SHV-Type Extended-Spectrum Beta-Lactamase Production Is Associated with Reduced Cefepime Susceptibility in
            <i>Enterobacter cloacae</i>

Szabó, Dóra; Bonomo, Robert A.; Silveira, Fernanda P.; Pasculle, A. William; Baxter, Carla M; Linden, Peter K.; Hujer, Andrea M.; Hujer, Kristine M.; Deeley, Kathleen; Paterson, David L.

doi:10.1128/jcm.43.10.5058-5064.2005

Cited by 57 publications

(33 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…was 12.73% which was different from the other results in Pakistan (50%, 14.93%) (21,22), Nigeria (37.5%) (10) and Pennsylvania, the USA (33.33%) (9).…”

Section: Discussioncontrasting

confidence: 54%

“…To date, more than 60 types CTX-M ESBLs belonging to five evolutionary groups are described. In most clinical isolates CTX-M-15 is the most frequent CTX-M type, and is reported in Enterobacteriaceae isolates from many regions of the world (7)(8)(9). It is necessary to know the frequency of ESBL positive strains in hospitals to formulate a policy of empirical therapy in high risk units where infections due to resistant organisms are much higher (8-10).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Emergence of blaCTX-M-15 Gene and Its Transferability in Enterobacter spp. Isolated From the Hospitals of Tehran, Iran

Rizi¹,

Peerayeh²,

Bakhshi³

et al. 2015

Avicenna J Clin Microbiol Infect

View full text Add to dashboard Cite

Background: Enterobacter spp. is increasingly recognized as an important nosocomial pathogen and implicated in many episodes of hospital acquired infections. Objectives: The current study aimed to describe distribution and transferability of bla CTX-M-15 gene, and the antibiotic susceptibility pattern in the clinical isolates of Enterobacter spp. Materials and Methods: A total of 110 Enterobacter isolates were collected from five hospitals in Tehran, Iran from May 2012 to April 2013. Enterobacter species were identified by API 20E system. Antibacterial susceptibility was determined by disk diffusion method, and extended spectrum beta lactamase (ESBL) production was confirmed by combined disk method. The bla CTX-M-15 gene was identified by PCR with specific primers. The transferability of the bla CTX-M-15 was tested by conjugation with broth matting method. Results: The prevalence of Enterobacter species was E. cloacae (78.2 %), E. aerogenes (6.13 %) and E. sakazakii (8.2%). They were from different clinical sources. Maximal resistance in Enterobacter isolates was noticed against Augmentin®, trimethoprim -sulfamethoxazole and cefoxitin 75.5%, 64.5%, and 59.1%, respectively. Fourteen isolates, showed ESBL phenotype. The bla CTX-M-15 gene frequency in Enterobacter isolates was 11.8%. Three conjugative plasmids containing bla CTX-M-15 were found in one Enterobacter isolate.

show abstract

“…was 12.73% which was different from the other results in Pakistan (50%, 14.93%) (21,22), Nigeria (37.5%) (10) and Pennsylvania, the USA (33.33%) (9).…”

Section: Discussioncontrasting

confidence: 54%

Section: Introductionmentioning

confidence: 99%

Emergence of blaCTX-M-15 Gene and Its Transferability in Enterobacter spp. Isolated From the Hospitals of Tehran, Iran

Rizi¹,

Peerayeh²,

Bakhshi³

et al. 2015

Avicenna J Clin Microbiol Infect

View full text Add to dashboard Cite

show abstract

“…No guidelines have been issued for extended-spectrum betalactamase (ESBL) detection in members of the Enterobacteriaceae with inducible chromosomal AmpC beta-lactamases, such as Enterobacter spp., although these species may cause hospital outbreaks (7,9,10), are frequently multidrug resistant (MDR) (9,10), and may constitute a reservoir for plasmidmediated ESBLs (3,12,13) for other Enterobacteriaceae species. The absence of such recommendations likely has two reasons.…”

mentioning

confidence: 99%

Method for Phenotypic Detection of Extended-Spectrum Beta-Lactamases in Enterobacter Species in the Routine Clinical Setting

