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Antimicrobial Agents and Chemotherapy, April 2004, p. 1249-1255, Vol. 48, No. 4
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.4.1249-1255.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Dissemination of CTX-M-Type ß-Lactamases among Clinical Isolates of Enterobacteriaceae in Paris, France

Laboratoire de Bactériologie, UPRES EA 2392, UFR Saint-Antoine, Université Paris VI,¹ Service de Bactériologie-Hygiène, Hôpital Tenon, AP-HP,⁴ Service de Bactériologie, Hôpital Saint-Michel,⁵ Service de Bactériologie, CHU Cochin, AP-HP, Paris,⁶ Service de Biologie, Hôpital Robert Ballanger, Aulnay-sous-bois,² Service de Microbiologie, Hôpital Louis Mourier, AP-HP, Colombes, France³

Received 19 March 2003/ Returned for modification 9 August 2003/ Accepted 30 December 2003

We analyzed 19 clinical isolates of the family Enterobacteriaceae (16 Escherichia coli isolates and 3 Klebsiella pneumoniae isolates) collected from four different hospitals in Paris, France, from 2000 to 2002. These strains had a particular extended-spectrum cephalosporin resistance profile characterized by a higher level of resistance to cefotaxime and aztreonam than to ceftazidime. The bla_CTX-M genes encoding these ß-lactamases were involved in this resistance, with a predominance of bla_CTX-M-15. Ten of the 19 isolates produced both TEM-1- and CTX-M-type enzymes. One strain (E. coli TN13) expressed CMY-2, TEM-1, and CTX-M-14. bla_CTX-M genes were found on large plasmids. In 15 cases the same insertion sequence, ISEcp1, was located upstream of the 5' end of the bla_CTX-M gene. In one case we identified an insertion sequence designated IS26. Examination of the other three bla_CTX-M genes by cloning, sequencing, and PCR analysis revealed the presence of a complex sul1-type integron that includes open reading frame ORF513, which carries the bla gene and the surrounding DNA. Five isolates had the same plasmid DNA fingerprint, suggesting clonal dissemination of CTX-M-15-producing strains in the Paris area.

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