Early Dissemination of CTX-M-Derived Enzymes in South America

Radice, Marcela; Power, Pablo; Conza, José Alejandro Di; Gutkind, Gabriel

doi:10.1128/aac.46.2.602-604.2002

Cited by 91 publications

(74 citation statements)

References 21 publications

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“…CTX-M-type enzymes, whose presence is now described all over the world, appear to be a new challenge for the medical community, as they occur in a wide range of species and in clones of given species and plasmids, probably in relation to the fact that the corresponding genes are located downstream of an insertion sequence element (an ISEcp1-like element) which seems to act as a key factor in the dissemination of bla CTX-M type genes and as a strong positive factor for the expression of these genes (35). However, to our knowledge, outbreaks due to CTX-M-type enzyme-producing isolates have essentially been described so far in countries where CTX-Mtype-producing isolates are endemic, notably, Japan (20,26) and South America (37). The present article, which reports on the dissemination of clonally related CTX-M-15-producing E. coli strains in a French 650-bed geriatric hospital, might prefigure the near future for Western European countries, which now seem to be concerned with CTX-M-type enzymes.…”

Section: Discussionmentioning

confidence: 89%

Emergence and Spread of Three Clonally Related Virulent Isolates of CTX-M-15-Producing Escherichia coli with Variable Resistance to Aminoglycosides and Tetracycline in a French Geriatric Hospital

Leflon‐Guibout¹,

Jurand

Bonacorsi

et al. 2004

Antimicrob Agents Chemother

115

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Three types of multidrug-resistant Escherichia coli isolates, called GEN S, GEN R, and AMG S, according to their three different aminoglycoside resistance patterns, were responsible for urinary tract colonization or infection in 87, 12, and 13 new patients, respectively, in a French 650-bed geriatric hospital over a 13-month period. The three E. coli types belonged to the same clone and phylogenetic group (group B2) and had identical transferable plasmid contents (a 120-kb plasmid), ␤-lactam and fluoroquinolone resistance genotypes (bla TEM-1B , bla CTX-M-15 , and double mutations in both the gyrA and the parC genes), and virulence factor genotypes (aer, fyuA, and irp2). They disseminated in the geriatric hospital, where the antibiotics prescribed most often were fluoroquinolones and ceftriaxone, but not in the affiliated acute-care hospital, where isolation precautions were applied to the transferred patients. Thus, E. coli isolates, both CTX-M-type ␤-lactamase producers and fluoroquinolone-resistant isolates, might present a new challenge for French health care settings.For the last 10 years, sporadically but regularly, the microbiology literature has reported on multidrug-resistant (MDR) bacteria in geriatric hospitals, long-term-care facilities, and nursing homes (14,26,30,44). The emergence of these bacteria in such health care facilities has become a public health concern because implementation of isolation precautions, which is the principal measure recommended in acute-care hospitals to avoid cross-transmission (12), is often considered deleterious for the quality of life of elderly people living in long-term-care facilities. Moreover, the elderly patients carrying MDR bacteria represent a reservoir of these bacteria in acute-care hospitals when they are transferred to them. The very least that can be done to address this double concern is to survey long-term-care facilities for the emergence and incidence of MDR bacteria and to inform clinicians in acute-care hospitals of the real or potential existence of these isolates in patients transferred from long-term-care facilities. Such a twofold approach, observation and an infection control program, is certainly more easily managed when the same microbiological department, as in Hôpital A. Paré, is in charge of the patients in both types of care settings.This article reports on molecular analyses performed with three types of MDR Escherichia coli isolates which successively emerged and spread in the 650-bed geriatric hospital which is affiliated with a 450-bed acute-care hospital, Hôpital A. Paré.It also describes the particular hygiene measures which were successfully established in the acute-care hospital to avoid secondary cases of MDR E. coli colonization or infection from the patients transferred from the geriatric hospital. MATERIALS AND METHODSPopulation and collection of bacteria. From October 2001 to October 2002, each first isolate of the family Enterobacteriaceae displaying an extended-spectrum ␤-lactamase (ESBL) production phenotype according to...

