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  • 1 Department of Phage Typing and Molecular Epidemiology, National Center for Epidemiology, Gyáli út 2-6, H-1097, Budapest, Hungary
  • | 2 Department of Bacteriology, National Center for Epidemiology, Gyáli út 2-6, H-1097, Budapest, Hungary
  • | 3 1st Department of Pediatrics, Semmelweis University, Bókay János u. 53-54, H-1083, Budapest, Hungary
  • | 4 “Jávorszky Ödön” Hospital, Argenti Döme tér 1-3, H-2600, Vác, Hungary
  • | 5 Institute of Medical Microbiology, Semmelweis University, Nagyvárad tér 4, H-1089, Budapest, Hungary
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Abstract

Molecular epidemiology and genetic features of an extended-spectrum β-lactamase (ESBL) producing Klebsiella pneumoniae epidemic clone (KP-EC) with elevated ciprofloxacin MIC (minimum inhibitory concentration) values from multiple nosocomial outbreaks and sporadic cases between 2006 and 2008 in Hungary were investigated.

As a result of continuous monitoring of ESBL-producing KP-ECs, 27 isolates collected from five healthcare facilities were selected for macrorestriction profile analysis by PFGE (pulsed field gel electrophoresis). Of these, 12 strains were isolated from adult inpatients, while 15 strains were from newborns. The MIC values for several antibiotics were determined by agar dilution technique. Molecular typing was further performed by PCR (polymerase chain reaction) and sequencing of several antibiotic resistance genes, plasmid profile analysis, transfer of resistance determinants and multilocus sequence typing (MLST).

All isolates showed moderate resistance to ciprofloxacin (MICs ranged from 0.5 to 8 mg L−1). PFGE revealed the existence of only one genetic cluster defined as EC IV. PstI digestion of plasmid DNA revealed two highly diverse restriction patterns in “adult” and “newborn” isolates corresponding to plasmids from the Hungarian Epidemic Clone and plasmids isolated from a neonatal nosocomial outbreak in 1998, respectively. Sequence analysis of b-lactamase genes from plasmids of 14 selected isolates detected blaSHV-2a in strains isolated exclusively from newborns and blaCTX-M-15 in strains isolated exclusively from adult inpatients. MLST established that strains of the PFGE cluster belonged to a novel sequence type ST274.

ESBL-producing K. pneumoniae isolates belonging to the novel sequence type ST274 appeared in the newborn and adult hospital settings in Hungary and acquired SHV-2a or CTX-M-15 type enzymes, respectively. Thus, a new antimicrobial resistance strategy for successful conformation to distinct hospital settings was found.

  • 1. T.M. Coque F. Baquero R. Canton 2008 Increasing prevalence of ESBL-producing Enterobacteriaceae in Europe Euro Surv 13 47 111.

  • 2. I. Damjanova Tóth J. Pászti M. Jakab H. Milch A. Bauerfeind M. Füzi 2007 Epidemiology of SHV-type beta-lactamaseproducing Klebsiella spp. from outbreaks in five geographically distant Hungarian neonatal intensive care units: widespread dissemination of epidemic R-plasmids Int J Antimicrob Agents 29 665671.

    • Search Google Scholar
    • Export Citation
  • 3. I. Damjanova Tóth J. Pászti G. Hajbel-Vékony M. Jakab J. Berta H. Milch M. Füzi 2008 Expansion and countrywide dissemination of ST11, ST15 and ST147 ciprofloxacin-resistant CTX-M-15-type beta-lactamase-producing Klebsiella pneumoniae epidemic clones in Hungary in 2005-the new ‘MRSAs’? J Antimicrob Chemother 62 978985.

    • Search Google Scholar
    • Export Citation
  • 4. ClinicalLaboratory Standards Institute 2005 Performance Standards for Antimicrobial Susceptibility Testing: Fifteenth Informational Supplement M100-S15 CLSI Wayne, PA.

    • Search Google Scholar
    • Export Citation
  • 5. O. Lomovskaya M.S. Warren A. Lee J. Galazzo R. Fronko M. Lee J. Blais D. Cho S. Chamberland et al.2001 Identification and characterization of inhibitors of multidrug resistance efflux pumps in Pseudomonas aeruginosa: novel agents for combination therapy Antimicrob Agents Chemother 45 105116.

    • Search Google Scholar
    • Export Citation
  • 6. A. Schumacher P. Steinke J.A. Bohnert M. Akova D. Jonas W.V. Kern 2006 Effect of 1-(1-naphthylmethyl)-piperazine, a novel putative efflux pump inhibitor, on antimicrobial drug susceptibility in clinical isolates of Enterobacteriaceae other than Escherichia coli J Antimicrob Chemother 57 344348.

    • Search Google Scholar
    • Export Citation
  • 7. F.C. Tenover R.D. Arbeit R.V. Goering P.A. Mickelsen B.E. Murray D.H. Persing B. Swaminathan 1995 Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial strain typing J Clin Microbiol 33 22332239.

    • Search Google Scholar
    • Export Citation
  • 8. Tóth M. Gacs K. Márialigeti G. Cech M. Füzi 2005 Occurrence and regional distribution of SHV-type extended-spectrum β-lactamases in Hungary Eur J Clin Microbiol Infect Dis 24 284287.

    • Search Google Scholar
    • Export Citation
  • 9. E. Karisik M.J. Ellington R. Pike R.E. Warren D.M. Livermore N. Woodford 2006 Molecular characterization of plasmids encoding CTX-M-15 β-lactamases from Escherichia coli strains in the United Kingdom J Antimicrob Chemother 58 665668.

