Extended-Spectrum β-Lactamases in
            <i>Klebsiella pneumoniae</i>
            Bloodstream Isolates from Seven Countries: Dominance and Widespread Prevalence of SHV- and CTX-M-Type β-Lactamases

Paterson, David L.; Hujer, Kristine M.; Hujer, Andrea M.; Yeiser, Bethany; Bonomo, Michael D.; Rice, Louis B.; Bonomo, Robert A.

doi:10.1128/aac.47.11.3554-3560.2003

Cited by 356 publications

(273 citation statements)

References 44 publications

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“…It is interesting to note that 41 of our 56 ESBL-positive E. coli isolates ( A similar tendency has been observed in other studies (Brasme et al, 2007;Valverde et al, 2004;Paterson et al, 2003). It would be interesting to track the evolution of these genes in the following years to detect whether this tendency is maintained.…”

Section: Jmm Correspondencesupporting

confidence: 82%

Characterization of extended-spectrum β-lactamases and integrons in Escherichia coli isolates in a Spanish hospital

Vinué

Lantero

Sáenz

et al. 2008

Journal of Medical Microbiology

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Section: Jmm Correspondencesupporting

confidence: 82%

Characterization of extended-spectrum β-lactamases and integrons in Escherichia coli isolates in a Spanish hospital

Vinué

Lantero

Sáenz

et al. 2008

Journal of Medical Microbiology

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

Section: Enterobacteriaceaementioning

confidence: 88%

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

Yezli

Shibl

Memish

2015

Journal of Medical Microbiology

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

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“…28 It creates a public health problem that requires clinical microbiology laboratories to carry out β-lactamase identification and typing. In most clinical settings, especially in the developing countries, the screening and detection of β-lactamases in bacteria has, for the most part, been based on the agar disk tests (such as the disk diffusion tests) and isoelectric focusing.…”

Section: Discussionmentioning

confidence: 99%

Development of a multiplex PCR system and its application in detection of blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes in clinical Klebsiella pneumoniae and Escherichia coli strains

et al. 2015

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Resistance to β-lactam antibiotics through β-lactamase production by Enterobacteriaceae continues to burden the health-care sector worldwide. Traditional methods for detection of β-lactamases are time-consuming and labor-intensive and newer methods with varying capabilities continue to be developed. The objective of this study was to develop a multiplex PCR (M-PCR) system for the detection of bla SHV , bla TEM , bla CTX-M-1 , bla CTX-M-9 and bla OXA-1 group genes and to apply it in clinical Klebsiella pneumoniae and Escherichia coli strains. To do this, we used group-specific PCR primers in singleplex reactions followed by optimization into multiplex reactions. Specificity and sensitivity of the M-PCR were then evaluated using 58 reference strains before its application to detect bla group genes in 203 clinical Enterobacteriaceae strains. PCR amplicons were sequenced to determine the β-lactamase subtypes. The M-PCR system exhibited 100% specificity and sensitivity. In all, 83.7% of K. pneumoniae and 89.8% of E. coli clinical strains harbored bla group genes with 46.9%, 40.1%, 15.0%, 21.1% and 6.1% of K. pneumoniae having bla SHV , bla TEM , bla CTX-M-1 , bla CTX-M-9 and bla OXA-1 group genes, respectively, whereas 12.2%, 77.6%, 22.4%, 36.7% and 8.2% of E. coli had bla SHV , bla TEM , bla CTX-M-1 , bla CTX-M-9 and bla OXA-1 group genes, respectively. Bla SHV-1 , bla SHV-11 , bla SHV-27 , bla SHV-33 , bla SHV-144 , bla TEM-1 , bla TEM-135 , bla OXA-1 , bla CTX-M-3 , bla CTX-M-9 , bla CTX-M-14 , bla CTX-M-15 , bla CTX-M-27 , bla CTX-M-55 , bla CTX-M-65 and bla CTX-M-104 were detected. In conclusion, the M-PCR system was efficient and versatile with an advantage of simultaneously detecting all the targeted bla group genes. Hence, it is a potential candidate for developing M-PCR kits for the screening of these genes for clinical or epidemiological purposes.

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Extended-Spectrum β-Lactamases in Klebsiella pneumoniae Bloodstream Isolates from Seven Countries: Dominance and Widespread Prevalence of SHV- and CTX-M-Type β-Lactamases

Cited by 356 publications

References 44 publications

Characterization of extended-spectrum β-lactamases and integrons in Escherichia coli isolates in a Spanish hospital

Characterization of extended-spectrum β-lactamases and integrons in Escherichia coli isolates in a Spanish hospital

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

Development of a multiplex PCR system and its application in detection of blaSHV, blaTEM, blaCTX-M-1, blaCTX-M-9 and blaOXA-1 group genes in clinical Klebsiella pneumoniae and Escherichia coli strains

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