title: Outbreak of SHV-5 beta-lactamase-producing Klebsiella pneumoniae in a neonatal-pediatric intensive care unit in Spain.
abstract: The objective was to analyze the beta-lactamase genes and the clonal relationship in a series of 12 clinical Klebsiella pneumoniae strains resistant to ceftazidime or cefotaxime (MIC >/=16 microg/ml) recovered in the neonatalpediatric intensive care unit (ICU) ward of a Spanish hospital during a 1-year period. TEM, SHV, CTX-M, CMY, or FOX beta-lactamase genes were analyzed by PCR and sequencing. The clonal study was performed by pulsed-field gel electrophoresis (PFGE) using XbaI. All but one of the 12 K. pneumoniae strains harbored the bla (SHV-5) gene, and the bla TEM-1a gene was also detected in one of them. These 11 strains belonged to two different clonal types: A (9 strains) and B (2 strains) and were grouped in the subtypes A(1) (6 strains), A(2), A(3), A(4), B(1), and B(2) (1 strain each). The clonal type A strains were isolated from 9 patients (in five cases from blood) during a 6-month period. The remaining K. pneumoniae strain harbored both the bla (SHV-11) + bla (CTX-M-14) genes and showed the clonal type C. A nosocomial outbreak by a SHV-5-producing multiresistant K. pneumoniae is reported in Spain in a neonatal-pediatric ICU ward. This is the first description of a K. pneumoniae harboring both the bla (SHV-11) and bla (CTX-M-14) genes in Spain.
authors.affiliation: Area Bioquímica y Biología Molecular, Universidad La Rioja, 26006 Logroño, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Briñas
authors.forename: Marta
authors.initials: M
authors.lastname: Lantero
authors.forename: Myriam
authors.initials: M
authors.lastname: Zarazaga
authors.forename: Francisco
authors.initials: F
authors.lastname: Pérez
authors.forename: Carmen
authors.initials: C
authors.lastname: Torres
mesh_terms: D003428:Cross Infection / Q000382:microbiology* / Q000635:transmission; D004269:DNA, Bacterial / Q000235:genetics; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007710:Klebsiella Infections / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics; D013030:Spain / Q000453:epidemiology; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: D004269:DNA, Bacterial; C117193:beta-lactamase SHV-5; D001618:beta-Lactamases