title: Characterization and molecular epidemiology of extended spectrum beta-lactamase producing Enterobacter cloacae isolated from a Tunisian hospital.
abstract: In 2009, out of the 66 nonrepetitive Enterobacter cloacae collected at Charles Nicolle hospital in Tunisia, 44 were extended spectrum β-lactamase (ESBL) producers. The aim of the current study was to detect and characterize the genes encoding the ESBLs including blaTEM, blaSHV, and blaCTX-M groups by polymerase chain reaction and sequencing. Pulsed-field gel electrophoresis (PFGE) analysis was used to determine the genetic relatedness between isolates. All strains were susceptible to carbapenems. They were resistant to fluoroquinolones, gentamicin, tobramycin, and trimethoprim+sulfamethoxazole but variably resistant to netilmicin, amikacin, and tetracyclines. Sequence analysis of the polymerase chain reaction products revealed the presence of blaCTX-M-15 (39 strains), blaSHV-12 (6 strains), and blaSHV-27 (1 strain). The coexistence of two ESBLs was observed in two isolates harboring, respectively, SHV-12+CTX-M-15 and SHV-27+CTX-M-15. PFGE revealed 36 unrelated profiles. Diffusion of E. cloacae producing CTX-M-15 ESBL in our hospital is the consequence of dissemination of identical or related plasmids harboring the CTX-M-15 gene.
authors.affiliation: Laboratoire de Recherche Résistance aux Antimicrobiens, Faculté de Médecine de Tunis, Tunis, Tunisie. hammamisamia@yahoo.fr
authors.forename: Samia
authors.initials: S
authors.lastname: Hammami
authors.forename: Ilhem
authors.initials: I
authors.lastname: Boutiba-Ben Boubaker
authors.forename: Mabrouka
authors.initials: M
authors.lastname: Saidani
authors.forename: Emna
authors.initials: E
authors.lastname: Lakhal
authors.forename: Aymen
authors.initials: A
authors.lastname: Ben Hassen
authors.forename: Aouatef
authors.initials: A
authors.lastname: Kamoun
authors.forename: Rafiaa
authors.initials: R
authors.lastname: Ghozzi
authors.forename: Amin
authors.initials: A
authors.lastname: Slim
authors.forename: Saida
authors.initials: S
authors.lastname: Ben Redjeb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics*; D015780:Carbapenems / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D016972:Enterobacter cloacae / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D010802:Phylogeny; D010957:Plasmids; D017422:Sequence Analysis, DNA; D014416:Tunisia / Q000453:epidemiology; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D001618:beta-Lactamases