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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


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LETTER
 
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).


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  		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.


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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
  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
  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
  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
  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
  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
  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
  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
  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
  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
  11. Rasmussen, B. A., and K. Bush. 1997. Carbapenem-hydrolyzing ß-lactamases. Antimicrob. Agents Chemother. 41:223-232.[Free Full Text]
    12. 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.



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