Distribution of extended spectrum β-lactamases-codifying genes in Klebsiella pneumoniae isolates from hospitals of Bogota, D.C., Colombia
Keywords:
Klebsiella pneumoniae, beta-lactamases, drug resistance, bacterial, sequence analysis, DNA, molecular epidemiology, Colombia.
Abstract
Introduction. Extended spectrum β-lactamases (ESBL) are the most widely distributed enzymes in Enterobacteriaceae of Latin America and are key enzymes in resistance to antibiotics in common use. However, in Colombia, little information is available concerning the identity of genes coding for these enzymes in Klebsiella pneumoniae.Objective. The bla genes were identified in K. pneumoniae isolated from hospitals in Bogotá D.C., Colombia.
Materials and methods. One hundred seventy-seven isolates of ESBL producers were collected from 10 hospitals in Bogota between 2003 and 2005. Antibiotic susceptibility was determined by disk diffusion, and the number of β-lactamases in each isolate was assessed by isoelectric focusing. blaCTX-M, blaSHV and blaTEM were identified by PCR and subsequent sequencing.
Results. Besides, the resitenance to third generation cephalosporins, 44.7 % and 49.7 % were resistant to amikacyn and thrimetoprim-sulaphametoxazole respectively. Lower resistance rates to other antibiotics were observed as well. An average of three β-lactamases were detected by isoelectric focusing, and the genes blaCTX-M-12 (56.0%) and blaSHV-12 (33.3%) were the most prevalent. blaSHV-5 (11.8%), blaCTX-M-1 (4.0%), blaSHV-27 (2.8%), blaSHV-2 (2.8%), blaCTX-M-2 (1.7%) and blaCTX-M-15 (0.6%) were present in smaller percentages. In addition, three genes were identified that coded for narrow spectrum β-lactamases.
Conclusion. Eleven bla genes were identified, eight of which were ESBL-coding. The diversity of the bla genes suggested a continuing exposure of K. pneumoniae to strong antibiotic pressures in Bogota hospitals.
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References
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24. Biedenbach DJ, Moet GJ, Jones RN. Ocurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997- 2002). Diag Microbiol Infect Dis. 2004;50:59-69.
25. Kariuki S, Corkill J, Revathi G, Musoke R, Hart CA. Molecular characterization of a novel plasmid-encoded-cefotaximase (CTX-M-12) found in clinical Klebsiella pneumoniae isolates from Kenya, Antimicrob Agents Chemother. 2001;45:2141-3.
26. Villegas MV, Correa A, Pérez F, Zuluaga T, Radice M, Gutkind G, et al. CTX-M-12 β-lactamase in a Klebsiella pneumoniae isolate in Colombia. Antimicrob Agents Chemother. 2004;48:629-31.
27. Corkill JE, Cuevas LE, Gurgel RQ, Greensill J, Hart CA. SHV-27, a novel cefotaxime-hydrolyzing ß-lactamase, identified in Klebsiella pneumoniae isolates from a Brazilian hospital. J Antimicrob Chemother. 2001;47:463-5.
28. Segatore B, Setacci D, Perilli M, Franchino L, Franceschini N, Agnifili A, et al. Antimicrobial susceptibility of clinical isolates of Enterobacteriaceae producing complex β-lactamase patterns including extended-spectrum enzymes. Int J Antimicrob Agents. 2004;23:480-6.
29. Xiong Z, Zhu D, Wang F, Zhang Y, Okamoto R, Inoue M. A Klebsiella pneumoniae producing three kinds of class A β-lactamases encoded by one single plasmid isolated from a patient in Huashan Hospital, Shanghai, China. Int J Antimicrob Agents. 2004;23:262-7.
30. Bradford PA. Extended-spectrum β-lactamases in the 21st century: Characterization, epidemiology and detection of this important resistance threat. Clin Microbiol Rev. 2001;14:933-51.
31. Siu LK, Lu P, Hsueh P, Lin FM, Chang S, Luh K, et al. Bacteremia due to extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric oncology ward: Clinical features and identification of different plasmids carrying both SHV-5 and TEM-1 genes. J Clin Microbiol. 1999;37:4020-7.
2. Bonnet R. Growing group of extended-spectrum β-lactamases: The CTX-M enzymes. Antimicrob Agents Chemother. 2004;48:1-14.
