title: Spread of Klebsiella pneumoniae producing SHV-5 beta-lactamase among hospitalized patients.
abstract: The first outbreak of infections caused by an SHV-5 producing strain of Klebsiella pneumoniae is reported. Within a period of 1 year and 9 months, multiresistant K. pneumoniae strains caused severe infections, mostly of the lower respiratory tract, in 22 patients. The strains were resistant to penicillins, third-generation cephalosporins, aztreonam, chloramphenicol, tetracycline and co-trimoxazole. The resistance determinants were transferable to Escherichia coli. All isolates produced a beta-lactamase with a pI of 8.2. Ceftazidime was hydrolyzed at this band. These characteristics, together with the resistance phenotype, are identical to those of a reference strain producing the beta-lactamase SHV-5. The K. pneumoniae strains of all patients were identical in their capsular serotype (K1), plasmid pattern and plasmid fingerprint after digestion with Dra I restriction endonuclease. We conclude that this outbreak was caused by the spread of one clone of K. pneumoniae producing SHV-5 beta-lactamase among patients of different wards. Our results indicate a real risk for failure of therapy by third-generation cephalosporins in intensive care patients due to SHV-5 producing pathogens.
authors.affiliation: Max-von-Pettenkofer-Institut, München, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Bauernfeind
authors.forename: E
authors.initials: E
authors.lastname: Rosenthal
authors.forename: E
authors.initials: E
authors.lastname: Eberlein
authors.forename: M
authors.initials: M
authors.lastname: Holley
authors.forename: S
authors.initials: S
authors.lastname: Schweighart
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D015373:Bacterial Typing Techniques; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology / Q000635:transmission*; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D008826:Microbial Sensitivity Tests; D001618:beta-Lactamases / Q000096:biosynthesis
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases