Regional Occurrence of Plasmid‐Mediated SHV‐7, an Extended‐Spectrum β‐Lactamase, in<i>Enterobacter cloacae</i>in Philadelphia Teaching Hospitals

Levison, Matthew E.; Mailapur, Yamini V.; Pradhan, Sandeep K.; Jacoby, George A.; Adams, Pamela S.; Emery, Christopher L.; May, Phyllis L.; Pitsakis, Peter G.

doi:10.1086/344178

Cited by 26 publications

(8 citation statements)

References 17 publications

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“…In all these cases, both genes cotransferred to a recipient E. coli strain in transconjugation experiments, as in our case. The coexistence of bla TEM and bla SHV in clinical isolates of E. cloacae was also reported in Italy, where the rate of coexistence was 50% (37), and in Philadelphia, Pa. (22). In France, on the other hand, one E. cloacae isolate was found to carry a TEM-1 gene together with CTX-M-1 on the same 55-kb plasmid, and another isolate was found to carry both TEM-1 and CTX-M-3 on the same 180-kb plasmid.…”

Section: Discussionmentioning

confidence: 55%

Extended-Spectrum Beta-Lactamases among Enterobacter Isolates Obtained in Tel Aviv, Israel

Schlesinger

Navon-Venezia

Chmelnitsky

et al. 2005

Antimicrob Agents Chemother

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The extended-spectrum beta-lactamase (ESBL)-producing phenotype is frequent among Enterobacter isolates at the Tel Aviv Sourasky Medical Center, Tel Aviv, Israel. We examined the clonal relatedness and characterized the ESBLs of a collection of these strains. Clonal relatedness was determined by pulsed-field gel electrophoresis. Isoelectric focusing (IEF) and transconjugation experiments were performed. ESBL gene families were screened by colony hybridization and PCR for bla TEM , bla SHV , bla CTX-M , bla IBC , bla PER , bla OXA , bla VEB , and bla SFO ; and the PCR products were sequenced. The 17 Enterobacter isolates studied comprised 15 distinct genotypes. All isolates showed at least one IEF band (range, one to five bands) whose appearance was suppressed by addition of clavulanate; pIs ranged from 5.4 to >8.2. Colony hybridization identified at least one family of beta-lactamase genes in 11 isolates: 10 harbored bla TEM and 9 harbored bla SHV . PCR screening and sequence analysis of the PCR products for bla TEM , bla SHV , and bla CTX-M identified TEM-1 in 11 isolates, SHV-12 in 7 isolates, SHV-1 in 1 isolate, a CTX-M-2-like gene in 2 isolates, and CTX-M-26 in 1 isolate. In transconjugation experiments with four isolates harboring bla TEM-1 and bla SHV-12 , both genes were simultaneously transferred to the recipient strain Escherichia coli HB101. Plasmid mapping, PCR, and Southern analysis with TEM-and SHV-specific probes demonstrated that a single transferred plasmid carried both the TEM-1 and the SHV-12 genes. The widespread presence of ESBLs among Enterobacter isolates in Tel Aviv is likely due not to clonal spread but, rather, to plasmid-mediated transfer, at times simultaneously, of genes encoding several types of enzymes. The dominant ESBL identified was SHV-12.Enterobacter spp. are leading nosocomial pathogens (26) that commonly cause pneumonia (25) and that are the most frequent gram-negative organisms causing bloodstream infections in intensive care units (14, 33). More than one-third of the Enterobacter sp. isolates in intensive care units reporting to the National Nosocomial Infection Surveillance System (26) are resistant to extended-spectrum cephalosporins. Moreover, treatment with extended-spectrum cephalosporins may lead to the emergence of resistance to these antimicrobial agents among susceptible strains of Enterobacter spp. (8,19,35). Emergence of resistance results in increased rates of mortality, longer hospital stays, and higher hospital charges (9, 10).The resistance of Enterobacter spp. to beta-lactam antibiotics is most frequently mediated by hyperproduction of chromosomal AmpC beta-lactamase, caused either by induction or, more likely, by selection of derepressed mutants (1). In the last decade, the production of plasmid-mediated extended-spectrum beta-lactamases (ESBLs) has been recognized as an additional important emerging mechanism of resistance among members of the family Enterobacteriaceae (3, 17), including clinical isolates of Enterobacter spp. (31). The most common ESBLs fo...

