title: Current status of extended spectrum β-lactamase-producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis in Okinawa prefecture, Japan.
abstract: Enterobacteriaceae producing extended spectrum β-lactamase (ESBL) are distributed worldwide. In this study, 114 ESBL-producing Enterobacteriaceae were isolated by analyzing 1672 clinical isolates of Enterobacteriaceae collected from an Okinawa prefectural hospital in Japan between June 2013 and July 2014. The overall prevalence of ESBL-producing Enterobacteriaceae was 6.8%; the prevalence of different bacterial species among the ESBL-producing isolates was as follows: 11.5% Escherichia coli (90 of 783 isolates), 6.2% Klebsiella pneumoniae (19 of 307 isolates), and 11.1% Proteus mirabilis (5 of 45 isolates). The ESBL types blaCTX-M-1, -3, -15, -2, -14, -27, and mutants of blaSHV-1 were detected. Among them, blaCTX-M-15 (33.3%), blaCTX-M-14 (27.8%) and blaCTX-M-27 (33.3%) were dominant in the E. coli isolates, whereas a blaSHV mutant which possessed four mutations (Tyr7Phe, Leu35Gln, Gly238Ser and Glu240Lys) in the amino acid sequence of SHV-1 dominated in the K. pneumoniae isolates (11 of 19, 57.9%). The pandemic E. coli ST131 clone was found to constitute 3.3% of the overall examined isolates and 62.2% of the ESBL-producing E. coli isolates. Our results suggest that the genetic combination of blaCTX-M, and blaSHV and antibiotics-resistant profile were different from that in other regions such as other areas of Japan, Asia, Europe, and North America, especially in the ESBL-producing K. pneumoniae isolates and in the E. coli B2-O25b-ST131 isolates possessing blaCTX-M-15 (40.7% of the E. coli B2-O25b-ST131 isolates). Taken together, our results indicate that the ESBL-producing Enterobacteriaceae in Okinawa, Japan, might be of a unique nature.
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Nakama
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Aoi
authors.initials: A
authors.lastname: Shingaki
authors.affiliation: Okinawa Prefectural Nambu Medical Center & Children's Medical Center, Haebaru, Okinawa 901-1193, Japan.
authors.forename: Hiroko
authors.initials: H
authors.lastname: Miyazato
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Rikako
authors.initials: R
authors.lastname: Higa
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Chota
authors.initials: C
authors.lastname: Nagamoto
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Kouta
authors.initials: K
authors.lastname: Hamamoto
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan; Japan Agency for Medical Research and Development/Japan International Cooperation Agency, Science and Technology Research Partnership for Sustainable Development (AMED/JICA, SATREPS), Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Ueda
authors.affiliation: Okinawa Prefectural Nambu Medical Center & Children's Medical Center, Haebaru, Okinawa 901-1193, Japan; Okinawa Prefectural Chubu Hospital, Uruma, Okinawa 904-2293, Japan.
authors.forename: Teruyuki
authors.initials: T
authors.lastname: Hachiman
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Touma
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan.
authors.forename: Kazufumi
authors.initials: K
authors.lastname: Miyagi
authors.affiliation: Japan Agency for Medical Research and Development/Japan International Cooperation Agency, Science and Technology Research Partnership for Sustainable Development (AMED/JICA, SATREPS), Japan; Osaka Prefectural Institute of Public Health, Higashinari-ku, Osaka 537-0025, Japan.
authors.forename: Ryuji
authors.initials: R
authors.lastname: Kawahara
authors.affiliation: Nursing for Home Care and Chronic Nursing, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Toyosato
authors.affiliation: Laboratory of Microbiology, School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0215, Japan; Japan Agency for Medical Research and Development/Japan International Cooperation Agency, Science and Technology Research Partnership for Sustainable Development (AMED/JICA, SATREPS), Japan. Electronic address: hiraii@med.u-ryukyu.ac.jp.
authors.forename: Itaru
authors.initials: I
authors.lastname: Hirai
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000201:enzymology / Q000472:pathogenicity; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D001618:beta-Lactamases
chemical_list: D000900:Anti-Bacterial Agents; D001618:beta-Lactamases
keywords: CTX-M-type extended spectrum β-lactamase; Klebsiella pneumoniae possessing bla(SHV); Prevalence