title: [Extended-spectrum-beta-lactamase-producing Proteus mirabilis: laboratory-based surveillance in cooperation with 12 clinical laboratories in the Kinki Region of Japan].
abstract: We studied 247 strains of Proteus mirabilis collected during the 6 months from November 2003 to April 2004 from 12 clinical laboratories in the Kinki region of Japan for the production of extended-spectrum beta-lactamase (ESBL). Eighteen strains (7.3%) showed MICs for cefpodoxime of > or = 2 microg/mL and 13 strains (5.2%) were positive for the double-disk synergy test. Susceptibility depended on genotype. MICs for cefepime, cefozopran, and cefpirome were high (> or = 8 microg/mL), and that for ceftazidime was low (0.12-0.5 microg/mL). Meropenem showed the lowest MIC (< or = 0.03-0.25 microg/mL) of the calbapenems, while other calbapenems showed somewhat higher values (0.5-2 microg/mL). The MIC of tazobactam/piperacillin was also relatively low (< or = 0.25-1 microg/mL). Analysis of the ESBL genotype by the polymerase chain reaction showed that 12 of 13 strains were CTX-M2 types. CTX-M9 was detected in a single laboratory. The clinical background showed 5 strains in urine samples. Twelve of 13 strains were detected in patients with minimal devices use. No symptoms were found in most cases of established syndrome. Analysis of PCR fingerprint profiles of random amplified polymorphic DNA patterns showed that 6 of 7 strains from hospital 1 showed the same pattern, and 5 of 5 strains from hospital 13 showed the same pattern, suggesting the nosocomial spread of P. mirabilis in each hospital.
authors.affiliation: Clinical Central Laboratory, Kansai Medical University Hospital.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nakamura
authors.forename: Masaru
authors.initials: M
authors.lastname: Komatsu
authors.forename: Kouichi
authors.initials: K
authors.lastname: Shimakawa
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Sueyoshi
authors.forename: Kaori
authors.initials: K
authors.lastname: Satoh
authors.forename: Masahiro
authors.initials: M
authors.lastname: Toyokawa
authors.forename: Hisaaki
authors.initials: H
authors.lastname: Nishio
authors.forename: Yasunao
authors.initials: Y
authors.lastname: Wada
authors.forename: Tamaki
authors.initials: T
authors.lastname: Orita
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kofuku
authors.forename: Masako
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Okamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Akagi
authors.forename: Shohiro
authors.initials: S
authors.lastname: Kinoshita
mesh_terms: D024881:Drug Resistance, Bacterial; D006801:Humans; D007564:Japan / Q000453:epidemiology; D011512:Proteus Infections / Q000453:epidemiology; D011513:Proteus mirabilis / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D001618:beta-Lactamases