title: Characterization of Extended-Spectrum β-Lactamase-Carrying Plasmids in Clinical Isolates of Klebsiella pneumoniae from Taiwan.
abstract: We analyzed the replicon types, sizes, and restriction fragment length polymorphism (RFLP) typing of plasmids carrying extended-spectrum β-lactamase (ESBL) genes in Klebsiella pneumoniae isolates from Taiwan. Fifty-one Escherichia coli transconjugant strains with plasmids from ESBL-producing K. pneumoniae from the Taiwan Surveillance of Antimicrobial Resistance III Program in 2002 were included. All the 51 plasmids carried a blaCTX-Mgene, the majority of which were blaCTX-M-3(28/51 [54.9%]). Plasmids ranged in size from 126 to 241 kb by S1 nuclease digestion and subsequent pulsed-field gel electrophoresis, and the most common plasmid size (37.3%) was 161-170 kb. The most common replicon type of plasmids was incompatibility group (Inc)A/C (60.8%). The IncA/C plasmids all carried blaCTX-M(blaCTX-M-3, -14, -15), and some also carried blaSHV(blaSHV-5, -12) genes. All 51 plasmids could be typed with PstI, and 27 (52.9%) belonged to 10 clusters. Thirty-eight of the 51 plasmids were typable with BamHI, and 21 plasmids (55.3%) fell into 7 clusters. Plasmids in the same cluster belonged to the same incompatibility group, with the exception of cluster C6. In conclusion, IncA/C plasmids are the main plasmid type responsible for the dissemination of ESBL genes of K. pneumoniae from Taiwan. RFLP with PstI possessed better discriminatory power than that with BamHI and PCR-based replicon typing for ESBL-carrying plasmids in K. pneumoniae in this study. Greater than 50% of plasmids fell into clusters, and >60% of cluster-classified plasmids were present in clonally unrelated isolates, indicating that horizontal transfer of plasmids plays an important role in the spread of ESBL genes.
authors.affiliation: 1 Department of Microbiology and Immunology, School of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .|2 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .
authors.forename: Chung-Yu
authors.initials: CY
authors.lastname: Chang
authors.affiliation: 1 Department of Microbiology and Immunology, School of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .|2 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .
authors.forename: Heng-Jia
authors.initials: HJ
authors.lastname: Lin
authors.affiliation: 1 Department of Microbiology and Immunology, School of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .|2 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .
authors.forename: Lin-Li
authors.initials: LL
authors.lastname: Chang
authors.affiliation: 3 National Institutes of Infectious Diseases and Vaccinology, National Health Research Institutes , Miaoli, Taiwan .
authors.forename: Ling
authors.initials: L
authors.lastname: Ma
authors.affiliation: 3 National Institutes of Infectious Diseases and Vaccinology, National Health Research Institutes , Miaoli, Taiwan .
authors.forename: L Kristopher
authors.initials: LK
authors.lastname: Siu
authors.affiliation: 4 Department of Public Health and Environmental Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .
authors.forename: Yi-Ching
authors.initials: YC
authors.lastname: Tung
authors.affiliation: 2 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung, Taiwan .|5 Department of Internal Medicine, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan .|6 Department of Laboratory Medicine, Kaohsiung Medical University Hospital , Kaohsiung, Taiwan .
authors.forename: Po-Liang
authors.initials: PL
authors.lastname: Lu
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002999:Clone Cells; D003227:Conjugation, Genetic; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D015964:Gene Expression Regulation, Bacterial; D022761:Gene Transfer, Horizontal; D006801:Humans; D007710:Klebsiella Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010802:Phylogeny; D010957:Plasmids / Q000737:chemistry / Q000145:classification / Q000378:metabolism*; D012150:Polymorphism, Restriction Fragment Length; D062486:Public Health Surveillance; D012093:Replicon; D013624:Taiwan / Q000453:epidemiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D001618:beta-Lactamases
keywords: ESBL; Klebsiella pneumoniae; RFLP; plasmid replicon typing