title: Dissemination of Proteus mirabilis isolates harboring CTX-M-14 and CTX-M-3 beta-lactamases at 2 hospitals in Taiwan.
abstract: From February to June 2003, 111 clinical isolates of Proteus mirabilis were mainly isolated from patients with respiratory or urinary tract infections hospitalized at 3 district hospitals (A, B, C) in central Taiwan. Among them, 34 (30.6%) strains, isolated within 2 hospitals (A and B), exhibited nonsusceptibility to cefotaxime with significant reduction of MIC (> or = 3 log2 dilution) by the effect of clavulanic acid, which confirmed the phenotype of extended-spectrum beta-lactamases (ESBLs). These ESBL producers were coresistant to gentamicin, isepamicin, and amikacin, but remained susceptible to ceftazidime (MIC, < or = 0.5 microg/mL) and meropenem (MIC, <0.5 microg/mL). By isoelectric focusing analysis, polymerase chain reaction, and nucleotide sequencing, we detected the presence of CTX-M-14 in 33 strains and CTX-M-3 in 6 strains (5 strains harboring both CTX-M-14 and CTX-M-3 enzymes). These beta-lactamase genes can be successfully transferred by the conjugative plasmid. Molecular epidemiology of the 34 ESBL-producing P. mirabilis strains by pulsed-field gel electrophoresis using SfiI restriction enzyme revealed 9 different genotypes, suggesting epidemic clones with intra- and interhospital spread. In conclusion, the broadly extended clonal spreading of CTX-M-type P. mirabilis was first discovered at the district hospitals in Taiwan.
authors.affiliation: The Institute of Medical Science and Department of Microbiology, China Medical University, Taichung 404, Taiwan.
authors.forename: Lii-Tzu
authors.initials: LT
authors.lastname: Wu
authors.forename: Hwa-Jen
authors.initials: HJ
authors.lastname: Wu
authors.forename: Jing-Gung
authors.initials: JG
authors.lastname: Chung
authors.forename: Yin-Ching
authors.initials: YC
authors.lastname: Chuang
authors.forename: Kuo-Chen
authors.initials: KC
authors.lastname: Cheng
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Yu
mesh_terms: D001426:Bacterial Proteins / Q000032:analysis / Q000235:genetics; D015415:Biomarkers; D016521:Electrophoresis, Gel, Pulsed-Field; D016680:Genome, Bacterial; D005838:Genotype; D006767:Hospitals, District; D006801:Humans; D007769:Lactams / Q000494:pharmacology; D017720:Molecular Epidemiology; D012150:Polymorphism, Restriction Fragment Length; D011512:Proteus Infections / Q000453:epidemiology* / Q000382:microbiology*; D011513:Proteus mirabilis / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification; D012141:Respiratory Tract Infections / Q000453:epidemiology / Q000382:microbiology; D013624:Taiwan; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000032:analysis / Q000235:genetics*
chemical_list: D001426:Bacterial Proteins; D015415:Biomarkers; D007769:Lactams; C456080:beta-lactamase CTX-M-14; C417271:beta-lactamase CTX-M-3; C048795:AmpC beta-lactamases; D001618:beta-Lactamases