et al. 2011

View full text Add to dashboard Cite

In 271 Enterobacter blood culture isolates from 12 hospitals, extended-spectrum beta-lactamase (ESBL) prevalence varied between 0% and 30% per hospital. High prevalence was associated with dissemination, indicating the potential relevance of infection control measures. Screening with cefepime or Vitek 2, followed by a cefepime/cefepime-clavulanate Etest, was an accurate strategy for ESBL detection in Enterobacter isolates (positive predictive value, 100%; negative predictive value, 99%).No guidelines have been issued for extended-spectrum betalactamase (ESBL) detection in members of the Enterobacteriaceae with inducible chromosomal AmpC beta-lactamases, such as Enterobacter spp., although these species may cause hospital outbreaks (7, 9, 10), are frequently multidrug resistant (MDR) (9, 10), and may constitute a reservoir for plasmidmediated ESBLs (3, 12, 13) for other Enterobacteriaceae species. The absence of such recommendations likely has two reasons. First, phenotypic detection of ESBLs in members of the Enterobacteriaceae coexpressing an AmpC beta-lactamase is complex, because AmpC expression may mask the synergy required for ESBL detection between third-generation cephalosporins and clavulanic acid. This problem may be circumvented by demonstrating synergy between clavulanic acid and cefepime, a fourth-generation cephalosporin hydrolyzed by ESBLs but generally not by AmpC beta-lactamases (11, 13). Second, the outcome of an ESBL detection test in Enterobacteriaceae spp. with inducible AmpC is considered of limited therapeutic consequence, since most clinicians consider cephalosporins, including cefepime, inappropriate for treatment of infections caused by these species (6, 8). As a result, data are sparse on ESBL prevalence in Enterobacteriaceae spp. with inducible chromosomal AmpC beta-lactamases.The aims of this study were (i) to develop a phenotypic ESBL detection strategy in Enterobacter species for the routine clinical laboratory and (ii) to determine whether infection control measures could potentially reduce the ESBL prevalence in Enterobacter species by assessing the association between prevalence and clonal relatedness of ESBL-positive isolates per hospital.For this study, all Enterobacter blood culture isolates (one per patient) obtained in 2006 and 2007 from 12 Dutch laboratories were included. Identification was performed by the participating laboratories using either Vitek 2 (bioMérieux, France) or Phoenix (Becton Dickinson). A total of 271 blood culture isolates were included; 227 (84%) were Enterobacter cloacae and 44 (16%) were Enterobacter aerogenes. Based on detection of TEM, SHV, and CTX-M ESBL genes by sequencing, 37 (14%) were ESBL producers (36 E. cloacae isolates and 1 E. aerogenes isolate). The most prevalent ESBL genes were CTX-M-9 (54%) and SHV-12 (38%), in accordance with results from previous studies (1, 7, 9, 13). CTX-M-15, CTX-M-3, and CTX-M-39 were each detected once.To develop a phenotypic ESBL detection strategy, the Vitek 2 advanced expert system (AES) (version 5.01; AST N...

show abstract

“…Accordingly, the increasing prevalence of MDR GNB in our ICU was disturbing. This trend towards increasing rates of MDR GNB has also been observed in several other studies of more limited scope than ours [26,30,35]. The reason that MDR and ESBLproduction rates are higher in our ICU is not exactly clear.…”

Section: Discussionmentioning

confidence: 44%

“…These observations are consistent with the results of other surveillance studies from Turkey [15,24], and suggest that carbapenems are still effective against Enterobacteriaceae; nevertheless, consideration should be given to carbapenamase-producing isolates, owing to their emergence and dissemination potential. In fact, the increased use of carbapenems to combat the growing prevalence of multidrug resistance, particularly ESBL-producing strains, shows early signs of eroding carbapenem effectiveness [30,31].…”

Section: Discussionmentioning

confidence: 99%

Gram-negative bacilli causing infections in an intensive care unit of a tertiary care hospital in Istanbul, Turkey

Şenbayrak

İnan

Cevan

et al. 2014

J Infect Dev Ctries

View full text Add to dashboard Cite

Introduction: This study aimed to demonstrate the changing epidemiology of infecting microorganisms and their long-term resistance profiles and to describe the microbiological point of view in anti-infective management of intensive care unit (ICU) patients. Methodology: A total of 5,690 isolates of Gram-negative bacilli were included in this study. Antibiotic susceptibility was tested using the disk diffusion method and Vitek 2 system. Chi-square tests were used for hypothesis testing. Results: The most frequently isolated organisms were A. baumannii (37.3%), P. aeruginosa (30.3%), Enterobacter spp. (10.4%), E. coli (10.4%), and Klebsiella spp. (8.9%). A. baumannii was the most frequently isolated organism from the respiratory tract (43.4%); the susceptibility rates for imipenem and meropenem decreased to 7% and 6% (p < 0.0001), respectively. The percentage of multidrug-resistant (MDR) A. baumannii isolates continuously increased from 18.7% in 2004 to 69% in 2011 (p < 0.0001), whereas MDR P. aeruginosa isolates increased from 1.5% to 22% (p < 0.0001). Carbapenem-resistant Klebsiella isolates emerged in 2010 and increased to 20% in the next year. The rates of ESBL-producing Enterobacteriaceae in the ICU was very high in 2011 -50% for E. coli and 80% for Klebsiella strains. Conclusion: The most common isolated Gram-negative bacillus in our study was A. baumannii and that the prevalence of MDR isolates has increased markedly over. Accordingly, the comparison of antibiotic resistance of other pathogens in 2004 and 2011 displayed an increasing trend. These data imply the urgent need for new and effective strategies in our hospital and in the region.

show abstract

SHV-Type Extended-Spectrum Beta-Lactamase Production Is Associated with Reduced Cefepime Susceptibility in Enterobacter cloacae

Cited by 57 publications

References 27 publications

Emergence of blaCTX-M-15 Gene and Its Transferability in Enterobacter spp. Isolated From the Hospitals of Tehran, Iran

Emergence of blaCTX-M-15 Gene and Its Transferability in Enterobacter spp. Isolated From the Hospitals of Tehran, Iran

Method for Phenotypic Detection of Extended-Spectrum Beta-Lactamases in Enterobacter Species in the Routine Clinical Setting

Gram-negative bacilli causing infections in an intensive care unit of a tertiary care hospital in Istanbul, Turkey

Contact Info

Product

Resources

About