title: Bacteremia due to extended-spectrum-β-lactamase-producing Aeromonas spp. at a medical center in Southern Taiwan.
abstract: Although extended-spectrum-β-lactamase (ESBL)-producing aeromonads have been increasingly reported in recent years, most of them were isolates from case reports or environmental isolates. To investigate the prevalence of ESBL producers among Aeromonas blood isolates and the genes encoding ESBLs, consecutive nonduplicate Aeromonas blood isolates collected at a medical center in southern Taiwan from March 2004 to December 2008 were studied. The ESBL phenotypes were examined by clavulanate combination disk test and the cefepime-clavulanate ESBL Etest. The presence of ESBL-encoding genes, including bla(TEM), bla(PER), bla(CTX-M), and bla(SHV) genes, was evaluated by PCR and sequence analysis. The results showed that 4 (2.6%) of 156 Aeromonas blood isolates, 1 Aeromonas hydrophila isolate and 3 Aeromonas caviae isolates, expressed an ESBL-producing phenotype. The ESBL gene in two A. caviae isolates was bla(PER-3), which was located in both chromosomes and plasmids, as demonstrated by Southern hybridization. Of four patients with ESBL-producing Aeromonas bacteremia, two presented with catheter-related phlebitis and the other two with primary bacteremia. Three patients had been treated with initial noncarbapenem β-lactams for 5 to 10 days, and all survived. In conclusion, ESBL producers exist among Aeromonas blood isolates, and clinical suspicion of ESBL production should be raised in treating infections due to cefotaxime-resistant Aeromonas isolates.
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Medical College and Hospital, Tainan, Taiwan.
authors.forename: Chi-Jung
authors.initials: CJ
authors.lastname: Wu
authors.forename: Yin-Ching
authors.initials: YC
authors.lastname: Chuang
authors.forename: Mei-Feng
authors.initials: MF
authors.lastname: Lee
authors.forename: Chin-Chi
authors.initials: CC
authors.lastname: Lee
authors.forename: Hsin-Chun
authors.initials: HC
authors.lastname: Lee
authors.forename: Nan-Yao
authors.initials: NY
authors.lastname: Lee
authors.forename: Chia-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Po-Lin
authors.initials: PL
authors.lastname: Chen
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Lin
authors.forename: Jing-Jou
authors.initials: JJ
authors.lastname: Yan
authors.forename: Wen-Chien
authors.initials: WC
authors.lastname: Ko
mesh_terms: D000046:Academic Medical Centers / Q000706:statistics & numerical data*; D057585:Aeromonas caviae / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D016980:Aeromonas hydrophila / Q000187:drug effects / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification*; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000453:epidemiology* / Q000382:microbiology*; D002439:Cefotaxime / Q000494:pharmacology; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D015995:Prevalence; D013624:Taiwan / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases; D002439:Cefotaxime