Molecular Epidemiology of the Integron-Located VEB-1 Extended-Spectrum β-Lactamase in Nosocomial Enterobacterial Isolates in Bangkok, Thailand

Journal of Clinical Microbiology - Tập 39 Số 1 - Trang 175-182 - 2001
Delphine Girlich1, Laurent Poirel1, Amornrut Leelaporn2, Amal Karim1, Chanwitt Tribuddharat3, Michael Fennewald3, Patrice Nordmann1
1Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 94275 Le Kremlin-Bicêtre, France1;
2Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand2; and
3Department of Microbiology and Immunology, Finch University of Health Sciences, The Chicago Medical School, North Chicago, Illinois 600643

Tóm tắt

ABSTRACTOver a 2½-month period in 1999, 37 ceftazidime-resistant nonrepetitive enterobacterial isolates were collected from 37 patients in a Bangkok hospital, Thailand. Eighty-one percent of these strains expressed a clavulanic acid-inhibited extended-cephalosporin resistance profile. An identical extended-spectrum β-lactamase (ESBL), VEB-1, was found in 16 unrelated enterobacterial isolates (Escherichia coli,n= 10;Enterobacter cloacae,n= 2;Enterobacter sakazakii,n= 1; andKlebsiella pneumoniae,n= 3) and in two clonally relatedE. cloacaeisolates. TheblaVEB-1gene was located on mostly self-conjugative plasmids (ca. 24 to 200 kb) that conferred additional non-β-lactam antibiotic resistance patterns. Additionally, theblaVEB-1gene cassette was part of class 1 integrons varying in size and structure. TheblaVEB-1-containing integrons were mostly associated withblaOXA-10-like andarr-2-like gene cassettes, the latter conferring resistance to rifampin. These data indicated the spread ofblaVEB-1in Bangkok due to frequent transfer of different plasmids and class 1 integrons and rarely to clonally related strains. Plasmid- and integron-mediated resistance to rifampin was also found in enterobacterial isolates.

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