BACKGROUND: In recent years, Acinetobacter baumannii isolates acquired resistance to cefepime have increased significantly. The aim of this study was to survey the prevalence of PER-1 extendedspectrum beta -lactamase (ESBL)-producing A. baumannii isolates in a University Hospital, Busan, Korea. METHODS: Antimicrobial susceptibilities were tested by the disk diffusion method, and double disk synergy test was performed for screening of ESBL-production. MICs were determined by agar dilution method. The isoelectric points of beta -lactamases were determined by isoelectric focusing. Transferability of cefepime-resistance were tested by conjugation. blaPER-1 and blaPER-2 alleles were detected by PCR, and the DNA sequences of amplified products were determined by using the dideoxy-chain termination method. RESULTS: Among 51 clinical isolates of A. baumannii intermediate or resistant to cefepime, 10 isolates (19.6%) showed positive results in double disk synergy test. PCR-based experiments detected blaPER-1 gene in all the 10 isolates. All the isolates contained three beta -lactamase bands: pI 5.3, 7.9, and 9.4. MICs of ampicillin, piperacillin, cephalothin, cefoxitin, cefoperazone, ceftazidime, cefotaxime, cefepime, and aztreonam were >256 mg/L, respectively, and them of imipenem were 8-16 mg/L. CONCLUSION: The prevalence of PER-1-producing A. baumannii strains in Busan was less than that of in Seoul. But an outbreak of infection caused by this strain in an intensive care unit shows that spread of PER-1-producing A. baumannii strains can be anticipated in a near future. Prevention of hospital infection by these resistant microorganisms are needed.
Acinetobacter baumannii* ; Acinetobacter* ; Agar ; Alleles ; Ampicillin ; Aztreonam ; Base Sequence ; Busan* ; Cefoperazone ; Cefotaxime ; Cefoxitin ; Ceftazidime ; Cephalothin ; Cross Infection ; Diffusion ; Imipenem ; Intensive Care Units ; Isoelectric Focusing ; Isoelectric Point ; Korea* ; Mass Screening ; Piperacillin ; Polymerase Chain Reaction ; Prevalence* ; Seoul

BACKGROUND: The aim of this study was to survey the nation wide susceptibilities of Esherichia coli and Klebsiella pneumoniae against cefotaxime and to determine the prevalence of CTX-M-type extended-spectrum beta- lactamases(ESBLs). METHODS: During the period of April to June, 2002, E. coli and K. pneumoniae isolates were collected from 13 hospitals. Antimicrobial susceptibilities to cefotaxime were tested by the disk diffusion method. ESBL production was determined by double disk synergy test. Cefotaxime-resistance of the ESBL-producers was transferred to azide-resistant E. coli J53 by conjugation. MICs of beta- lactam antibiotics were determined by agar dilution method. Searches for blaCTX-M genes were performed by PCR amplication. pIs of beta-lactamases were determined by isoelectric focusing. RESULTS: Ten percents of E. coli and 35 percents of K. pneumoniae isolates among 260 strains of each were intermediate or resistant to cefotaxime. Twenty-three isolates of E. coli and 78 K. pneumoniae isolates showed positive results in the double disk synergy test. One isolate of E. coli and 2 K. pneumoniae isolates harbored blaCTX-M-3 gene, 2 E. coli isolates harbored blaCTX-M-15 gene, and 2 E. coli and 2 K. pneumoniae isolates harbored blaCTX-M-14 gene. CONCLUSION: E. coli and K. pneumoniae isolates producing CTX-M-type ESBLs are not uncommon in Korean hospitals. The spread of CTX-M-type ESBL genes could compromise the future usefulness of 3rd generation cephalosporins and aztreonam for the treatment of E. coli and K. pneumoniae infections.
Agar ; Anti-Bacterial Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Cephalosporins ; Diffusion ; Isoelectric Focusing ; Klebsiella pneumoniae* ; Klebsiella* ; Korea* ; Pneumonia ; Polymerase Chain Reaction ; Prevalence*