JAC Advance Access published online on October 14, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh455
© 2004 by The British Society for Antimicrobial Chemotherapy
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1 Department of Pathology, National Cheng Kung University Hospital, No. 138, Sheng-Li Rd, Tainan 70428, Taiwan; Departments of Pathology, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 70101, Taiwan
* To whom correspondence should be addressed. E-mail: jingjou{at}mail.ncku.edu.tw.
Objectives: This study was conducted to investigate the occurrence of 16S rRNA methylases that confer high-level aminoglycoside resistance in Klebsiella pneumoniae and Escherichia coli isolates from two Taiwanese hospitals and the characteristics of these isolates. Methods: A total of 1624 K. pneumoniae and 2559 E. coli isolates consecutively collected over an 18 month period from a university hospital and seven E. coli and eight K. pneumoniae isolates that were resistant to amikacin from a district hospital were analysed. Two 16S rRNA methylase genes, armA and rmtB, were detected by PCR-based assays. Results: Overall, 28 armA-positive and seven rmtB-positive isolates were identified, and extended-spectrum Conclusions: This is the first report of the emergence of 16S rRNA methylases in Enterobacteriaceae in Taiwan. The spread of the multidrug-resistant isolates producing both ESBLs and 16S rRNA methylases may become a clinical problem.
Revised September 3, 2004
Accepted September 11, 2004
Original article
Plasmid-mediated 16S rRNA methylases conferring high-level aminoglycoside resistance in Escherichia coli and Klebsiella pneumoniae isolates from two Taiwanese hospitals
2 Department of Medical Technology, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 70101, Taiwan
3 Department of Internal Medicine, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 70101, Taiwan
4 Department of Pathology, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 70101, Taiwan
5 Department of Pathology, National Cheng Kung University Hospital, No. 138, Sheng-Li Rd, Tainan 70428, Taiwan
6 Department of Laboratory Medicine, Tainan Municipal Hospital, No. 670, Chongde Rd, Tainan City 70173, Taiwan
Abstract 
-Lactamase characteristics were determined by phenotypic and genotypic methods.-lactamases (ESBLs) were detected in 33 (94.3%) isolates. The prevalence rates of armA and rmtB at the university hospital were 0.9% (n=15) and 0.3% (n=5) in K. pneumoniae and 0.4% (n=10) and 0.04% (n=1) in E. coli. CTX-M-3, CTX-M-14, SHV-5-like ESBLs, and CMY-2 were detected alone or in combination in 21, 6, 11, and 2, respectively, of the 28 armA-positive isolates. CTX-M-14 was detected in six of the seven rmtB-positive isolates. Fingerprinting of conjugative plasmids revealed the dissemination of closely related plasmids containing both armA and blaCTX-M-3. PFGE suggests that armA and rmtB spread by both horizontal transfer and clonal spread.-lactamases.
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