1887

Abstract

The emergence of multidrug-resistant (MDR) and extended-spectrum -lactamase (ESBL)-producing poses a serious antibiotic management problem as resistance genes are easily transferred from one organism to another. Fifty-one strains of isolated from sporadic cases in various hospitals throughout Malaysia were analysed by antimicrobial susceptibility testing, PCR detection of ESBL-encoding genes and DNA fingerprinting. Although 27 of the 51 strains were MDR (i.e. resistant to three or more classes of antibiotics), the majority of the strains (98 %) were sensitive to imipenem. PCR detection using ESBL gene-specific primers showed that 46 of the strains harboured , 19 harboured , 5 harboured and 4 harboured . Class 1 integron-encoded integrase was detected in 21 of the 51 strains and amplification of the integron 5′CS region showed the presence of several known antibiotic resistance gene cassettes of various sizes. Results of conjugation and transformation experiments indicated that some of the ESBL-encoding genes (i.e. , and ) were transmissible and were likely plasmid-encoded. DNA fingerprinting using PFGE and PCR-based methods indicated that the 51 strains were genetically diverse and heterogeneous.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.011114-0
2009-11-01
2019-10-18
Loading full text...

Full text loading...

/deliver/fulltext/jmm/58/11/1463.html?itemId=/content/journal/jmm/10.1099/jmm.0.011114-0&mimeType=html&fmt=ahah

