Affiliation:
1. Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, 10700
2. Division of Infectious Diseases, Faculty of Medicine, Thammasart University Hospital, Pratumthani, Thailand, 12120
Abstract
ABSTRACT
Extended-spectrum β-lactamase (ESBL)-producing
Escherichia coli
and
Klebsiella pneumoniae
have rapidly spread worldwide and pose a serious threat for health care-associated (HA) infection. We conducted molecular detection and characterization of ESBL-related
bla
genes, including
bla
TEM
,
bla
SHV
,
bla
CTX-M
,
bla
VEB
,
bla
OXA
,
bla
PER
, and
bla
GES
, among 362 isolates of ESBL-producing
E. coli
(
n
= 235) and ESBL-producing
K. pneumoniae
(
n
= 127) collected from patients who met the definition of HA infection at two major university hospitals in Thailand from December 2004 to May 2005. The prevalence of ESBL-producing
E. coli
and ESBL-producing
K. pneumoniae
, patient demographics and the susceptibilities of these bacteria to various antimicrobial agents were described. A total of 87.3% of isolates carried several
bla
genes. The prevalence of
bla
CTX-M
was strikingly high: 99.6% for ESBL-producing
E. coli
(CTX-M-14, -15, -27, -40, and -55) and 99.2% for ESBL-producing
K. pneumoniae
(CTX-M-3, -14, -15, -27, and -55). IS
Ecp1
was found in the upstream region of
bla
CTX-M
in most isolates. Up to 77.0% and 71.7% of ESBL-producing
E. coli
and ESBL-producing
K. pneumoniae
, respectively, carried
bla
TEM
; all of them encoded TEM-1. ESBL-producing
K. pneumoniae
carried
bla
SHV
at 87.4% (SHV-1, -2a, -11, -12, -27, -71, and -75) but only at 3.8% for ESBL-producing
E. coli
(SHV-11 and -12).
bla
genes encoding VEB-1 and OXA-10 were found in both ESBL-producing
E. coli
(8.5% and 8.1%, respectively) and ESBL-producing
K. pneumoniae
(10.2% and 11.8%, respectively). None of the isolates were positive for
bla
PER
and
bla
GES
. Pulsed-field gel electrophoresis analysis demonstrated that there was no major clonal relationship among these ESBL producers. This is the first study to report CTX-M-3, CTX-M-27, CTX-M-40, SHV-27, SHV-71, and SHV-75 in Thailand and to show that CTX-M ESBL is highly endemic in the country.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Cited by
183 articles.
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