Dissemination of transferable CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli in Korea

S. H. Jeong, I. K. Bae, S. B. Kwon, J. H. Lee, J. S. Song, H. I. Jung, K. H. Sung, S. J. Jang, Sang H. Lee

Research output: Contribution to journalArticle

37 Citations (Scopus)

Abstract

Aims: Among 365 Escherichia coli isolated in 2003, 31 cefotaxime-resistant isolates were obtained from clinical specimens taken from adults hospitalized in Busan, Korea. Six extended-spectrum β-lactamase (ESBL)-producing isolates were investigated further to determine the mechanism of resistance. Methods and Results: These isolates were analysed by antibiotic susceptibility testing, pI determination, plasmid profiles, transconjugation test, PCR-restriction fragment length polymorphism (RFLP), enterobacterial repetitive consensus (ERIC)-PCR and DNA sequencing. All six of these isolates were found to contain the CTX-M-type ESBL genes. Five clinical isolates and their transconjugants produced CTX-M-3. One clinical isolate (K17391) and its transconjugant (trcK17391) produced CTX-M-15. Five clinical isolates also produced another TEM-1. One clinical isolate (K12776) also contained another TEM-52. CTX-M-3 ESBL gene was responsible for the resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam. CTX-M-15 or TEM-52 was especially responsible for the resistance to ceftazidime. Conclusions: These results appear to represent the in vivo evolution of CTX-M-type β-lactamase genes (blaCTX-M-3 → blaCTX-M-15) under the selective pressure of antimicrobial therapy (especially ceftazidime). PCR-RFLP is a reliable method to discriminate CTX-M-15 gene from CTX-M-3 gene. ERIC-PCR analysis revealed that dissemination of CTX-M-3 was not due to a clonal outbreak of a resistant strain but to the intra-species spread of resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam in Korea. Significance and Impact of the Study: This is the first report of the occurrence of CTX-M-1 cluster ESBLs in Korea. A more comprehensive survey of these ESBL types from Korea is urgently needed because of the in vivo evolution of CTX-M-15 from CTX-M-3. The emergence of these CTX-M-type ESBLs suggests that diagnostic laboratories should screen for ESBLs with ceftazidime as well as cefotaxime; they should still perform clavulanate synergy tests on resistant isolates.

Original languageEnglish
Pages (from-to)921-927
Number of pages7
JournalJournal of Applied Microbiology
Volume98
Issue number4
DOIs
Publication statusPublished - 2005 Apr 20

Fingerprint

Korea
Cefotaxime
Ceftazidime
Escherichia coli
Aztreonam
Cephalothin
Polymerase Chain Reaction
Piperacillin
Genes
Restriction Fragment Length Polymorphisms
Clavulanic Acid
DNA Sequence Analysis
Disease Outbreaks
Plasmids
galantide
Anti-Bacterial Agents
cefepime
Therapeutics

All Science Journal Classification (ASJC) codes

  • Biotechnology
  • Applied Microbiology and Biotechnology

Cite this

Jeong, S. H. ; Bae, I. K. ; Kwon, S. B. ; Lee, J. H. ; Song, J. S. ; Jung, H. I. ; Sung, K. H. ; Jang, S. J. ; Lee, Sang H. / Dissemination of transferable CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli in Korea. In: Journal of Applied Microbiology. 2005 ; Vol. 98, No. 4. pp. 921-927.
@article{d54d3e1bc2c9415d9f5c0977338bb506,
title = "Dissemination of transferable CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli in Korea",
abstract = "Aims: Among 365 Escherichia coli isolated in 2003, 31 cefotaxime-resistant isolates were obtained from clinical specimens taken from adults hospitalized in Busan, Korea. Six extended-spectrum β-lactamase (ESBL)-producing isolates were investigated further to determine the mechanism of resistance. Methods and Results: These isolates were analysed by antibiotic susceptibility testing, pI determination, plasmid profiles, transconjugation test, PCR-restriction fragment length polymorphism (RFLP), enterobacterial repetitive consensus (ERIC)-PCR and DNA sequencing. All six of these isolates were found to contain the CTX-M-type ESBL genes. Five clinical isolates and their transconjugants produced CTX-M-3. One clinical isolate (K17391) and its transconjugant (trcK17391) produced CTX-M-15. Five clinical isolates also produced another TEM-1. One clinical isolate (K12776) also contained another TEM-52. CTX-M-3 ESBL gene was responsible for the resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam. CTX-M-15 or TEM-52 was especially responsible for the resistance to ceftazidime. Conclusions: These results appear to represent the in vivo evolution of CTX-M-type β-lactamase genes (blaCTX-M-3 → blaCTX-M-15) under the selective pressure of antimicrobial therapy (especially ceftazidime). PCR-RFLP is a reliable method to discriminate CTX-M-15 gene from CTX-M-3 gene. ERIC-PCR analysis revealed that dissemination of CTX-M-3 was not due to a clonal outbreak of a resistant strain but to the intra-species spread of resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam in Korea. Significance and Impact of the Study: This is the first report of the occurrence of CTX-M-1 cluster ESBLs in Korea. A more comprehensive survey of these ESBL types from Korea is urgently needed because of the in vivo evolution of CTX-M-15 from CTX-M-3. The emergence of these CTX-M-type ESBLs suggests that diagnostic laboratories should screen for ESBLs with ceftazidime as well as cefotaxime; they should still perform clavulanate synergy tests on resistant isolates.",
author = "Jeong, {S. H.} and Bae, {I. K.} and Kwon, {S. B.} and Lee, {J. H.} and Song, {J. S.} and Jung, {H. I.} and Sung, {K. H.} and Jang, {S. J.} and Lee, {Sang H.}",
year = "2005",
month = "4",
day = "20",
doi = "10.1111/j.1365-2672.2004.02526.x",
language = "English",
volume = "98",
pages = "921--927",
journal = "Journal of Applied Microbiology",
issn = "1364-5072",
publisher = "Wiley-Blackwell",
number = "4",

}

Dissemination of transferable CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli in Korea. / Jeong, S. H.; Bae, I. K.; Kwon, S. B.; Lee, J. H.; Song, J. S.; Jung, H. I.; Sung, K. H.; Jang, S. J.; Lee, Sang H.

