title: Molecular typing and characterization of TEM, SHV, CTX-M, and CMY-2 β-lactamases in Enterobacter cloacae strains isolated in patients and their hospital environment in the west of Algeria.
abstract: OBJECTIVE
  Enterobacter cloacae is a major nosocomial bacterium causing severe infections. A multicenter retrospective cohort study was conducted to collect baseline information on the molecular characteristics of β-lactamase producing Enterobacter cloacae in the west of Algeria.
  
  
  METHODS
  We report a series of 42 extended-spectrum β-lactamase (ESBL) producing non-repetitive Enterobacter cloacae strains, collected in 3 university hospital (Tlemcen, Oran, and Sidi Bel Abbes). Antibiotic susceptibility testing (antibiogram and MIC) and screening for ESBL were performed according to the French Society for Microbiology guidelines. PFGE typing was used to characterize the clonality of all the strains. β-lactamase genes (blaTEM, blaSHV, blaCTX-M, blaECB, and blaCMY-2) were amplified by PCR with specific primers. Plasmid isolation, electroporation, and conjugation experiments were carried out using standard methods.
  
  
  RESULTS
  Sequence analysis revealed that most strains produced CTX-M type ESBLs (CTX-M-15 and CTX-M-3), whereas only 5 produced SHV-type ESBLs (SHV-12). The blaTEM gene was identified in all strains of Enterobacter cloacae. Several epidemic clones were determined. One strain was found to produce plasmid-mediated AmpC β-lactamase (CMY-2); this gene was transferred from E. cloacae by electroporation. Conjugation experiments showed that blaCTX-M, blaTEM, and blaSHV were carried by conjugative plasmids of high molecular weight (≥70kb).
  
  
  CONCLUSIONS
  The emergence of resistance genes is a public health problem.
authors.affiliation: Laboratoire antibiotiques, antifongiques, physico-chimie, synthèse et activité biologiques (LAPSAB), faculté des sciences de la nature, de la vie, de la terre et de l'univers, université Abou-Bekr-Belkaid-Tlemcen, BP 119, Tlemcen 13000, Algeria. Electronic address: souna.microbiologie@yahoo.fr.
authors.forename: D
authors.initials: D
authors.lastname: Souna
authors.affiliation: Service d'anesthésie-réanimation du CHU Hassani-Abdelkader-Sidi, Bel-Abbes, Algeria.
authors.forename: A S
authors.initials: AS
authors.lastname: Amir
authors.affiliation: Laboratoire de microbiologie du CHU d'Oran, rue du Dr Benzerdjeb-Oran, Oran, Algeria.
authors.forename: S N
authors.initials: SN
authors.lastname: Bekhoucha
authors.affiliation: Laboratoire antibiotiques, antifongiques, physico-chimie, synthèse et activité biologiques (LAPSAB), faculté des sciences de la nature, de la vie, de la terre et de l'univers, université Abou-Bekr-Belkaid-Tlemcen, BP 119, Tlemcen 13000, Algeria.
authors.forename: M
authors.initials: M
authors.lastname: Berrazeg
authors.affiliation: Laboratoire antibiotiques, antifongiques, physico-chimie, synthèse et activité biologiques (LAPSAB), faculté des sciences de la nature, de la vie, de la terre et de l'univers, université Abou-Bekr-Belkaid-Tlemcen, BP 119, Tlemcen 13000, Algeria.
authors.forename: M
authors.initials: M
authors.lastname: Drissi
mesh_terms: D000462:Algeria; D015331:Cohort Studies; D016972:Enterobacter cloacae / Q000145:classification* / Q000201:enzymology* / Q000302:isolation & purification; D006761:Hospitals; D006801:Humans; D058889:Molecular Typing; D012189:Retrospective Studies; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: C103022:beta-lactamase CMY-2; C417271:beta-lactamase CTX-M-3; C114942:beta-lactamase CTX-M-5; C107198:beta-lactamase SHV-12; D001618:beta-Lactamases; C034413:beta-lactamase TEM-1
keywords: Antibiotic resistance; Enterobacter cloacae; Extended-spectrum β-lactamase; Résistance aux antibiotiques; β-lactamase à spectre étendu