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Journal of Clinical Microbiology, September 2003, p. 4264-4269, Vol. 41, No. 9
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.9.4264-4269.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Multiple CTX-M-Type Extended-Spectrum ß-Lactamases in Nosocomial Isolates of Enterobacteriaceae from a Hospital in Northern Italy

Laura Pagani,1 Emanuela Dell'Amico,2 Roberta Migliavacca,1 Marco Maria D'Andrea,2 Ernesto Giacobone,3 Gianfranco Amicosante,4 Egidio Romero,1 and Gian Maria Rossolini2*

Dipartimento di Scienze Morfologiche Eidologiche e Cliniche, Sezione di Microbiologia, Università di Pavia,1 Servizio di Analisi Microbiologiche IRCCS San Matteo, I-27100 Pavia,3 Dipartimento di Biologia Molecolare, Sezione di Microbiologia, Università di Siena, I-53100 Siena,2 Dipartimento di Scienze e Tecnologie Biomediche, Università di L'Aquila, I-67100 L'Aquila, Italy4

Received 10 February 2003/ Returned for modification 22 April 2003/ Accepted 23 June 2003

Twelve isolates of Enterobacteriaceae (1 of Klebsiella pneumoniae, 8 of Escherichia coli, 1 of Proteus mirabilis, and 2 of Proteus vulgaris) classified as extended-spectrum ß-lactamase (ESBL) producers according to the ESBL screen flow application of the BD-Phoenix automatic system and for which the cefotaxime MICs were higher than those of ceftazidime were collected between January 2001 and July 2002 at the Laboratory of Clinical Microbiology of the San Matteo University Hospital of Pavia (northern Italy). By PCR and sequencing, a CTX-M-type determinant was detected in six isolates, including three of E. coli (carrying blaCTX-M-1), two of P. vulgaris (carrying blaCTX-M-2), and one of K. pneumoniae (carrying blaCTX-M-15). The three CTX-M-1-producing E. coli isolates were from different wards, and genotyping by pulsed-field gel electrophoresis (PFGE) revealed that they were clonally unrelated to each other. The two CTX-M-2-producing P. vulgaris isolates were from the same ward (although isolated several months apart), and PFGE analysis revealed probable clonal relatedness. The blaCTX-M-1 and blaCTX-M-2 determinants were transferable to E. coli by conjugation, while conjugative transfer of the blaCTX-M-15 determinant from K. pneumoniae was not detectable. Present findings indicate that CTX-M enzymes of various types are present also in Italy and underscore that different CTX-M determinants can be found in a single hospital and can show different dissemination patterns. This is also the first report of CTX-M-2 in P. vulgaris.

* Corresponding author. Mailing address: Dipartimento di Biologia Molecolare, Sez. di Microbiologia, Università di Siena, Policlinico Le Scotte, 53100 Siena, Italy. Phone: 39 0577 233327. Fax: 39 0577 233325. E-mail: rossolini{at}unisi.it.

Journal of Clinical Microbiology, September 2003, p. 4264-4269, Vol. 41, No. 9
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.9.4264-4269.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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