Journal Article

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

Dolores Alcantar-Curiel, Juan Carlos Tinoco, Catalina Gayosso, Angeles Carlos, Carlos Daza, Maria C. Perez-Prado, Lorena Salcido, Jose I. Santos and Celia M. Alpuche-Aranda

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 8, pages 1067-1074
Published in print April 2004 | ISSN: 1058-4838
Published online April 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/382354
Nosocomial Bacteremia and Urinary Tract Infections Caused by Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae with Plasmids Carrying Both SHV-5 and TLA-1 Genes

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We describe the prevalence and molecular characteristics of extended-spectrum β-lactamase (ESBL)-producing Klebsiella 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.

Journal Article.  3930 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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