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Journal of Clinical Microbiology, January 2001, p. 175-182, Vol. 39, No. 1
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.1.175-182.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Molecular Epidemiology of the Integron-Located VEB-1 Extended-Spectrum beta -Lactamase in Nosocomial Enterobacterial Isolates in Bangkok, Thailand

Delphine Girlich,1 Laurent Poirel,1 Amornrut Leelaporn,2 Amal Karim,1 Chanwitt Tribuddharat,3 Michael Fennewald,3 and Patrice Nordmann1,*

Service de Bactériologie-Virologie, Hôpital de Bicêtre, Assistance Publique-Hôpitaux de Paris, Faculté de Médecine Paris-Sud, 94275 Le Kremlin-Bicêtre, France1; Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand2; and Department of Microbiology and Immunology, Finch University of Health Sciences, The Chicago Medical School, North Chicago, Illinois 600643

Received 20 July 2000/Returned for modification 4 September 2000/Accepted 31 October 2000

Over a 21/2-month period in 1999, 37 ceftazidime-resistant nonrepetitive enterobacterial isolates were collected from 37 patients in a Bangkok hospital, Thailand. Eighty-one percent of these strains expressed a clavulanic acid-inhibited extended-cephalosporin resistance profile. An identical extended-spectrum beta -lactamase (ESBL), VEB-1, was found in 16 unrelated enterobacterial isolates (Escherichia coli, n = 10; Enterobacter cloacae, n = 2; Enterobacter sakazakii, n = 1; and Klebsiella pneumoniae, n = 3) and in two clonally related E. cloacae isolates. The blaVEB-1 gene was located on mostly self-conjugative plasmids (ca. 24 to 200 kb) that conferred additional non-beta -lactam antibiotic resistance patterns. Additionally, the blaVEB-1 gene cassette was part of class 1 integrons varying in size and structure. The blaVEB-1-containing integrons were mostly associated with blaOXA-10-like and arr-2-like gene cassettes, the latter conferring resistance to rifampin. These data indicated the spread of blaVEB-1 in Bangkok due to frequent transfer of different plasmids and class 1 integrons and rarely to clonally related strains. Plasmid- and integron-mediated resistance to rifampin was also found in enterobacterial isolates.

* Corresponding author. Mailing address: Service de Bactériologie-Virologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre Cedex, France. Phone: 33-1-45-21-36-32. Fax: 33-1-45-21-63-40. E-mail: nordmann.patrice{at}bct.ap-hop-paris.fr.

Journal of Clinical Microbiology, January 2001, p. 175-182, Vol. 39, No. 1
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.1.175-182.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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