISTANCE. Patricia Ruiz Garbajosa Servicio de Microbiología Hospital Universitario Ramón y Cajal NEXT STEP TO STOP THE SPREAD OF ANTIMICROBIAL RESISTANCE Patricia Ruiz Garbajosa Servicio de Microbiología Hospital Universitario Ramón y Cajal ANTIMICROBIAL RESISTANCE AND HEALTHCARE-ASSOCIATED INFECTION

More information

WELCOME. to the CDS WORKSHOP

WELCOME. to the CDS WORKSHOP WELCOME to the CDS WORKSHOP Sydney 2010 Excel Spreadsheet for Registration Recent Additions to the CDS Doripenem 10mg disc A carbapenem claimed to be more active against Pseudomonas than Meropenem Daptomycin:

More information

Genotypic and Phenotypic Correlations of Multidrug Resistant Acinetobacter baumannii-

Genotypic and Phenotypic Correlations of Multidrug Resistant Acinetobacter baumannii- JCM Accepts, published online ahead of print on 25 August 2010 J. Clin. Microbiol. doi:10.1128/jcm.01585-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Antimicrobial Agents and Chemotherapy New Data Letter

Antimicrobial Agents and Chemotherapy New Data Letter AAC Accepted Manuscript Posted Online 15 August 2016 Antimicrob. Agents Chemother. doi:10.1128/aac.01519-16 Copyright 2016, American Society for Microbiology. All Rights Reserved. 1 Antimicrobial Agents

More information

Key words: ESBLs; Ceftriaxone; Escherichia coli; MICs; Bacteremia

Key words: ESBLs; Ceftriaxone; Escherichia coli; MICs; Bacteremia JCM Accepts, published online ahead of print on 16 April 2014 J. Clin. Microbiol. doi:10.1128/jcm.00716-14 Copyright 2014, American Society for Microbiology. All Rights Reserved. 1 1 2 Title: Determining

More information

JOHN DEMPSEY HOSPITAL Farmington, Connecticut ANTIBIOTIC SUSCEPTIBILITY PROFILES for INPATIENT Bacterial Isolates

JOHN DEMPSEY HOSPITAL Farmington, Connecticut ANTIBIOTIC SUSCEPTIBILITY PROFILES for INPATIENT Bacterial Isolates JOHN DEMPSEY HOSPITAL Farmington, Connecticut 2017 ANTIBIOTIC SUSCEPTIBILITY PROFILES for INPATIENT Bacterial Isolates **GROUPED BY CULTURE SOURCES** (data from 1/1/17 1/1/18) Prepared by: UCHC/JDH Antimicrobial

More information

The biomérieux solution. VITEK2 : A challenge with ESBL ESBL. Karen Bush

The biomérieux solution. VITEK2 : A challenge with ESBL ESBL. Karen Bush International Newsletter n 4 December 2003 Through the IDENTIFYING RESISTANCE Newsletter, biomérieux s ambition is to contribute to the awareness and progress in the field of resistance to antibiotics.

More information

The Prevalence of TEM-1 gene causing resistance to beta-lactam antibiotics in Klebsiella pneumoniae isolates from clinical samples and plasmid curing

The Prevalence of TEM-1 gene causing resistance to beta-lactam antibiotics in Klebsiella pneumoniae isolates from clinical samples and plasmid curing Available online at www.ijmrhs.com ISSN No: 2319-5886 International Journal of Medical Research & Health Sciences, 2016, 5, 11:557-561 The Prevalence of TEM-1 gene causing resistance to beta-lactam antibiotics

More information

CME/SAM. Clinical Laboratory Detection of AmpC β-lactamase Does It Affect Patient Outcome?

CME/SAM. Clinical Laboratory Detection of AmpC β-lactamase Does It Affect Patient Outcome? Microbiology and Infectious Disease / Laboratory Detection of AmpC β-lactamase Clinical Laboratory Detection of AmpC β-lactamase Does It Affect Patient Outcome? Kenneth H. Rand, MD, 1 Bradley Turner, MD,

More information

Extended Spectrum β-lactamases: Critical Tools of Bacterial Resistance

Extended Spectrum β-lactamases: Critical Tools of Bacterial Resistance Review Article Mahidol University Journal of Pharmaceutical Science 2012; 39 (1), 1-8 Extended Spectrum β-lactamases: Critical Tools of Bacterial Resistance Department of Microbiology, Faculty of Pharmacy,

More information

Resistance, Yonsei University College of Medicine, Seoul, Korea; and 2 Department of

Resistance, Yonsei University College of Medicine, Seoul, Korea; and 2 Department of AAC Accepts, published online ahead of print on March 0 Antimicrob. Agents Chemother. doi:./aac.0- Copyright 0, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights Reserved.