References

  1. Ben-Hamouda, T., Foulan, T., Ben-Cheikh-Masmoudi, A., Fendri, C., Belhadj, O. & Ben-Mahrez, K. ( 2003; ). Molecular epidemiology of an outbreak of multiresistant Klebsiella pneumoniae in a Tunisan neonatal ward. J Med Microbiol 52, 427–433.[CrossRef]
    [Google Scholar]
  2. Bradford, P. A. ( 2001; ). Extended-spectrum β-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 14, 933–951.[CrossRef]
    [Google Scholar]
  3. Cartelle, M., Tomas, M. D. M., Pertega, S., Beceiro, A., Dominguez, M. A., Velasco, D., Molina, F., Villanueva, R. & Bou, G. ( 2004; ). Risk factors for colonization and infection in a hospital outbreak caused by a strain of Klebsiella pneumoniae with reduced susceptibility to extended-spectrum cephalosporins. J Clin Microbiol 42, 4242–4249.[CrossRef]
    [Google Scholar]
  4. Chaikittisuk, N. & Munsrichoom, A. ( 2007; ). Extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae in children at Queen Sirikit National Institute of Child Health. J Infect Dis Antimicrob Agents 24, 107–115.
    [Google Scholar]
  5. Chanawong, A., M'Zali, F. H., Heritage, J., Xiong, J. H. & Hawkey, P. M. ( 2002; ). Three cefotaximes, CTX-M-9, CTX-M-13, and CTX-M-14, among Enterobacteriaceae in the People's Republic of China. Antimicrob Agents Chemother 46, 630–637.[CrossRef]
    [Google Scholar]
  6. CLSI ( 2006; ). Performance Standards for Antimicrobial Susceptibility Testing; 16th Informational Supplement. Wayne, PA: Clinical and Laboratory Standards Institute.
  7. Conceição, T., Brízio, A., Duarte, A., Lito, L. M., Melo Cristino, J. & Salgado, M. J. ( 2005; ). First description of CTX-M-15-producing Klebsiella pneumoniae in Portugal. Antimicrob Agents Chemother 49, 477–478.[CrossRef]
    [Google Scholar]
  8. Daikos, G. L., Kosmidis, C., Tassios, P. T., Petrikkos, G., Vasilakopoulou, A., Psychogiou, M., Stefanou, I., Avlami, A. & Katsilambros, N. ( 2007; ). Enterobacteriaceae bloodstream infections: presence of integrons, risk factors and outcome. Antimicrob Agents Chemother 51, 2366–2372.[CrossRef]
    [Google Scholar]
  9. de Bruijn, F. J. ( 1992; ). Use of repetitive (repetitive extragenic palindromic and enterobacterial repetitive intergeneric consensus) sequences and the polymerase chain reaction to fingerprint the genomes of Rhizobium meliloti isolates and other soil bacteria. Appl Environ Microbiol 58, 2180–2187.
    [Google Scholar]
  10. Ensor, V. M., Livermore, D. M. & Hawkey, P. M. ( 2007; ). A novel reverse-line hybridization assay for identifying genotypes of CTX-M-type extended-spectrum β-lactamases. J Antimicrob Chemother 59, 387–395.[CrossRef]
    [Google Scholar]
  11. Giakkoupi, P., Xanthaki, A., Kanelopoulou, M., Vlahaki, A., Mirigou, V., Kontou, S., Papafraggas, E., Malamou-Lada, H., Tzouvelekis, L. S. & other authors ( 2003; ). VIM-1 metallo-β-lactamase-producing Klebsiella pneumoniae in Greek hospitals. J Clin Microbiol 41, 3893–3896.[CrossRef]
    [Google Scholar]
  12. Jarlier, V., Nicolas-Chanoine, M. H., Fournier, G. & Philippon, A. ( 1988; ). Extended-broad spectrum β-lactamases conferring transferable resistance to newer β-lactam agents in Enterobacteriaceae: hospital prevalence and susceptibility patterns. Rev Infect Dis 10, 867–878.[CrossRef]
    [Google Scholar]
  13. Jiang, X., Zhang, Z., Li, M., Zhou, D., Ruan, F. & Lu, R. ( 2006; ). Detection of extended-spectrum β-lactamases in clinical strains of Pseudomonas aeruginosa. Antimicrob Agents Chemother 50, 2990–2995.[CrossRef]
    [Google Scholar]
  14. Kang, H. Y., Young, S. J., Jae, Y. O., Sung, H. T., Chui, H. C., Dong, C. M., Won, K. L., Yoo, C. L., Sung, Y. S. & other authors ( 2005; ). Characterization of antimicrobial resistance and class 1 integrons found in Escherichia coli strains from humans and animals in Korea. J Antimicrob Chemother 55, 639–644.[CrossRef]
    [Google Scholar]
  15. Latha, R., Suryanarayanan, T. S. & Swaminathan, M. S. ( 2004; ). Genetic diversity in Acremonium endophytes isolated from warm-season grasses as revealed by RAPD markers. J Plant Biochem Biotechnol 13, 39–42.[CrossRef]
    [Google Scholar]
  16. Livermore, D. M., Canton, R., Gniadkowski, M., Nordmann, P., Rossolini, G. M., Arlet, G., Ayala, J., Coque, T. M., Zdanowicz, I. K. & other authors ( 2007; ). CTX-M: changing the face of ESBLs in Europe. J Antimicrob Chemother 59, 165–174.
    [Google Scholar]
