Molecular characterization of an outbreak caused by CTX-M-12-producing Klebsiella pneumoniae in a Colombian hospital´s neonatal intensive care unit
Keywords:
Klebsiella pneumoniae, beta-Lactamases, Cross Infection, Drug Resistance, Cephalosporins, Bacterial Typing Techniques
Abstract
Introduction. Molecular characterisation of Klebsiella pneumoniae strains is a tool that assits in the reduction of the disemination of drug resistance and the control of nosocomial infections that are caused by this pathogen.Objective. Molecular description of an outbreak of nosocomial infection caused by Klebsiella pneumoniae in a neonatal intensive care unit in a tertiary level hospital in Bogotá.
Methods: Eleven Klebsiella pneumoniae isolates were analysed. Production of Extended Spectrum Beta-Lactamases was verified by agar diffusion tests. Isoelectric points of the enzymes were determined by isoelectric focusing. The blaCTX-M-12 gene was detected by PCR and pulsed field gel electrophoresis genotyping was done.
Results. All the isolates were Extended Spectrum Beta-Lactamase producers. Pulsed field gel electrophoresis and BOX-PCR genotyping grouped two isolates from hospital objects and eight infection-causing isolates into a single epidemic clone. The isolate from a thermometer was not grouped into the epidemic clone and showed a different resistance pattern. Isoelectric focusing revealed simultaneous beta-lactamase production having different isoelectric points. PCR amplification revealed the presence of the blaCTX-M-12 gene in the 11 isolates studied.
Conclusion. This is the first report of a molecularly characterised outbreak of CTX-M-12-producing Klebsiella pneumoniae from Colombia. The results of this study provide additional evidence of the global dissemination of CTX-M ESBL and the need for epidemiological follow-up in our hospitals.
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References
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3. Paterson DL, Hujer KM, Hujer AM, Yeiser B, Bonomo MD, Rice LB, et al. Extended-spectrum betalactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and
widespread prevalence of SHV- and CTX-M-type betalactamases. Antimicrob Agents Chemother 2003;47:3554-60.
4. Tzouvelekis LS, Tzelepi E, Tassios PT, Legakis NJ. CTX-M-type beta-lactamases: an emerging group of extended-spectrum enzymes. Int J Antimicrob Agents 2000;14:137-42.
5. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing. Eleventh Informational Supplement. NCCLS approved standard M100-S11. Wayne, PA: National Committee for Clinical Laboratory Standards; 2002.
6. Bonnet R, Sampaio JL, Labia R, De Champs C, Sirot D, Chanal C, et al. A novel CTX-M beta-lactamase (CTX-M-8) in cefotaxime-resistant Enterobacteriaceae isolated in Brazil. Antimicrob Agents Chemother 2000;44:1936-42.
7. Yagi T, Kurokawa H, Senda K, Ichiyama S, Ito H, Ohsuka S, et al. Nosocomial spread of cephem-resistant Escherichia coli strains carrying multiple Toho-1 like beta-lactamase genes. Antimicrob Agents Chemother 1997;41:2606-11.
8. Chanawong A, M'Zali FH, Heritage J, Xiong JH, Hawkey PM. Three cefotaximases, CTX-M-9, CTXM- 13, and CTX-M-14, among Enterobacteriaceae in the People's Republic of China. Antimicrob Agents Chemother 2002;46:630-7.
9. Mantilla JR, García I, Espinal PA, Valenzuela EM. Estandarización y evaluación de tres sistemas de rep- PCR para la tipificación de Klebsiella pneumoniae. Revista Colombiana de Ciencias Químico-
Farmacéuticas 2004;33:48-58.
10. Miranda G, Kelly C, Solórzano F, Leanos B, Coria R, Patterson JE. Use of pulsed-field gel electrophoresis typing to study an outbreak of infection due to Serratia marcescens in a neonatal intensive care unit. J Clin Microbiol 1996;34:3138-41.
11. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, et al. Interpreting chromosomal DNA restriction patterns produced by pulsedfield gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233-9.
12. Malathum K, Singh KV, Weinstock GM, Murray BE. Repetitive sequence-based PCR versus pulsedfield gel electrophoresis for typing of Enterococcus faecalis at the subspecies level. J Clin Microbiol 1998; 36:211-5.
13. Kariuki S, Corkill JE, Revathi G, Musoke R, Hart CA. Molecular characterization of a novel plasmidencoded cefotaximase (CTX-M-12) found in clinical Klebsiella pneumoniae isolates from Kenya. Antimicrob Agents Chemother 2001;45:2141-3.
14. Baraniak A, Sadowy E, Hryniewicz W, Gniadkowski M. Two different extended-spectrum beta-lactamases (ESBLs) in one of the first ESBL-producing Salmonella isolates in Poland. J Clin Microbiol 2002;40:1095-7.
