Abstract
Klebsiella aerogenes K41, resistant to third generation cephalosporins and aminoglycosides, was isolated from clinical samples of 153 in-patients. Blood cultures accounted for 24 (15.7%) of isolates. The MIC(90) of ceftazidime for the isolates of 84 patients was >512 mg/l and was reduced to 2.0 by 4 mg/l of clavulanic acid, but only to 64 by 4 mg/l of sulbactam. Isolates of K. aerogenes K41 produced extended-spectrum beta-lactamase (ESBL) SHV-5 and TEM-1, identified by isoelectric focusing. Plasmid profiles showed that co-dissemination of cephalosporin and aminoglycoside resistance, plus ESBL production, coincided with the acquisition of a 116-kb plasmid. This plasmid was transferable in vitro from K. aerogenes K41 to other serotypes and genera of the Enterobacteriaceae.
MeSH terms
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Aminoglycosides
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Anti-Bacterial Agents / pharmacology*
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Anti-Bacterial Agents / therapeutic use
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Bacteremia / drug therapy
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Bacteremia / microbiology
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Cephalosporin Resistance*
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Cephalosporins / pharmacology
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Conjugation, Genetic
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Drug Resistance, Microbial
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Drug Resistance, Multiple
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Enterobacter aerogenes / drug effects*
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Enterobacter aerogenes / genetics
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Enterobacter aerogenes / isolation & purification
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Enterobacteriaceae / drug effects*
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Enterobacteriaceae / genetics
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Enterobacteriaceae / isolation & purification
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Enterobacteriaceae Infections / drug therapy
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Enterobacteriaceae Infections / microbiology*
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Humans
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Microbial Sensitivity Tests
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Penicillin Resistance
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Plasmids*
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beta-Lactamases / metabolism
Substances
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Aminoglycosides
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Anti-Bacterial Agents
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Cephalosporins
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beta-lactamase SHV-5
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beta-Lactamases
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beta-lactamase TEM-1