Extended-Spectrum β-Lactamases in Enterobacteriaceae in Buenos Aires, Argentina, Public Hospitals

Open Access
Publisher Website
Google Scholar
Abstract
Resistance to extended-spectrum cephalosporins is often associated with plasmid encoded extended spectrum β-lactamases (ESBL). In order to evaluate the prevalence and diversity of ESBLs in enterobacteria in our city, a 1-month-period survey was carried out from April to May 2000. Extended-spectrum-cephalosporin-resistant strains, isolated from inpatient clinical specimens other than stools, were collected among 17 participating hospitals. From a total of 427 enterobacterial strains that were collected during this period, 39 were extended-spectrum cephalosporin resistant. The National Committee for Clinical Laboratory Standards' Screening and Confirmatory Tests for ESBL production were performed using cefotaxime and ceftazidime; cefepime and cefepime-clavulanic acid-containing disks were included. β-Lactamases were characterized by isoelectric focusing and PCR amplification using specific primers. Three different ESBLs were detected: SHV-related (4 isolates), PER-2-type (9 isolates), and CTX-M-2-related (26 isolates). Sequencing of the corresponding genes confirmed CTX-M-2 in 19 of 21 and CTX-M-31 (an allelic variant) in the remaining 2 of 21. CTX-M-2 (or its variant) was detected in all Escherichia coli , Enterobacter aerogenes , Serratia marcescens , Proteus mirabilis , and Providencia stuartii strains, while PER-2 was detected in Enterobacter cloacae , E. aerogenes , and Klebsiella pneumoniae ; SHV-related ESBL were found only in K. pneumoniae . These results clearly show that CTX-M-2 is the most prevalent ESBL produced by enterobacterial species isolated from public hospitals in Buenos Aires.