Skip to main page content

• HOME
• Current Issue
• Archive
• Alerts
• About ASM
• Contact us
• Tech Support
• Journals.ASM.org

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fosse, T. Articles by Ortonne, J. P. Search for Related Content PubMed PubMed Citation Articles by Fosse, T. Articles by Ortonne, J. P.

 Previous Article  |  Next Article 

Antimicrobial Agents and Chemotherapy, June 2004, p. 2342-2343, Vol. 48, No. 6
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.6.2342-2343.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

LETTER TO THE EDITOR

Aeromonas hydrophila with Plasmid-Borne Class A Extended-Spectrum ß-Lactamase TEM-24 and Three Chromosomal Class B, C, and D ß-Lactamases, Isolated from a Patient with Necrotizing Fasciitis

Top Letter References

 
We report a case of necrotizing fasciitis with probable in vivo transfer of a TEM-24 plasmid-borne extended-spectrum ß-lactamase (ESBL) gene from Enterobacter aerogenes to Aeromonas hydrophila. The patient was an 87-year-old female with a leg lesion following a trauma. She had a history of rheumatoid polyarthritis treated by 10 mg of prednisone per day, refractory anemia, and chronic venous insufficiency of the lower limbs. Within 5 days, the infection grew worse and the initial amoxicillin-clavulanic acid antibiotic therapy was replaced with ceftriaxone-metronidazole (1 to 1.5 g daily). Surgical debridement revealed extensive necrosis, and 3 days later, the lesion evolved toward typical necrotizing fasciitis (1, 6), leading to a second surgical intervention for above-knee amputation followed by complete healing.

Routine bacteriological procedures revealed (i) Escherichia coli NI-202 susceptible to most ß-lactam compounds, (ii) E. aerogenes NI-203 resistant to all ß-lactam antibiotics except imipenem, (iii) A. hydrophila NI-204 resistant to ceftazidime, and (iv) A. hydrophila NI-205 susceptible to ceftazidime (Table 1). Pulsed-field electrophoresis confirmed that A. hydrophila NI-204 and NI-205 derived from a single clone. For ß-lactamase analysis, the E. aerogenes isolate was grown in brain heart infusion broth with and without cefoxitin or ceftazidime induction (10 µg/ml) at 37°C before analytical isoelectric focusing with crude sonic cell extracts on polyacrylamide gels (2, 4). Two bands of ß-lactamase activity were detected with iodine gel with cefazolin (500 µg/ml) as the substrate, which was suggestive of the production of an inducible cephalosporinase (pI 8.8) and an ESBL (pI 6.5). Aeromonas isolates were grown at 30°C with cefoxitin (10 µg/ml), imipenem (1 µg/ml), or tobramycin (1 µg/ml) induction (5). Analytical isoelectric focusing with penicillin and cefazolin as substrates revealed three bands (pI 7, 7.8, and 8.2) probably corresponding to previously described cephalosporinase-, imipenemase-, and oxacillinase-type inducible ß-lactamases (5, 11, 12). A. hydrophila NI-204 produced an additional enzyme similar to E. aerogenes NI-203 ESBL (pI 6.5).

View this table: [in this window] [in a new window]

TABLE 1. ß-Lactamases, plasmid content, and MICs (µg/ml) of the clinical isolates and transconjugant strains

Taking into account resistance to ceftazidime, pI determination, and local epidemiology, the ESBL was presumed to be the plasmid-mediated TEM-24 ßlactamase (2-4, 7). The plasmid was transferred from E. aerogenes NI-203 to A. hydrophila NI-205 and to E. coli C1a at a high frequency (10^–4). Recipient strains (NI-206 and NI-207, Table 1) presented the same acquired resistance pattern. After plasmid extraction and gel electrophoresis, both wild-type strains (E. aerogenes NI-203, A. hydrophila NI-204) and recipient strains (A. hydrophila NI-206, E. coli C1a NI-207) showed a common 180-kb band, as previously characterized with Enterobacteriaceae, Pseudomonas aeruginosa, and recently A. caviae (4, 7-9). The capacity of Aeromonas salmonicida to maintain either or both of the Pseudomonas and Enterobacteriaceae R factors has already been observed (10). PCR amplification with TEM family-specific primers was applied to E. aerogenes NI-203 and A. hydrophila NI-204 and showed a deduced protein sequence with 100% identity to that of TEM-24 (3, 7).

This report demonstrates probable in vivo transfer of ESBL TEM-24 from E. aerogenes to the genus Aeromonas. It was observed in a wild-type strain of A. hydrophila simultaneously producing the class A, B, C, and D ß-lactamases.

