期刊
YONSEI MEDICAL JOURNAL
卷 49, 期 1, 页码 53-57出版社
YONSEI UNIV COLL MEDICINE
DOI: 10.3349/ymj.2008.49.1.53
关键词
outbreak; Klebsiella pneumoniae; SHV-12; DHA-1; extended-spectrum beta-lactamase; AmpC beta-lactamase
Purpose: Coexistence of different classes of beta-lactamases in a single bacterial isolate may pose diagnostic and therapeutic challenges. We investigated a spread of Klebsiella pneumoniae isolates co-producing an AmpC beta-lactamase and an extended-spectrum beta-lactamase (ESBL) in a university hospital. Materials and Methods: Over a three-month period, a total of 11 K pneumoniae isolates, which exhibited resistance to cefotaxime, aztreonam, and cefoxitin, were isolated. These isolates showed positive to ESBLs by double disk tests. Minimal inhibitory concentrations (MICs) were determined by broth microdilution testing. All isolates were examined by isoelectric focusing, PCR and sequence analysis to identify bla(SHV) and bla(DHA), and molecular typing by pulsed-field gel electrophoresis (PFGE). Results: All 11 isolates were highly resistant (MIC, >= 128 mu g/ml) to ceftazidime, aztreonam, and cefoxitin, while they were susceptible (MIC, <= 2 mu g/ml) to imipenem. The bla(SHV-12) and bla(DHA-1) genes were detected by PCR and sequence analysis. PFGE revealed a similar pattern in 10 of the 11 strains tested. Conclusion: This is the first outbreak report of K. pneumoniae in Korea which co-produced SHV-12 and DHA-1 beta-lactamase, and we suggest a clonal spread of multidrug-resistant K pneumoniae at a hospital.
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