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JAC Advance Access originally published online on September 5, 2007
Journal of Antimicrobial Chemotherapy 2007 60(5):956-964; doi:10.1093/jac/dkm319
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© The Author 2007. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Incidence of class A extended-spectrum ß-lactamases in Champagne-Ardenne (France): a 1 year prospective study

L. Brasme1, P. Nordmann2, F. Fidel1, M. F. Lartigue2, O. Bajolet1, L. Poirel2, D. Forte1, V. Vernet-Garnier1, J. Madoux1, J. C. Reveil3, C. Alba-Sauviat4, I. Baudinat5, P. Bineau6, C. Bouquigny-Saison7, C. Eloy8, C. Lafaurie9, D. Siméon10, J. P. Verquin11, F. Noël12, C. Strady1 and C. De Champs1,*

1 Laboratoire de Bactériologie-Virologie-Hygiène CHU de Reims, UFR Médecine Université Reims Champagne-Ardenne, 51092 Reims, France 2 Service de Bactériologie-Virologie, Hôpital de Bicêtre Faculté de Médecine Paris-Sud, Université Paris XI, 94275 K. Bicêtre, France 3 Centre Hospitalier de Manchester, Laboratoire, 41 avenue de Manchester, 08011 Charleville-Mézières, France 4 Centre Hospitalier de Chaumont, Laboratoire, 2 rue Jeanne d'Arc, 52000 Chaumont, France 5 Chalons en Champagne, Laboratoire, 51 rue du Commandant Derrien, 51000 Chalons en Champagne, France 6 Centre Hospitalier de Saint Dizier, Laboratoire, rue Godard Jeanson, 52100 Saint Dizier, France 7 Centre Hospitalier de Soissons, Laboratoire, 46 rue du Général de Gaulle, 02209 Soissons, France; 8 Centre Hospitalier de Troyes, Laboratoire de Microbiologie, 101 rue Anatole France, 10000 Troyes, France 9 Centre Hospitalier Auban Moët, Laboratoire, 137 rue de l'Hôpital, 51205 Epernay, France 10 Centre Hospitalier de Langres, Laboratoire, 52206 Langres, France 11 Laboratoire Gillard, 27 rue du Clou dans le fer, 51100 Reims, France 12 Laboratoire Leulier, 79 rue de Courlancy, 51100 Reims, France

Received 6 March 2007; returned 27 April 2007; revised 7 June 2007; accepted 27 July 2007

* Corresponding author. Tel: +33-326-787-702; Fax: +33-326-784-134; E-mail: cdechamps{at}chu-reims.fr

Objectives: To assess the frequency and diversity of extended spectrum ß-lactamases (ESBLs) in the Champagne-Ardenne region France, and to identify genetic elements associated with the blaCTX-M genes.

Methods: During 2004, all the non-duplicate isolates of Pseudomonas aeruginosa and Acinetobacter baumannii resistant to ceftazidime and of Enterobacteriaceae intermediate or resistant to ceftazidime and/or cefotaxime, screening samples excluded, were collected in 10 public hospitals and 3 private clinics. bla genes were sequenced and blaCTX-M environment characterized by PCR mapping.

Results: In Enterobacteriaceae (138/21 861; 0.6%), ESBLs were predominantly TEM-24 (n = 52; 37.7%) and CTX-M-15 (n = 37; 26.8%). Three new enzymes were identified, CTX-M-61 (CTX-M-1 group), TEM- and SHV-type. A. baumannii (n = 5) produced VEB-1 and P. aeruginosa (n = 2) SHV-2a. ISEcp1 was detected in 22/27 strains, disrupted in 7 of them. The IS903-like element was downstream of blaCTX-M-14 and blaCTX-M-16. ISCR1 was found upstream of blaCTX-M-2 and blaCTX-M-9, and ISCR1 and blaCTX-M-2 were located on a sul1-type class 1 integron. In comparison with 2001–02, ESBL distribution among Enterobacteriaceae showed an increase in CTX-M-type (44.9% vs 3.7% P < 10–7) due to Escherichia coli CTX-M-15 and to the almost total disappearance of TEM-3 (0.9% vs 51.2%). E. coli was the most frequent species (50.0% vs 5.1% in 1998) despite a similar prevalence to that in 1998 (0.5% vs 0.2%).

Conclusions: A careful detection of blaCTX-M-type spread to other species would help to anticipate clonal endemics such as those observed in Enterobacter aerogenes TEM-24.

Keywords: ESBLs , Enterobacteriaceae , Pseudomonas aeruginosa , Acinetobacter baumannii , insertion sequences


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