3. Pagani L, Dell´Amico E, Migliavacca R, D'Andrea MM, Giacobone E, Amicosante G, et al. Multiple CTX-M-type extended-spectrum β-lactamases in nosocomial isolates of Enterobacteriaceae from a hospital in Northern Italy. J Clin Microbiol. 2003;41:4264-9.
4. Van't veen A, van der Zee A, Nelson J, Speelberg B, Kluytmans JA, Buiting AG. Outbreak of infection with a multiresistant Klebsiella pneumoniae strain associated with contaminated roll boards in operating rooms. J Clin Microbiol. 2005;43:4961-7.
5. Ben-Hamouda T, Foulon T, Ben-Cheikn-Masmoudi A, Fendri C, Belhadj O, Ben Mahrez K. Molecular epidemiology of an outbreak of multiresistant Klebsiella pneumoniae in a Tunisian neonatal ward. J Med Microbiol. 2003;52:427-33.
6. Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: Epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev. 1998;11:589-603.
7. Winokur PL, Canton R, Casellas JM, Legakis N. Variations in the prevalence of strains expressing an extended-spectrum β-lactamase phenotype and characterization of isolates from Europe, the Americas, and the Western Pacific region. Clin Infect Dis. 2001;32(Suppl. 2):S94-103.
8. The Colombian Resistance Antimicrobial Group, Jones RN, Salazar JC, Pfaller MA, Doern GV. Multicenter evaluation of antimicrobial resistance to six broad-spectrum β-lactams in Colombia using the Etest method. Diagn Microbiol Infect Dis. 1997;29:265-72.
9. The Colombian Antimicrobial Resistance Study Group, Pfaller MA, Jones RN, Doern GV, Salazar JC. Multicenter evaluation of antimicrobial resistance to six broad-spectrum beta-lactams in Colombia: Comparison of data from 1997 and 1998 using the Etest method. Diagn Microbiol Infect Dis. 1999;35:235-41.
10. Valenzuela E, Mantilla J, Reguero M, González E, Pulido I, Llerena I, et al. Detection of CTX-M-1, CTX-M-15, and CTX-M-2 in clinical isolates of Enterobacteriaceae in Bogotá, Colombia. J Clin Microbiol. 2005;44:1919-20.
11. Espinal P, Mantilla J, Saavedra C, Leal A, Alpuche C, Valenzuela E. Epidemiología molecular de la infección nosocomial por Klebsiella pneumoniae productora de beta-lactamasas de espectro extendido. Biomédica. 2004;24:252-61.
12. Villegas M, Correa A, Pérez F, Miranda MC, Zuluaga T, Quinn JP, et al. Prevalence and characterization of extended-spectrum β-lactamases in Klebsiella pneumoniae and Escherichia coli isolates from Colombian hospitals. Diagn Microbiol Infect Dis. 2004;49:217-22.
13. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibillity testing. Sixteenth Informational supplement. CLSI document M-100-S16 (ISBN 1-56238-588-7). Wayne: Clinical and Laboratory Standards Institute; 2006.
14. Jarlier V, Nicolas MH, Fournier G, Philippon A. Extended broad-spectrum β-lactamases conferring transferable resistance to newer β-lactams agents in Enterobacteriaceae: Hospital prevalence and susceptibility patterns. Rev Infect Dis. 1988;10:867-78.
15. Cao V, Lambert T, Quynh Nhu D, Loan HK, Hoang N, Arlet G, et al. Distribution of extended-spectrun β-lactamases in clinical isolates of Enterobacteriaceae in Vietnam. Antimicrob Agents Chemother. 2002;46:3739-43.
16. Neuwirth C, Madec S, Siebor E. TEM-89 β-lactamase produced by Proteus mirabilis clinical isolate: New complex mutant (CMT 3) with mutations in both TEM-59 (IRT-17) and TEM-3. Antimicrob Agents Chemother. 2001;45:3591-4.
17. Bonnet R, Dutour J, Sampaio M, Chanal C, Sirot D, Labia R, et al. Novel cefotaxime (CTX-M-16) with increase catalytic efficiency due to substitution Asp-240-Gli. Antimicrob Agents Chemother. 2001;45:2269-75.
