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Molecular mechanisms of carbapenem resistance in Enterobacter cloacae clinical isolates from Korea and clinical outcome

Authors
 Yangsoon Lee  ;  Heekyeong Choi  ;  Jong Hwa Yum  ;  Girung Kang  ;  Il Kwon Bae  ;  Seok Hoon Jeong  ;  Kyungwon Lee 
Citation
 ANNALS OF CLINICAL AND LABORATORY SCIENCE, Vol.42(3) : 281-286, 2012 
Journal Title
 ANNALS OF CLINICAL AND LABORATORY SCIENCE 
ISSN
 0091-7370 
Issue Date
2012
MeSH
Aged ; Bacterial Outer Membrane Proteins/metabolism ; Carbapenems/pharmacology* ; Child ; Drug Resistance, Microbial/drug effects* ; Drug Resistance, Microbial/genetics* ; Electrophoresis, Polyacrylamide Gel ; Enterobacter cloacae/drug effects* ; Enterobacter cloacae/genetics ; Enterobacter cloacae/isolation & purification* ; Female ; Genes, Bacterial/genetics ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Republic of Korea ; Treatment Outcome ; beta-Lactamases/genetics
Keywords
Aged ; Bacterial Outer Membrane Proteins/metabolism ; Carbapenems/pharmacology* ; Child ; Drug Resistance, Microbial/drug effects* ; Drug Resistance, Microbial/genetics* ; Electrophoresis, Polyacrylamide Gel ; Enterobacter cloacae/drug effects* ; Enterobacter cloacae/genetics ; Enterobacter cloacae/isolation & purification* ; Female ; Genes, Bacterial/genetics ; Humans ; Infant ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Republic of Korea ; Treatment Outcome ; beta-Lactamases/genetics
Abstract
We investigated the molecular mechanisms of carbapenem resistance in clinical isolates of Enterobacter cloacae and their clinical characteristics. Nonreplicable E. cloacae isolates were recovered from six cancer patients and one patient with liver cirrhosis at a tertiary-care hospital in Korea between 2002 and 2009. Two patients who were considered to have a true infection caused by these microorganisms have died. All isolates produced AmpC β-lactamases, including ACT-1, ACT-2, MIR-3 and DHA-1, and CTX-M- or SHV-type extended-spectrum β-lactamase. Two isolates produced plasmid-borne VIM-2 carbapenemase. All probes specific for bla(AmpC) genes hybridized with I-CeuI chromosomal fragments were also recognized by a probe specific for 16S rDNA, suggesting a chromosomal location. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that a major outer membrane protein, OmpF, was absent in all isolates. PFGE of XbaI-digested DNA were considered to be unrelated. The results of our study suggest that the chromosomal AmpC β-lactamase with impermeability in E. cloacae clinical isolates implicated in reduced carbapenem susceptibility. Although carbapenem-resistant E. cloacae isolates were isolated in a few patients in our study, the clinical outcomes were grave. Therefore, the patients colonized or infected by carbapenem-resistant E. cloacae isolates should gain attention of antibiotic therapy.
Full Text
http://www.annclinlabsci.org/content/42/3/281.long
DOI
22964616
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Bae, Il Kwon(배일권)
Lee, Kyungwon(이경원) ORCID logo https://orcid.org/0000-0003-3788-2134
Lee, Yang Soon(이양순)
Jeong, Seok Hoon(정석훈) ORCID logo https://orcid.org/0000-0001-9290-897X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89493
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