TITLE

Nosocomial Bacteremia and Urinary Tract Infections Caused by Extended-Spectrum b -Lactamase-- Producing Klebsiella pneumoniae with Plasmids Carrying Both SHV-5 and TLA-1 Genes

AUTHOR(S)
Alcantar-curiel, Dolores; Tinoco, Juan Carlos; Gayosso, Catalina; Carlos, Angeles; Daza, Carlos; Perez-prado, Maria C.; Salcido, Lorena; Santos, Jose I.; Alpuche-Aranda, Celia M.
PUB. DATE
April 2004
SOURCE
Clinical Infectious Diseases;4/15/2004, Vol. 38 Issue 8, p1067
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
We describe the prevalence and molecular characteristics of extended-spectrum β-lactamase (ESBL)-producing Kiebsiella pneumoniae causing nosocomial bacteremia and urinary tract infections in a Mexican general hospital. We analyzed 82 episodes of bacteremia (∼60% of episodes) and urinary tract infection (∼40% of episodes) due to K. pneumoniae during a 23-month surveillance period. The neonatal intensive care unit accounted for 49% of all episodes. All strains were imipenem susceptible; 62.2% of the strains were resistant to ceftazidime, cefotaxime, and aztreonam; 69.5% were resistant to amikacin; 58.5% were resistant to gentamicin; and 7.3% were resistant to ciprofloxacin. All strains were associated with 28 pulsed-field gel electrophoresis patterns, and dissemination of 2 ceftazidime-resistant clones produced 44% of the cases. The ESBL phenotype in these clones was transferred by identical or highly related megaplasmids. The ESBL activity corresponded to SHV- 5 and TLA-1. Cross-transmission of 2 ceftazidime-resistant clones and the horizontal spread of identical or highly related megaplasmids explain the high prevalence of ESBL phenotype in these infections.
ACCESSION #
13015090

 

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