18. Nagano N, Shibata N, Saitou Y, Nagano Y, Arakawa Y. Nosocomial outbreak infections by Proteus mirabilis that produces extended-spectrum CTX-M-2 type β-lactamase. J Clin Microbiol. 2003;41:5530-6.
19. Chanawong A, M'Zali FH, Heritage J, Xiong J, Hawkey PM. Three cefotaximases, CTX-M-9, CTX-M-13, and CTX-M-14, among Enterobacteriaceae in the People's Republic of China. Antimicrob Agents Chemother. 2002;46:630-7.
20. Shibata N, Kurokawa H, Doi Y, Yagi T, Yamane K, Wachino J, et al. PCR classification of CTX-M-type β-lactamase genes identified in clinically isolated gram-negative bacilli in Japan. Antimicrob Agents Chemother. 2006;50:791-5.
21. Bouza E, San Juan R, Muñoz P, Voss A, Kluytmans J. A European perspective on nosocomial urinary tract infections II. Report on incidence, clinical characteristics and outcome (ESGNI-004study). Clin Microbiol Infect. 2001;7:532-42.
22. Kil K, Darouiche RO, Hull RA, Mansouri MD, Musher DM. Identification of a Klebsiella pneumoniae strain associated with nosocomial urinary tract infection. J Clin Microbiol. 1997;35:2370-4.
23. Suljagic V, Cobeljic M, Jankovic S, Mirovic V, Markovic-Denic L, Romic P, et al. Nosocomial bloodstream infections in ICU and non-ICU patients. Am J Infect Control. 2005;33:333-40.
24. Biedenbach DJ, Moet GJ, Jones RN. Ocurrence and antimicrobial resistance pattern comparisons among bloodstream infection isolates from the SENTRY Antimicrobial Surveillance Program (1997- 2002). Diag Microbiol Infect Dis. 2004;50:59-69.
25. Kariuki S, Corkill J, Revathi G, Musoke R, Hart CA. Molecular characterization of a novel plasmid-encoded-cefotaximase (CTX-M-12) found in clinical Klebsiella pneumoniae isolates from Kenya, Antimicrob Agents Chemother. 2001;45:2141-3.
26. Villegas MV, Correa A, Pérez F, Zuluaga T, Radice M, Gutkind G, et al. CTX-M-12 β-lactamase in a Klebsiella pneumoniae isolate in Colombia. Antimicrob Agents Chemother. 2004;48:629-31.
27. Corkill JE, Cuevas LE, Gurgel RQ, Greensill J, Hart CA. SHV-27, a novel cefotaxime-hydrolyzing ß-lactamase, identified in Klebsiella pneumoniae isolates from a Brazilian hospital. J Antimicrob Chemother. 2001;47:463-5.
28. Segatore B, Setacci D, Perilli M, Franchino L, Franceschini N, Agnifili A, et al. Antimicrobial susceptibility of clinical isolates of Enterobacteriaceae producing complex β-lactamase patterns including extended-spectrum enzymes. Int J Antimicrob Agents. 2004;23:480-6.
29. Xiong Z, Zhu D, Wang F, Zhang Y, Okamoto R, Inoue M. A Klebsiella pneumoniae producing three kinds of class A β-lactamases encoded by one single plasmid isolated from a patient in Huashan Hospital, Shanghai, China. Int J Antimicrob Agents. 2004;23:262-7.
30. Bradford PA. Extended-spectrum β-lactamases in the 21st century: Characterization, epidemiology and detection of this important resistance threat. Clin Microbiol Rev. 2001;14:933-51.
31. Siu LK, Lu P, Hsueh P, Lin FM, Chang S, Luh K, et al. Bacteremia due to extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae in a pediatric oncology ward: Clinical features and identification of different plasmids carrying both SHV-5 and TEM-1 genes. J Clin Microbiol. 1999;37:4020-7.
How to Cite
1.
Pulido IY, Mantilla JR, Valenzuela EM, Reguero MT, González EB. Distribution of extended spectrum β-lactamases-codifying genes in Klebsiella pneumoniae isolates from hospitals of Bogota, D.C., Colombia. biomedica [Internet]. 2011 Apr. 16 [cited 2024 May 18];31(1):15-20. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/331
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