Foodborne Nosocomial Outbreak of SHV1 and CTX-M-15-producing Klebsiella pneumoniae: Epidemiology and Control

Calbo, Esther; Freixas, N.; Xercavins, Mariona; Riera, Montserrat; Nicolás, Carmen; Monistrol, Olga; Solé, Mar; Sala, M.; Vila, Jordi; Garau, Javier

doi:10.1093/cid/ciq238

Cited by 126 publications

(92 citation statements)

References 37 publications

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“…All isolates were resistant to many b-lactams of importance in veterinary mastitis therapy (penicillins, cefquinome, cefazolin, cefoperazone), as well as to lincosamides (pirlimycin) and macrolides (erythromycin). Although the members of the genus Klebsiella can on occasion contain different resistance markers (Severin et al, 2010;Calbo et al, 2011), the broad resistance patterns of these isolates are remarkable.…”

Section: Resultsmentioning

confidence: 99%

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Sudarwanto

Akineden

Odenthal

et al. 2015

Foodborne Pathogens and Disease

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Bulk tank milk from 80 dairy farms located in the West Java Region of Indonesia was analyzed for the presence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae. Isolates from seven dairy farms were ESBL positive, and all were identified as Klebsiella pneumoniae. The isolates showed ESBL-characteristic antibiotic resistance patterns. Further analysis revealed that all K. pneumoniae isolates harbored the blaSHV gene, and two isolates were additionally positive for the blaTEM-1 and blaCTX-M-15 genes. Isolates from different farms were clonally diverse according to macrorestriction analysis. The results indicate that the relatively high frequency of ESBL-producing K. pneumoniae in bulk tank milk implies the risk that milk is both a source of local exposure and a vector contributing to the supraregional spread of antibiotic-resistant bacteria by trade.

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Section: Resultsmentioning

confidence: 99%

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Sudarwanto

Akineden

Odenthal

et al. 2015

Foodborne Pathogens and Disease

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“…18,34 To identify group-specific bla CTX-M genes, including the bla CTX-M-1 , bla CTX-M-2 , bla CTX-M-8 , and bla CTX-M-9 group genes, a multiplex PCR was performed as described previously. 2 After bla CTX-M group identification, specific primers were used to amplify all genes of each group. Purified PCR products were sequenced bidirectionally or were cloned in pGEM-T vectors and then sequenced.…”

Section: Pcr Amplification and Sequencingmentioning

confidence: 99%

High Prevalence of CTX-M Beta-Lactamases in Enterobacteriaceae from Healthy Individuals in Guangzhou, China

Yong

Zhang

et al. 2015

Microbial Drug Resistance

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This study aimed to determine the prevalence of extended-spectrum beta-lactamases (ESBLs) in Enterobacteriaceae and to characterize the genetic composition of ESBL determinants among Enterobacteriaceae isolates from healthy people in Guangzhou, China. A total of 200 rectal swab samples were collected from healthy asymptomatic individuals and tested for ESBL production using ChromID ESBL agar. Phenotypic ESBL producers were screened for blaCTX-M, blaTEM, and blaSHV genes using PCR and DNA sequencing. The prevalence of ESBL-producing Enterobacteriaceae among rectal swab samples was 69.5%. All ESBL-producing isolates harbored blaCTX-M genes (n=138) except for one isolate that harbored blaSHV-2a. Eleven CTX-M ESBL genes were detected. The most predominant CTX-M-type genes were blaCTX-M-14 (n=82), followed by blaCTX-M-55 (n=19), blaCTX-M-65 (n=10), and blaCTX-M-27 (n=9). Isolates carrying blaCTX-M-38,-3,-15,-14b,-98,-121 and -123 were also identified. Molecular homology analysis of the selected isolates was performed by phylogenetic grouping and multilocus sequence typing and indicated that the predominant clone belonged to A-CC10. This study showed a high rate of CTX-M-type ESBL genes among Enterobacteriaceae isolates from healthy individuals in China.

