JAC Advance Access published online on February 11, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg103
© 2003 by The British Society for Antimicrobial Chemotherapy
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Original article
1 Division of Clinical Microbiology,
Department of Clinical Laboratory, Wakayama Rosai Hospital,
435 Koya, Wakayama
* Corresponding author. E-mail: microbiology{at}tenriyorozu-hp.or.jp.
Received 3 April 2002
; revised 19 August 2002
; accepted 25 November 2002
The aim of this study was to research the distribution
in the Kinki region of Japan of Enterobacteriaceae and Pseudomonas
aeruginosa that produce extended-spectrum
Production of CTX-M-3 extended-spectrum
-lactamase and IMP-1 metallo -lactamase
by five Gram-negative bacilli: survey of
clinical isolates from seven laboratories collected in 1998 and
2000,
in the Kinki region of Japan
2 Department
of Clinical Pathology, Tenri Hospital, 200 Misima, Tenri, Nara 632-8552
3 Bacteriological Testing Section
of Central Laboratory, FALCO Biosystems Ltd, Central Laboratory,
Kyoto
4 Department of Clinical
and Laboratory Medicine, National Cardiovascular Center, Osaka
5 Department of Clinical Laboratory,
Shiga Medical Center for Adults, Shiga
6 Division of Clinical Microbiology, Department of
Medical Technology, Kinki University School of Medicine, Osaka
7 Department of Clinical Laboratory,
Kobe University Hospital, Hyogo, Japan
-lactamase (ESBL)
and metallo -lactamase (MBL). One thousand
isolates, 200 of each of four enterobacterial species (i.e. Escherichia
coli, Klebsiella pneumoniae, Enterobacter
cloacae and Serratia marcescens) and 200 of P. aeruginosa, were collected from seven different
laboratories during two 2 month periods, one in 1998 and one
in 2000. A double-disc synergy test (DDST) and 2-mercaptopropionic
acid inhibition test (2-MPAT) were used to confirm -lactamase-producing
isolates. The DDST was positive for one isolate of E.
coli, five of K. pneumoniae, two of E.
cloacae and 14 of S. marcescens. The 2-MPAT
was positive for five isolates of S. marcescens and
two of P. aeruginosa. We identified the -lactamase
type of each isolate by molecular confirmatory tests (isoelectric
focusing, PCR and DNA sequencing): CTX-M-3 ESBLs (three isolates
of K. pneumoniae, two of E. cloacae and
13 of S. marcescens), CTX-M-2 ESBL (one isolate
of K. pneumoniae), SHV-12 ESBLs (one isolate of E. coli and one of S. marcescens),
CTX-M-3 and SHV-12 combination ESBL (one isolate of K.
pneumoniae) and IMP-1 MBLs (five isolates of S.
marcescens and two of P. aeruginosa). In conclusion,
many species of Gram-negative bacilli that produce CTX-M-3 ESBLs
and IMP-1 MBLs were disseminated widely in different hospitals of
the Kinki region of Japan. Therefore, monitoring of laboratory bacterial
ecology seems important to stop the spread of these strains through
nosocomial outbreaks.
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