SHV-5 extended-spectrum beta-lactamase from Klebsiella pneumoniae associated with a nosocomial outbreak in a paediatric oncology unit in Malaysia

Palasubramaniam, Selvi; Subramaniam, G.; Muniandy, Sekaran; Parasakthi, N

doi:10.1016/j.ijid.2004.07.005

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…In this study, we found that gram negatives were most prevalent, of which the most common were E. coli , K. pneumonia and H. influenzae , while in blood cultures, the most common pathogen was K. pneumoniae . These findings are similar to data in Malaysia showing that E. coli and K. pneumoniae are also common causes of CAP but different from the findings in the United States 14,15 . These different findings may be due to the differences in geographical exposure and prevalence of bacteria.…”

Section: Discussionsupporting

confidence: 75%

See 1 more Smart Citation

Neonatal community‐acquired pneumonia: Pathogens and treatment

Wang

Tang

Xiong

et al. 2010

J Paediatrics Child Health

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Section: Discussionsupporting

confidence: 75%

“…These findings are similar to data in Malaysia showing that E. coli and K. pneumoniae are also common causes of CAP but different from the findings in the United States. 14,15 These different findings may be due to the differences in geographical exposure and prevalence of bacteria.…”

Section: Discussionmentioning

confidence: 99%

Neonatal community‐acquired pneumonia: Pathogens and treatment

Wang

Tang

Xiong

et al. 2010

J Paediatrics Child Health

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“…SHV-5 has been previously identified as the most common ESBL gene in Malaysian K . pneumoniae isolated during a nosocomial outbreak in the pediatric oncology unit of University of Malaya Medical Center, Kuala Lumpur [ 27 ]. A subsequent study in this setting reported the emergence of SHV-12, a derivative from SHV-5 by acquisition of a single mutation (Leu35Gln) [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Molecular Analysis of Antibiotic Resistance Determinants and Plasmids in Malaysian Isolates of Multidrug Resistant Klebsiella pneumoniae

2015

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Infections caused by multidrug resistant Klebsiella pneumoniae have been increasingly reported in many parts of the world. A total of 93 Malaysian multidrug resistant K. pneumoniae isolated from patients attending to University of Malaya Medical Center, Kuala Lumpur, Malaysia from 2010-2012 were investigated for antibiotic resistance determinants including extended-spectrum beta-lactamases (ESBLs), aminoglycoside and trimethoprim/sulfamethoxazole resistance genes and plasmid replicons. CTX-M-15 (91.3%) was the predominant ESBL gene detected in this study. aacC2 gene (67.7%) was the most common gene detected in aminoglycoside-resistant isolates. Trimethoprim/sulfamethoxazole resistance (90.3%) was attributed to the presence of sul1 (53.8%) and dfrA (59.1%) genes in the isolates. Multiple plasmid replicons (1-4) were detected in 95.7% of the isolates. FIIK was the dominant replicon detected together with 13 other types of plasmid replicons. Conjugative plasmids (1-3 plasmids of ~3-100 kb) were obtained from 27 of 43 K. pneumoniae isolates. An ESBL gene (either CTX-M-15, CTX-M-3 or SHV-12) was detected from each transconjugant. Co-detection with at least one of other antibiotic resistance determinants [sul1, dfrA, aacC2, aac(6ˊ)-Ib, aac(6ˊ)-Ib-cr and qnrB] was noted in most conjugative plasmids. The transconjugants were resistant to multiple antibiotics including β-lactams, gentamicin and cotrimoxazole, but not ciprofloxacin. This is the first study describing the characterization of plasmids circulating in Malaysian multidrug resistant K. pneumoniae isolates. The results of this study suggest the diffusion of highly diverse plasmids with multiple antibiotic resistance determinants among the Malaysian isolates. Effective infection control measures and antibiotic stewardship programs should be adopted to limit the spread of the multidrug resistant bacteria in healthcare settings.

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“…Among the ESBL enzymes, CTX-M type has been increasingly reported [1,3]. In Malaysia, Palasubramaniam et al (2005) reported an association of bla SHV-5 ESBL gene in K. pneumoniae with a nosocomial outbreak, followed by several other reports [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Molecular characterization of extended-spectrum β-lactamase-producing Klebsiella pneumoniae from a Malaysian hospital

et al. 2019

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Multidrug-resistant (MDR) and extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae associated with nosocomial infections have caused serious problems in antibiotic management with limited therapeutic choices. This study aimed to determine the genotypic and phenotypic characteristics of K. pneumoniae strains isolated from a tertiary hospital in Malaysia. Ninety-seven clinical K. pneumoniae strains were analyzed for antimicrobial susceptibility, all of which were sensitive to amikacin and colistin (except one strain), while 31.9 % and 27.8 % were MDR and ESBL producers, respectively. PCR and DNA sequencing of the amplicons indicated that the majority of MDR strains (26/27) were positive for bla TEM, followed by bla SHV (24/27), bla CTX-M-1 group (23/27), bla CTX-M-9 group (2/27), and mcr-1 (1/27). Thirty-seven strains were hypervirulent and PCR detection of virulence genes showed 38.1 %, 22.7 %, and 16.5 % of the strains were positive for K1, wabG, and uge genes, respectively. Genotyping by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) showed that these strains were genetically diverse and heterogeneous. Sequence types, ST23, ST22, and ST412 were the predominant genotypes. This is the first report of colistin-resistant K. pneumoniae among clinical strains associated with mcr-1 plasmid in Malaysia. The findings in this study have contributed to the effort in combating the increase in antimicrobial resistance by providing better understanding of genotypic characteristics and resistance mechanisms of the organisms.

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SHV-5 extended-spectrum beta-lactamase from Klebsiella pneumoniae associated with a nosocomial outbreak in a paediatric oncology unit in Malaysia

Cited by 6 publications

References 8 publications

Neonatal community‐acquired pneumonia: Pathogens and treatment

Neonatal community‐acquired pneumonia: Pathogens and treatment

Molecular Analysis of Antibiotic Resistance Determinants and Plasmids in Malaysian Isolates of Multidrug Resistant Klebsiella pneumoniae

Molecular characterization of extended-spectrum β-lactamase-producing Klebsiella pneumoniae from a Malaysian hospital

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