Outer membrane protein change combined with co-existing TEM-1 and SHV-1 β-lactamases lead to false identification of ESBL-producing Klebsiella pneumoniae

Tsu Lan Wu, L. K. Siu, Lin Hui Su, T. L. Lauderdale, F. M. Lin, Hsieh Shong Leu, Tzou Yien Lin, Monto Ho

Research output: Contribution to journalArticle

48 Citations (Scopus)

Abstract

Nine isolates of Klebsiella pneumoniae, obtained from one colonized and eight bacteraemic patients on a paediatric ward, were shown to be identical by PFGE, indicating an outbreak. Screening for extended-spectrum β-lactamase (ESBL) production using the double-disc synergy test, Etest for ESBLs and agar diffusion tests indicated ESBL production. The isolates showed reduced susceptibility to cefotaxime but not to other third-generation cephalosporins. Molecular studies revealed production of TEM-1 and SHV-1 but no ESBLs were identified. Deficiency in expression of an outer membrane protein (OmpK35) was also observed. These observations led us to postulate that the extremely low level of OmpK35 expression and the co-existence of TEM-1 and SHV-1 resulted in an increased MIC of cefotaxime and the false designation of the isolates as ESBL producers. All the infected infants were treated with either third-generation cephalosporins alone or multiple antibiotics including a third-generation cephalosporin, and recovered and were discharged without sequelae.

Original languageEnglish
Pages (from-to)755-761
Number of pages7
JournalJournal of Antimicrobial Chemotherapy
Volume47
Issue number6
Publication statusPublished - 2001
Externally publishedYes

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Klebsiella pneumoniae
Cephalosporins
Membrane Proteins
Cefotaxime
Disk Diffusion Antimicrobial Tests
Agar
Disease Outbreaks
Pediatrics
Anti-Bacterial Agents

ASJC Scopus subject areas

  • Pharmacology
  • Microbiology

Cite this

Outer membrane protein change combined with co-existing TEM-1 and SHV-1 β-lactamases lead to false identification of ESBL-producing Klebsiella pneumoniae. / Wu, Tsu Lan; Siu, L. K.; Su, Lin Hui; Lauderdale, T. L.; Lin, F. M.; Leu, Hsieh Shong; Lin, Tzou Yien; Ho, Monto.

In: Journal of Antimicrobial Chemotherapy, Vol. 47, No. 6, 2001, p. 755-761.

Research output: Contribution to journalArticle

Wu, Tsu Lan ; Siu, L. K. ; Su, Lin Hui ; Lauderdale, T. L. ; Lin, F. M. ; Leu, Hsieh Shong ; Lin, Tzou Yien ; Ho, Monto. / Outer membrane protein change combined with co-existing TEM-1 and SHV-1 β-lactamases lead to false identification of ESBL-producing Klebsiella pneumoniae. In: Journal of Antimicrobial Chemotherapy. 2001 ; Vol. 47, No. 6. pp. 755-761.
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AU - Siu, L. K.

AU - Su, Lin Hui

AU - Lauderdale, T. L.

AU - Lin, F. M.

AU - Leu, Hsieh Shong

AU - Lin, Tzou Yien

AU - Ho, Monto

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