Bauernfeind A, Rosenthal E, Eberlein E, Holley M, Schweighart S
Max-von-Pettenkofer-Institut, München, Germany.
Infection. 1993 Jan-Feb;21(1):18-22. doi: 10.1007/BF01739303.
The first outbreak of infections caused by an SHV-5 producing strain of Klebsiella pneumoniae is reported. Within a period of 1 year and 9 months, multiresistant K. pneumoniae strains caused severe infections, mostly of the lower respiratory tract, in 22 patients. The strains were resistant to penicillins, third-generation cephalosporins, aztreonam, chloramphenicol, tetracycline and co-trimoxazole. The resistance determinants were transferable to Escherichia coli. All isolates produced a beta-lactamase with a pI of 8.2. Ceftazidime was hydrolyzed at this band. These characteristics, together with the resistance phenotype, are identical to those of a reference strain producing the beta-lactamase SHV-5. The K. pneumoniae strains of all patients were identical in their capsular serotype (K1), plasmid pattern and plasmid fingerprint after digestion with Dra I restriction endonuclease. We conclude that this outbreak was caused by the spread of one clone of K. pneumoniae producing SHV-5 beta-lactamase among patients of different wards. Our results indicate a real risk for failure of therapy by third-generation cephalosporins in intensive care patients due to SHV-5 producing pathogens.
据报道，首次出现由产SHV-5型肺炎克雷伯菌引起的感染暴发。在1年9个月的时间内，多重耐药的肺炎克雷伯菌菌株在22例患者中引发了严重感染，主要为下呼吸道感染。这些菌株对青霉素、第三代头孢菌素、氨曲南、氯霉素、四环素和复方新诺明耐药。耐药决定因子可转移至大肠杆菌。所有分离株均产生pI为8.2的β-内酰胺酶。头孢他啶在此条带处被水解。这些特征以及耐药表型与产β-内酰胺酶SHV-5的参考菌株相同。所有患者的肺炎克雷伯菌菌株在荚膜血清型（K1）、质粒图谱以及经Dra I限制性内切酶消化后的质粒指纹图谱方面均相同。我们得出结论，此次暴发是由一株产SHV-5β-内酰胺酶的肺炎克雷伯菌在不同病房的患者中传播所致。我们的结果表明，由于产SHV-5的病原体，重症监护患者使用第三代头孢菌素治疗失败存在实际风险。
