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JAC Advance Access published online on September 5, 2007
Journal of Antimicrobial Chemotherapy, 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.

Key Words: ESBLs , Enterobacteriaceae , Pseudomonas aeruginosa , Acinetobacter baumannii , insertion sequences


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