Ann Lab Med.  2013 Mar;33(2):141-144. 10.3343/alm.2013.33.2.141.

CTX-M-55-Type Extended-Spectrum beta-lactamase-Producing Shigella sonnei Isolated from a Korean Patient Who Had Travelled to China

• Lee W
• Chung HS
• Lee H
• Yum JH
• Yong D
• Jeong SH
• Lee K
• Chong Y

• KMID: 1781315
• DOI: http://doi.org/10.3343/alm.2013.33.2.141

Abstract

We report a case of CTX-M-55-type extended-spectrum beta-lactamase (ESBL)-producing Shigella sonnei infection in a 27-year-old Korean woman who had traveled to China. The patient was admitted to the hospital due to abdominal pain, watery diarrhea, and fever (39.3degrees C). S. sonnei was isolated from her stool specimens, and the pathogen was found to be resistant to cefotaxime due to CTX-M-55-type ESBL. Insertion sequence (IS)Ecp1 was found upstream of the blaCTX-M-55 gene. The blaCTX-M-55 gene was transferred from the S. sonnei isolate to an Escherichia coli J53 recipient by conjugation. Pulsed-field gel electrophoresis and Southern blotting revealed that the blaCTX-M-55 gene was located on a plasmid of approximately 130 kb.

Keyword

CTX-M-55; Shigella sonnei; ESBL

MeSH Terms

Adult
Anti-Bacterial Agents/pharmacology
Asian Continental Ancestry Group
Cefotaxime/pharmacology
China
Drug Resistance, Bacterial/drug effects
Dysentery, Bacillary/diagnosis/*microbiology
Electrophoresis, Gel, Pulsed-Field
Escherichia coli/metabolism
Feces/microbiology
Female
Humans
Plasmids/chemistry/genetics
Republic of Korea
Shigella sonnei/enzymology/*isolation & purification
Travel
beta-Lactamases/genetics/*metabolism
Anti-Bacterial Agents
Cefotaxime
beta-Lactamases

Figure

• 

  Fig. 1 Pulsed-field gel electrophoresis of the S1 nuclease-digested genomic DNA (A) and Southern blot hybridization with the blaCTX-M-55 probe (B). The arrow indicates plasmids in the Shigella sonnei isolate (lane 1) and the transconjugant (lane 2).

Reference

1. Zhang W, Luo Y, Li J, Lin L, Ma Y, Hu C, et al. Wide dissemination of multidrug-resistant Shigella isolates in China. J Antimicrob Chemother. 2011; 66:2527–2535. PMID: 21859815.

2. Christopher PR, David KV, John SM, Sankarapandian V. Antibiotic therapy for Shigella dysentery. Cochrane Database Syst Rev. 2010; CD006784. PMID: 20687081.

3. Livermore DM, Mushtaq S, Nguyen T, Warner M. Strategies to overcome extended-spectrum β-lactamases (ESBLs) and AmpC β-lactamases in shigellae. Int J Antimicrob Agents. 2011; 37:405–409. PMID: 21276715.

4. Bhattacharya D, Purushottaman SA, Bhattacharjee H, Thamizhmani R, Sudharama SD, Manimunda SP, et al. Rapid emergence of third-generation cephalosporin resistance in Shigella sp. isolated in Andaman and Nicobar Islands, India. Microb Drug Resist. 2011; 17:329–332. PMID: 21352076.

5. Nguyen NT, Ha V, Tran NV, Stabler R, Pham DT, Le TM, et al. The sudden dominance of bla_CTX-M harbouring plasmids in Shigella spp. Circulating in Southern Vietnam. PLoS Negl Trop Dis. 2010; 4:e702. PMID: 20544028.

6. Cheung TK, Chu YW, Tsang GK, Ngan JY, Hui IS, Kam KM. Emergence of CTX-M-type β-lactam resistance in Shigella spp. in Hong Kong. Int J Antimicrob Agents. 2005; 25:350–352. PMID: 15784319.

7. Andres P, Petroni A, Faccone D, Pasterán F, Melano R, Rapoport M, et al. Extended-spectrum β-lactamases in Shigella flexneri from Argentina: first report of TOHO-1 outside Japan. Int J Antimicrob Agents. 2005; 25:501–507. PMID: 15878653.

8. Rossolini GM, D'Andrea MM, Mugnaioli C. The spread of CTX-M-type extended-spectrum β-lactamases. Clin Microbiol Infect. 2008; 14:33–41. PMID: 18154526.

9. Hong SJ, Lee CH, Wang JH, Song W, Jung SH. Clinical characteristics of extended-spectrum β-lactamase producing Shigella sonnei infection outbreaked in Chungju Area. Korean J Lab Med. 2006; 26:168–173. PMID: 18156720.

10. Kim S, Kim J, Kang Y, Park Y, Lee B. Occurrence of extended-spectrum β-lactamases in members of the genus Shigella in the Republic of Korea. J Clin Microbiol. 2004; 42:5264–5269. PMID: 15528724.

11. Pai H, Choi EH, Lee HJ, Hong JY, Jacoby GA. Identification of CTX-M-14 extended-spectrum β-lactamase in clinical isolates of Shigella sonnei, Escherichia coli, and Klebsiella pneumoniae in Korea. J Clin Microbiol. 2001; 39:3747–3749. PMID: 11574608.