More information

The Laboratory Diagnosis of Enterobacteriaceae that produce Carbapenemases. and Johann DD Pitout 1-3

The Laboratory Diagnosis of Enterobacteriaceae that produce Carbapenemases. and Johann DD Pitout 1-3 JCM Accepts, published online ahead of print on 19 September 2012 J. Clin. Microbiol. doi:10.1128/jcm.02117-12 Copyright 2012, American Society for Microbiology. All Rights Reserved. 1 The Laboratory Diagnosis

More information

Prevalence and Molecular Characteristics of Carbapenemase-Producing Enterobacteriaceae From Five Hospitals in Korea

Prevalence and Molecular Characteristics of Carbapenemase-Producing Enterobacteriaceae From Five Hospitals in Korea Original Article Clinical Microbiology Ann Lab Med 6;6:9- http://dx.doi.org/.4/alm.6.6.6.9 ISSN 4-86 eissn 4-84 Prevalence and Molecular Characteristics of Carbapenemase-Producing Enterobacteriaceae From

More information

Occurrence and Detection of AmpC β-lactamases among Enterobacteriaceae in a Tertiary Care Centre in Trivandrum, India

Occurrence and Detection of AmpC β-lactamases among Enterobacteriaceae in a Tertiary Care Centre in Trivandrum, India International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 08 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.708.023

More information

Novel genetic environment of the plasmid-mediated KPC-3 gene detected in Escherichia coli and Citrobacter freundii isolates from China

Novel genetic environment of the plasmid-mediated KPC-3 gene detected in Escherichia coli and Citrobacter freundii isolates from China Eur J Clin Microbiol Infect Dis (2011) 30:575 580 DOI 10.1007/s10096-010-1124-7 ARTICLE Novel genetic environment of the plasmid-mediated KPC-3 gene detected in Escherichia coli and Citrobacter freundii

More information

A Verification Study for Implementing the Revised CLSI Breakpoints. Summary. Glossary CDC 1

A Verification Study for Implementing the Revised CLSI Breakpoints. Summary. Glossary CDC 1 A Verification Study for Implementing the Revised CLSI Breakpoints Jean B. Patel, PhD, D(ABMM) Deputy Director, Office of Antimicrobial Resistance National Center for Emerging and Zoonotic Infectious Disease

More information

Title: Description of the First Escherichia coli Clinical Isolate Harboring Colistin-

Title: Description of the First Escherichia coli Clinical Isolate Harboring Colistin- AAC Accepted Manuscript Posted Online 24 October 2016 Antimicrob. Agents Chemother. doi:10.1128/aac.01945-16 Copyright 2016, American Society for Microbiology. All Rights Reserved. 1 2 Title: Description

More information

Detection and molecular characterization of extended spectrum of beta lactamase (ESBL) producing Escherichia coli

Detection and molecular characterization of extended spectrum of beta lactamase (ESBL) producing Escherichia coli ISSN: 2319-7706 Volume 2 Number 8 (2013) pp. 196-205 http://www.ijcmas.com Original Research Article Detection and molecular characterization of extended spectrum of beta lactamase (ESBL) producing Escherichia

More information

Carbapenem-resistant Enterobacteriaceae (CRE): Surveillance and Response. David Selvage, MHS, PA-C New Mexico Department of Health March 15, 2016

Carbapenem-resistant Enterobacteriaceae (CRE): Surveillance and Response. David Selvage, MHS, PA-C New Mexico Department of Health March 15, 2016 Carbapenem-resistant Enterobacteriaceae (CRE): Surveillance and Response David Selvage, MHS, PA-C New Mexico Department of Health March 15, 2016 What are Carbapenem-resistant Enterobacteriaceae (CRE)?

More information

Received 16 September 2005/Accepted 20 September 2005

Received 16 September 2005/Accepted 20 September 2005 JOURNAL OF CLINICAL MICROBIOLOGY, Dec. 2005, p. 5945 5949 Vol. 43, No. 12 0095-1137/05/$08.00 0 doi:10.1128/jcm.43.12.5945 5949.2005 Copyright 2005, American Society for Microbiology. All Rights Reserved.

