Korean J Clin Microbiol.
2002 Mar;5(1):6-14.
Prevalence and Mechanism of Third-Generation Cephalosporins-Resistant Escherichia coli and Klebsiella pneumoniae Strains Isolated from Clinical Specimen
- Affiliations
-
- 1Department of Clinical Pathology, Dong-A University College of Medicine, Korea.
- 2Department of Clinical Pathology, Kosin University College of Medicine, Busan, Korea.
- 3Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
- 4Department of Urology, Kosin University College of Medicine, Busan, Korea.
- 5Department of Genetic Engineering, Youngdong University, Chungbuk, Korea.
- 6Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea. kscpjsh@ns.kosinmed.or.kr
Abstract
-
BACKGROUND: Among Gram-negative pathogens in Korea, the incidence of resistance to thirdgeneration cephalosporins is becoming an ever-increasing problem. This study was designed to determine the prevalence of third-generation cephalosporins-resistant Escherichia coli and Klebsiella pneumoniae isolates from patients in a tertiary care hospital in Busan, Korea, and to characterize the mechanism of resistance.
METHODS
A total of 710 E. coli and 237 K. pneumoniae non-duplicate isolates were collected from patients in Kosin Medical Center in 1999. Antimicrobial susceptibilities were tested by the disk diffusion method. Extended-spectrum beta-lactamase (ESBL) production was determined by the double disk synergy test. MICs were determined by the agar dilution method. Searches for blaTEM, blaSHV, and blaCMY genes in cefotaxime-resistant or intermediate isolates were performed by PCR amplification. PCR products were used to determine the sequence of resistance genes by the dideoxy-chain termination method.
RESULTS
Seven percent of E. coli and 25% of K. pneumoniae isolates were resistant to cefotaxime. Among the isolates with decreased susceptibility to cefotaxime, 69% (18/26) of E. coli and 80% (20/25) of K. pneumoniae isolates showed positive results in double disk synergy test. Banding patterns of PCR amplification showed that the blaTEM, blaSHV, and blaCMY genes were harboured by 71% (20/28), 86% (24/28) and 14% (4/28) of isolates with decreased susceptibility to cefotaxime,respectively. Seventy-one percent (20/28) of the isolates contained more than two types of beta- lactamase genes. Nucleotide sequence analysis of PCR products revealed that blaSHV-12 and blaTEM-1b were the dominant types of beta-lactamase gene. In addition, we also identified blaTEM-52, blaSHV-5, and a new ESBL gene named blaTEM-17b.
CONCLUSIONS
Third-generation cephalosporins-resistant E. coli and K. pneumoniae are wide spread in Kosin Medical Center, Busan, Korea. Most of the isolates with decreased susceptibility to cefotaxime had blaTEM and/or blaSHV, and some isolates harboured blaCMY genes that may confer resistance against cephamycins. The spread of these beta-lactamase genes could compromise the future usefulness of third-generation cephalosporins for the treatment of infections caused by E. coli and K. pneumoniae.
Keyword
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- Detection Rate of Extended-Spectrum beta-Lactamase Producers in Klebsiella pneumoniae and Escherichia coli Isolated at Yeungnam University Medical Center
- Prevalence of Extended-spectrum beta-lactamase-producing Enterobacteriaceae and Evaluation of Methods for Detection
- Evaluation of the Method to Screen Isolates of Extended-Spectrum -Lactamase-Producing Klebsiella pneumoniae and Escherichia coli Using Cefpodoxime Disk
- Evaluation of MicroScan Neg Combo Panel type 21 to Detect ESBL
- Antimicrobial Susceptibility of Escherichia coli and Klebsiella pneumoniae Blood Isolates over 5 years:Influence of Extended-Spectrum Beta-Lactamase-Producing Organisms
