title: A clinical strain of Escherichia coli possessing CMY-2 plasmid-mediated amp C beta-lactamase: an emerging concern in pediatrics?
abstract: A 5-year-old child was colonized by an isolate of Escherichia coli that transferred resistance to third-generation cephalosporins and cefoxitin. This resistance phenotype was encoded on a >75-kb plasmid pLRM 22. The transferable plasmid contained both blaCMY-2 and blaTEM-1b. Increasing reports of CMY-2 beta-lactamase in clinical isolates in children raise concerns about the empiric use of third-generation cephalosporins in this patient group.
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Pediatrics, Rainbow Babies and Childrens' Hospital, Cleveland, OH 44106, USA.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Hoyen
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Hujer
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Hujer
authors.forename: Steven H
authors.initials: SH
authors.lastname: Marshall
authors.forename: Lenore
authors.initials: L
authors.lastname: Carias
authors.forename: Philip
authors.initials: P
authors.lastname: Toltzis
authors.forename: Louis B
authors.initials: LB
authors.lastname: Rice
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bonomo
mesh_terms: D001426:Bacterial Proteins; D002648:Child; D002675:Child, Preschool; D015169:Colony Count, Microbial; D003227:Conjugation, Genetic; D004269:DNA, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects* / Q000235:genetics*; D004927:Escherichia coli Infections / Q000382:microbiology*; D005260:Female; D006801:Humans; D007525:Isoelectric Focusing; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D004269:DNA, Bacterial; C048795:AmpC beta-lactamases; D001618:beta-Lactamases