Intra- and inter-generic plasmid-mediated spread of cephalosporin and aminoglycoside resistance amongst Klebsiella aerogenes K41 and other enterobacteria.
Klebsiella aerogenes K41, resistant to third generation cephalosporins and aminoglycosides, was isolated from clinical samples of 153 in-patients. Blood cultures accounted for 24 (15.7%) of isolates. The MIC(90) of ceftazidime for the isolates of 84 patients was >512 mg/l and was reduced to 2.0 by 4 mg/l of clavulanic acid, but only to 64 by 4 mg/l of sulbactam. Isolates of K. aerogenes K41 produced extended-spectrum beta-lactamase (ESBL) SHV-5 and TEM-1, identified by isoelectric focusing. Plasmid profiles showed that co-dissemination of cephalosporin and aminoglycoside resistance, plus ESBL production, coincided with the acquisition of a 116-kb plasmid. This plasmid was transferable in vitro from K. aerogenes K41 to other serotypes and genera of the Enterobacteriaceae.
Verma
A
A
Dulwich Public Health Laboratory and Medical Microbiology, Guy's, King's and St. Thomas' School of Medicine, King's College Hospital, Bessemer Road, SE5 9PJ, London, UK.
Desai
N
N
Shannon
K
K
Philpott-Howard
J
J
Hill
R L
RL
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology; D018550:Cephalosporin Resistance; D002511:Cephalosporins / Q000494:pharmacology; D003227:Conjugation, Genetic; D004352:Drug Resistance, Microbial; D018432:Drug Resistance, Multiple; D021902:Enterobacter aerogenes / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D010403:Penicillin Resistance; D010957:Plasmids; D001618:beta-Lactamases / Q000378:metabolism
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D002511:Cephalosporins; C117193:beta-lactamase SHV-5; D001618:beta-Lactamases; C034413:beta-lactamase TEM-1