Frequency and diversity of Class A extended-spectrum beta-lactamases in hospitals of the Auvergne, France: a 2 year prospective study.
OBJECTIVE
To evaluate the frequency and diversity of extended-spectrum beta-lactamases (ESBLs) produced by Enterobacteriaceae and Pseudomonas aeruginosa in one French region.


METHODS
During 2001-2002, all the non-duplicate isolates of P. aeruginosa resistant to ceftazidime and of Enterobacteriaceae intermediate or resistant to ceftazidime and/or cefotaxime and/or aminoglycosides with an AAC(6') I phenotype were collected in nine hospitals of the area. ESBL isoelectric points were determined, bla genes were amplified and sequenced and epidemic isolates were genotyped with ERIC2-PCR.


RESULTS
ESBLs were observed in 297 Enterobacteriaceae (0.8%). The most frequent were TEM-3 like (n=152; 51.2%) and TEM-24 (n=115; 38.7%). Four new enzymes were observed, TEM-112 (pI 5.4), TEM-113 (pI 6.3), TEM-114 (pI 5.9) and TEM-126 (pI 5.4). Other TEMs were TEM-8, TEM-12, TEM-16, TEM-19, TEM-20, TEM-21, TEM-29 and TEM-71. The other ESBLs were SHV-4, SHV-5 and SHV-12, CTX-M-1, CTX-M-3, CTX-M-14 and CTX-M-15. In 37 P. aeruginosa (0.7%) only one ESBL was observed, PER-1. Five epidemic strains were detected, Serratia marcescens TEM-3 and four observed in several hospitals, Enterobacter aerogenes TEM-24, Citrobacter koseri TEM-3, Proteus mirabilis TEM-3 and P. aeruginosa PER-1.


CONCLUSIONS
ESBL frequency was lower than in 1998, and CTX-M-type frequency higher (2.1% of ESBLs in 2001, 4.9% in 2002). This long-term survey detected new sporadic enzymes (TEM-112, TEM-113, TEM-114 and TEM-126) and interhospital epidemic strains while avoiding any overestimation of ESBL frequency that may otherwise have occurred because of acute epidemics.
De Champs
C
C
Centre Hospitalier Universitaire de Clermont-Ferrand, rue Montalembert, 63000 Clermont-Ferrand, France. cdechaps@chu-reims.fr
Chanal
C
C
Sirot
D
D
Baraduc
R
R
Romaszko
J P
JP
Bonnet
R
R
Plaidy
A
A
Boyer
M
M
Carroy
E
E
Gbadamassi
M C
MC
Laluque
S
S
Oules
O
O
Poupart
M C
MC
Villemain
M
M
Sirot
J
J
D019943:Amino Acid Substitution; D003001:Cloning, Molecular; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D017931:DNA Primers; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics*; D005602:France / Q000453:epidemiology; D005787:Gene Frequency; D006801:Humans; D007525:Isoelectric Focusing; D011159:Population Surveillance; D011446:Prospective Studies; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D001618:beta-Lactamases / Q000235:genetics*
D017931:DNA Primers; D001618:beta-Lactamases