15. Villegas MV, Correa A, Perez F, Zuluaga T, Radice M, Gutkind G, et al. CTX-M-12 beta-lactamase in a Klebsiella pneumoniae clinical isolate in Colombia. Antimicrob Agents Chemother 2004;48:629-31.
16. Peña C, Pujol M, Ardanuy C, Ricart A, Pallares R, Liñares J, et al. Epidemiology and successful control of a large outbreak due to Klebsiella pneumoniae producing extended-spectrum beta-lactamases. Antimicrob Agents Chemother 1998;42:53-8.
2. Medeiros AA. Evolution and dissemination of betalactamases accelerated by generations of beta-lactam antibiotics. Clin Infect Dis 1997;24(suppl.1):S19-45.
3. Paterson DL, Hujer KM, Hujer AM, Yeiser B, Bonomo MD, Rice LB, et al. Extended-spectrum betalactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and
widespread prevalence of SHV- and CTX-M-type betalactamases. Antimicrob Agents Chemother 2003;47:3554-60.
4. Tzouvelekis LS, Tzelepi E, Tassios PT, Legakis NJ. CTX-M-type beta-lactamases: an emerging group of extended-spectrum enzymes. Int J Antimicrob Agents 2000;14:137-42.
5. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing. Eleventh Informational Supplement. NCCLS approved standard M100-S11. Wayne, PA: National Committee for Clinical Laboratory Standards; 2002.
6. Bonnet R, Sampaio JL, Labia R, De Champs C, Sirot D, Chanal C, et al. A novel CTX-M beta-lactamase (CTX-M-8) in cefotaxime-resistant Enterobacteriaceae isolated in Brazil. Antimicrob Agents Chemother 2000;44:1936-42.
7. Yagi T, Kurokawa H, Senda K, Ichiyama S, Ito H, Ohsuka S, et al. Nosocomial spread of cephem-resistant Escherichia coli strains carrying multiple Toho-1 like beta-lactamase genes. Antimicrob Agents Chemother 1997;41:2606-11.
8. Chanawong A, M'Zali FH, Heritage J, Xiong JH, Hawkey PM. Three cefotaximases, CTX-M-9, CTXM- 13, and CTX-M-14, among Enterobacteriaceae in the People's Republic of China. Antimicrob Agents Chemother 2002;46:630-7.
9. Mantilla JR, García I, Espinal PA, Valenzuela EM. Estandarización y evaluación de tres sistemas de rep- PCR para la tipificación de Klebsiella pneumoniae. Revista Colombiana de Ciencias Químico-
Farmacéuticas 2004;33:48-58.
10. Miranda G, Kelly C, Solórzano F, Leanos B, Coria R, Patterson JE. Use of pulsed-field gel electrophoresis typing to study an outbreak of infection due to Serratia marcescens in a neonatal intensive care unit. J Clin Microbiol 1996;34:3138-41.
11. Tenover FC, Arbeit RD, Goering RV, Mickelsen PA, Murray BE, Persing DH, et al. Interpreting chromosomal DNA restriction patterns produced by pulsedfield gel electrophoresis: criteria for bacterial strain typing. J Clin Microbiol 1995;33:2233-9.
12. Malathum K, Singh KV, Weinstock GM, Murray BE. Repetitive sequence-based PCR versus pulsedfield gel electrophoresis for typing of Enterococcus faecalis at the subspecies level. J Clin Microbiol 1998; 36:211-5.
13. Kariuki S, Corkill JE, Revathi G, Musoke R, Hart CA. Molecular characterization of a novel plasmidencoded cefotaximase (CTX-M-12) found in clinical Klebsiella pneumoniae isolates from Kenya. Antimicrob Agents Chemother 2001;45:2141-3.
14. Baraniak A, Sadowy E, Hryniewicz W, Gniadkowski M. Two different extended-spectrum beta-lactamases (ESBLs) in one of the first ESBL-producing Salmonella isolates in Poland. J Clin Microbiol 2002;40:1095-7.
15. Villegas MV, Correa A, Perez F, Zuluaga T, Radice M, Gutkind G, et al. CTX-M-12 beta-lactamase in a Klebsiella pneumoniae clinical isolate in Colombia. Antimicrob Agents Chemother 2004;48:629-31.
16. Peña C, Pujol M, Ardanuy C, Ricart A, Pallares R, Liñares J, et al. Epidemiology and successful control of a large outbreak due to Klebsiella pneumoniae producing extended-spectrum beta-lactamases. Antimicrob Agents Chemother 1998;42:53-8.
How to Cite
1.
Mantilla JR, Reguero MT, González EB, García IA, Leal AL, Espinal PA, et al. Molecular characterization of an outbreak caused by CTX-M-12-producing Klebsiella pneumoniae in a Colombian hospital´s neonatal intensive care unit. biomedica [Internet]. 2006 Sep. 1 [cited 2024 May 17];26(3):408-14. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/359
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