Novel β-lactamase in a clinical isolate of <i>Klebsiella pneumoniae</i> conferring unusual resistance to β-lactam antibiotics

Spencer, R C; Wheat, P. F.; Winstanley, T. G.; Cox, Dermot; Plested, S. J.

doi:10.1093/jac/20.6.919

Cited by 68 publications

(28 citation statements)

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“…IC50s of clavulanic acid were considerably lower than that observed for the TEM-1 enzyme ( Table 2, the amino acid sequence of the TEM-26 enzyme closely resembles that of the TEM-9 extended-spectrum 1-lactamase, which is also capable of hydrolyzing ceftazidime and was first identified in ceftazidime-resistant clinical isolates in England (9,25). The only differences in amino acid sequence between these enzymes are the Phe-19 and Met-261 substitutions found in TEM-9 but not TEM-26.…”

Section: Methodsmentioning

confidence: 88%

Outbreak of ceftazidime resistance due to a novel extended-spectrum beta-lactamase in isolates from cancer patients

Naumovski

Quinn

Miyashiro

et al. 1992

Antimicrob Agents Chemother

173

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Ceftazidime is widely used in the therapy of infectious complications in neutropenic patients. We studied an outbreak of ceftazidime-resistant gram-negative bacillary infections in pediatric cancer patients receiving empirical ceftazidime therapy for neutropenic fever. Fourteen isolates (12 KlebsieUla pneuwniawe and 2 Escherichia coli) from 13 patients were studied. Specimens were obtained from multiple clinical sites including blood, urine, throat, and lung. The organisms were resistant to ceftazidime, aztreonam, and penicillins but remained susceptible to cephamycins and imipenem. All resistant isolates produced a novel 13-lactamase (TEM-26) with a pl of approximately 5.58, which was transferred by transformation to E. coli on a 7.9-kb nonconjugative plasmid which cotransferred resistance to trimethoprim-sulfamethoxazole. This enzyme readily hydrolyzed ceftazidime, aztreonam, and penicillins in a spectrophotometric assay. DNA sequencing data suggest that TEM-26 is derived from TEM-1.

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Section: Methodsmentioning

confidence: 88%

Outbreak of ceftazidime resistance due to a novel extended-spectrum beta-lactamase in isolates from cancer patients

Naumovski

Quinn

Miyashiro

et al. 1992

Antimicrob Agents Chemother

173

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“…First, there is an increasing prevalence of ESBLs worldwide (see below). Second, many strains producing ESBLs demonstrate an inoculum effect in that the MICs of expanded-spectrum cephalosporins rise as the inoculum increases (36,74,158). Medeiros and Crellin found that the MICs of most cephalosporins rose dramatically when the inoculum of susceptibility tests was raised from 10 5 to 10 7 CFU/ml (97).…”

Section: Medical Significance Of Detection Of Esblsmentioning

confidence: 99%

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

2001

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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.

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“…The first outbreak of a TEM-derived ESBL, TEM-3, was recorded in France (28). Outbreaks of ESBL-producing organisms have since been reported worldwide (3,4,9,18,22,29,35). Prior to this study, there had been no detailed investigation of the prevalence of ESBLs in Ireland, although one institution had reported an outbreak of ESBL-producing K. pneumoniae (11).…”

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confidence: 99%

Extended-Spectrum β-Lactamases in Ireland, Including a Novel Enzyme, TEM-102

Morris¹,

O’Hare²,

Glennon

et al. 2003

Antimicrob Agents Chemother

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Organisms producing extended-spectrum ␤-lactamases (ESBLs) have been reported in many countries, but there is no information on the prevalence of ESBL-producing members of the family Enterobacteriaceae in Ireland. A total of 925 isolates of ampicillin-resistant members of the Enterobacteriaceae were received from six hospitals in Ireland over a 3-year period from September 1996 to September 1999. Isolates were screened for ESBL production by the double-disk diffusion (DDD) method. DDD-positive isolates that were (i) confirmed as ESBL producers by National Committee for Clinical Laboratory Standards (NCCLS) confirmatory testing and (ii) susceptible to cefoxitin by disk diffusion were considered ESBL producers. By these criteria, 27 (3%) of the ampicillin-resistant members of the Enterobacteriaceae studied were categorized as ESBL producers. Molecular typing suggested that some intra-and interhospital spread of ESBL-producing isolates had occurred. DNA sequencing of amplified bla TEM and bla SHV genes resulted in the detection of a novel bla TEM ESBL gene, bla TEM-102 in two isolates (Klebsiella pneumoniae and Enterobacter cloacae) received from the same hospital but isolated from different patients. The study suggests dissemination of ESBL-producing bacteria within the health care system in Ireland and emphasizes the need for measures to control such spread.

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Novel β-lactamase in a clinical isolate of Klebsiella pneumoniae conferring unusual resistance to β-lactam antibiotics

Cited by 68 publications

References 0 publications

Outbreak of ceftazidime resistance due to a novel extended-spectrum beta-lactamase in isolates from cancer patients

Outbreak of ceftazidime resistance due to a novel extended-spectrum beta-lactamase in isolates from cancer patients

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

Extended-Spectrum β-Lactamases in Ireland, Including a Novel Enzyme, TEM-102

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