title: Dissemination of extended-spectrum beta-lactamase-producing Enterobacteriaceae in intensive care units of a medical center in Taiwan.
abstract: The prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae in a tertiary hospital in Taiwan was assessed over a 16-month period. A total of 125 nonrepetitive ESBL-producing isolates of Enterobacter cloacae, Escherichia coli, and Klebsiella pneumoniae were available for investigation using molecular methods. Four predominant intensive care units (ICUs) were identified, and SHV-12 (59%), CTX-M- 3 (36%), and CTX-M-14 (14%) were the three most frequent ESBLs. SHV-12 was predominant among E. cloacae in the burn unit and K. pneumoniae in the other three chest medicine-related ICUs. CTX-M-3 was predominant among E. coli and K. pneumoniae in three other ICUs. The dissemination of ESBL-producing Enterobacteriaceae in four ICUs of a medical center in Taiwan is a consequence of the clonal dissemination of a few epidemic strains along with the horizontal transmission of resistance genes-carrying plasmids among bacterial organisms.
authors.affiliation: Department of Clinical Pathology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Tsu-Lan
authors.initials: TL
authors.lastname: Wu
authors.forename: Ju-Hsin
authors.initials: JH
authors.lastname: Chia
authors.forename: Lin-Hui
authors.initials: LH
authors.lastname: Su
authors.forename: Chishih
authors.initials: C
authors.lastname: Chu
authors.forename: An-Jing
authors.initials: AJ
authors.lastname: Kuo
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
mesh_terms: D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology / Q000635:transmission*; D022761:Gene Transfer, Horizontal; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests / Q000379:methods; D010957:Plasmids; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics* / Q000378:metabolism
chemical_list: C417271:beta-lactamase CTX-M-3; C107198:beta-lactamase SHV-12; D001618:beta-Lactamases