title: Emergence of Proteus mirabilis isolates producing TEM-52 extended-spectrum beta-lactamases in Croatia.
abstract: BACKGROUND
  An increased frequency of extended-spectrum beta-lactamase (ESBL)-positive Proteus mirabilis isolates was observed recently in the Clinical Hospital Center Split in Croatia. The aim of this study was the molecular characterization of ESBLs in P. mirabilis isolates from this hospital.
  
  
  METHODS
  Seven strains showing reduced susceptibility to ceftazidime were investigated. Antimicrobial susceptibility was determined using the broth microdilution method. ESBLs were characterized by PCR and sequencing of bla(ESBL) genes. Quinolone resistance determinants (qnr genes) were characterized by PCR. Genotyping of strains was performed by pulsed-field gel electrophoresis (PFGE).
  
  
  RESULTS
  The presence of an ESBL was confirmed in all strains by a double-disk synergy test. All strains were resistant to amoxicillin, piperacillin, gentamicin, ciprofloxacin, chloramphenicol, sulfamethoxazole and trimethoprim, but susceptible to ceftazidime/clavulanic acid, piperacillin/tazobactam, cefoxitin, imipenem and meropenem; PCR sequencing using primers targeting bla(ESBL) genes revealed TEM-52 beta-lactamase. PFGE genotyping demonstrated the clonal relatedness of TEM-52-producing P. mirabilis strains isolated from different clinical samples and wards within the hospital. Bla(TEM-52) in 3 isolates was carried by a 70-kb conjugative plasmid.
  
  
  CONCLUSIONS
  Our findings indicate the emergence of the TEM-52 enzyme among P. mirabilis in Croatia.
authors.affiliation: Department of Microbiology, Clinical Hospital Center Split, Split, Croatia. sandasard@gmail.com
authors.forename: Sanda
authors.initials: S
authors.lastname: Sardelić
authors.forename: Branka
authors.initials: B
authors.lastname: Bedenić
authors.forename: Dubravko
authors.initials: D
authors.lastname: Sijak
authors.forename: Celine
authors.initials: C
authors.lastname: Colinon
authors.forename: Smilja
authors.initials: S
authors.lastname: Kalenić
mesh_terms: D002442:Ceftazidime / Q000494:pharmacology; D017523:Croatia; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D011513:Proteus mirabilis / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D018440:beta-Lactam Resistance / Q000187:drug effects / Q000502:physiology; D001618:beta-Lactamases / Q000096:biosynthesis*
chemical_list: D002442:Ceftazidime; C445691:TEM-52 beta-lactamase; D001618:beta-Lactamases