ISSN-01862 391

e-ISSN-2395-8235

Indizada en: CONACyT, DOAJ, EBSCO (MedicLatina), Latindex, Redalyc, SciELO, Scopus y Emerging Sources Citation Index.
Órgano Oficial del Instituto Nacional de Pediatría

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Periodicidad: bimestral
Editor: José N. Reynés Manzur
Abreviatura: Acta Pediatr Méx
ISSN: 0186-2391
e-ISSN: 2395-8235

Sulfhydryl variable-5 extended spectrum β-lactamase in nosocomial enteric bacteria causing sepsis in mexican children

Sulfhydryl variable-5 extended spectrum β-lactamase in nosocomial enteric bacteria causing sepsis in mexican children

Acta Pediatr Mex 2015;36:383-388.

Angélica Flores-Pérez,1 Catalina Gayosso-Vázquez2, María Dolores Alcántar-Curiel,2 Patricia Arzate-Barbosa,3 Celia Alpuche-Aranda,4 José Luis Arredondo-García1

1 Laboratorio de Investigación Clínica, Instituto Nacional de Pediatría. D.F, México.
2 Laboratorio de Infectología, Microbiología e Inmunología, Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F.
3 Laboratorio de Bacteriología, Instituto Nacional de Pediatría, México, D.F.
4 Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Salud Pública Cuernavaca, Morelos, México.

Recibido: 15 de mayo del 2015
Aceptado: 11 de septiembre del 2015

Correspondencia: Dr. José Luis Arredondo-García
Laboratorio de Investigación Clínica
Instituto Nacional de Pediatría
Insurgentes Sur 3700-C
CP 04530, México D.F.
[email protected]

Este artículo debe citarse como
Flores-Pérez A, Gayosso-Vázquez C, Alcántar-Curiel MD, Arzate-Barbosa P, Alpuche-Aranda C, Arredondo-García JL. Sulfhydryl variable-5 extended spectrum β-lactamase in nosocomial enteric bacteria causing sepsis in mexican children. Acta Pediatr Mex 2015;36:383-388.

Abstract

Introduction: Enteric bacteria causing nosocomial infections are often resistant to third-generation cephalosporins due to the production of extended-spectrum β-lactamases (ESBLs).

Objective: To describe and characterize the ESBLs pattern present in Klebsiella pneumoniae and Serratia marcescens strains, isolated as causative of nosocomial sepsis in pediatric patients at Instituto Nacional de Pediatría (National Institute of Pediatrics).

Material and methods: We analyzed 94 strains of K. pneumoniae and 7 of S. marcescens isolated from clinical specimens from 2002-2005, causative of sepsis in a children’s hospital. We evaluated antibiotic susceptibility and detection of ESBL phenotypes by disk diffusion methods; ceftazidime-resistant isolates were further characterized by pulsed field gel electrophoresis (PFGE); and ESBLs were phenotypically and genotypically characterized by isoelectric focusing, polymerase chain reaction (PCR) and sequencing. We also assed for presence of conjugative plasmids bearing the ESBL gene.

Results: 51/94 (54%) of K. pneumoniae isolates, and 5/7 (71%) of S. marcescens isolates were resistant to ceftazidime; all carried a blaSHV-5 gene. All K. pneumoniae isolates had a distinct PFGE profile, yet all carried a ~48-Kb plasmid, that was conjugatively transferable to an Escherichia coli receptor, which expressed the resistance phenotype. On the other hand, all S. marcescens isolates had a similar PFGE profile, were unable to transfer the ceftazidime-resistance phenotype, and were isolated from the same ward in a short time-span suggesting an outbreak.

Conclusions: The overall prevalence of ESBL-producing enteric bacteria in this hospital is high but similar to other Latin American reports. The sulfhydryl variable-5 (SHV-5) ESBL gene appears to reside in a highly mobile plasmid, capable of spreading among different K. pneumoniae clones and perhaps even to S. marcescens.

Keywords: SHV-5, extended-spectrum beta-lactamase, Klebsiella pneumoniae, Serratia marcescens.

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