JAC Advance Access originally published online on November 16, 2006
Journal of Antimicrobial Chemotherapy 2007 59(1):102-105; doi:10.1093/jac/dkl456
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Wide geographic spread of diverse acquired AmpC ß-lactamases among Escherichia coli and Klebsiella spp. in the UK and Ireland
1 Centre for Infections, Health Protection Agency London, NW9 5EQ, UK 2 Department of Microbiology, Lancashire Teaching Hospitals NHS Foundation Trust Preston PR2 9HT, UK
Received 22 August 2006; returned 3 October 2006; revised 5 October 2006; accepted 12 October 2006
*Correspondence address. Antibiotic Resistance Monitoring and Reference Laboratory, Centre for Infections, Health Protection Agency, London NW9 5EQ, UK. Tel: +44-20-8327-7255; Fax +44-20-8327-6264; E-mail: neil.woodford{at}hpa.org.uk
Objectives: To determine the distribution of acquired AmpC ß-lactamases in 173 isolates of Escherichia coli and Klebsiella spp. submitted to the UK's national reference laboratory for antibiotic resistance.
Methods: MICs were determined and interpreted according to BSAC guidelines. Candidate isolates were those resistant to cefotaxime and/or ceftazidime, irrespective of addition of clavulanic acid. Genes encoding six phylogenetic groups of acquired AmpC enzymes were sought by PCR. Selected isolates were compared by pulsed-field gel electrophoresis (PFGE), and one blaAmpC amplicon was sequenced.
Results: Genes encoding acquired AmpC enzymes were detected in 67 (49%) candidate E. coli and 21 (55%) Klebsiella spp. Sixty isolates produced CIT-type enzymes, 14 had ACC types, 11 had FOX types and 3 had DHA enzymes. The low-level cephalosporin resistance of the remaining isolates (n = 85; 49%) was inferred to result from reduced permeability or, in E. coli, from hyperexpression of chromosomal ampC. Twenty-four E. coli isolates from one hospital produced a CIT-type enzyme, with 20 of these additionally producing a group 1 CTX-M extended-spectrum ß-lactamase. PFGE indicated that these isolates belonged to UK epidemic strain A, which normally produces CTX-M-15, but no acquired AmpC. Sequencing a representative blaAmpC amplicon indicated that in one centre this strain had acquired a novel CMY-2 variant, designated CMY-23.
Conclusions: Diverse acquired AmpC enzymes occur in E. coli and Klebsiella spp. isolates in the UK and Ireland, with CIT types the most common. Producers are geographically scattered, but with some local outbreaks. Acquisition of a CMY-2-like enzyme by E. coli epidemic strain A suggests that these enzymes may be poised to become an important public health issue.
Keywords: cephalosporins , resistance , Enterobacteriaceae , plasmids
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  G. G. Zhanel, P. J. Baudry, F. Tailor, L. Cox, D. J. Hoban, and J. A. Karlowsky Determination of the pharmacodynamic activity of clinically achievable tigecycline serum concentrations against clinical isolates of Escherichia coli with extended-spectrum {beta}-lactamases, AmpC {beta}-lactamases and reduced susceptibility to carbapenems using an in vitro model J. Antimicrob. Chemother., October 1, 2009; 64(4): 824 - 828. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. Petersen, C. H. Jones, A. M. Venkatesan, T. S. Mansour, S. J. Projan, and P. A. Bradford Establishment of In Vitro Susceptibility Testing Methodologies and Comparative Activities of Piperacillin in Combination with the Penem {beta}-Lactamase Inhibitor BLI-489 Antimicrob. Agents Chemother., February 1, 2009; 53(2): 370 - 384. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. A. Jacoby AmpC {beta}-Lactamases Clin. Microbiol. Rev., January 1, 2009; 22(1): 161 - 182. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Y. Tan, L. S. Y. Ng, J. He, T. H. Koh, and L. Y. Hsu Evaluation of Screening Methods To Detect Plasmid-Mediated AmpC in Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis Antimicrob. Agents Chemother., January 1, 2009; 53(1): 146 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. H. Lau, M. E. Kaufmann, D. M. Livermore, N. Woodford, G. A. Willshaw, T. Cheasty, K. Stamper, S. Reddy, J. Cheesbrough, F. J. Bolton, et al. UK epidemic Escherichia coli strains A-E, with CTX-M-15 {beta}-lactamase, all belong to the international O25:H4-ST131 clone J. Antimicrob. Chemother., December 1, 2008; 62(6): 1241 - 1244. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Tumbarello, M. Sali, E. M. Trecarichi, F. Leone, M. Rossi, B. Fiori, G. De Pascale, T. D'Inzeo, M. Sanguinetti, G. Fadda, et al. Bloodstream Infections Caused by Extended-Spectrum-{beta}-Lactamase- Producing Escherichia coli: Risk Factors for Inadequate Initial Antimicrobial Therapy Antimicrob. Agents Chemother., September 1, 2008; 52(9): 3244 - 3252. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Baudry, K. Nichol, M. DeCorby, L. Mataseje, M. R. Mulvey, D. J. Hoban, and G. G. Zhanel Comparison of Antimicrobial Resistance Profiles among Extended-Spectrum-{beta}-Lactamase-Producing and Acquired AmpC {beta}-Lactamase-Producing Escherichia coli Isolates from Canadian Intensive Care Units Antimicrob. Agents Chemother., May 1, 2008; 52(5): 1846 - 1849. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Y Tan, S Y Ng, L Teo, Y Koh, and C H Teok Detection of plasmid-mediated AmpC in Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis J. Clin. Pathol., May 1, 2008; 61(5): 642 - 644. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Mammeri, F. Eb, A. Berkani, and P. Nordmann Molecular characterization of AmpC-producing Escherichia coli clinical isolates recovered in a French hospital J. Antimicrob. Chemother., March 1, 2008; 61(3): 498 - 503. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yang and B J. Guglielmo Diagnosis and Treatment of Extended-Spectrum and AmpC {beta}-Lactamase-Producing Organisms Ann. Pharmacother., September 1, 2007; 41(9): 1427 - 1435. [Abstract] [Full Text] [PDF]
|
|