title: Molecular epidemiology of the integron-located VEB-1 extended-spectrum beta-lactamase in nosocomial enterobacterial isolates in Bangkok, Thailand.
abstract: Over a 21/2-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 beta-lactamase (ESBL), VEB-1, was found in 16 unrelated enterobacterial isolates (Escherichia coli, n = 10; Enterobacter cloacae, n = 2; Enterobacter sakazakii, n = 1; and Klebsiella pneumoniae, n = 3) and in two clonally related E. cloacae isolates. The bla(VEB-1) gene was located on mostly self-conjugative plasmids (ca. 24 to 200 kb) that conferred additional non-beta-lactam antibiotic resistance patterns. Additionally, the bla(VEB-1) gene cassette was part of class 1 integrons varying in size and structure. The bla(VEB-1)-containing integrons were mostly associated with bla(OXA-10)-like and arr-2-like gene cassettes, the latter conferring resistance to rifampin. These data indicated the spread of bla(VEB-1) in 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.
authors.affiliation: Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 94275 Le Kremlin-Bicêtre, France.
authors.forename: D
authors.initials: D
authors.lastname: Girlich
authors.forename: L
authors.initials: L
authors.lastname: Poirel
authors.forename: A
authors.initials: A
authors.lastname: Leelaporn
authors.forename: A
authors.initials: A
authors.lastname: Karim
authors.forename: C
authors.initials: C
authors.lastname: Tribuddharat
authors.forename: M
authors.initials: M
authors.lastname: Fennewald
authors.forename: P
authors.initials: P
authors.lastname: Nordmann
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002442:Ceftazidime / Q000494:pharmacology; D003227:Conjugation, Genetic; D003428:Cross Infection / Q000382:microbiology*; D018274:Electroporation / Q000379:methods; D004755:Enterobacteriaceae / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D029968:Escherichia coli Proteins; D006801:Humans; D019426:Integrases / Q000235:genetics; D008826:Microbial Sensitivity Tests / Q000379:methods; D017720:Molecular Epidemiology; D010957:Plasmids; D016133:Polymerase Chain Reaction; D013785:Thailand / Q000453:epidemiology; D018440:beta-Lactam Resistance / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D029968:Escherichia coli Proteins; D047090:beta-Lactams; D002442:Ceftazidime; D019426:Integrases; C119424:beta-lactamase VEB-1, E coli; D001618:beta-Lactamases