Journal of Antimicrobial Chemotherapy (1992) 30, 429-447
© 1992 The British Society for Antimicrobial Chemotherapy
research-article |
Survey of the prevalence of ßlactamases amongst 1000 Gram-negative bacilli isolated consecutively at the Royal London Hospital
Department of Medical Microbiology, The London Hospital Medical College Turner Street, London E1 2AD, UK
Received 24 March 1992; returned 29 May 1992; accepted 29 May 1992
*Corresponding author
ß-Lactamase expression was examined in 1000 consecutive Gram-negative bacilli isolated from urine, wound swab, sputum or blood specimens received at the Microbiology Laboratory of the Royal London Hospital. This survey, performed between January and April, 1991, followed a similar study undertaken in early 1982. The distribution of species was similar in the two surveys, except that the proportion of Pseudomonas aeruginosa isolates had increased from 11% in 1982 to 17·5% in the present study. This increase was balanced by a decreased proportion of enterobac-teria. Amongst plasmid-mediated ß-lactamases, TEM-1 (especially), TEM-2, SHV-l and OXA types continued to predominate in enterobacteria. Their frequency in Escherichia coli was unchanged (46% in 1991 compared with 43% in 1982), but had increased from 5 to 22% amongst Proteus mirabilis isolates. An apparent decrease in their frequency amongst Enterobacter cloacae isolates, from 48% in 1982 to 17% in 1991, probably reflected changes to strain prevalence rather than enzyme prevalence. Plasmid type ß-lactamases were present in fewer than 2% of P. aeruginosa isolates in both surveys. In the present study, chromosomal ß-lactamase derepression (constitutive hyperproduction) was detected in 10/76 isolates of E. cloacae, Enterobacter aerogenes, Citrobacter freundii, Serratia spp. and Morganella morganii, and in 2/170 P. aeruginosa isolates. These proportions were increased, compared with those seen the 1982 survey, though the significance was borderline (P 
0-05; x2 test). Extended-spectrum plasmid mediated ß-lactamases, unknown in 1982, were found in 11/70 Klebsiellae pneumoniae isolates in the present study. Ten of these organisms, representing at least five distinct strains, produced TEM-10 enzyme, encoded by a plasmid of c. 90 kb; the remaining organism had an unidentified SHV-derived enzyme.
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