title: Outbreak of infection caused by Enterobacter cloacae producing the novel VEB-3 beta-lactamase in China.
abstract: Over a 4-month period from November 2002 to February 2003, 27 ceftazidime-resistant or cefotaxime-resistant nonrepetitive Enterobacter cloacae isolates were collected from 27 patients hospitalized at HuaShan Hospital, Shanghai, People's Republic of China. The Etest did not detect extended-spectrum beta-lactamases (ESBLs) in those 27 isolates; however, screening by the NCCLS ESBL disk test and confirmatory tests detected ESBLs in 4 of 27 isolates and PCR detected ESBLs in 23 of 27 isolates. The majority of ESBL producers exhibited the same repetitive extragenic palindromic PCR pattern but harbored different ESBL genes. CTX-M-3 was the most prevalent ESBL in our study. Interestingly, 12 clonally related E. cloacae isolates possessed a novel bla(VEB)-type beta-lactamase, bla(VEB-3). Bla(VEB-3) was encoded by the chromosome and was located in an integron. Nine of the 12 isolates harbored both the bla(VEB-3) and the bla(CTX-M-3)-like ESBLs. This is the first report of a VEB-1-like ESBL in China and the first report of the simultaneous presence of VEB-1 and CTX-M-3-like ESBLs in an isolate.
authors.affiliation: Center of Laboratory Medicine of Huashan Hospital, Fudan University, 12 Central Urumqi Rd., Shanghai 200040, People's Republic of China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Jiang
authors.forename: Yuxing
authors.initials: Y
authors.lastname: Ni
authors.forename: Yanqun
authors.initials: Y
authors.lastname: Jiang
authors.forename: Feiyi
authors.initials: F
authors.lastname: Yuan
authors.forename: Lizhong
authors.initials: L
authors.lastname: Han
authors.forename: Ming
authors.initials: M
authors.lastname: Li
authors.forename: Hong
authors.initials: H
authors.lastname: Liu
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000595:Amino Acid Sequence; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D016972:Enterobacter cloacae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D010957:Plasmids / Q000235:genetics; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D047090:beta-Lactams; D001618:beta-Lactamases