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Extended-spectrum β-lactamase (ESBL)-producingEscherichia coli andKlebsiella pneumoniae have rapidly spread worldwide and pose a serious threat for health care-associated (HA) infection. We conducted molecular detection and characterization of ESBL-relatedbla genes, includingbla TEM ,bla SHV ,bla CTX-M ,bla VEB ,bla OXA ,bla PER , andbla GES , among 362 isolates of ESBL-producingE. coli (n = 235) and ESBL-producingK. pneumoniae (n = 127) collected from patients who met the definition of HA infection at two major university hospitals in Thailand from December 2004 to May 2005. The prevalence of ESBL-producingE. coli and ESBL-producingK. pneumoniae , patient demographics and the susceptibilities of these bacteria to various antimicrobial agents were described. A total of 87.3% of isolates carried severalbla genes. The prevalence ofbla CTX-M was strikingly high: 99.6% for ESBL-producingE. coli (CTX-M-14, -15, -27, -40, and -55) and 99.2% for ESBL-producingK. pneumoniae (CTX-M-3, -14, -15, -27, and -55). ISEcp1 was found in the upstream region ofbla CTX-M in most isolates. Up to 77.0% and 71.7% of ESBL-producingE. coli and ESBL-producingK. pneumoniae , respectively, carriedbla TEM ; all of them encoded TEM-1. ESBL-producingK. pneumoniae carriedbla SHV at 87.4% (SHV-1, -2a, -11, -12, -27, -71, and -75) but only at 3.8% for ESBL-producingE. coli (SHV-11 and -12).bla genes encoding VEB-1 and OXA-10 were found in both ESBL-producingE. coli (8.5% and 8.1%, respectively) and ESBL-producingK. pneumoniae (10.2% and 11.8%, respectively). None of the isolates were positive forbla PER andbla GES . Pulsed-field gel electrophoresis analysis demonstrated that there was no major clonal relationship among these ESBL producers. This is the first study to report CTX-M-3, CTX-M-27, CTX-M-40, SHV-27, SHV-71, and SHV-75 in Thailand and to show that CTX-M ESBL is highly endemic in the country.

antimicrobial agents and chemotherapy

Molecular Characterization and Epidemiology of Extended-Spectrum- β-Lactamase-Producing <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> Isolates Causing Health Care-Associated Infection in Thailand, Where the CTX-M Family Is Endemic

Molecular Characterization and Epidemiology of Extended-Spectrum- β-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates Causing Health Care-Associated Infection in Thailand, Where the CTX-M Family Is Endemic