A Novel CTX-M β-Lactamase (CTX-M-8) in Cefotaxime-Resistant
            <i>Enterobacteriaceae</i>
            Isolated in Brazil

Bonnet, Richard; Sampaio, Jorge Luiz Mello; Labia, Roger; Champs, Christophe de; Sirot, D.; Chanal, C.; Sirot, J.

doi:10.1128/aac.44.7.1936-1942.2000

Cited by 186 publications

(119 citation statements)

References 44 publications

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“…Insertion sequences (IS) might be involved in the mobilization of bla CTX-M genes. 21 The bla CTX-M genes have also been associated with ISCR1, which is often found downstream of complex class 1 integrons. 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.…”

Section: Resultsmentioning

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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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: Resultsmentioning

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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“…This family has become one of the most important families of ESBL enzymes in many countries [28][29][30] . CTX-M ß-lactamases are the predominant type of ESBLs in Europe and South America 29,31 , including Brazil 32 .…”

Section: Discussionmentioning

confidence: 99%

Nosocomial infection and characterization of extended-spectrum β-lactamases-producing Enterobacteriaceae in Northeast Brazil

Abreu

Marques

Monteiro-Neto

et al. 2011

Rev. Soc. Bras. Med. Trop.

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Introduction: Extended spectrum β-lactamases (ESBLs) are enzymes that degrade β-lactam antibiotics and have been reported to be an important cause of nosocomial infection in worldwide. Methods: During 2009, 659 enterobacteria strains were isolated from different clinical specimens and tested for ESBL production. The disk approximation test, combined disk method and addition of clavulanic acid were used for phenotypic detection of the ESBL-producing strains and PCR for detection of the bla TEM and bla CTX-M genes. Results: Among the isolates, 125 were ESBL producers. The bla CTX-M and bla TEM genes were detected in 90.4% and 75% of the strains, respectively. Most strains were isolated from urine. Klebsiella pneumoniae was the most prevalent organism. Microorganisms presented high resistance to the antibiotics. Conclusions: These results support the need for extending ESBL detection methods to different pathogens of the Enterobacteriaceae family because these methods are only currently standardized by the CLSI for Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca and Proteus mirabilis. Carbapenems were the antibiotic class of choice for the treatment of infections caused by ESBL-producing Enterobacteriaceae.

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“…These enzymes are becoming increasingly expressed by many strains of pathogenic bacteria with a potential for dissemination. They compromise the activity of wide-spectrum antibiotics creating major therapeutic difficulties with a significant impact on the outcome of patients [20,21].…”

Section: Molecular Analysis By Pcrmentioning

confidence: 99%

Study of CTX-M Type of Extended Spectrum β-Lactamase among Nosocomial Isolates of Escherichia coli and Klebsiella pneumoniae in South India

et al. 2011

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Data on CTX-M type extended-spectrum b-lactamase (ESBL) produced by Gram-negative bacteria by molecular methods are limited from India. This study was conducted to investigate the prevalence of CTX-M type ESBL producing Escherichia coli and Klebsiella pneumoniae from nosocomial isolates in a tertiary care hospital in southern India. A total of 179 clinical isolates of K. pneumoniae (n = 72) and E. coli (n = 107) were obtained in a period of 3 months and assessed for ESBL production phenotypically. Associated resistance to a panel of antibiotics and Minimum Inhibitory Concentration for 3rd generation cephalosporins was determined. Phenotypically ESBL positive isolates were subjected to PCR for bla CTX-M gene using two sets of primers for the simultaneous detection of all the five major groups of CTX-M types. All the positive isolates were then subjected to a group specific PCR to detect the prevalent group. Out of 179 isolates, 156 (87.1%) were positive for ESBL phenotypically, which includes 39.2% of K. pneumoniae and 60.8% of E. coli. All of them were examined by PCR using two primers for the presence of bla CTX-M genes. Among the 156 phenotypic positive isolates, 124 (79.4%) were positive for bla CTX-M genes, of which 45 (36.2%) were K. pneumoniae, 79 (63.7%) were E. coli. When the 124 positive clinical isolates were further tested with CTX-M group-specific primers, all were positive for the CTX-M-1 group. Our findings document evidence of the high prevalence of multidrug resistant CTX-M group 1 type ESBL among nosocomial isolates in this region. High co-resistance to other non-b-lactam antibiotics is a major challenge for management of ESBL infections. This is alarming and calls for the judicious use of carbapenems, especially in developing countries. This has significant implications for patient management, and indicates the need for increased surveillance and for further molecular characterization of these isolates.

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A Novel CTX-M β-Lactamase (CTX-M-8) in Cefotaxime-Resistant Enterobacteriaceae Isolated in Brazil

Cited by 186 publications

References 44 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

Nosocomial infection and characterization of extended-spectrum β-lactamases-producing Enterobacteriaceae in Northeast Brazil

Study of CTX-M Type of Extended Spectrum β-Lactamase among Nosocomial Isolates of Escherichia coli and Klebsiella pneumoniae in South India

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