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Journal of Clinical Microbiology, September 2001, p. 3193-3196, Vol. 39, No. 9
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.9.3193-3196.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Outbreak of Infection with Extended-Spectrum beta -Lactamase-Producing Klebsiella pneumoniae in a Mexican Hospital

Jesus Silva,1,* Rodolfo Gatica,1 Cecilia Aguilar,1,dagger Zita Becerra,1 Ulises Garza-Ramos,1 Manuel Velázquez,1 Guadalupe Miranda,2 Blanca Leaños,2 Fortino Solórzano,2 and Gabriela Echániz2,3

Department of Bacterial Resistance1 and Department of Clinical Epidemiology,3 National Institute of Public Health, Center for Research on Infectious Diseases, Cuernavaca, Morelos, and Hospital de Pediatría, Centro Médico Nacional Siglo XXI,1 Instituto Mexicano del Seguro Social México, D.F.,2 Mexico.

Received 6 November 2000/Returned for modification 8 January 2001/Accepted 20 April 2001

Thirty-one strains of Klebsiella pneumoniae (including 10 duplicates) from 21 septicemic pediatric patients (age, <2 months) were studied during a 4-month period (June to October 1996) in which the fatality rate was 62% (13 of 21). These isolates identified by the API 20E system yielded the same biotype. Pulsed-field gel electrophoresis experiments revealed the same clone in 31 strains. The isolates were multidrug-resistant but were still susceptible to ciprofloxacin, imipenem, and cefoxitin. A 135-kb plasmid was harbored in all of the isolates. No transconjugants were obtained that were resistant to ampicillin, cefotaxime, tetracycline, or gentamicin. Isoelectric focusing for beta -lactamases was performed on all strains, and three bands with pIs of 5.4, 7.6, and 8.2 were obtained. Of these, the pI 8.2 beta -lactamase had an extended-spectrum beta -lactamase phenotype. PCR amplification of both TEM- and SHV-type genes was obtained. The sequence analysis of the SHV PCR product indicated a mutation corresponding to the SHV-5 beta -lactamase.

* Corresponding author. Mailing address: National Institute of Public Health, Center for Research on Infectious Diseases, Av. Universidad 655, Col. Sta. Ma. Ahuacatitlán, C.P. 62508 Cuernavaca, Morelos, Mexico. Phone: (52) 73-29-30-21. Fax: (52) 73-17-54-85. E-mail: jsilva{at}correo.insp.mx.

dagger Present address: Depto. de Biotecnología, Instituto de Investigaciones Biomédicas, Circuito Escolar, Ciudad Universitaria, UNAM, México, D.F., Mexico.

Journal of Clinical Microbiology, September 2001, p. 3193-3196, Vol. 39, No. 9
0095-1137/01/$04.00+0   DOI: 10.1128/JCM.39.9.3193-3196.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


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