More information

Original Article Detection of integrons in Escherichia coli producing plasmid-mediated AmpC β-lactamases

Original Article Detection of integrons in Escherichia coli producing plasmid-mediated AmpC β-lactamases Int J Clin Exp Med 2019;12(2):1690-1696 www.ijcem.com /ISSN:1940-5901/IJCEM0079457 Original Article Detection of integrons in Escherichia coli producing plasmid-mediated AmpC β-lactamases Juanjuan Ding,

More information

Curriculum Vitae. Abbas Maleki, Ph.D. Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran

Curriculum Vitae. Abbas Maleki, Ph.D. Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran Curriculum Vitae Abbas Maleki, Ph.D Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran E-mail: abbasmaleki_ilam@yahoo.com maleki-a@medilam.ac.ir Tel: +989187419401 Personal

More information

Investigation of Klebsiella pneumoniae Isolates Producing SHV-12 and SHV-11 β-lactamases in Korean Hospitals

Investigation of Klebsiella pneumoniae Isolates Producing SHV-12 and SHV-11 β-lactamases in Korean Hospitals J. Microbiol. Biotechnol. (2009), 19(2), 000 000 doi: 10.4014/jmb.0808.472 First published online 3 June 2009 Investigation of Klebsiella pneumoniae Isolates Producing SHV-12 and SHV-11 β-lactamases in

More information

Dissemination of transposon Tn6001 in carbapenem-non-susceptible and extensively drug-resistant Pseudomonas aeruginosa in Taiwan

Dissemination of transposon Tn6001 in carbapenem-non-susceptible and extensively drug-resistant Pseudomonas aeruginosa in Taiwan Journal of Antimicrobial Chemotherapy (2009) 64, 1170 1174 doi:10.1093/jac/dkp341 Advance Access publication 22 September 2009 Dissemination of transposon Tn6001 in carbapenem-non-susceptible and extensively

More information

A Verification Study for Implementing the Revised CLSI Breakpoints. Summary. Breakpoint Differences Cephalosporin Breakpoints for Enterobacteriaceae

A Verification Study for Implementing the Revised CLSI Breakpoints. Summary. Breakpoint Differences Cephalosporin Breakpoints for Enterobacteriaceae A Verification Study for Implementing the Revised CLSI Breakpoints Jean B. Patel, PhD, D(ABMM) Deputy Director, Office of Antimicrobial Resistance National Center for Emerging and Zoonotic Infectious Disease

More information

Combatting AMR: diagnostics

Combatting AMR: diagnostics Combatting AMR: diagnostics Professor Neil Woodford Antimicrobial Resistance & Healthcare Associated Infections (AMRHAI) Reference Unit Crown copyright Gonorrhoea: a paradigm for better diagnostics International

More information

ANTIMICROBIAL SUSCEPTIBILITY TESTING: ADVANCED

ANTIMICROBIAL SUSCEPTIBILITY TESTING: ADVANCED ANTIMICROBIAL SUSCEPTIBILITY TESTING: ADVANCED Romney Humphries, Ph.D., DABMM Section Chief, Clinical Microbiology University of California Los Angeles Lost Angeles, CA Susan E. Sharp, Ph.D., DABMM, FAAM

More information

Received 17 September 2008/Returned for modification 29 October 2008/Accepted 18 November 2008

Received 17 September 2008/Returned for modification 29 October 2008/Accepted 18 November 2008 JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 2009, p. 294 299 Vol. 47, No. 2 0095-1137/09/$08.00 0 doi:10.1128/jcm.01797-08 Copyright 2009, American Society for Microbiology. All Rights Reserved. Identification

More information

ORIGINAL ARTICLE /j x

ORIGINAL ARTICLE /j x ORIGINAL ARTICLE 10.1111/j.1469-0691.2006.01645.x Development and clinical validation of a molecular diagnostic assay to detect CTX-M-type b-lactamases in Enterobacteriaceae J. D. D. Pitout 1,2,3, N. Hamilton

More information

PHICO THERAPEUTICS. SASPject: First in a new class of novel biological antibacterials. Dr Adam Wilkinson R&D Manager

PHICO THERAPEUTICS. SASPject: First in a new class of novel biological antibacterials. Dr Adam Wilkinson R&D Manager PHICO THERAPEUTICS SASPject: First in a new class of novel biological antibacterials Dr Adam Wilkinson R&D Manager Phico Founded 2000 by CEO Dr Heather Fairhead 20 employees Raised 13 M from 140 shareholders

More information

Use of Boronic Acid Disk Tests To Detect Extended- Spectrum -Lactamases in Clinical Isolates of KPC Carbapenemase-Possessing Enterobacteriaceae

Use of Boronic Acid Disk Tests To Detect Extended- Spectrum -Lactamases in Clinical Isolates of KPC Carbapenemase-Possessing Enterobacteriaceae JOURNAL OF CLINICAL MICROBIOLOGY, Nov. 2009, p. 3420 3426 Vol. 47, No. 11 0095-1137/09/$12.00 doi:10.1128/jcm.01314-09 Copyright 2009, American Society for Microbiology. All Rights Reserved. Use of Boronic

