[A SHV-derived extended-spectrum beta-lactamase (SHV-12) produced by an Escherichia coli recovered from wound abscess in post operative case with rectal carcinoma]

Escherichia coli producing CTX-M-2 beta-lactamase in cattle, Japan

From November 2000 to June 2001, Escherichia coli strains producing CTX-M-2 β-lactamase were isolated from 6 (1.5%) of 396 cattle fecal samples and 2 (0.7%) of 270 surface swabs of cattle carcasses in Japan. The bla_CTX-M-2 gene responsible for CTX-M-2 production was encoded on transferable plasmids, and the gene was transferred to E. coli CSH2 with a very high frequency (2 x 10^-4 to 6 x 10^-1 per donor cells) by conjugation. Random amplified polymorphic DNA analysis of nine isolates showed at least five different patterns. These findings suggest that CTX-M-2 producers might have originated from cattle through the use of cephalosporins such as ceftiofur and that cattle could be a reservoir of CTX-M-2–producing E. coli. Continuous and strategic surveillance of antimicrobial-resistant bacteria in livestock is essential to suppress further dissemination of these bacteria into society at large.

Evaluation of MicroScan ESBL confirmation panel for Enterobacteriaceae-producing, extended-spectrum beta-lactamases isolated in Japan

We assessed use of the MicroScan ESBL confirmation panel (Dade Behring, Tokyo, Japan) for the detection of eight Enterobacteriaceae-producing extended-spectrum beta-lactamases (ESBL) species. Of 137 bacterial strains isolated from patients in 32 hospitals in the Kinki area of Japan, 91 produced ESBL and comprised 60 bacteria (of E. coli, K. oxytoca, and K. pneumoniae) targeted by the NCCLS ESBL test and 31 non-target bacteria such as chromosomal AmpC-producing bacteria (e.g., Serratia marcescens, Enterobacter spp.). Sensitivity and specificity of the MicroScan panel for the target bacteria were 92% and 93%, respectively; sensitivity and specificity for non-target bacteria were 52% and 100%, respectively. There were 20 ESBL-positive strains that were not inhibited by clavulanic acid in the MicroScan panel (3 of 32 ESBL-producing E. coli strains, 1 of 24 K. pneumoniae, 1 of 4 K. oxytoca, 8 of 13 E. cloacae, and 7 of 14 S. marcescens), and most of them were bacteria not targeted by the NCCLS test. In 19 of the 20 strains, the synergy effect of clavulanic acid was observed in the modified-double-disk synergy test using only the cefepime-disk. Because these strains had high MICs of > or = 16 microg/ml for cephamycins such as cefoxitin and cefmetazole, these strains might produce high levels of AmpC in addition to ESBL. The MicroScan ESBL confirmation panel showed excellent performance in detecting target, but not other bacteria. Addition of cefepime and clavulanic acid to the MicroScan panel may significantly improve detection of non-target bacteria.

Trends in antimicrobial-drug resistance in Japan

Multidrug resistance in gram-positive bacteria has become common worldwide. In Japan until recently, gram-negative bacteria such as Pseudomonas aeruginosa, Klebsiella pneumoniae, and Serratia marcescens were controlled by carbapenems, fluoroquinolones, and aminoglycosides. However, several of these microorganisms have recently developed resistance against many antimicrobial drugs.