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“…Screening for carbapenemase/MBL production yielded positive results when using either the cloverleaf test (modified Hodge test) or imipenem-EDTA Etest strips. PCR screening for ␤-lactamase genes followed by DNA sequencing using specific primers (NDM-1 F, 5Ј-CCAATATTATGCACC CGGTCG-3Ј, and NDM-1 R 5Ј-ATGCGGGCCGTATGAGT GATTG-3Ј) (2,14,21) identified the presence of bla NDM-1 , bla CTX-M-15 , bla TEM-1 , and a partial sequence of the bla DHA-1 gene. In addition, screening for aminoglycoside resistance genes (21) identified the armA gene, encoding a 16S rRNA methylase conferring resistance to aminoglycosides.…”

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confidence: 99%

First Description of an Escherichia coli Strain Producing NDM-1 Carbapenemase in Spain

Solé

Pitart

Roca

et al. 2011

Antimicrob Agents Chemother

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A carbapenem-resistant Escherichia coli strain (DVR22) was recovered from a stool specimen from a patient with traveler's diarrhea who had traveled to India. Molecular screening led to the first identification of NDM-1 in Spain. The bla NDM-1 gene was located in a conjugative plasmid of ca. 300 kb that also contained the bla CTX-M-15 , bla TEM-1 , ⌬bla DHA-1 , and armA genes. In addition, bla NDM-1 was preceded by an ISAba125 insertion element only found in Acinetobacter spp.The emergence of carbapenem resistance among Enterobacteriaceae is a major cause of concern since carbapenems currently represent the treatment of choice for severe infections caused by multidrug-resistant strains producing extended-spectrum ␤-lactamases (ESBLs) (8).In addition to commonly known carbapenem-hydrolyzing enzymes in Enterobacteriaceae (IMP, VIM, KPC, and OXA-48), a novel class B metallo-␤-lactamase (NDM-1) has recently been described. This enzyme, first identified in Klebsiella pneumoniae and Escherichia coli clinical isolates recovered in Sweden from a traveler returning from India, confers resistance to all ␤-lactams except aztreonam (22). Since then, several reports have identified bla NDM genes worldwide that have typically been associated with multidrug-resistant strains (1,5,12,(16)(17)(18)23).A 40-year-old Spanish Caucasian male reported intermittent abdominal discomfort, fever, and bloody diarrhea about 5 days before returning from India. He visited a local dispensary in India where treatment with ofloxacin and ornidazole tablets (twice a day) was prescribed for 5 days. The patient reported to the Hospital Clinic of Barcelona 1 day after his return, still complaining of bloody diarrhea, although with fewer unformed stools. He was afebrile, without any sign of dehydration, and the rest of the physical examination was normal. The diarrhea resolved spontaneously over the next 9 days.A carbapenem-resistant E. coli (DVR22) strain was recovered from the stool samples of the patient, and after isolation and identification, antimicrobial susceptibility profiling analysis performed with both BD Phoenix (Becton Dickinson, Franklin Lakes, NJ) and Etest strips (AB bioMérieux, Solna, Sweden) indicated that strain DVR22 was resistant to all the antibiotics tested except tigecycline (MIC of 0.75 g/ml), fosfomycin (MIC of 32 g/ml), and colistin (MIC of 0.5 g/ml) (Table 1), presenting MICs of 8 g/ml and 16 g/ml for imipenem and meropenem, respectively, 24 g/ml for ertapenem, and 6 g/ml for doripenem (CLSI breakpoints from broth microdilution tests were used to classify the MICs obtained by Etest [7]). Screening for carbapenemase/MBL production yielded positive results when using either the cloverleaf test (modified Hodge test) or imipenem-EDTA Etest strips. PCR screening for ␤-lactamase genes followed by DNA sequencing using specific primers (NDM-1 F, 5Ј-CCAATATTATGCACC CGGTCG-3Ј, and NDM-1 R 5Ј-ATGCGGGCCGTATGAGT GATTG-3Ј) (2, 14, 21) identified the presence of bla NDM-1 , bla CTX-M-15 , bla TEM-1 , and a partial sequence of the bla DHA-...

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Foodborne Nosocomial Outbreak of SHV1 and CTX-M-15-producing Klebsiella pneumoniae: Epidemiology and Control

Abstract: To our knowledge, this is the first reported hospital outbreak that provides evidence that food can be a transmission vector for ESBL K. pneumoniae.

Cited by 126 publications

References 37 publications

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

Extended-Spectrum β-Lactamase (ESBL)–ProducingKlebsiella pneumoniaein Bulk Tank Milk from Dairy Farms in Indonesia

High Prevalence of CTX-M Beta-Lactamases in Enterobacteriaceae from Healthy Individuals in Guangzhou, China

First Description of an Escherichia coli Strain Producing NDM-1 Carbapenemase in Spain

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