title: Outbreak of infection with extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in a Mexican hospital.
abstract: Thirty-one strains of Klebsiella pneumoniae (including 10 duplicates) from 21 septicemic pediatric patients (age, <2 months) were studied during a 4-month period (June to October 1996) in which the fatality rate was 62% (13 of 21). These isolates identified by the API 20E system yielded the same biotype. Pulsed-field gel electrophoresis experiments revealed the same clone in 31 strains. The isolates were multidrug-resistant but were still susceptible to ciprofloxacin, imipenem, and cefoxitin. A 135-kb plasmid was harbored in all of the isolates. No transconjugants were obtained that were resistant to ampicillin, cefotaxime, tetracycline, or gentamicin. Isoelectric focusing for beta-lactamases was performed on all strains, and three bands with pIs of 5.4, 7.6, and 8.2 were obtained. Of these, the pI 8.2 beta-lactamase had an extended-spectrum beta-lactamase phenotype. PCR amplification of both TEM- and SHV-type genes was obtained. The sequence analysis of the SHV PCR product indicated a mutation corresponding to the SHV-5 beta-lactamase.
authors.affiliation: Department of Bacterial Resistance, National Institute of Public Health, Center for Research on Infectious Diseases, Cuernavaca, Morelos, Mexico. jsilva@correo.insp.mx
authors.forename: J
authors.initials: J
authors.lastname: Silva
authors.forename: R
authors.initials: R
authors.lastname: Gatica
authors.forename: C
authors.initials: C
authors.lastname: Aguilar
authors.forename: Z
authors.initials: Z
authors.lastname: Becerra
authors.forename: U
authors.initials: U
authors.lastname: Garza-Ramos
authors.forename: M
authors.initials: M
authors.lastname: Velázquez
authors.forename: G
authors.initials: G
authors.lastname: Miranda
authors.forename: B
authors.initials: B
authors.lastname: Leaños
authors.forename: F
authors.initials: F
authors.lastname: Solórzano
authors.forename: G
authors.initials: G
authors.lastname: Echániz
mesh_terms: D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology; D015373:Bacterial Typing Techniques; D003428:Cross Infection; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification* / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D008800:Mexico / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D047090:beta-Lactams; D001618:beta-Lactamases