Top Letter References

 

1
1. Angel, M. F., F. Zhang, M. Jones, J. Henderson, and S. W. Chapman. 2002. Necrotizing fasciitis of the upper extremity resulting from a water moccasin bite. South. Med. J. 95:1090-1094.[Medline]
2
2. Bradford, P. A. 2001. Extended-spectrum ß-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin. Microbiol. Rev. 14:933-951.[Abstract/Free Full Text]
3
3. Chanal, C., M.-C. Poupart, D. Sirot, R. Labia, J. Sirot, and R. Cluzel. 1992. Nucleotide sequences of CAZ-2, CAZ-6, and CAZ-7 ß-lactamase genes. Antimicrob. Agents Chemother. 36:1817-1820.[Abstract/Free Full Text]
4
4. Dumarche, P., C. De Champs, D. Sirot, C. Chanal, R. Bonnet, and J. Sirot. 2002. TEM derivative-producing Enterobacter aerogenes strains: dissemination of a prevalent clone. Antimicrob. Agents Chemother. 46:1128-1131.[Abstract/Free Full Text]
5
5. Fosse, T., C. Giraud-Morin, I. Madinier, and R. Labia. 2003. Sequence analysis and biochemical characterization of chromosomal CAV-1 (Aeromonas caviae), the parental cephalosporinase of plasmid-mediated AmpC 'FOX' cluster. FEMS Microbiol. Lett. 222:93-98.[CrossRef][Medline]
6
6. Furusu, A., N. Yoshizuka, K. Abe, O. Sasaki, K. Miyazaki, M. Miyazaki, Y. Hirakata, Y. Ozono, T. Harada, and S. Kohno. 1997. Aeromonas hydrophila necrotizing fasciitis and gas gangrene in a diabetic patient on hemodialysis. Nephrol. Dial. Transplant. 12:1730-1734.[Abstract/Free Full Text]
7
7. Giraud-Morin, C., and T. Fosse. 2003. A seven-year survey of Klebsiella pneumoniae producing TEM-24 extended-spectrum ß-lactamase in Nice University Hospital (1994-2000). J. Hosp. Infect. 54:25-31.[CrossRef][Medline]
8
8. Marchandin, H., H. Jean-Pierre, C. De Champs, D. Sirot, H. Darbas, P. F. Perigault, and C. Carriere. 2000. Production of a TEM-24 plasmid-mediated extended-spectrum ß-lactamase by a clinical isolate of Pseudomonas aeruginosa. Antimicrob. Agents Chemother. 44:213-216.[Abstract/Free Full Text]
9
9. Marchandin, H., S. Godreuil, H. Darbas, H. Jean-Pierre, E. Jumas-Bilak, C. Chanal, and R. Bonnet. 2003. Extended-spectrum ß-lactamase TEM-24 in an Aeromonas clinical strain: acquisition from the prevalent Enterobacter aerogenes clone in France. Antimicrob. Agents Chemother. 47:3994-3995.[Free Full Text]
10
10. Olsen, R. H., and C. D. Wright. 1976. Interaction of Pseudomonas and Enterobacteriaceae plasmids in Aeromonas salmonicida. J. Bacteriol. 128:228-234.[Abstract/Free Full Text]
11
11. Rasmussen, B. A., and K. Bush. 1997. Carbapenem-hydrolyzing ß-lactamases. Antimicrob. Agents Chemother. 41:223-232.[Medline]
12
12. Walsh, T. R., L. Hall, A. P. MacGowan, and P. M. Bennett. 1995. A clinical isolate of Aeromonas sobria with three chromosomally mediated inducible ß-lactamases: a cephalosporinase, a penicillinase and a third enzyme displaying carbapenemase activity. J. Antimicrob. Chemother. 35:271-279.[Abstract/Free Full Text]

						T. Fosse* C. Giraud-Morin I. Madinier Laboratoire de Bactériologie Hôpital L'Archet 2 Centre Hospitalier Universitaire de Nice B.P. 3079 06202 Nice Cedex 3, France F. Mantoux J. P. Lacour J. P. Ortonne Service de Dermatologie Centre Hospitalier Universitaire Nice, France
						* Phone: 33 4 92 03 62 14, Fax: 33 4 92 03 59 52, E-mail: fosse{at}unice.fr

---

Antimicrobial Agents and Chemotherapy, June 2004, p. 2342-2343, Vol. 48, No. 6
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.6.2342-2343.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

This article has been cited by other articles:

• Picao, R. C., Poirel, L., Demarta, A., Petrini, O., Corvaglia, A. R., Nordmann, P. (2008). Expanded-Spectrum {beta}-Lactamase PER-1 in an Environmental Aeromonas media Isolate from Switzerland. Antimicrob. Agents Chemother. 52: 3461-3462 [Full Text]  
• Seshadri, R., Joseph, S. W., Chopra, A. K., Sha, J., Shaw, J., Graf, J., Haft, D., Wu, M., Ren, Q., Rosovitz, M. J., Madupu, R., Tallon, L., Kim, M., Jin, S., Vuong, H., Stine, O. C., Ali, A., Horneman, A. J., Heidelberg, J. F. (2006). Genome Sequence of Aeromonas hydrophila ATCC 7966T: Jack of All Trades. J. Bacteriol. 188: 8272-8282 [Abstract] [Full Text]  
• de la Prieta, M. C., Francia, M. V., Seoane, A., Lobo, J. M. G. (2006). Characterization of defective {beta}-lactamase genes in Yersinia enterocolitica. J Antimicrob Chemother 58: 661-664 [Abstract] [Full Text]  
• Poirel, L., Heritier, C., Nordmann, P. (2005). Genetic and biochemical characterization of the chromosome-encoded class B {beta}-lactamases from Shewanella livingstonensis (SLB-1) and Shewanella frigidimarina (SFB-1). J Antimicrob Chemother 55: 680-685 [Abstract] [Full Text]  

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Reprints and Permissions Copyright Information Books from ASM Press MicrobeWorld Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Fosse, T. Articles by Ortonne, J. P. Search for Related Content PubMed PubMed Citation Articles by Fosse, T. Articles by Ortonne, J. P.