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Section: Discussionmentioning

confidence: 55%

Extended-Spectrum Beta-Lactamases among Enterobacter Isolates Obtained in Tel Aviv, Israel

Schlesinger

Navon-Venezia

Chmelnitsky

et al. 2005

Antimicrob Agents Chemother

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“…Many clinical microbiology laboratories make no effort to detect ESBL production by gram negative bacilli and have a problem in detecting ESBL mediated resistance. A few point mutations at selected loci within the gene give rise to extended spectrum phenotype (Levison et al, 2002, Cagatay et al, 2003, Komatsu et al, 2003). These enzymes are not very closely related to TEM or SHV β lactamases and exhibit approximately 40% identity with these two commonly isolated β lactamases (Glupczynski et al, 2007, Kim et al, 2007, Muzaheed Doi et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Superintendence of antimicrobial resistance observed in bacterial flora isolated from human faecal carriage in Vellore, India

Priyadharshini

Ramalingam

Ramesh³

2017

Saudi Journal of Biological Sciences

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A frequent cross-sectional study was conducted to determine the patterns of antimicrobial resistance in 296 bacterial strains isolated from in-patient faecal samples of Government Vellore Medical College and Hospital, Vellore. Isolation and identification of bacterial strains were done using enrichment media, selective media, and biochemical tests. Antimicrobial susceptibility testing by the disc diffusion method and minimal inhibitory concentration method was conducted and the strains were subjected to extended spectrum beta-lactamases screening. Antibiotic sensitivity pattern of Staphylococcus spp. showed oxacillin resistance. Almost all the strains were sensitive to linezolid, vancomycin, gentamycin and chloramphenicol. In gram negative isolates ciprofloxacin and tobramycin showed better sensitivity and ceftazidime showed a higher percentage of resistance by MIC. Out of 250 isolates, Enterobacteriaceae showed positive for 86/250, 82/250 and 94/250 isolates and 3/10, 4/10 and 4/10 non-Enterobacteriaceae isolates were found to be positive for CTX-M gene, TEM gene and SHV gene, respectively. This study helps to assess/analyse the relation between the spectrum of microorganisms present in various grades of faecal carriage and their susceptibility pattern in this part of the Vellore town.

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“…are significant causes of nosocomial infections and are intrinsically resistant to aminopenicillins, cefazolin, and cefoxitin due to the production of constitutive chromosomal AmpC ␤-lactamases. Moreover, ESBL-producing Enterobacter spp., particularly E. cloacae, have been identified in the United States (13) and Europe (27), and carbapenems are considered the drug of choice in these cases. To our knowledge, this is the first study that compares the epidemiology and outcomes of VIM-1-positive and VIM-1-negative Enterobacter nosocomial infections.…”

Section: Discussionmentioning

confidence: 99%

Infections with VIM-1 Metallo-β-Lactamase-Producing Enterobacter cloacae and Their Correlation with Clinical Outcome

et al. 2009

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The aim of this study was to ascertain the incidence and clinical significance of metallo-␤-lactamases among Enterobacter strains isolated from patients with nosocomial infections. We prospectively collected data on patients with Enterobacter infection during a 13-month period. All of the strains were investigated for antibiotic susceptibility, the presence and expression of metallo-␤-lactamases, and clonality. Of 29 infections (11 involving the urinary tract, 7 pneumonias, 3 skin/soft tissue infections, 3 intra-abdominal infections, 3 bacteremias, and 2 other infections), 7 (24%) were caused by Enterobacter cloacae strains harboring a bla VIM-1 gene associated or not with a bla SHV12 gene. Infections caused by VIM-1-producing strains were more frequently associated with a recent prior hospitalization (P ‫؍‬ 0.006), cirrhosis (P ‫؍‬ 0.03), relapse of infection (P < 0.001), and more prolonged duration of antibiotic therapy (P ‫؍‬ 0.01) than were other infections. All of the isolates were susceptible to imipenem and meropenem and had bla VIM-1 preceded by a weak P1 promoter and inactivated P2 promoters. Most VIM-1-producing Enterobacter isolates belonged to a main clone, but four different clones were found. Multiclonal VIM-1-producing E. cloacae infections are difficult to diagnose due to an apparent susceptibility to various beta-lactams, including carbapenems, and are associated with a high relapse rate and a more prolonged duration of antibiotic therapy.

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Regional Occurrence of Plasmid‐Mediated SHV‐7, an Extended‐Spectrum β‐Lactamase, inEnterobacter cloacaein Philadelphia Teaching Hospitals

Cited by 26 publications

References 17 publications

Extended-Spectrum Beta-Lactamases among Enterobacter Isolates Obtained in Tel Aviv, Israel

Extended-Spectrum Beta-Lactamases among Enterobacter Isolates Obtained in Tel Aviv, Israel

Superintendence of antimicrobial resistance observed in bacterial flora isolated from human faecal carriage in Vellore, India

Infections with VIM-1 Metallo-β-Lactamase-Producing Enterobacter cloacae and Their Correlation with Clinical Outcome

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