In: Journal of Applied Microbiology, Vol. 98, No. 4, 20.04.2005, p. 921-927.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dissemination of transferable CTX-M-type extended-spectrum β-lactamase-producing Escherichia coli in Korea

AU - Jeong, S. H.

AU - Bae, I. K.

AU - Kwon, S. B.

AU - Lee, J. H.

AU - Song, J. S.

AU - Jung, H. I.

AU - Sung, K. H.

AU - Jang, S. J.

AU - Lee, Sang H.

PY - 2005/4/20

Y1 - 2005/4/20

N2 - Aims: Among 365 Escherichia coli isolated in 2003, 31 cefotaxime-resistant isolates were obtained from clinical specimens taken from adults hospitalized in Busan, Korea. Six extended-spectrum β-lactamase (ESBL)-producing isolates were investigated further to determine the mechanism of resistance. Methods and Results: These isolates were analysed by antibiotic susceptibility testing, pI determination, plasmid profiles, transconjugation test, PCR-restriction fragment length polymorphism (RFLP), enterobacterial repetitive consensus (ERIC)-PCR and DNA sequencing. All six of these isolates were found to contain the CTX-M-type ESBL genes. Five clinical isolates and their transconjugants produced CTX-M-3. One clinical isolate (K17391) and its transconjugant (trcK17391) produced CTX-M-15. Five clinical isolates also produced another TEM-1. One clinical isolate (K12776) also contained another TEM-52. CTX-M-3 ESBL gene was responsible for the resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam. CTX-M-15 or TEM-52 was especially responsible for the resistance to ceftazidime. Conclusions: These results appear to represent the in vivo evolution of CTX-M-type β-lactamase genes (blaCTX-M-3 → blaCTX-M-15) under the selective pressure of antimicrobial therapy (especially ceftazidime). PCR-RFLP is a reliable method to discriminate CTX-M-15 gene from CTX-M-3 gene. ERIC-PCR analysis revealed that dissemination of CTX-M-3 was not due to a clonal outbreak of a resistant strain but to the intra-species spread of resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam in Korea. Significance and Impact of the Study: This is the first report of the occurrence of CTX-M-1 cluster ESBLs in Korea. A more comprehensive survey of these ESBL types from Korea is urgently needed because of the in vivo evolution of CTX-M-15 from CTX-M-3. The emergence of these CTX-M-type ESBLs suggests that diagnostic laboratories should screen for ESBLs with ceftazidime as well as cefotaxime; they should still perform clavulanate synergy tests on resistant isolates.

AB - Aims: Among 365 Escherichia coli isolated in 2003, 31 cefotaxime-resistant isolates were obtained from clinical specimens taken from adults hospitalized in Busan, Korea. Six extended-spectrum β-lactamase (ESBL)-producing isolates were investigated further to determine the mechanism of resistance. Methods and Results: These isolates were analysed by antibiotic susceptibility testing, pI determination, plasmid profiles, transconjugation test, PCR-restriction fragment length polymorphism (RFLP), enterobacterial repetitive consensus (ERIC)-PCR and DNA sequencing. All six of these isolates were found to contain the CTX-M-type ESBL genes. Five clinical isolates and their transconjugants produced CTX-M-3. One clinical isolate (K17391) and its transconjugant (trcK17391) produced CTX-M-15. Five clinical isolates also produced another TEM-1. One clinical isolate (K12776) also contained another TEM-52. CTX-M-3 ESBL gene was responsible for the resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam. CTX-M-15 or TEM-52 was especially responsible for the resistance to ceftazidime. Conclusions: These results appear to represent the in vivo evolution of CTX-M-type β-lactamase genes (blaCTX-M-3 → blaCTX-M-15) under the selective pressure of antimicrobial therapy (especially ceftazidime). PCR-RFLP is a reliable method to discriminate CTX-M-15 gene from CTX-M-3 gene. ERIC-PCR analysis revealed that dissemination of CTX-M-3 was not due to a clonal outbreak of a resistant strain but to the intra-species spread of resistance to piperacillin, cephalothin, cefotaxime, cefepime and aztreonam in Korea. Significance and Impact of the Study: This is the first report of the occurrence of CTX-M-1 cluster ESBLs in Korea. A more comprehensive survey of these ESBL types from Korea is urgently needed because of the in vivo evolution of CTX-M-15 from CTX-M-3. The emergence of these CTX-M-type ESBLs suggests that diagnostic laboratories should screen for ESBLs with ceftazidime as well as cefotaxime; they should still perform clavulanate synergy tests on resistant isolates.

UR - http://www.scopus.com/inward/record.url?scp=16444381291&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=16444381291&partnerID=8YFLogxK

U2 - 10.1111/j.1365-2672.2004.02526.x

DO - 10.1111/j.1365-2672.2004.02526.x

M3 - Article

C2 - 15752339

AN - SCOPUS:16444381291

VL - 98

SP - 921

EP - 927

JO - Journal of Applied Microbiology

JF - Journal of Applied Microbiology

SN - 1364-5072

IS - 4

ER -