A total of 904 consecutive nosocomial isolates of Escherichia coli and Klebsiella pneumoniae collected from 28 Russian hospitals were screened for production of extended-spectrum -lactamases (ESBLs). The ESBL phenotype was detected in 78 (15.8%) E. coli and 248 (60.8%) K. pneumoniae isolates. One hundred fifteen isolates carried the genes for CTX-M-type -lactamases, which, as shown by PCR-restriction fragment length polymorphism analysis, were distributed into the two genetic groups of CTX-M-1 (93%)-and CTX-M-2 (7%)-related enzymes. Isolates producing the enzymes of the first group were found in 20 hospitals from geographically distant regions of the country and were characterized by considerable diversity of genetic types, as was demonstrated by enterobacterial repetitive consensus PCR typing. Within this group the CTX-M-3 and the CTX-M-15 -lactamases were identified. In contrast, the enzymes of the CTX-M-2 group (namely, CTX-M-5) were detected only in eight clonally related E. coli isolates from a single hospital. Notably, the levels of resistance to ceftazidime were remarkably variable among the CTX-M producers. This study provides further evidence of the global dissemination of CTX-M type ESBLs and emphasizes the need for their epidemiological monitoring.During the past decade extended-spectrum -lactamases (ESBLs) of the CTX-M type emerged in many countries of the world. The first organisms producing -lactamases of this type were identified both as single and epidemic clinical isolates in very distant geographic regions (Germany and France and Argentina) in the early 1990s (3, 5, 7). More recently, a rapid increase in the proportion of multiple CTX-M variants to the TEM-and SHV-derived ESBLs has been reported in many hospitals in Spain (9,12,15,35) (14), and Korea (28). Furthermore, CTX-M -lactamases, mainly types CTX-M-2 and CTX-M-3, were found to be widespread or even predominant ESBL types in several countries, including Argentina (31, 34; M. Galas, F. Pasteran, R. Melano, A. Petroni, G. Lopez, A. Corso, A. Rossi, et al., Abstr. 38th Intersci. Conf. Antimicrob. Agents Chemother., abstr. E-109, 1998), Japan (41), and Poland (1).Currently the CTX-M family includes more than 20 -lactamases, which may be grouped on the basis of sequence similarity into four distinct clusters (subtypes) epitomized by CTX-M-1, CTX-M-2, CTX-M-8, and CTX-M-9 (26, 37; http: //www.lahey.org/studies/webt.htm). Within each cluster there is a high degree of bla CTX-M gene sequence identity (Ͼ95%), although members of different subtypes share only 70 to 77% similarity at the nucleotide level. The recent finding of Kluyvera ascorbata species-specific -lactamases (KluA) which share 98.6 to 100% identity with CTX-M-2 and CTX-M-5 and analysis of DNA sequences adjacent to the KluA-and CTX-Mcoding genes provide strong evidence of the direct evolution of the CTX-M-2 cluster from the chromosomal enzyme of K. ascorbata (20,36). Likewise, the chromosomal KLUG-1 enzyme of Kluyvera georgiana was found to be the most-probable progenitor of ...