This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yan, J.-J. Articles by Wu, J.-J. Search for Related Content PubMed PubMed Citation Articles by Yan, J.-J. Articles by Wu, J.-J.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, September 2002, p. 3121-3126, Vol. 40, No. 9
0095-1137/02/$04.00+0     DOI: 10.1128/JCM.40.9.3121-3126.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Emergence of Klebsiella pneumoniae Isolates Producing Inducible DHA-1 ß-Lactamase in a University Hospital in Taiwan

Departments of Pathology,¹ Internal Medicine,² Medical Technology, College of Medicine, National Cheng Kung University,⁴ Department of Pathology, Sinlau Christian Hospital, Tainan, Taiwan³

Received 26 March 2002/ Returned for modification 25 May 2002/ Accepted 22 June 2002

Ten nonrepetitive clinical isolates of Klebsiella pneumoniae exhibiting an unusual inducible ß-lactam resistance phenotype were identified between January 1999 and September 2001 in a university hospital in Taiwan. In the presence of 2 µg of clavulanic acid, the isolates showed a one to four twofold concentration increase in the MICs of ceftazidime, cefotaxime, and aztreonam but remained susceptible to cefepime (MICs, 0.5 µg/ml) and imipenem (MICs, 0.5 µg/ml). PCR, sequence analysis, and isoelectric focusing revealed production by these isolates of TEM-1, SHV-11, and DHA-1, a plasmid-encoded inducible AmpC ß-lactamase originally found in a Salmonella enterica serovar Enteritidis strain. Transfer of the resistance by conjugation experiments was not successful, but Southern hybridization showed that bla_DHA-1 was located on 70-kb plasmids, suggesting that the bla_DHA-1-containing plasmids in the K. pneumoniae isolates were non-self-transmissible. Five isolates were recovered from patients in two surgery wards and two intensive care units. Acquisition of the DHA-1 producers could be traced back to previous hospitalizations 1 to 5 months earlier for the other five patients. Six and seven patterns among the isolates were demonstrated by plasmid analysis and ribotyping, respectively, indicating that the spread of the DHA-1 producers was due to both horizontal transfer of bla_DHA-1 and dissemination of endemic clones.

This article has been cited by other articles:

• Padilla, E., Alonso, D., Domenech-Sanchez, A., Gomez, C., Perez, J. L., Alberti, S., Borrell, N. (2006). Effect of Porins and Plasmid-Mediated AmpC {beta}-Lactamases on the Efficacy of {beta}-Lactams in Rat Pneumonia Caused by Klebsiella pneumoniae.. Antimicrob. Agents Chemother. 50: 2258-2260 [Abstract] [Full Text]  
• Yan, J.-J., Hsueh, P.-R., Lu, J.-J., Chang, F.-Y., Shyr, J.-M., Wan, J.-H., Liu, Y.-C., Chuang, Y.-C., Yang, Y.-C., Tsao, S.-M., Wu, H.-H., Wang, L.-S., Lin, T.-P., Wu, H.-M., Chen, H.-M., Wu, J.-J. (2006). Extended-Spectrum {beta}-Lactamases and Plasmid-Mediated AmpC Enzymes among Clinical Isolates of Escherichia coli and Klebsiella pneumoniae from Seven Medical Centers in Taiwan.. Antimicrob. Agents Chemother. 50: 1861-1864 [Abstract] [Full Text]  
• Power, P., Galleni, M., Ayala, J. A., Gutkind, G. (2006). Biochemical and Molecular Characterization of Three New Variants of AmpC {beta}-Lactamases from Morganella morganii. Antimicrob. Agents Chemother. 50: 962-967 [Abstract] [Full Text]  
• Su, L.-H., Chen, H.-L., Chia, J.-H., Liu, S.-Y., Chu, C., Wu, T.-L., Chiu, C.-H. (2006). Distribution of a transposon-like element carrying blaCMY-2 among Salmonella and other Enterobacteriaceae. J Antimicrob Chemother 57: 424-429 [Abstract] [Full Text]  
• Verdet, C., Benzerara, Y., Gautier, V., Adam, O., Ould-Hocine, Z., Arlet, G. (2006). Emergence of DHA-1-Producing Klebsiella spp. in the Parisian Region: Genetic Organization of the ampC and ampR Genes Originating from Morganella morganii. Antimicrob. Agents Chemother. 50: 607-617 [Abstract] [Full Text]  
• Wei, Z.-Q., Chen, Y.-G., Yu, Y.-S., Lu, W.-X., Li, L.-J. (2005). Nosocomial spread of multi-resistant Klebsiella pneumoniae containing a plasmid encoding multiple {beta}-lactamases. J Med Microbiol 54: 885-888 [Abstract] [Full Text]  
• Kang, C.-I., Pai, H., Kim, S.-H., Kim, H.-B., Kim, E.-C., Oh, M.-d., Choe, K.-W. (2004). Cefepime and the inoculum effect in tests with Klebsiella pneumoniae producing plasmid-mediated AmpC-type {beta}-lactamase. J Antimicrob Chemother 54: 1130-1133 [Abstract] [Full Text]  
• Liebana, E., Batchelor, M., Clifton-Hadley, F. A., Davies, R. H., Hopkins, K. L., Threlfall, E. J. (2004). First Report of Salmonella Isolates with the DHA-1 AmpC {beta}-Lactamase in the United Kingdom. Antimicrob. Agents Chemother. 48: 4492-4492 [Full Text]  
• Yan, J.-J., Ko, W.-C., Wu, H.-M., Tsai, S.-H., Chuang, C.-L., Wu, J.-J. (2004). Complexity of Klebsiella pneumoniae Isolates Resistant to Both Cephamycins and Extended-Spectrum Cephalosporins at a Teaching Hospital in Taiwan. J. Clin. Microbiol. 42: 5337-5340 [Abstract] [Full Text]  
• Pai, H., Kang, C.-I., Byeon, J.-H., Lee, K.-D., Park, W. B., Kim, H.-B., Kim, E.-C., Oh, M.-d., Choe, K.-W. (2004). Epidemiology and Clinical Features of Bloodstream Infections Caused by AmpC-Type-{beta}-Lactamase-Producing Klebsiella pneumoniae. Antimicrob. Agents Chemother. 48: 3720-3728 [Abstract] [Full Text]  
• Wachino, J.-i., Doi, Y., Yamane, K., Shibata, N., Yagi, T., Kubota, T., Ito, H., Arakawa, Y. (2004). Nosocomial Spread of Ceftazidime-Resistant Klebsiella pneumoniae Strains Producing a Novel Class A {beta}-Lactamase, GES-3, in a Neonatal Intensive Care Unit in Japan. Antimicrob. Agents Chemother. 48: 1960-1967 [Abstract] [Full Text]