title: Molecular epidemiology of an SHV-5 extended-spectrum beta-lactamase in enterobacteriaceae isolated from infants in a neonatal intensive care unit.
abstract: Klebsiella oxytoca that produced extended-spectrum beta-lactamase (ESBL) and were resistant to ceftazidime were isolated from infants in a neonatal intensive care unit (NICU). During a 30-week period, 3 infants developed infections and an additional 60 infants were colonized with these bacteria. The molecular typing data suggested transmission of a single strain of ceftazidime-resistant K. oxytoca among 48 of the 63 infants. The ESBL of 46 of the 48 similar isolates, 14 of the remaining 15 isolates, and 6 other Enterobacteriaceae appeared to be associated with a conjugative plasmid of approximately 85 kb. The ESBL gene was cloned, and DNA sequencing confirmed that the ESBL was an SHV-5. Hybridization data suggested that the SHV-5 gene was transmitted to other Enterobacteriaceae in vivo. The spread of the ESBL was reduced through adherence to infection control practices.
authors.affiliation: Department of Pathology and Laboratory Medicine, Albany Medical Center Hospital, New York 12208, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Venezia
authors.forename: F J
authors.initials: FJ
authors.lastname: Scarano
authors.forename: K E
authors.initials: KE
authors.lastname: Preston
authors.forename: L M
authors.initials: LM
authors.lastname: Steele
authors.forename: T P
authors.initials: TP
authors.lastname: Root
authors.forename: R
authors.initials: R
authors.lastname: Limberger
authors.forename: W
authors.initials: W
authors.lastname: Archinal
authors.forename: M A
authors.initials: MA
authors.lastname: Kacica
mesh_terms: D015373:Bacterial Typing Techniques; D002442:Ceftazidime / Q000627:therapeutic use; D018550:Cephalosporin Resistance / Q000235:genetics; D002511:Cephalosporins / Q000627:therapeutic use; D003001:Cloning, Molecular; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D017809:Fatal Outcome; D005798:Genes, Bacterial; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007525:Isoelectric Focusing; D007709:Klebsiella / Q000201:enzymology* / Q000302:isolation & purification; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D010957:Plasmids; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D002511:Cephalosporins; D002442:Ceftazidime; D001618:beta-Lactamases