More information

Cloning and Characterization of E. meningoseptica Beta Lactamase

Cloning and Characterization of E. meningoseptica Beta Lactamase Cloning and Characterization of E. meningoseptica Beta Lactamase Authors: Lindsey Purcell, Jessica Matts, Patricia Canaan* Department of Biochemistry and Molecular Biology Abstract Elizabethkingia meningoseptica

More information

ORIGINAL ARTICLE /j x

ORIGINAL ARTICLE /j x ORIGINAL ARTICLE 10.1111/j.1469-0691.2008.02030.x Metallo-b-lactamase-producing Pseudomonas aeruginosa isolated from a large tertiary centre in Kenya J. D. D. Pitout 1,2,3, G. Revathi 4, B. L Chow 1, B.

More information

Extended double disc synergy testing reveals a low prevalence of extended-spectrum b-lactamases in Enterobacter spp. in Vienna, Austria

Extended double disc synergy testing reveals a low prevalence of extended-spectrum b-lactamases in Enterobacter spp. in Vienna, Austria Journal of Antimicrobial Chemotherapy (2007) 59, 854 859 doi:10.1093/jac/dkm060 Advance Access publication 8 March 2007 Extended double disc synergy testing reveals a low prevalence of extended-spectrum

More information

Emerging Resistance in Gram- Negative Bacteria CLSI Recommendations. James H. Jorgensen, PhD

Emerging Resistance in Gram- Negative Bacteria CLSI Recommendations. James H. Jorgensen, PhD Emerging Resistance in Gram- Negative Bacteria CLSI Recommendations James H. Jorgensen, PhD Most Important Emerging or Evolving Resistance in GNs Newer ESBLs Plasmid-mediated mediated AmpCs KPCs, VIM,

More information

CRE is not the first organism we ve had that has become resistant to antibiotics, so why is it so important? CRE resistance is complex because it can

CRE is not the first organism we ve had that has become resistant to antibiotics, so why is it so important? CRE resistance is complex because it can 1 Enterobacteriaceae are a large family of bacteria that are a normal part of a person's digestive system (2). Examples include Escherichia coli and species of the genera Klebsiella, Enterobacter, Serratia,

More information

by author How to effectively report laboratory findings to clinicians (Breakpoints and Interpretation)

by author How to effectively report laboratory findings to clinicians (Breakpoints and Interpretation) How to effectively report laboratory findings to clinicians (Breakpoints and Interpretation) A Vatopoulos National School of Public Health & Central Public Health Laboratory KEELPNO Antibiotic Activity

More information

Accurate and Timely Identification of Genes Conferring Resistance to Carbapenems Serves as an Important Tool for Infection Control Measures

Accurate and Timely Identification of Genes Conferring Resistance to Carbapenems Serves as an Important Tool for Infection Control Measures International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 05 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.705.296

More information

Key words: Extended spectrum β-lactamase (ESBL), Double Disk Synergy Test (DDST), Antibiogram, Plasmid, PCR

Key words: Extended spectrum β-lactamase (ESBL), Double Disk Synergy Test (DDST), Antibiogram, Plasmid, PCR DOI: 10.7860/JCDR/2013/6460.3462 Microbiology Section Original Article Prevalence and antibiogram of Extended Spectrum β-lactamase (ESBL) producing Gram negative bacilli and further molecular characterization

More information

ABSTRACT IDENTIFICATION AND CHARACTERIZATION OF. CARBAPENEM HYDROLYSING β-lactamase KPC AMONG ENTEROBACTERIACEAE: A REPORT FROM NORTH INDIA

ABSTRACT IDENTIFICATION AND CHARACTERIZATION OF. CARBAPENEM HYDROLYSING β-lactamase KPC AMONG ENTEROBACTERIACEAE: A REPORT FROM NORTH INDIA IDENTIFICATION AND CHARACTERIZATION OF CARBAPENEM HYDROLYSING β-lactamase KPC AMONG ENTEROBACTERIACEAE: A REPORT FROM NORTH INDIA ORGINAL ARTICLE, Vol-3 No.2 Asian Journal of Medical Science, Volume-3(2012)

More information

Characteristics of the Molecular Epidemiology of CTX-M-Producing Escherichia coli Isolated from a Tertiary Hospital in Daejeon, Korea

Characteristics of the Molecular Epidemiology of CTX-M-Producing Escherichia coli Isolated from a Tertiary Hospital in Daejeon, Korea J. Microbiol. Biotechnol. (2016), 26(9), 1643 1649 http://dx.doi.org/10.4014/jmb.1603.03063 Review Research Article jmb Characteristics of the Molecular Epidemiology of CTX-M-Producing Escherichia coli

