title: A 7-year surveillance for ESBL-producing Escherichia coli and Klebsiella pneumoniae at a university hospital in Taiwan: the increase of CTX-M-15 in the ICU.
abstract: To monitor the changing trend of extended-spectrum beta-lactamase (ESBL)-producing bacteria, a 7-year continuous study was launched in 2001 at the largest tertiary hospital in Taiwan. A significant increase over the study period was evident for ESBL-producing isolates of Escherichia coli (4.8-10.0%) and Klebsiella pneumoniae (15.0-23.4%). Molecular investigation conducted in three separate periods revealed the prevalent ESBL types and their genetic relatedness. CTX-M-producing isolates (73.8%) were more prevalent than SHV-type ESBLs (37.0%), the most frequent being CTX-M-14 (34.3%), CTX-M-3 (25.9%), and SHV-12 (25.7%). However, a marked increase of CTX-M-15-producing isolates from 2.1% in 2002 to 29.6% in 2007 was also noted. The increase of ESBL-producing isolates in both species may be mainly due to the horizontal transmission of resistance plasmids, while clonal expansion of some epidemic strains further added to the dispersion of ESBL-producing K. pneumoniae.
authors.affiliation: Department of Medical Biotechnology and Laboratory Science, Chang Gung University College of Medicine, Kweishan, Taoyuan, Taiwan.
authors.forename: J C
authors.initials: JC
authors.lastname: Shu
authors.forename: J H
authors.initials: JH
authors.lastname: Chia
authors.forename: A J
authors.initials: AJ
authors.lastname: Kuo
authors.forename: Lin-Hui
authors.initials: LH
authors.lastname: Su
authors.forename: Tsu-Lan
authors.initials: TL
authors.lastname: Wu
mesh_terms: D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology*; D004927:Escherichia coli Infections / Q000382:microbiology* / Q000517:prevention & control; D015964:Gene Expression Regulation, Bacterial; D015971:Gene Expression Regulation, Enzymologic; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units; D007710:Klebsiella Infections / Q000382:microbiology* / Q000517:prevention & control; D007711:Klebsiella pneumoniae / Q000187:drug effects / Q000201:enzymology*; D015995:Prevalence; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D018440:beta-Lactam Resistance; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism*
chemical_list: C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases