Molecular epidemiology of extended-spectrum β-lactamase-producing Klebsiella pneumoniae in a neonatal intensive care unit

被引:56
作者
Bagattini, M
Crivaro, V
Di Popolo, A
Gentile, F
Scarcella, A
Triassi, M
Villari, P
Zarrilli, R [1 ]
机构
[1] Univ Naples Federico II, Sez Igiene, Dipartimento Sci Med Prevent, Naples, Italy
[2] Univ Molise, Dipartimento Sci Salute, Campobasso, Italy
[3] Univ Naples Federico II, Dipartimento Pediat, Naples, Italy
[4] Univ Roma La Sapienza, Dipartimento Med Sperimentale & Patol, Rome, Italy
[5] CEINGE Biotecnol Avanzate, Naples, Italy
关键词
nosocomial infections; antimicrobial resistance; genotyping; horizontal gene transfer;
D O I
10.1093/jac/dkl077
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Objectives: To investigate the molecular epidemiology of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae in the neonatal intensive care unit of a university hospital in Italy. Methods: Antibiotic susceptibility was evaluated by disc diffusion and Etest. ESBLs were identified by isoelectric focusing, PCR and DNA sequencing analysis. Genotyping was performed by PFGE analysis. Conjugation was performed by broth mating. Results: Molecular typing of K. pneumoniae isolates identified three distinct PFGE patterns. Isolates of PFGE profile A were isolated during an epidemic in 1996, while isolates of PFGE profiles B and C were sequentially isolated from September 2002 to December 2004, when 233 colonizations and 19 infections by K. pneumoniae occurred. All K. pneumoniae strains of different PFGE types were identified as ESBL producers. DNA sequencing of amplified beta-lactamase genes identified a novel bla(TEM) ESBL (bla(TEM-136)) along with bla(SHV-1) in chromosomal and plasmid DNA from K. pneumoniae of PFGE type A, respectively, and bla(TEM-1) and bla(SHV-12) in plasmid DNA from K. pneumoniae of PFGE types B and C. Conjugation experiments demonstrated that resistance to third-generation cephalosporins, along with an similar to 80 kb plasmid containing bla(SHV-12) and bla(TEM-1), was transferred from K. pneumoniae epidemic strains of PFGE types B and C to a susceptible Escherichia coli host at a frequency of 4 x 10(-6) and 1 x 10(-6) cfu/recipient cell, respectively. Conclusions: The selection of ESBL-producing clones and the transfer of the bla(SHV-12) ESBL gene between different clones were responsible for the spread of K. pneumoniae in the neonatal intensive care unit.
引用
收藏
页码:979 / 982
页数:4
相关论文
共 10 条
[1]   Extended-spectrum β-lactamases in the 21st century:: Characterization, epidemiology, and detection of this important resistance threat [J].
Bradford, PA .
CLINICAL MICROBIOLOGY REVIEWS, 2001, 14 (04) :933-951
[2]   Dissemination of CTX-M-type β-lactamases among clinical isolates of Enterobacteriaceae in Paris, France [J].
Eckert, C ;
Gautier, V ;
Saladin-Allard, M ;
Hidri, N ;
Verdet, C ;
Ould-Hocine, Z ;
Barnaud, G ;
Delisle, F ;
Rossier, A ;
Lambert, T ;
Philippon, A ;
Arlet, G .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2004, 48 (04) :1249-1255
[3]   Complexity and diversity of Klebsiella pneumoniae strains with extended-spectrum β-lactamases isolated in 1994 and 1996 at a teaching hospital in Durban, South Africa [J].
Essack, SY ;
Hall, LMC ;
Pillay, DG ;
McFadyen, ML ;
Livermore, DM .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 2001, 45 (01) :88-95
[4]   A cluster of nosocomial Klebsiella pneumoniae bloodstream infections in a neonatal intensive care department:: Identification of transmission and intervention [J].
Gastmeier, P ;
Groneberg, K ;
Weist, K ;
Rüden, H .
AMERICAN JOURNAL OF INFECTION CONTROL, 2003, 31 (07) :424-430
[5]   Detection of extended-spectrum beta-lactamases in clinical isolates of Klebsiella pneumoniae and Escherichia coli [J].
Jacoby, GA ;
Han, P .
JOURNAL OF CLINICAL MICROBIOLOGY, 1996, 34 (04) :908-911
[6]   Clonal and horizontal dissemination of Klebsiella pneumoniae expressing SHV-5 extended-spectrum β-lactamase in a Mexican pediatric hospital [J].
Miranda, G ;
Castro, N ;
Leaños, B ;
Valenzuela, A ;
Garza-Ramos, U ;
Rojas, T ;
Solórzano, F ;
Chihu, L ;
Silva, J .
JOURNAL OF CLINICAL MICROBIOLOGY, 2004, 42 (01) :30-35
[7]  
National Committee for Clinical Laboratory Standards - NCCLS, 2004, M100S14 NCCLS
[8]   Antibiotic therapy for Klebsiella pneumoniae bacteremia:: Implications of production of extended-spectrum β-lactamases [J].
Paterson, DL ;
Ko, WC ;
Von Gottberg, A ;
Mohapatra, S ;
Casellas, JM ;
Goossens, H ;
Mulazimoglu, L ;
Trenholme, G ;
Klugman, KP ;
Bonomo, RA ;
Rice, LB ;
Wagener, MM ;
McCormack, JG ;
Yu, VL .
CLINICAL INFECTIOUS DISEASES, 2004, 39 (01) :31-37
[9]   Molecular characterization of extended-spectrum β-lactamases produced by nosocomial isolates of Enterobacteriaceae from an Italian nationwide survey [J].
Perilli, M ;
Dell'Amico, E ;
Segatore, B ;
de Massis, MR ;
Bianchi, C ;
Luzzaro, F ;
Rossolini, GM ;
Toniolo, A ;
Nicoletti, G ;
Amicosante, G .
JOURNAL OF CLINICAL MICROBIOLOGY, 2002, 40 (02) :611-614
[10]   Molecular epidemiology as an effective tool in the surveillance of infections in the neonatal intensive care unit [J].
Villari, P ;
Iacuzio, L ;
Torre, I ;
Scarcella, A .
JOURNAL OF INFECTION, 1998, 37 (03) :274-281