title: Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strains causing nosocomial outbreaks of infection in the United Kingdom.
abstract: Representative isolates from 10 distinct extended-spectrum beta-lactamase-producing strains of Klebsiella pneumoniae that caused hospital outbreaks in the United Kingdom from 1991 to 1994 were examined for relationships between their enzymes and plasmids. The beta-lactamases were identified by a combination of isoelectric focusing and gene sequencing. SHV-2 beta-lactamase was produced by isolates from four outbreaks, SHV-5 was involved in three, and SHV-4, TEM-15, and TEM-26 were involved in one outbreak each. All of the extended-spectrum beta-lactamases were encoded by self-transmissible plasmids, with sizes ranging from about 70 to 160 kb. No similarities between the restriction digest patterns of the extended-spectrum beta-lactamase-encoding plasmids were detected, except to some extent between those that produced TEM-15 and TEM-26. Thus, outbreaks of hospital infection with these organisms in the United Kingdom from 1991 to 1994 involved distinct organisms and resistance plasmids and appeared to be unrelated.
authors.affiliation: Department of Microbiology, United Medical and Dental Schools, St. Thomas's Campus, London SE1 7EH, United Kingdom. k.shannon@umds.ac.uk
authors.forename: K
authors.initials: K
authors.lastname: Shannon
authors.forename: P
authors.initials: P
authors.lastname: Stapleton
authors.forename: X
authors.initials: X
authors.lastname: Xiang
authors.forename: A
authors.initials: A
authors.lastname: Johnson
authors.forename: H
authors.initials: H
authors.lastname: Beattie
authors.forename: F
authors.initials: F
authors.lastname: El Bakri
authors.forename: B
authors.initials: B
authors.lastname: Cookson
authors.forename: G
authors.initials: G
authors.lastname: French
mesh_terms: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D017931:DNA Primers; D004196:Disease Outbreaks; D006801:Humans; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010957:Plasmids; D016133:Polymerase Chain Reaction; D006113:United Kingdom / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D017931:DNA Primers; D001618:beta-Lactamases