Naslov
Persistence of Klebsiella Pneumoniae Producing SHV-5 beta-Lactamase in University Hospital, Zagreb.
(Persistence of Klebsiella pneumoniae Producing SHV-5 beta-Lactamase in University Hospital, Zagreb.)

Autori
Bedenić, Branka ; Schmidt, Herbert ; Herold, Sylvia ; Monaco, Monica ; Plečko, Vanda ; Kalenić, Smilja ; Katić, Stjepan ;

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Book of Abstracts of the World Conference on dosing of Antiinfectives. Paul Ehrlich Symposium. / - Nürnberg, 2004

Skup
World Conference on dosing of Antiinfectives. Paul Ehrlich Symposium.

Mjesto i datum
Nürnberg, Njemačka, 09.09.2004. - 12.09.2004

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
Klebsiella pneumoniae; extended-spectrum beta-lactamases

Sažetak
Plasmid-encoded resistance to broad-spectrum cephalosporins and aztreonam is becoming a widespread phenomenon in clinical medicine. These antibiotics are inactivated by an array of different extended-spectrum beta-lactamases (ESBLs), which have evolved by point mutations of parenthal TEM or SHV beta-lactamases. In the previous study conducted during 1994-1995 SHV-2, SHV-2a and SHV-5 beta-lactamases were found among Klebsiella pneumoniae isolates in Dubrava University Hospital. High prevalence of ESBLs among Klebsiella pneumoniae strains in this hospital (20%) required further investigation. In this investigation, beta-lactamases from 42 Klebsiella pneumoniae strains collected in 1997 and 15 in 2004 from Dubrava University Hospital, were characterized in order to study the evolution of plasmid-encoded resistance to extended-spectrum cephalosporins and aztreonam in that hospital over a prolonged study period. Susceptibility to antibiotics was determined by disk-diffusion and broth microdilution method. beta-lactamases were characterized by isoelectric focusing, substrate profile determination, polymerase chain reaction and sequencing of blaSHV genes. All Klebsiella pneumoniae strains and their Escherichia coli transconjugants produced beta-lactamase with the isoelectric point of 8.2. Based on sequencing of blaSHV genes enzymes of all transconjugants were identified as SHV-5 beta-lactamase which conferred on the producing isolates high level of ceftazidime and aztreonam resistance. Most of the isolates have shown to be clonally related by pulsed-field gel electrophoresis. In this study, an outbreak of nosocomial infections caused by SHV-5 producing Klebsiella pneumoniae was described in 1997 which evolved to endemic spread of SHV-5 producing Klebsiella pneumoniae due to multiple plasmid transfer in the Dubrava University Hospital. In the previous study from 1994-1995, it was found that SHV-2 beta-lactamase, which is a cefotaximase according to the substrate profile, was the most prevalent type of ESBL in Dubrava Hospital, but in 1997 and 2004 it was completely replaced by SHV-5 beta-lactamase probably due selective pressure of ceftazidime which is the most widely prescribed expanded-spectrum cephalosporin in Croatian hospitals. Hospital hygiene measures should be applied in order to control the spread of epidemic strains through the hospital wards and the consumption of the broad-spectrum cephalosporins needs to be restricted to reduce the selection pressure which enables the proliferation of ESBL producers in hospital.

Izvorni jezik
Engleski

Znanstvena područja
Temeljne medicinske znanosti, Kliničke medicinske znanosti

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