More information

Evaluation of a 12 Disc Test for Phenotypic Detection of β- lactamases Resistance in Gram Negative Bacilli

Evaluation of a 12 Disc Test for Phenotypic Detection of β- lactamases Resistance in Gram Negative Bacilli International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 5 Number 6 (2016) pp. 105-114 Journal homepage: http://www.ijcmas.com Original Research Article http://dx.doi.org/10.20546/ijcmas.2016.506.013

More information

Curing antibiotic resistance in vivo. Muhammad Kamruzzaman

Curing antibiotic resistance in vivo. Muhammad Kamruzzaman Curing antibiotic resistance in vivo Muhammad Kamruzzaman Occurrence of resistance -Some bacteria are naturally resistant to certain antibiotics -Gene mutation -Horizontal transfer of antibiotic resistance

More information

Original article DOI: Journal of International Medicine and Dentistry 2016; 3(1): 34-41

Original article DOI:  Journal of International Medicine and Dentistry 2016; 3(1): 34-41 Original article DOI: http://dx.doi.org/10.18320/jimd/201603.0134 JOURNAL OF INTERNATIONAL MEDICINE AND DENTISTRY To search..to know...to share p-issn: 2454-8847 e-issn: 2350-045X Comparative analysis

More information

Extended-Spectrum β-lactamases Producing Escherichia coli Strains Monitored Over 4 Years in The University Hospital in Košice, Slovakia

Extended-Spectrum β-lactamases Producing Escherichia coli Strains Monitored Over 4 Years in The University Hospital in Košice, Slovakia Current Research in Microbiology Original Research Paper Extended-Spectrum β-lactamases Producing Escherichia coli Strains Monitored Over 4 Years in The University Hospital in Košice, Slovakia 1 Viera

More information

Carbapenem-Resistant KPC-2-Producing Escherichia coli in a Tel Aviv Medical Center, 2005 to 2008

Carbapenem-Resistant KPC-2-Producing Escherichia coli in a Tel Aviv Medical Center, 2005 to 2008 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, June 2010, p. 2687 2691 Vol. 54, No. 6 0066-4804/10/$12.00 doi:10.1128/aac.01359-09 Copyright 2010, American Society for Microbiology. All Rights Reserved. Carbapenem-Resistant

More information

Carbapenem-Resistant KPC-2-Producing Escherichia coli in a Tel Aviv Medical Center, 2005 to 2008

Carbapenem-Resistant KPC-2-Producing Escherichia coli in a Tel Aviv Medical Center, 2005 to 2008 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, June 2010, p. 2687 2691 Vol. 54, No. 6 0066-4804/10/$12.00 doi:10.1128/aac.01359-09 Copyright 2010, American Society for Microbiology. All Rights Reserved. Carbapenem-Resistant

More information

Role of inducers in detection of bla PDC resistance in Pseudomonas aeruginosa

Role of inducers in detection of bla PDC resistance in Pseudomonas aeruginosa Indian J Med Res 145, May 2017, pp 659-664 DOI: 10.4103/ijmr.IJMR_628_15 Quick Response Code: Role of inducers in detection of bla PDC -mediated oxyiminocephalosporin resistance in Pseudomonas aeruginosa

More information

Comparison of different methods of determining b-lactam susceptibility in clinical strains of Pseudomonas aeruginosa

Comparison of different methods of determining b-lactam susceptibility in clinical strains of Pseudomonas aeruginosa Journal of Medical Microbiology (2009), 58, 625 629 DOI 10.1099/jmm.0.005587-0 Comparison of different methods of determining b-lactam susceptibility in clinical strains of Pseudomonas aeruginosa Eva Torres,

More information

The American University in Cairo

The American University in Cairo The American University in Cairo School of Science and Engineering MOLECULAR CHARACTERIZATION OF EXTENDED- SPECTRUM Beta LACTAMASE (ESBL) PRODUCING Klebsiella pneumoniae AND Escherichia coli AMONG HOSPITALIZED

More information

Advances in Life Science and Technology ISSN (Paper) ISSN X (Online) Vol.13, 2013

Advances in Life Science and Technology ISSN (Paper) ISSN X (Online) Vol.13, 2013 The Reliability of Using Vitek 2 Compact System to Detect Extended-Spectrum Beta-lactamase-producing Isolates in Escherichia coli and Klebsiella pneumoniae in Accra, Ghana *Henry Kwadwo Hackman 1, George

More information

Genomic epidemiology of bacterial pathogens. Sylvain BRISSE Microbial Evolutionary Genomics, Institut Pasteur, Paris

Genomic epidemiology of bacterial pathogens. Sylvain BRISSE Microbial Evolutionary Genomics, Institut Pasteur, Paris Genomic epidemiology of bacterial pathogens Sylvain BRISSE Microbial Evolutionary Genomics, Institut Pasteur, Paris Typing Population genetics Analysis of strain diversity within species Aim: Local epidemiology?

