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Antimicrobial Agents and Chemotherapy, January 2002, p. 151-159, Vol. 46, No. 1
0066-4804/01/$04.00+0     DOI: 10.1128/AAC.46.1.151-159.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.

Countrywide Spread of CTX-M-3 Extended-Spectrum ß-Lactamase-Producing Microorganisms of the Family Enterobacteriaceae in Poland

Anna Baraniak, Janusz Fiett, Agnieszka Sulikowska, Waleria Hryniewicz, and Marek Gniadkowski*

Sera & Vaccines Central Research Laboratory, 00-725 Warsaw, Poland

Received 16 March 2001/ Returned for modification 23 July 2001/ Accepted 5 October 2001

Eighty-four clinical isolates of the family Enterobacteriaceae, recovered from 1998 to 2000 in 15 hospitals in 10 Polish cities, were analyzed. All the isolates produced ß-lactamases with pIs of 8.4 and 5.4, and the pI 8.4 enzymes were demonstrated to hydrolyze cefotaxime but not ceftazidime in the in vitro bioassay. PCR analysis and DNA sequencing have revealed that in all cases the pI 8.4 ß-lactamase was probably the CTX-M-3 extended-spectrum ß-lactamase (ESBL) variant, which was originally identified in 1996 in Praski Hospital in Warsaw. In the majority of isolates, blaCTX-M-3 genes resided within large conjugative plasmids with similar fingerprints, which, in the context of the high degree of diversity of the randomly amplified polymorphic DNA types of the isolates, suggested that horizontal transfer of plasmids was likely the main mechanism of CTX-M-3 spread. The dissemination of plasmids was probably preceded by the center-to-center transmission of several strains, as indicated by the identification by pulsed-field gel electrophoresis of closely related or possibly related Klebsiella pneumoniae, Escherichia coli, and Citrobacter freundii isolates in five different hospitals. CTX-M-3-producing organisms revealed a very high degree of diversity in ß-lactam resistance levels and patterns. This was attributed to several factors, such as the production of other ß-lactamases including additional ESBLs, possible quantitative variations in CTX-M-3 expression, segregation of AmpC derepressed mutants, and permeability alterations.

* Corresponding author. Mailing address: Sera & Vaccines Central Research Laboratory, ul. Chelmska 30/34, 00-725 Warsaw, Poland. Phone: 48 22 851 46 70. Fax: 48 22 841 29 49. E-mail: marekg{at}ibbrain.ibb.waw.pl.

Antimicrobial Agents and Chemotherapy, January 2002, p. 151-159, Vol. 46, No. 1
0066-4804/01/$04.00+0     DOI: 10.1128/AAC.46.1.151-159.2002
Copyright © 2002, American Society for Microbiology. All Rights Reserved.



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