title: Incidence of class A extended-spectrum beta-lactamases in Champagne-Ardenne (France): a 1 year prospective study.
abstract: OBJECTIVE
  To assess the frequency and diversity of extended spectrum beta-lactamases (ESBLs) in the Champagne-Ardenne region France, and to identify genetic elements associated with the bla(CTX-M) genes.
  
  
  METHODS
  During 2004, all the non-duplicate isolates of Pseudomonas aeruginosa and Acinetobacter baumannii resistant to ceftazidime and of Enterobacteriaceae intermediate or resistant to ceftazidime and/or cefotaxime, screening samples excluded, were collected in 10 public hospitals and 3 private clinics. bla genes were sequenced and bla(CTX-M) environment characterized by PCR mapping.
  
  
  RESULTS
  In Enterobacteriaceae (138/21 861; 0.6%), ESBLs were predominantly TEM-24 (n = 52; 37.7%) and CTX-M-15 (n = 37; 26.8%). Three new enzymes were identified, CTX-M-61 (CTX-M-1 group), TEM- and SHV-type. A. baumannii (n = 5) produced VEB-1 and P. aeruginosa (n = 2) SHV-2a. ISEcp1 was detected in 22/27 strains, disrupted in 7 of them. The IS903-like element was downstream of bla(CTX-M-14) and bla(CTX-M-16). ISCR1 was found upstream of bla(CTX-M-2) and bla(CTX-M-9), and ISCR1 and bla(CTX-M-2) were located on a sul1-type class 1 integron. In comparison with 2001-02, ESBL distribution among Enterobacteriaceae showed an increase in CTX-M-type (44.9% vs 3.7% P < 10(-7)) due to Escherichia coli CTX-M-15 and to the almost total disappearance of TEM-3 (0.9% vs 51.2%). E. coli was the most frequent species (50.0% vs 5.1% in 1998) despite a similar prevalence to that in 1998 (0.5% vs 0.2%).
  
  
  CONCLUSIONS
  A careful detection of bla(CTX-M)-type spread to other species would help to anticipate clonal endemics such as those observed in Enterobacter aerogenes TEM-24.
authors.affiliation: Laboratoire de Bactériologie-Virologie-Hygiène CHU de Reims, UFR Médecine Université Reims Champagne-Ardenne, 51092 Reims, France.
authors.forename: L
authors.initials: L
authors.lastname: Brasme
authors.forename: P
authors.initials: P
authors.lastname: Nordmann
authors.forename: F
authors.initials: F
authors.lastname: Fidel
authors.forename: M F
authors.initials: MF
authors.lastname: Lartigue
authors.forename: O
authors.initials: O
authors.lastname: Bajolet
authors.forename: L
authors.initials: L
authors.lastname: Poirel
authors.forename: D
authors.initials: D
authors.lastname: Forte
authors.forename: V
authors.initials: V
authors.lastname: Vernet-Garnier
authors.forename: J
authors.initials: J
authors.lastname: Madoux
authors.forename: J C
authors.initials: JC
authors.lastname: Reveil
authors.forename: C
authors.initials: C
authors.lastname: Alba-Sauviat
authors.forename: I
authors.initials: I
authors.lastname: Baudinat
authors.forename: P
authors.initials: P
authors.lastname: Bineau
authors.forename: C
authors.initials: C
authors.lastname: Bouquigny-Saison
authors.forename: C
authors.initials: C
authors.lastname: Eloy
authors.forename: C
authors.initials: C
authors.lastname: Lafaurie
authors.forename: D
authors.initials: D
authors.lastname: Siméon
authors.forename: J P
authors.initials: JP
authors.lastname: Verquin
authors.forename: F
authors.initials: F
authors.lastname: Noël
authors.forename: C
authors.initials: C
authors.lastname: Strady
authors.forename: C
authors.initials: C
authors.lastname: De Champs
mesh_terms: D040981:Acinetobacter baumannii / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001424:Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D005602:France / Q000453:epidemiology; D006801:Humans; D011159:Population Surveillance; D011550:Pseudomonas aeruginosa / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D013997:Time Factors; D001618:beta-Lactamases / Q000145:classification* / Q000302:isolation & purification*