More information

DETECTION AND SPREAD OF OXA-48-PRODUCING KLEBSIELLA OXYTOCA ISOLATES IN ISTANBUL, TURKEY

DETECTION AND SPREAD OF OXA-48-PRODUCING KLEBSIELLA OXYTOCA ISOLATES IN ISTANBUL, TURKEY DETECTION AND SPREAD OF OXA-48-PRODUCING KLEBSIELLA OXYTOCA ISOLATES IN ISTANBUL, TURKEY Hasan Nazik 1, Selda Aydin 2, Rüveyda Albayrak 1, Esma A Bilgi 3, Ismail Yildiz 4, Nuray Kuvat 1, Fatih M Kelesoglu

More information

Evaluation of a Double Synergy Differential Test (DSDT) for differential detection of ESBL and AmpC-type

Evaluation of a Double Synergy Differential Test (DSDT) for differential detection of ESBL and AmpC-type NEW MICROBIOLOGICA, 35, 221-225, 2012 Evaluation of a Double Synergy Differential Test (DSDT) for differential detection of ESBL and AmpC-type β-lactamases in Escherichia coli, Klebsiella pneumoniae and

More information

Extended-spectrum b-lactamases of Escherichia coli and Klebsiella pneumoniae screened by the VITEK 2 system

Extended-spectrum b-lactamases of Escherichia coli and Klebsiella pneumoniae screened by the VITEK 2 system Journal of Medical Microbiology (2011), 60, 756 760 DOI 10.1099/jmm.0.024075-0 Extended-spectrum b-lactamases of Escherichia coli and Klebsiella pneumoniae screened by the VITEK 2 system Maria José Espinar,

More information

Detection of Extended-Spectrum Beta-Lactamases among Enterobacteriaceae by Use of Semiautomated Microbiology Systems and Manual Detection Procedures

Detection of Extended-Spectrum Beta-Lactamases among Enterobacteriaceae by Use of Semiautomated Microbiology Systems and Manual Detection Procedures JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 2007, p. 1167 1174 Vol. 45, No. 4 0095-1137/07/$08.00 0 doi:10.1128/jcm.01988-06 Copyright 2007, American Society for Microbiology. All Rights Reserved. of Extended-Spectrum

More information

Phenotypic and Molecular Detection of CTX-M- -Lactamases Produced by Escherichia coli and Klebsiella spp.

Phenotypic and Molecular Detection of CTX-M- -Lactamases Produced by Escherichia coli and Klebsiella spp. JOURNAL OF CLINICAL MICROBIOLOGY, Dec. 2004, p. 5715 5721 Vol. 42, No. 12 0095-1137/04/$08.00 0 DOI: 10.1128/JCM.42.12.5715 5721.2004 Copyright 2004, American Society for Microbiology. All Rights Reserved.

More information

Strains of Klebsiella Pneumoniae from Intensive Care Unit Producing CTX-M-15 Extended Spectrum Beta Lactamases

Strains of Klebsiella Pneumoniae from Intensive Care Unit Producing CTX-M-15 Extended Spectrum Beta Lactamases American Journal of Microbiology 2 (2): 35-39, 2011 ISSN 1948-982x 2011 Science Publications Strains of Klebsiella Pneumoniae from Intensive Care Unit Producing CTX-M-15 Extended Spectrum Beta Lactamases

More information

ACCEPTED. Laboratory Medicine, Kosin University College of Medicine, , 34 Amnam-Dong,

ACCEPTED. Laboratory Medicine, Kosin University College of Medicine, , 34 Amnam-Dong, AAC Accepts, published online ahead of print on 21 May 2007 Antimicrob. Agents Chemother. doi:10.1128/aac.00279-07 Copyright 2007, American Society for Microbiology and/or the Listed Authors/Institutions.