    • Search Google Scholar
    • Export Citation
  • 10. C. Kehrenberg S. Friederichs A. de Jong G.B. Michael S. Schwarz 2006 Identification of the plasmid-borne quinolone resistance gene qnrS in Salmonella enterica serovar Infantis J Antimicrob Chemother 58 1822.

    • Search Google Scholar
    • Export Citation
  • 11. L. Diancourt V. Passet J. Verhoef P.A. Grimont S. Brisse 2005 Multilocus sequence typing of Klebsiella pneumoniae nosocomial isolates J Clin Microbiol 43 41784182.

    • Search Google Scholar
    • Export Citation
  • 12. N. Woodford M.J. Ellington 2007 The emergence of antibiotic resistance by mutation Clin Microbiol Infect 13 518.

  • 13. T. Deguchi A. Fukuoka M. Yasuda M. Nakano S. Ozeki E. Kanematsu Y. Nishino S. Ishihara Y. Ban et al.1997 Alteration in the GyrA subunit of DNS gyrase and the ParC subunit of topoisomerase IV in quinolone-resistant clinical isolates of Klebsiella pneumoniae Antimicrob Agents Chemother 41 699701.

    • Search Google Scholar
    • Export Citation
  • 14. S. Brisse D. Milatovic A.C. Fluit J. Verhoef N. Martin S. Scheuring K. Köhrer F.J. Schmitz 1999 Comparative in vitro activities of ciprofloxacin, clinafloxacin, gatifloxacin, levofloxacin, moxifloxacin, and trovafloxacin against Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Enterobacter aerogenes clinical isolates with alterations in GyrA and ParC proteins Antimicrob Agent Chemother 43 20512055.

    • Search Google Scholar
    • Export Citation
  • 15. F.M. Wagenlehner P. Heisig C. Irtenkauf F. Notka J. Decker N. Lehn H. Linde 2003 Clinically significant borderline resistance of sequential clinical isolates of Klebsiella pneumoniae Int J Antimicrob Agents 22 36773.

    • Search Google Scholar
    • Export Citation
  • 16. A. Robicsek G.A. Jacoby D.C. Hooper 2006 The worldwide emergence of plasmid-mediated quinolone resistance Lancet Infect Dis 6 629640.

    • Search Google Scholar
    • Export Citation
  • 17. A. Robicsek J. Strahilevitz G.A. Jacoby M. Macielag D. Abbanat C.H. Park K. Bush D.C. Hooper 2006 Fluoroquinolone-modifying enzyme: a new adaptation of a common aminoglycoside acetyltransferase Nat Med 12 8388.

    • Search Google Scholar
    • Export Citation
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Senior editors

Editor(s)-in-Chief: Dunay, Ildiko Rita

Editor(s)-in-Chief: Heimesaat, Markus M.

Vice Editor(s)-in-Chief: Fuchs, Anja

Editorial Board

Chair of the Editorial Board:
Jeffrey S. Buguliskis (Thomas Jefferson University, USA)

  • Jörn Albring (University of Münster, Germany)
  • Stefan Bereswill (Charité - University Medicine Berlin, Germany)
  • Dunja Bruder (University of Megdeburg, Germany)
  • Jan Buer (University of Duisburg, Germany)
  • Jeff Buguliskis (Thomas Jefferson University, USA)
  • Edit Buzas (Semmelweis University, Hungary)
  • Charles Collyer (University of Sydney, Australia)
  • Renato Damatta (UENF, Brazil)
  • Ivelina Damjanova (Semmelweis University, Hungary)
  • Maria Deli (Biological Research Center, HAS, Hungary)
  • Olgica Djurković-Djaković (University of Belgrade, Serbia)
  • Jean-Dennis Docquier (University of Siena, Italy)
  • Anna Erdei (Eötvös Loránd University, Hungary)
  • Zsuzsanna Fabry (University of Washington, USA)
  • Beniam Ghebremedhin (Witten/Herdecke University, Germany)
  • Nancy Guillen (Institute Pasteur, France)
  • Georgina L. Hold (University of Aberdeen, United Kingdom)
  • Ralf Ignatius (Charité - University Medicine Berlin, Germany)
  • Zsuzsanna Izsvak (MDC-Berlin, Germany)
  • Achim Kaasch (University of Cologne, Germany)
  • Tamás Laskay (University of Lübeck, Germany)
  • Oliver Liesenfeld (Roche, USA)
  • Shreemanta Parida (Vaccine Grand Challenge Program, India)
  • Matyas Sandor (University of Wisconsin, USA)
  • Ulrich Steinhoff (University of Marburg, Germany)
  • Michal Toborek (University of Miami, USA)
  • Mary Jo Wick (University of Gothenburg, Sweden)
  • Susanne A. Wolf (MDC-Berlin, Germany)

 

Dr. Dunay, Ildiko Rita
Magdeburg, Germany
E-mail: ildikodunay@gmail.com

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2020  
CrossRef Documents 23
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European Journal of Microbiology and Immunology
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European Journal of Microbiology and Immunology
Language English
Size A4
Year of
Foundation
2011
Volumes
per Year
1
Issues
per Year
4
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
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H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
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Chief Executive Officer, Akadémiai Kiadó
ISSN 2062-509X (Print)
ISSN 2062-8633 (Online)

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