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 Nagano, N. Articles by Arakawa, Y. Search for Related Content PubMed PubMed Citation Articles by Nagano, N. Articles by Arakawa, Y.

 Previous Article  |  Next Article 

Journal of Clinical Microbiology, December 2003, p. 5530-5536, Vol. 41, No. 12
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.12.5530-5536.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Nosocomial Outbreak of Infections by Proteus mirabilis That Produces Extended-Spectrum CTX-M-2 Type ß-Lactamase

Medical Microbiology Laboratory, Funabashi Medical Center, 1-21-1 Kanasugi, Funabashi, Chiba,¹ Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo, Japan²

Received 9 May 2003/ Returned for modification 25 August 2003/ Accepted 18 September 2003

Nineteen multidrug-resistant Proteus mirabilis strains were isolated from 19 patients suffering from infections probably caused by P. mirabilis. These strains were recovered from urine or other urogenital specimens of 16 inpatients and three outpatients with a hospitalization history in a urology ward of Funabashi Medical Center, from July 2001 to August 2002. These strains demonstrated resistance to cefotaxime, ceftriaxone, cefpodoxime, and aztreonam, while they were highly susceptible to ceftazidime (MIC, 0.5 µg/ml). The resistance level of these strains to cefotaxime was decreased by the presence of clavulanic acid. Therefore, the strains were speculated to produce extended-spectrum class A ß-lactamases. These strains were later found to carry bla_CTX-M-2 genes by both PCR and sequencing analyses. The profiles of SmaI-digested genomic DNA of 19 isolates were distinguished into five different clusters by biased sinusoidal field gel electrophoresis. Four of them, consisting of 18 isolates, were suggested to be a clonal expansion. These findings suggested that a nosocomial outbreak of infections by CTX-M-2-producing P. mirabilis had occurred in our medical center. Most patients suffered from urogenital malignancies with long-term catheterization. Cefazolin, cefoperazone-sulbactam, and/or levofloxacin were mostly administered to the patients, but these agents seemed ineffective for eradication of CTX-M-2 producers. Early recognition and rapid identification of colonizing antimicrobial-resistant bacteria, including CTX-M-2-producing P. mirabilis, would be the most effective measures to cope with further spread of this kind of hazardous microorganism in clinical environments.

This article has been cited by other articles:

• Nagano, N., Nagano, Y., Kimura, K., Tamai, K., Yanagisawa, H., Arakawa, Y. (2008). Genetic Heterogeneity in pbp Genes among Clinically Isolated Group B Streptococci with Reduced Penicillin Susceptibility. Antimicrob. Agents Chemother. 52: 4258-4267 [Abstract] [Full Text]  
• Navon-Venezia, S., Chmelnitsky, I., Leavitt, A., Carmeli, Y. (2008). Dissemination of the CTX-M-25 family {beta}-lactamases among Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae and identification of the novel enzyme CTX-M-41 in Proteus mirabilis in Israel. J Antimicrob Chemother 62: 289-295 [Abstract] [Full Text]  
• (2008). Ulcer Infection by ES{beta}L-Producing Proteus mirabilis: A Case Report. INT J LOW EXTREM WOUNDS 7: 99-101  
• Nagano, N., Cordevant, C., Nagano, Y. (2008). Upper and lower urinary tract infection caused by Klebsiella pneumoniae serotype K2 and CTX-M-15 -lactamase-producing serotype K1: a case report and characterization of serum killing resistance. J Med Microbiol 57: 121-124 [Abstract] [Full Text]  
• Shibata, N., Kurokawa, H., Doi, Y., Yagi, T., Yamane, K., Wachino, J.-i., Suzuki, S., Kimura, K., Ishikawa, S., Kato, H., Ozawa, Y., Shibayama, K., Kai, K., Konda, T., Arakawa, Y. (2006). PCR Classification of CTX-M-Type {beta}-Lactamase Genes Identified in Clinically Isolated Gram-Negative Bacilli in Japan. Antimicrob. Agents Chemother. 50: 791-795 [Abstract] [Full Text]  
• Yagi, T., Wachino, J.-i., Kurokawa, H., Suzuki, S., Yamane, K., Doi, Y., Shibata, N., Kato, H., Shibayama, K., Arakawa, Y. (2005). Practical Methods Using Boronic Acid Compounds for Identification of Class C {beta}-Lactamase-Producing Klebsiella pneumoniae and Escherichia coli. J. Clin. Microbiol. 43: 2551-2558 [Abstract] [Full Text]  
• Ishii, Y., Kimura, S., Alba, J., Shiroto, K., Otsuka, M., Hashizume, N., Tamura, K., Yamaguchi, K. (2005). Extended-Spectrum {beta}-Lactamase-Producing Shiga Toxin Gene (stx1)-Positive Escherichia coli O26:H11: a New Concern. J. Clin. Microbiol. 43: 1072-1075 [Abstract] [Full Text]  
• Pallecchi, L., Malossi, M., Mantella, A., Gotuzzo, E., Trigoso, C., Bartoloni, A., Paradisi, F., Kronvall, G., Rossolini, G. M. (2004). Detection of CTX-M-Type {beta}-Lactamase Genes in Fecal Escherichia coli Isolates from Healthy Children in Bolivia and Peru. Antimicrob. Agents Chemother. 48: 4556-4561 [Abstract] [Full Text]  
• Nagano, N., Nagano, Y., Cordevant, C., Shibata, N., Arakawa, Y. (2004). Nosocomial Transmission of CTX-M-2 {beta}-Lactamase-Producing Acinetobacter baumannii in a Neurosurgery Ward. J. Clin. Microbiol. 42: 3978-3984 [Abstract] [Full Text]