More information

JOURNAL OF INTERNATIONAL ACADEMIC RESEARCH FOR MULTIDISCIPLINARY Impact Factor 1.393, ISSN: , Volume 2, Issue 8, September 2014

JOURNAL OF INTERNATIONAL ACADEMIC RESEARCH FOR MULTIDISCIPLINARY Impact Factor 1.393, ISSN: , Volume 2, Issue 8, September 2014 EVALUATION OF CHROMAGAR-CTX FOR THE DETECTION OF CTX-M-ESBL- PRODUCING GRAM NEGATIVE BACTERIAL ISOLATES RASHA H. ELSHERIF* LAMIAA A. MADKOUR** REHAM A. DWEDAR*** *Clinical Pathology Department, Faculty

More information

J. Appl. Environ. Biol. Sci., 5(12) , , TextRoad Publication

J. Appl. Environ. Biol. Sci., 5(12) , , TextRoad Publication J. Appl. Environ. Biol. Sci., 5(2)262-268, 205 205, TextRoad Publication ISSN: 2090-4274 Journal of Applied Environmental and Biological Sciences www.textroad.com Study of routine antibiotic Resistance

More information

Faecal prevalence of extended-spectrum ß-lactamase (ESBL)- producing coliforms in a geriatric population and among haematology patients

Faecal prevalence of extended-spectrum ß-lactamase (ESBL)- producing coliforms in a geriatric population and among haematology patients Malaysian J Pathol 2005; 27(2) : 75 81 FAECAL ESBL-PRODUCING COLIFORMS Faecal prevalence of extended-spectrum ß-lactamase (ESBL)- producing coliforms in a geriatric population and among haematology patients

More information

Prevalence of metallo-β-lactamases in clinical isolates of Pseudomonas aeruginosa from King Abdulaziz University Hospital in Jeddah

Prevalence of metallo-β-lactamases in clinical isolates of Pseudomonas aeruginosa from King Abdulaziz University Hospital in Jeddah World Journal of Pharmaceutical Sciences ISSN (Print): 2321-3310; ISSN (Online): 2321-3086 Published by Atom and Cell Publishers All Rights Reserved Available online at: http://www.wjpsonline.org/ Original

More information

AAC Accepts, published online ahead of print on 2 June 2008 Antimicrob. Agents Chemother. doi: /aac

AAC Accepts, published online ahead of print on 2 June 2008 Antimicrob. Agents Chemother. doi: /aac AAC Accepts, published online ahead of print on June 00 Antimicrob. Agents Chemother. doi:.11/aac.00175-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights

More information

Infection Control Forum HA Fact Sheet on Carbapenem resistant Enterobacteriaceae (CRE)

Infection Control Forum HA Fact Sheet on Carbapenem resistant Enterobacteriaceae (CRE) Infection Control Forum HA Fact Sheet on Carbapenem resistant Enterobacteriaceae (CRE) 9th December 2010 Lecture Theatre, G/F Centre for Health Protection Gram positive cocci Staphylococcus aureus Streptococcus

More information

Verification of Disk Diffusion Tests

Verification of Disk Diffusion Tests Verification of Disk Diffusion Tests Objectives 1. Describe disk diffusion tests 2. Describe process of FDA clearance of susceptibility tests 3. Discuss CLIA requirements for laboratory verification of

More information

REVIEW. The spread of CTX-M-type extended-spectrum b-lactamases G. M. Rossolini, M. M. D Andrea and C. Mugnaioli

REVIEW. The spread of CTX-M-type extended-spectrum b-lactamases G. M. Rossolini, M. M. D Andrea and C. Mugnaioli REVIEW The spread of CTX-M-type extended-spectrum b-lactamases G. M. Rossolini, M. M. D Andrea and C. Mugnaioli Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, Siena,

More information

Extended-spectrum b-lactamase and carbapenemase production among burn and non-burn clinical isolates of Klebsiella pneumoniae

Extended-spectrum b-lactamase and carbapenemase production among burn and non-burn clinical isolates of Klebsiella pneumoniae Volume 7 Number 3 (June 2015) 144-149 ORIGINAL ARTICLE Extended-spectrum b-lactamase and carbapenemase production among burn and non-burn clinical isolates of Klebsiella pneumoniae Fereshteh Eftekhar *,

More information

Received 24 June 2008/Returned for modification 12 August 2008/Accepted 14 September 2008

Received 24 June 2008/Returned for modification 12 August 2008/Accepted 14 September 2008 ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Dec. 2008, p. 4268 4273 Vol. 52, No. 12 0066-4804/08/$08.00 0 doi:10.1128/aac.00830-08 Copyright 2008, American Society for Microbiology. All Rights Reserved. High

More information

PERANAN MIKROBIOLOGI DALAM DIAGNOSIS PENYAKIT INFEKSI. dr. Agus Eka Darwinata, Ph.D.