12. Lee SG, Jeong SH, Lee H, Kim CK, Lee Y, Koh E, et al. Spread of CTX-M-type extended-spectrum β-lactamases among bloodstream isolates of Escherichia coli and Klebsiella pneumoniae from a Korean hospital. Diagn Microbiol Infect Dis. 2009; 63:76–80. PMID: 19073302.

13. Park Y, Kang HK, Bae IK, Kim J, Kim JS, Uh Y, et al. Prevalence of the extended-spectrum β-lactamase and qnr genes in clinical isolates of Escherichia coli. Korean J Lab Med. 2009; 29:218–223. PMID: 19571619.

14. Jacoby G, Bush K. β-lactamase classification and amino acid sequences for TEM, SHV and OXA extended-spectrum and inhibitor resistant enzymes. Updated on Aug 2012. http://www.lahey.org/Studies/other.asp#table1.

15. Yong D, Toleman MA, Giske CG, Cho HS, Sundman K, Lee K, et al. Characterization of a new metallo-β-lactamase gene, bla_NDM-1, and a novel erythromycin esterase gene carried on a unique genetic structure in Klebsiella pneumoniae sequence type 14 from India. Antimicrob Agents Chemother. 2009; 53:5046–5054. PMID: 19770275.

16. Carattoli A, Bertini A, Villa L, Falbo V, Hopkins KL, Threlfall EJ. Identification of plasmids by PCR-based replicon typing. J Microbiol Methods. 2005; 63:219–228. PMID: 15935499.

17. Bush K, Jacoby GA. Updated functional classification of β-lactamases. Antimicrob Agents Chemother. 2010; 54:969–976. PMID: 19995920.

18. Kiratisin P, Apisarnthanarak A, Saifon P, Laesripa C, Kitphati R, Mundy LM. The emergence of a novel ceftazidime-resistant CTX-M extended-spectrum β-lactamase, CTX-M-55, in both community-onset and hospital-acquired infections in Thailand. Diagn Microbiol Infect Dis. 2007; 58:349–355. PMID: 17449211.

19. Li J, Ma Y, Hu C, Jin S, Zhang Q, Ding H, et al. Dissemination of cefotaxime-M-producing Escherichia coli isolates in poultry farms, but not swine farms, in China. Foodborne Pathog Dis. 2010; 7:1387–1392. PMID: 20583961.

20. Sun Y, Zeng Z, Chen S, Ma J, He L, Liu Y, et al. High prevalence of bla_CTX-M extended-spectrum β-lactamase genes in Escherichia coli isolates from pets and emergence of CTX-M-64 in China. Clin Microbiol Infect. 2010; 16:1475–1481. PMID: 21681998.

21. Zheng H, Zeng Z, Chen S, Liu Y, Yao Q, Deng Y, et al. Prevalence and characterisation of CTX-M β-lactamases amongst Escherichia coli isolates from healthy food animals in China. Int J Antimicrob Agents. 2012; 39:305–310. PMID: 22325120.

22. Sjölund-Karlsson M, Howie R, Krueger A, Rickert R, Pecic G, Lupoli K, et al. CTX-M-producing non-Typhi Salmonella spp. isolated from humans, United States. Emerg Infect Dis. 2011; 17:97–99. PMID: 21192864.

23. Tamang MD, Nam HM, Jang GC, Kim SR, Chae MH, Jung SC, et al. Molecular characterization of extended-spectrum β-lactamase and plasmid mediated AmpC β-lactamase-producing Escherichia coli isolated from stray dogs from Korea. Antimicrob Agents Chemother. 2012; 56:2705–2712. PMID: 22354297.

24. Poirel L, Gniadkowski M, Nordmann P. Biochemical analysis of the ceftazidime-hydrolysing extended-spectrum β-lactamase CTX-M-15 and of its structurally related β-lactamase CTX-M-3. J Antimicrob Chemother. 2002; 50:1031–1034. PMID: 12461028.

25. Yu F, Chen Q, Yu X, Li Q, Ding B, Yang L, et al. High prevalence of extended-spectrum β-lactamases among Salmonella enterica Typhimurium isolates from pediatric patients with diarrhea in China. PLoS One. 2011; 6:e16801. PMID: 21390297.

26. Song W, Lee H, Lee K, Jeong SH, Bae IK, Kim JS, et al. CTX-M-14 and CTX-M-15 enzymes are the dominant type of extended-spectrum β-lactamase in clinical isolates of Escherichia coli from Korea. J Med Microbiol. 2009; 58:261–266. PMID: 19141747.

27. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-second Informational supplement, M100-S22. 2012. Wayne, PA: Clinical and Laboratory Standards Institute.

28. Eckert C, Gautier V, Arlet G. DNA sequence analysis of the genetic environment of various bla_CTX-M genes. J Antimicrob Chemother. 2006; 57:14–23. PMID: 16291869.

29. Tängdén T, Cars O, Melhus A, Löwdin E. Foreign travel is a major risk factor for colonization with Escherichia coli producing CTX-M-type extended-spectrum β-lactamases: a prospective study with Swedish volunteers. Antimicrob Agents Chemother. 2010; 54:3564–3568. PMID: 20547788.

30. Tham J, Walder M, Melander E, Odenholt I. Duration of colonization with extended-spectrum β-lactamase-producing Escherichia coli in patients with travellers' diarrhoea. Scand J Infect Dis. 2012; 44:573–577. PMID: 22292796.