title: Molecular characterization of extended-spectrum beta-lactamases in clinical Escherichia coli and Klebsiella pneumoniae isolates from Surabaya, Indonesia.
abstract: BACKGROUND
  No detailed reports regarding extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae are currently available from Indonesia, the fourth most populous country in the world.
  
  
  METHODS
  A survey was carried out to investigate the molecular epidemiology and genetic characteristics of clinical ESBL-producing Escherichia coli and Klebsiella pneumoniae isolates originating from the Dr. Soetomo Academic Hospital in Surabaya, Indonesia, over a 4 month period (January to April 2005). ESBLs were characterized by isoelectric focusing and PCR assays. Clonality of the isolates was assessed by PFGE and repetitive-sequence-based PCR (rep-PCR). Phylogenetic grouping was performed among CTX-M-15-producing E. coli.
  
  
  RESULTS
  In total, 73 consecutive non-duplicate ESBL-positive E. coli and 72 K. pneumoniae strains were isolated. The bla(CTX-M-15) gene was found to be highly prevalent (69/73 strains, 94.5%) among the 73 ESBL-positive E. coli isolates. The gene was detected in both clonal and non-clonal isolates, as defined by PFGE and rep-PCR. Sixteen CTX-M-15-positive E. coli could be assigned to a single rep-PCR type and phylogenetic group B2 and belonged to the well-known O25b-ST131 clone. Among the 72 ESBL-positive K. pneumoniae isolates, bla(CTX-M-15) was again the most prevalent ESBL (40/72, 55.6%). Several SHV-type enzymes were also frequently detected: SHV-5 (n = 28); SHV-12 (n = 13); and SHV-2 (n = 6). TEM-type ESBLs were not detected in any of the isolates.
  
  
  CONCLUSIONS
  Indonesia is another developing country affected by the emergence and spread of bacterial strains harbouring ESBL genes, including the CTX-M-15-producing B2-E. coli O25b-ST131 clone.
authors.affiliation: Department of Medical Microbiology and Infectious Diseases, Erasmus MC, University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands. j.severin@erasmusmc.nl
authors.forename: Juliëtte A
authors.initials: JA
authors.lastname: Severin
authors.forename: Ni Made
authors.initials: NM
authors.lastname: Mertaniasih
authors.forename: Kuntaman
authors.initials: K
authors.lastname: Kuntaman
authors.forename: Endang S
authors.initials: ES
authors.lastname: Lestari
authors.forename: Marijam
authors.initials: M
authors.lastname: Purwanta
authors.forename: Nicole
authors.initials: N
authors.lastname: Lemmens-Den Toom
authors.forename: D Offra
authors.initials: DO
authors.lastname: Duerink
authors.forename: Usman
authors.initials: U
authors.lastname: Hadi
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
authors.forename: Wil H
authors.initials: WH
authors.lastname: Goessens
mesh_terms: D015373:Bacterial Typing Techniques; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005838:Genotype; D006785:Hospitals, University; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007710:Klebsiella Infections / Q000453:epidemiology / Q000382:microbiology*; D007711:Klebsiella pneumoniae / Q000145:classification / Q000201:enzymology* / Q000235:genetics / Q000302:isolation & purification; D017720:Molecular Epidemiology; D001618:beta-Lactamases / Q000737:chemistry* / Q000235:genetics*
chemical_list: D001618:beta-Lactamases