PERANAN MIKROBIOLOGI DALAM DIAGNOSIS PENYAKIT INFEKSI. dr. Agus Eka Darwinata, Ph.D. PERANAN MIKROBIOLOGI DALAM DIAGNOSIS PENYAKIT INFEKSI dr. Agus Eka Darwinata, Ph.D. CLINICAL MICROBIOLOGY Clinical microbiology is the discipline of detection, characterization, and quantification of

More information

Sequences of -Lactamase Genes Encoding CTX-M-1 (MEN-1) and CTX-M-2 and Relationship of Their Amino Acid Sequences with Those of Other -Lactamases

Sequences of -Lactamase Genes Encoding CTX-M-1 (MEN-1) and CTX-M-2 and Relationship of Their Amino Acid Sequences with Those of Other -Lactamases ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Feb. 1996, p. 509 513 Vol. 40, No. 2 0066-4804/96/$04.00 0 Copyright 1996, American Society for Microbiology Sequences of -Lactamase Genes Encoding CTX-M-1 (MEN-1)

More information

Emergence of Enterobacteriaceae co-producing CTX-M-15, ArmA and PMQR in Poland

Emergence of Enterobacteriaceae co-producing CTX-M-15, ArmA and PMQR in Poland Original papers Emergence of Enterobacteriaceae co-producing CTX-M-15, ArmA and PMQR in Poland Katarzyna Piekarska A,D,F, Katarzyna Zacharczuk C, Tomasz Wołkowicz C, Natalia Wolaniuk B, Magdalena Rzeczkowska

More information

Escherichia coli and Klebsiella isolates in patients

Escherichia coli and Klebsiella isolates in patients ORIGINAL ARTICLE Frequency assessment of β-lactamase enzymes in Escherichia coli and Klebsiella isolates in patients with urinary tract infection Reza Moayednia 1, Dariush Shokri 2, Sina Mobasherizadeh

More information

Game plan. Lecture. Lab. Antibiotics Antibiotic resistance Gene transfer Transformation Transduction Conjugation

Game plan. Lecture. Lab. Antibiotics Antibiotic resistance Gene transfer Transformation Transduction Conjugation Game plan Lecture Antibiotics Antibiotic resistance Gene transfer Transformation Transduction Conjugation Lab Review temp and UV labs Growth control: alcohol, antiseptics and antibiotics Pre-lab Transformation

More information

Screening for Resistant Organisms and Infection Control

Screening for Resistant Organisms and Infection Control Screening for Resistant Organisms and Infection Control Dr Sonal Saxena Professor Department of Microbiology Lady Hardinge Medical College New Delhi 1 MDRO The proportion of K. pneumoniae and E. coli with

More information

ACCEPTED. Variant CTX-M-59 in a Neonatal Intensive Care Unit in. Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh,

ACCEPTED. Variant CTX-M-59 in a Neonatal Intensive Care Unit in. Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, AAC Accepts, published online ahead of print on 1 March 00 Antimicrob. Agents Chemother. doi:./aac.0-0 Copyright 00, American Society for Microbiology and/or the Listed Authors/Institutions. All Rights

More information

Extended-Spectrum -Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

Extended-Spectrum -Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat CLINICAL MICROBIOLOGY REVIEWS, Oct. 2001, p. 933 951 Vol. 14, No. 4 0893-8512/01/$04.00 0 DOI: 10.1128/CMR.14.4.933 951.2001 Copyright 2001, American Society for Microbiology. All Rights Reserved. Extended-Spectrum

More information

ANTIMICROBIAL SUSCEPTIBILITY INCREASING COMPLEXITY FOR TREATMENT OF URINARY

ANTIMICROBIAL SUSCEPTIBILITY INCREASING COMPLEXITY FOR TREATMENT OF URINARY TRACT INFECTIONS This specimen was stated to be "from a urine culture" and was to be identified to the species level and tested for antimicrobial susceptibility. The culture contained an Escherichia coli

More information

Supplementary Information for

Supplementary Information for Supplementary Information for Direct, rapid antimicrobial susceptibility test from positive blood cultures based on microscopic imaging analysis J. Choi 1, H. Y. Jeong 2,3, G. Y. Lee 2,4, S. Han 1, S.

More information

Antibiotic Susceptibility Testing (ABST/AST)

Antibiotic Susceptibility Testing (ABST/AST) Antibiotic Susceptibility Testing (ABST/AST) Goal Offer guidance to physicians in selecting effective antibacterial therapy for a pathogen in a specific body site. Performed on bacteria isolated from clinical

More information

Educational Workshops 2016

Educational Workshops 2016 Educational Workshops 2016 Case One: Outbreak of CPE We are grateful to Suzy Fitzgerald, Consultant Microbiologist, St Vincent s University Hospital, Dublin for composing this case. 2011 Spring 2011 Sporadic

More information