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Section: Discussionmentioning

confidence: 89%

Emergence and Spread of Three Clonally Related Virulent Isolates of CTX-M-15-Producing Escherichia coli with Variable Resistance to Aminoglycosides and Tetracycline in a French Geriatric Hospital

Leflon‐Guibout¹,

Jurand

Bonacorsi

et al. 2004

Antimicrob Agents Chemother

115

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“…The genetic environment of the bla CTX-M genes was investigated by PCR and sequencing of the regions surrounding these genes according to a previously described method (Eckert et al, 2006). The regions upstream of the bla CTX-M genes were amplified with forward primers hybridizing to the insertion sequences IS26 and ISEcp1 and to the ORF513 region and the CTX-M reverse primer (Radice et al, 2002). Both strands of the PCR products were sequenced.…”

Section: Methodsmentioning

confidence: 99%

“…AJ416343) have also been reported to associate with bla CTX-M-2 and bla CTX-M-9 genes (Saladin et al, 2002;Eckert et al, 2006). CTX-M enzymes have been found predominantly in members of the Enterobacteriaceae, most prevalently in E. coli, K. pneumoniae and Salmonella enterica serovar Typhimurium in South America (Radice et al, 2002;Villegas et al, 2004) and Europe (Baraniak et al, 2002;Batchelor et al, 2005;Livermore & Hawkey, 2005), although they are rarely isolated in Japan (Yagi et al, 2000). The spread of CTX-M enzyme-producing E. coli among community-and hospital-based patients has also been reported (Woodford et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Regional outbreak of CTX-M-2 β-lactamase-producing Proteus mirabilis in Japan

Nakano

Abe

et al. 2012

Journal of Medical Microbiology

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Proteus mirabilis is a common cause of urinary tract infection. Wild-type P. mirabilis strains are usually susceptible to penicillins and cephalosporins, but occurrences of P. mirabilis producing extended-spectrum b-lactamases (ESBLs) have been recently reported. Here, we surveyed the prevalence of cefotaxime resistance among P. mirabilis strains at seven different hospitals in Kanagawa Prefecture, Japan, and investigated their molecular epidemiology to explain the mechanism of their spread. The prevalence of cefotaxime resistance among P. mirabilis increased annually, from 10.1 % in 1998 to 23.1 % in 2003, and increased drastically in 2004, exceeding 40 %. We collected 105 consecutive and non-duplicate cefotaxime-resistant P. mirabilis isolates (MIC 16 to .256 mg ml "1 ) from these hospitals from June 2004 to May 2005 and characterized their profile. PCR and sequence analysis revealed that all resistant strains produced exclusively CTX-M-2 b-lactamase. PFGE analysis identified 47 banding patterns with 83 % or greater similarity. These results indicated that a regional outbreak of P. mirabilis producing CTX-M-2 blactamase has occurred in Japan and suggest that the epidemic spread occurred within and across hospitals and communities by extended clonal strains. Plasmid analysis revealed that 44.8 % of plasmids harboured by bla CTX-M-2 isolates had common profiles, encoding ISEcp1, IS26 and Int1, and belonged to incompatibility group T. Spread of the resistant isolates in Japan resulted from dissemination of narrow-host-range plasmids of the IncT group encoding bla CTX-M-2 . These findings indicate the rapidly developing problem of treating the species to prevent dissemination of ESBL producers.

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“…CTX-M-2 cefotaximase is the ESBL having the greatest prevalence in Argentina, where it recently was reported for the first time (7). It has since become disseminated in several countries in South America (7) and is also endemic in Asian countries (1).…”

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confidence: 99%

Detection of CTX-M-1, CTX-M-15, and CTX-M-2 in Clinical Isolates of Enterobacteriaceae in Bogotá, Colombia

et al. 2006

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This is the first report regarding the detection of bla CTX-M genes encoding CTX-M-1, CTX-M-15, and CTX-M-2 cefotaximases in clinical isolates of enterobacteria collected in hospitals in Bogotá, Colombia.During a period of 4 months in 2005, 117 isolates of enterobacteria having extended spectrum beta-lactamase (ESBL) phenotype were collected from nine third-level hospitals in Bogotá, Colombia. Beta-lactamase-producing bla CTX-M genes were detected in 56 of them (47.9%) by PCR, having isoelectric points of 8.0, 8.7, and 8.9. CTX-M-1 group genes were detected in 89.3% of these isolates; the rest were from the CTX-M-2 group. No other bla CTX-M genes were detected. Amplified product sequences showed 100% similarity with the bla CTX-M-12 gene in 56 isolates (60.7%), with bla CTX-M-1

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Early Dissemination of CTX-M-Derived Enzymes in South America

Cited by 91 publications

References 21 publications

Emergence and Spread of Three Clonally Related Virulent Isolates of CTX-M-15-Producing Escherichia coli with Variable Resistance to Aminoglycosides and Tetracycline in a French Geriatric Hospital

Emergence and Spread of Three Clonally Related Virulent Isolates of CTX-M-15-Producing Escherichia coli with Variable Resistance to Aminoglycosides and Tetracycline in a French Geriatric Hospital

Regional outbreak of CTX-M-2 β-lactamase-producing Proteus mirabilis in Japan

Detection of CTX-M-1, CTX-M-15, and CTX-M-2 in Clinical Isolates of Enterobacteriaceae in Bogotá, Colombia

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