Molecular epidemiology of extended-spectrum β-lactamase-producing, fluoroquinolone-resistant isolates of Klebsiella pneumoniae in Taiwan

W. L. Yu, R. N. Jones, R. J. Hollis, S. A. Messer, D. J. Biedenbach, L. M. Deshpande, Michael A. Pfaller

研究成果: 雜誌貢獻文章

35 引文 (Scopus)

摘要

Strains of extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) have emerged worldwide. Concomitant ciprofloxacin resistance with ESBL production in K. pneumoniae isolates would severely restrict treatment options. Among 39 (18.5%) of 211 ESBL-KP isolates resistant to ciprofloxacin (MIC, ≥4 μg/ml), 37 (95%) were high level resistant (MIC, ≥16 μg/ml). These isolates were also cross resistant to the newer fluoroquinolones, including levofloxacin, gatifloxacin, gemifloxacin, and garenoxacin (BMS 284756). Sitafloxacin was most active against these ciprofloxacin-resistant ESBL-KP isolates with MICs for 67% of the isolates being ≤2 μg/ml. The molecular epidemiology of these multiresistant isolates was investigated by automated ribotyping and pulsed-field gel electrophoresis (PFGE). Ribotyping identified 18 different strains among the 39 ciprofloxacin-resistant ESBL-KP isolates. The majority (67%) of these isolates were contained in six ribogroups which were further confirmed by PFGE. The distribution of the six major strains of ciprofloxacinresistant ESBL-KP within Taiwan included one (ribogroup 255.3-PFGE type E) with a nationwide distribution and several institution-specific strains. Interhospital cooperation appears necessary, with strict infection control practices coupled with restriction of fluoroquinolone and extended-spectrum β-lactam use to control both the major epidemic strain and the more diverse strains observed within individual institutions.

原文英語
頁(從 - 到)4666-4669
頁數4
期刊Journal of Clinical Microbiology
40
發行號12
DOIs
出版狀態已發佈 - 十二月 1 2002
對外發佈Yes

指紋

Molecular Epidemiology
Fluoroquinolones
Klebsiella pneumoniae
Ciprofloxacin
Taiwan
Pulsed Field Gel Electrophoresis
Ribotyping
Lactams
Levofloxacin
Infection Control
garenoxacin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Microbiology

引用此文

Molecular epidemiology of extended-spectrum β-lactamase-producing, fluoroquinolone-resistant isolates of Klebsiella pneumoniae in Taiwan. / Yu, W. L.; Jones, R. N.; Hollis, R. J.; Messer, S. A.; Biedenbach, D. J.; Deshpande, L. M.; Pfaller, Michael A.

於: Journal of Clinical Microbiology, 卷 40, 編號 12, 01.12.2002, p. 4666-4669.

研究成果: 雜誌貢獻文章

Yu, W. L. ; Jones, R. N. ; Hollis, R. J. ; Messer, S. A. ; Biedenbach, D. J. ; Deshpande, L. M. ; Pfaller, Michael A. / Molecular epidemiology of extended-spectrum β-lactamase-producing, fluoroquinolone-resistant isolates of Klebsiella pneumoniae in Taiwan. 於: Journal of Clinical Microbiology. 2002 ; 卷 40, 編號 12. 頁 4666-4669.
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abstract = "Strains of extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) have emerged worldwide. Concomitant ciprofloxacin resistance with ESBL production in K. pneumoniae isolates would severely restrict treatment options. Among 39 (18.5{\%}) of 211 ESBL-KP isolates resistant to ciprofloxacin (MIC, ≥4 μg/ml), 37 (95{\%}) were high level resistant (MIC, ≥16 μg/ml). These isolates were also cross resistant to the newer fluoroquinolones, including levofloxacin, gatifloxacin, gemifloxacin, and garenoxacin (BMS 284756). Sitafloxacin was most active against these ciprofloxacin-resistant ESBL-KP isolates with MICs for 67{\%} of the isolates being ≤2 μg/ml. The molecular epidemiology of these multiresistant isolates was investigated by automated ribotyping and pulsed-field gel electrophoresis (PFGE). Ribotyping identified 18 different strains among the 39 ciprofloxacin-resistant ESBL-KP isolates. The majority (67{\%}) of these isolates were contained in six ribogroups which were further confirmed by PFGE. The distribution of the six major strains of ciprofloxacinresistant ESBL-KP within Taiwan included one (ribogroup 255.3-PFGE type E) with a nationwide distribution and several institution-specific strains. Interhospital cooperation appears necessary, with strict infection control practices coupled with restriction of fluoroquinolone and extended-spectrum β-lactam use to control both the major epidemic strain and the more diverse strains observed within individual institutions.",
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