Reduced Susceptibility to Cefepime in Clinical Isolates of Enterobacteriaceae Producing OXA-1 Beta-Lactamase

被引:17
作者
Torres, Eva [1 ]
Lopez-Cerero, Lorena [1 ,2 ]
Manuel Rodriguez-Martinez, Jose [2 ]
Pascual, Alvaro [1 ,2 ]
机构
[1] Univ Hosp Virgen Macarena, Infect Dis & Clin Microbiol Unit, Avda Doctor Fedriani 3, Seville 41071, Spain
[2] Univ Seville, Dept Microbiol, Seville, Spain
关键词
ESCHERICHIA-COLI; ANTIBIOTIC-RESISTANCE; STRAINS; EXPRESSION; PHENOTYPE; IMPACT;
D O I
10.1089/mdr.2015.0122
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
An increase of Enterobacteriaceae isolates with reduced susceptibility to cefepime (FEP) and amoxicillin/clavulanate (AMC) has been observed in our area. The aim of this study was to characterize this antibiotic resistance phenotype and its molecular epidemiology. A total of 33 Enterobacteriaceae strains were studied. bla(OXA-1) genes and their genetic environment were analyzed by polymerase chain reaction (PCR) and sequencing. Plasmids were transferred by conjugation and/or transformation and classified using PCR-based inc/rep typing and IncF subtyping. Escherichia coli isolates were typed by phylogroup, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing. Outer membrane proteins were studied by sodium dodecylsulfate-polyacrylamide gel electrophoresis and expression of bla(OXA-1) genes by reverse transcription-PCR. FEP minimum inhibitory concentration yielded values of 1-16 mg/L. Twenty-nine (87.9%) isolates produced OXA-1, of which 24 (82.7%) were located in class 1 integron, and 9 (27.3%) produced TEM-1. Among the 24 E. coli OXA-1-producers, PFGE revealed two main clusters: one belonged to C-ST88 and the other to B2(3)-ST131. Thirteen plasmids containing bla(OXA-1) were transferred, nine belonged to IncF replicon (4 F2:A1:B-, 2 F1:A1:B1, 1 F1:A2:B-, 1 F18:A2:B1, 1 F5:A-:B1) and four were nontypeable. In conclusion, reduced susceptibility to FEP was mostly due to OXA-1 beta-lactamase. In E. coli, this increase is mainly due to the dissemination of two clones, which have captured different IncF plasmids. Among non-E. coli strains, five isolates produced OXA-1 and one isolate produced only TEM-1.
引用
收藏
页码:141 / 146
页数:6
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