title: Emergence and wide dissemination of CTX-M-type ESBLs, and CMY-2- and DHA-1-type AmpC beta-lactamases in Korean respiratory isolates of Klebsiella pneumoniae.
abstract: Respiratory isolates of Klebsiella pneumoniae in Korea during 2002-2003 were studied to determine the prevalence and types of extended-spectrum beta-lactamases (ESBLs) and plasmid-mediated AmpC beta-lactamases (PABLs). ESBL-production was tested by double-disk synergy, and genotypes of beta-lactamases were determined by PCR and sequencing. ESBLs were detected in 28.4% of 373 isolates, and the most prevalent types were SHV-12 (63 isolates) and CTX-M-14 (9 isolates). Forty of 75 ESBL-producers (53.5%) also had PABLs: 21 isolates with CMY-2-like, 17 with DHA-1-like. Pulsed-field gel electrophoresis showed 19 types and 25 of 74 isolates had an identical pattern, indicating nosocomial spread. Dissemination of ESBL- and PABL-producing K. pneumoniae strains in Korea is a particular concern, as it limits the choice of antimicrobial agents for treatment of infections.
authors.affiliation: Department of Laboratory Medicine, Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jong Hwa
authors.initials: JH
authors.lastname: Yum
authors.forename: Shinyoung
authors.initials: S
authors.lastname: Kim
authors.forename: Hyukmin
authors.initials: H
authors.lastname: Lee
authors.forename: Dongeun
authors.initials: D
authors.lastname: Yong
authors.forename: Kyungwon
authors.initials: K
authors.lastname: Lee
authors.forename: Sang-Nae
authors.initials: SN
authors.lastname: Cho
authors.forename: Yunsop
authors.initials: Y
authors.lastname: Chong
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001426:Bacterial Proteins / Q000096:biosynthesis / Q000145:classification / Q000235:genetics; D001483:Base Sequence; D003428:Cross Infection / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005798:Genes, Bacterial; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification*; D007723:Korea; D012141:Respiratory Tract Infections / Q000188:drug therapy / Q000382:microbiology*; D001618:beta-Lactamases / Q000096:biosynthesis / Q000145:classification* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; C103022:beta-lactamase CMY-2; C456080:beta-lactamase CTX-M-14; C048795:AmpC beta-lactamases; D001618:beta-Lactamases