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Journal of Clinical Microbiology, December 2000, p. 4320-4325, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Dissemination of CTX-M-3 and CMY-2 beta -Lactamases among Clinical Isolates of Escherichia coli in Southern Taiwan

Jing-Jou Yan,1 Wen-Chien Ko,2 Shu-Huei Tsai,1 Hsiu-Mei Wu,3 Ying-Tai Jin,1 and Jiunn-Jong Wu3,*

Departments of Pathology1 and Medicine,2 National Cheng Kung University Medical Center, and Department of Medical Technology,3 National Cheng Kung University Medical College, Tainan, Taiwan

Received 2 June 2000/Returned for modification 8 July 2000/Accepted 13 September 2000

A total of 1,210 clinical isolates of Escherichia coli collected from a university hospital in southern Taiwan were screened for production of extended-spectrum beta -lactamases (ESBLs). Expression of classical ESBLs (resistant to extended-spectrum beta -lactam agents and susceptible to beta -lactam inhibitors) was inferred in 18 isolates by the phenotypic confirmatory test. These included 10 isolates producing CTX-M-3, 2 strains carrying SHV-12, 1 strain harboring SHV-5, 1 strain expressing TEM-10, and 4 strains producing unidentifiable ESBLs with a pI of 8.05, 8.0, or 7.4. Eighteen isolates that showed decreased susceptibilities to ceftazidime and/or cefotaxime, negative results for the confirmatory test, and high-level resistance to cefoxitin (MICs of >= 128 µg/ml) were also investigated. Five isolates were found to produce CMY-2 AmpC enzymes, one isolate carried both CTX-M-3 and CMY-2, and the remaining three and nine isolates expressed putative AmpC beta -lactamases with pIs of >9.0 and 8.9, respectively. Thus, together with the isolate producing CTX-M-3 and CMY-2, 19 (1.6%) isolates produced classical ESBLs. Pulsed-field gel electrophoresis revealed that all isolates carrying CTX-M-3 and/or CMY-2 were genetically unrelated, indicating that dissemination of resistance plasmids was responsible for the spread of these two enzymes among E. coli in this area. Among the 16 isolates expressing CTX-M-3 and/or CMY-2, 5 might have colonized outside the hospital environment. Our data indicate that CTX-M-3 and CMY-2, two beta -lactamases initially identified in Europe, have been disseminated to and are prevalent in Taiwan.

* Corresponding author. Mailing address: Department of Medical Technology, National Cheng Kung University Medical College, No. 1 University Rd., Tainan, Taiwan 70101. Phone: 886-6-2353535, x5775. Fax: 886-6-2363956. E-mail: jjwu{at}mail.ncku.edu.tw.

Journal of Clinical Microbiology, December 2000, p. 4320-4325, Vol. 38, No. 12
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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