Detection of new SHV-12, SHV-5 and SHV-2a variants of extended spectrum beta-lactamase in Klebsiella pneumoniae in Egypt

Klebsiella pneumoniae outbreaks possessing extended-spectrum β-lactamase- (ESBL) mediated resistance to third-generation cephalosporins have increased significantly in hospital and community settings worldwide. The study objective was to characterize prevalent genetic determinants of TEM, SHV and CT...

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Bibliographic Details
Published in:	Annals of clinical microbiology and antimicrobials Vol. 12; no. 1; p. 16
Main Authors:	Newire, Enas A, Ahmed, Salwa F, House, Brent, Valiente, Esmeralda, Pimentel, Guillermo
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 18-07-2013 BioMed Central
Subjects:	Analysis Anti-Bacterial Agents - pharmacology Antibiotics Bacterial pneumonia Bacterial Typing Techniques Base Sequence Beta lactamases beta-Lactamases - genetics Biotechnology industry Care and treatment Cephaloridine Cephalosporins Community-Acquired Infections - microbiology Cross Infection - microbiology Diagnosis Distribution DNA sequencing DNA, Bacterial - analysis Drug Resistance, Multiple, Bacterial - genetics Egypt Egypt - epidemiology Gene mutations Genes Genetic aspects Genetic Variation Glycine Hospitals Humans Klebsiella Klebsiella Infections - drug therapy Klebsiella Infections - epidemiology Klebsiella Infections - microbiology Klebsiella pneumoniae Klebsiella pneumoniae - enzymology Klebsiella pneumoniae - genetics Klebsiella pneumoniae - isolation & purification Lebanon Microbiology Moxalactam Nosocomial infections Nucleotide sequencing Plasmids Pneumonia Risk factors Sequence Analysis, DNA Studies Teaching hospitals United States Egypt Lebanon United States United States > US Cairo Egypt
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Summary:	Klebsiella pneumoniae outbreaks possessing extended-spectrum β-lactamase- (ESBL) mediated resistance to third-generation cephalosporins have increased significantly in hospital and community settings worldwide. The study objective was to characterize prevalent genetic determinants of TEM, SHV and CTX-M types ESBL activity in K. pneumoniae isolates from Egypt. Sixty five ESBL-producing K. pneumoniae strains, isolated from nosocomial and community-acquired infections from 10 Egyptian University hospitals (2000-2003), were confirmed with double disc-synergy method and E-test. blaTEM, blaSHV and blaCTX-m genes were identified by PCR and DNA sequencing. Pulsed-field gel electrophoresis (PFGE) was conducted for genotyping. All isolates displayed ceftazidime and cefotaxime resistance. blaTEM and blaSHV genes were detected in 98% of the isolates' genomes, while 11% carried blaCTX-m. DNA sequencing revealed plasmid-borne SHV-12,-5,-2a (17%), CTX-m-15 (11%), and TEM-1 (10%) prevalence. Among SHV-12 (n=8), one isolate displayed 100% blaSHV-12 amino acid identity, while others had various point mutations: T17G (Leu to Arg, position 6 of the enzyme: n=2); A8T and A10G (Tyr and Ile to Phe and Val, positions 3 and 4, respectively: n=4), and; A703G (Lys to Glu 235: n=1). SHV-5 and SHV-2a variants were identified in three isolates: T17G (n=1); A703G and G705A (Ser and Lys to Gly and Glu: n=1); multiple mutations at A8T, A10G, T17G, A703G and G705A (n=1). Remarkably, 57% of community-acquired isolates carried CTX-m-15. PFGE demonstrated four distinct genetic clusters, grouping strains of different genetic backgrounds. This is the first study demonstrating the occurrence of SHV-12, SHV-5 and SHV-2a variants in Egypt, indicating the spread of class A ESBL in K. pneumoniae through different mechanisms.
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ISSN:	1476-0711 1476-0711
DOI:	10.1186/1476-0711-12-16