Identification of TEM-26 beta-lactamase responsible for a major outbreak of ceftazidime-resistant Klebsiella pneumoniae

Urban, Carl; Meyer, Kenneth S.; Mariano, Noriel; Rahal, James J.; Flamm, Rk; Rasmussen, Beth A.; Bush, Karen

doi:10.1128/aac.38.2.392

Cited by 65 publications

(41 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…For example, TEM-10 has been responsible for several unrelated outbreaks of ESBL-producing organisms in the United States for a number of years (26,112,143,175). However, TEM-10 has only recently been reported in Europe with the same frequency (8,84).…”

Section: Epidemiologymentioning

confidence: 99%

Extended-Spectrum β-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

2001

View full text Add to dashboard Cite

SUMMARY β-Lactamases continue to be the leading cause of resistance to β-lactam antibiotics among gram-negative bacteria. In recent years there has been an increased incidence and prevalence of extended-spectrum β-lactamases (ESBLs), enzymes that hydrolyze and cause resistance to oxyimino-cephalosporins and aztreonam. The majority of ESBLs are derived from the widespread broad-spectrum β-lactamases TEM-1 and SHV-1. There are also new families of ESBLs, including the CTX-M and OXA-type enzymes as well as novel, unrelated β-lactamases. Several different methods for the detection of ESBLs in clinical isolates have been suggested. While each of the tests has merit, none of the tests is able to detect all of the ESBLs encountered. ESBLs have become widespread throughout the world and are now found in a significant percentage of Escherichia coli and Klebsiella pneumoniae strains in certain countries. They have also been found in other Enterobacteriaceae strains and Pseudomonas aeruginosa. Strains expressing these β-lactamases will present a host of therapeutic challenges as we head into the 21st century.

show abstract

Section: Epidemiologymentioning

confidence: 99%

Extended-Spectrum β-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

2001

View full text Add to dashboard Cite

show abstract

“…However, the production of TEM-24 in K. pneumoniae only concerned 13.3% of the K. pneumoniae isolates producing ESBLs, while in a neighboring geographic region these bacteria remained at epidemic proportions (18). In France, TEM-3 is secreted largely by Klebsiella spp., P. mirabilis, and C. koseri, while in other countries, other ESBLs are in the majority (4,8,11,24,26,30,34). ESBLs in the CTX-M group (CTX-M-3, CTX-M-14, and CTX-M-15) were only observed in E. coli strains.…”

mentioning

confidence: 99%

Molecular Epidemiology of Enterobacteriaceae Isolates Producing Extended-Spectrum β-Lactamases in a French Hospital

et al. 2004

View full text Add to dashboard Cite

In 2002, 80 isolates of Enterobacteriaceae producing extended-spectrum ␤-lactamases (ESBLs) were collected from infected patients in our hospital. Enterobacter aerogenes was the most common bacterium isolated from all specimens (36.5%). The ESBLs were predominantly (90%) TEM derivatives (TEM-24, TEM-3). Pulsed-field gel electrophoresis highlighted that E. aerogenes, Klebsiella pneumoniae, and Citrobacter koseri had a clonal propagation.

show abstract

“…Of these isolates, 8 (7.6%) had been misidentified and 66 (62.9%) generated different codes on repeat testing that could be identified by ␤lasEN. It is possible that some of these differences in codes could have been due to the loss one or more resistance mechanisms during storage and transport between the initial and repeat test sites (1,26,43).…”

Section: Discussionmentioning

confidence: 99%

βlasEN: Microdilution Panel for Identifying β-Lactamases Present in Isolates of Enterobacteriaceae

et al. 2002

View full text Add to dashboard Cite

A dried investigational use-only microdilution panel named ␤lasEN (a short named derived from the panel's purpose, to identify ␤-lactamases in Enterobacteriaceae) containing 10 ␤-lactam drugs with and without ␤-lactamase inhibitors was developed to identify ␤-lactamases among clinical isolates of Escherichia coli, Klebsiella pneumoniae, Klebsiella oxytoca, Citrobacter koseri, Citrobacter freundii group, Enterobacter spp., and Serratia marcescens. The MICs obtained with a collection of 383 organisms containing well-characterized ␤-lactamases were used to develop numeric codes and logic pathways for computerized analysis of results. The resultant logic pathways and ␤lasEN panel were then used to test and identify ␤-lactamases among 885 isolates of Enterobacteriaceae recovered in cultures obtained at six different hospital laboratories across the United States. ␤-Lactamases present in 801 (90.5%) of the 885 isolates were identified by ␤lasEN by using the existing logic pathways and codes or after minor modifications were made to the existing codes. The 84 strains that gave codes that ␤lasEN could not identify were collected, reidentified, and retested by using ␤lasEN. Three strains had been misidentified, 54 strains gave different codes upon repeat testing that could be identified by ␤lasEN, and 27 strains repeated new codes. The ␤-lactamases in these strains were identified, and the new codes were added to the ␤lasEN logic pathways. These results indicate that ␤lasEN can identify clinically important ␤-lactamases among most isolates of Enterobacteriaceae. The results also show that good quality control and attention to proper performance of the tests are essential to the correct performance of ␤lasEN.Over the past 10 years, there has been a significant increase in the numbers and types of ␤-lactamases encountered among clinical isolates of Enterobacteriaceae (4-7, 9, 14-16, 18, 23, 31, 37; H. Kurokawa et al., Letter, Lancet 354:955, 1999). Not only have the older plasmid-mediated ␤-lactamases such as TEM-1 and SHV-1 become more prevalent but also new derivatives of these enzymes capable of producing resistance to expandedspectrum ␤-lactam antibiotics have appeared (9,19). Plasmid derivatives of chromosomal ␤-lactamases have also appeared (2, 9, 14), as have enzymes capable of producing resistance to the carbapenems (9, 12, 22, 28; G. Cornaglia et al., Letter, Lancet 353:899-900, 1999). Unfortunately, many Enterobacteriaceae producing these new ␤-lactamases do not show frank resistance in routine susceptibility tests with certain ␤-lactam antibiotics despite clinical evidence that the drugs do not provide effective therapy (8,10,21,29,44). Thus, it has become imperative to design tests that will help microbiologists identify which ␤-lactamase(s) may be present in a clinical isolate of Enterobacteriaceae (8,11,12,17,20,25,33,34,(38)(39)(40).A series of studies have been performed to determine whether or not results of microdilution panels with or without ␤-lactamase inhibitors could be used to determine the presen...

show abstract

Identification of TEM-26 beta-lactamase responsible for a major outbreak of ceftazidime-resistant Klebsiella pneumoniae

Cited by 65 publications

References 22 publications

Extended-Spectrum β-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

Extended-Spectrum β-Lactamases in the 21st Century: Characterization, Epidemiology, and Detection of This Important Resistance Threat

Molecular Epidemiology of Enterobacteriaceae Isolates Producing Extended-Spectrum β-Lactamases in a French Hospital

βlasEN: Microdilution Panel for Identifying β-Lactamases Present in Isolates of Enterobacteriaceae

Contact Info

Product

Resources

About