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Antimicrobial Agents and Chemotherapy, November 2004, p. 4263-4270, Vol. 48, No. 11
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.11.4263-4270.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Infections with Nontyphoidal Salmonella Species Producing TEM-63 or a Novel TEM Enzyme, TEM-131, in South Africa

Enteric Diseases Reference Unit, National Institute for Communicable Diseases (NHLS), and University of the Witwatersrand, Johannesburg, Republic of South Africa,¹ Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania,² Institute for Medical Microbiology, Semmelweis University, Budapest, Hungary,³ Research Service, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, Ohio⁴

Received 18 November 2003/ Returned for modification 13 February 2004/ Accepted 7 July 2004

Salmonella spp. producing extended-spectrum beta-lactamases (ESBLs) have been reported in many countries, but there is no information on their prevalence in Africa. ESBL-producing Salmonella enterica serotype Isangi and S. enterica serotype Typhimurium strains have been noted in South Africa since 2001. A total of 160 consecutive isolates of Salmonella spp. were collected from 13 hospitals located in different cities in South Africa over a 5-month period from December 2002 to April 2003. All strains were screened for production of ESBLs by the double disk diffusion test and for AmpC production by assessing resistance to cefoxitin. bla_SHV, bla_TEM, bla_CTX-M, and bla_CMY-2 were sought from all ESBL-positive and cefoxitin-resistant isolates. A total of 15.6% (25 of 160) isolates produced SHV or TEM ESBLs, and 1.9% (3 of 160) produced CMY-2. Nine S. enterica serotype Typhimurium, eight S. enterica serotype Isangi, and three S. enterica serotype Muenchen strains produced either TEM-63 or a derivative of TEM-63 designated TEM-131. Both TEM-63 and TEM-131 have an isoelectric point of 5.6, and their sequences have the following amino acid substitutions compared to the TEM-1 sequence: Leu21Phe, Glu104Lys, Arg164Ser, and Met182Thr. Additionally, TEM-131 has an Ala237Thr substitution. ESBL-producing Salmonella spp. have become a significant public health problem in South Africa with particular implications for the treatment of serious nontyphoidal Salmonella infections in children, for whom extended-spectrum cephalosporins were the preferred treatment.

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