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JAC Advance Access originally published online on October 7, 2004
Journal of Antimicrobial Chemotherapy 2004 54(5):881-888; doi:10.1093/jac/dkh440
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JAC vol.54 no.5 © The British Society for Antimicrobial Chemotherapy 2004; all rights reserved

Outbreak of multi-resistant Klebsiella oxytoca involving strains with extended-spectrum ß-lactamases and strains with extended-spectrum activity of the chromosomal ß-lactamase

Dominique Decré1,2,*, Béatrice Burghoffer1, Valérie Gautier1, Jean-Claude Petit1,2 and Guillaume Arlet1,3

1 UPRES n°EA2392, Faculté de Médecine, UFR Saint-Antoine, Université Paris 6; 2 Laboratoire de bactériologie, Hôpital Saint Antoine, 27 rue Chaligny, 75012 Paris Cedex 12; 3 Laboratoire de bactériologie Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, France

* Corresponding author. Tel: +33-1-40-01-13-82; Email: dominique.decre{at}chusa.jussieu.fr

Objectives: This study was conducted to analyse broad-spectrum cephalosporin-resistant Klebsiella oxytoca strains.

Methods: The 57 isolates studied were recovered from clinical specimens (n=23) or from rectal swabs (n=34) during a 26-month period. Antibiotic susceptibility patterns were determined using standard agar diffusion and dilution methods including the synergy test between extended-spectrum cephalosporins and clavulanic acid. ERIC-2 PCR and pulsed-field gel electrophoresis (PFGE) methods were used to study the clonal relatedness of the strains. Plasmid-mediated and chromosomal ß-lactamases were characterized by mating and specific bla gene amplification and sequencing.

Results: Four different antibiotic resistance patterns were identified whereas ERIC-2 PCR and PFGE revealed six main profiles. Extended-spectrum ß-lactamases (ESBLs) were found in 32 strains: TEM-7 (n=26), TEM-129 (n=1), TEM-3 (n=4), SHV-2 (n=1). The new TEM-type ß-lactamase, TEM-129, differed from TEM-7 by one mutation (Glu-104->Lys). All TEM-7 or TEM-129 producers were genetically related. Twenty-five other strains with identical ERIC-2 PCR and PFGE profiles harboured a blaOXY-2 gene different from the reference gene: 24 strains displayed one substitution (Ala-237->Ser) in the KTG motif and one strain, highly resistant to ceftazidime, showed an additional substitution (Pro-167->Ser).

Conclusions: The study demonstrated that the majority of strains (n=52) harbouring the OXY-2-type ß-lactamase corresponded to two clones. The first clone (n=27) corresponded to ESBL-producing strains. The second clone (n=25) displayed extended-spectrum activity of the chromosomal ß-lactamase.

Keywords: OXY-2 ß-lactamase , TEM-7 , TEM-129


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