  17. Loh, L. C., Chin, H. K., Chong, Y. Y., Jeyaratnam, A., Raman, S., Vijayasingham, P., Thayaparan, T. & Kumar, S. ( 2007; ). Klebsiella pneumoniae respiratory strains from 2000 to 2004 in a Malaysia hospital: characteristics and relation to hospital antibiotics consumption. Singapore Med J 48, 813–818.
    [Google Scholar]
  18. Machado, E., Canton, R., Banquero, F., Galan, J. C., Rollan, A., Peixe, L. & Coque, T. M. ( 2005; ). Integron content of extended-spectrum β-lactamases producing Escherichia coli strains over 12 years in a single hospital in Madrid, Spain. Antimicrob Agents Chemother 49, 1823–1829.[CrossRef]
    [Google Scholar]
  19. Manchanda, V., Goyal, S. R., Kumar, A. & Thukral, S. S. ( 2005; ). Phenotypic characteristics of clinical strains of Klebsiella pneumoniae and evaluation of available phenotypic techniques for detection of extended spectrum beta-lactamases. Indian J Med Res 122, 330–337.
    [Google Scholar]
  20. Navia, M. M., Capitang, L., Ruiz, J., Vargas, M., Urassa, H., Schellemberh, D., Gascon, J. & Vila, J. ( 1999; ). Typing and characterization of mechanisms of resistance of Shigella spp. isolated from feces of children under 5 years of age from Ifakara, Tanzania. J Clin Microbiol 37, 3113–3117.
    [Google Scholar]
  21. Oliver, A., Weigel, L. M., Rasheed, J. K., McGowan, J. E., Jr, Raney, P. & Tenover, F. C. ( 2002; ). Mechanisms of decreased susceptibility of cefpodoxime in Escherichia coli. Antimicrob Agents Chemother 46, 3829–3836.[CrossRef]
    [Google Scholar]
  22. Pagani, L., Amico, E. D., Migliavacca, R., Andrea, M. M. D., Giacobone, E., Amicosante, G., Romero, E. & Rossolini, G. M. ( 2003; ). Multiple CTX-M extended-spectrum β-lactamases in nosocomial strains of Enterobacteriaceae from a hospital in Northern Italy. J Clin Microbiol 41, 4264–4269.[CrossRef]
    [Google Scholar]
  23. Pai, H., Kang, C. I., Byeon, J. H., Lee, K. D., Park, W. B., Kim, H. B., Kim, E. C., Oh, M. D. & Kang, W. C. ( 2004; ). Epidemiology and clinical features of bloodstream infections caused by AmpC-type β-lactamase-producing Klebsiella pneumoniae. Antimicrob Agents Chemother 48, 3720–3728.[CrossRef]
    [Google Scholar]
  24. Palasubramaniam, S., Subramaniam, G., Muniandy, S. & Parasakthi, N. ( 2005; ). SHV-5 extended-spectrum beta-lactamase from Klebsiella pneumoniae associated with a nosocomial outbreak in a paediatric oncology unit in Malaysia. Int J Infect Dis 9, 170–172.[CrossRef]
    [Google Scholar]
  25. Parasakthi, N., Vadivelu, J., Ariffin, H., Iyer, L., Palasubramaniam, S. & Arasu, A. ( 2000; ). Epidemiology and molecular characterization of nosocomially transmitted multidrug-resistant Klebsiella pneumoniae. Int J Infect Dis 4, 123–128.[CrossRef]
    [Google Scholar]
  26. Podschun, R. & Ullmann, U. ( 1998; ). Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 11, 589–603.
    [Google Scholar]
  27. Romero, E. D. V., Padila, T. P., Hernandez, A. H., Grande, R. P., Vazquez, M. F., Garcia, I. G., Rodrigurz, J. A. G. & Bellido, J. L. M. ( 2007; ). Prevalence of clinical strains of Escherichia coli and Klebsiella spp. producing multiple extended-spectrum β-lactamases. Diagn Microbiol Infect Dis 59, 433–437.[CrossRef]
    [Google Scholar]
  28. Senda, K., Arakawa, Y., Ichiyama, S., Nakashima, K., Ito, H., Ohsuka, S., Shimokata, K., Kato, N. & Ohta, M. ( 1996; ). PCR detection of metallo-β-lactamase gene (bla IMP) in Gram-negative rods resistant to broad-spectrum β-lactams. J Clin Microbiol 34, 2909–2913.
    [Google Scholar]
  29. Singh, A., Goering, R. V., Simjee, S., Foley, S. L. & Zervos, M. J. ( 2006; ). Application of molecular techniques to the study of hospital infection. Clin Microbiol Rev 19, 512–530.[CrossRef]
    [Google Scholar]
  30. Thong, K. L., Lai, K. S., Puthucheary, S. D., Koh, Y. T., Ahmad, N. & Yasin, R. M. ( 2007; ). Subtyping of Salmonella enterica serovar Muenchen by pulsed-field gel electrophoresis, plasmid profiling and antimicrobial susceptibility testing. Malay J Sci 26, 1–13.
    [Google Scholar]
  31. Tofteland, S., Haldorsen, B., Dahl, K. H., Simonsen, G. S., Steinbakk, M., Walsh, T. R., Sundsfjord, A. & ( 2007; ). Effects of phenotype and genotype on methods for detection of extended-spectrum-β-lactamase-producing clinical strains of Escherichia coli and Klebsiella pneumoniae in Norway. J Clin Microbiol 45, 199–205.[CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.011114-0
Loading
/content/journal/jmm/10.1099/jmm.0.011114-0
Loading

Data & Media loading...

Supplements

vol. , part 11, pp. 1463-1469

Primer sequences and corresponding PCR conditions. [PDF](81 KB)



PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error