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  • Title: [1st Spanish epidemic of plasmid resistance to 3d generation cephalosporins: the implication of SHV-2].
    Author: Fernández-Rodríguez A, Reguera JA, Pérez-Díaz JC, Picazo JJ, Baquero F.
    Journal: Enferm Infecc Microbiol Clin; 1992 Oct; 10(8):456-61. PubMed ID: 1489773.
    Abstract:
    BACKGROUND: The first spanish outbreak of bacterial strains showing resistance to third generation cephalosporins and due to the presence of the extended spectrum beta-lactamase SHV-2 is reported. This outbreak was observed in Madrid during the years 1988-1990 and involved the San Carlos University Hospital with the same type of isolates at the Ramón y Cajal University Hospital. METHODS: The screening for extended-spectrum beta-lactamases was performed by the double-disk synergy test. Analytical isoelectric focusing and susceptibility tests were performed in all the strains showing a presumptive extended-spectrum beta-lactamase. RESULTS: Fifty-nine strains belonging to four bacterial species (Klebsiella pneumoniae, 61%; Serratia marcescens, 31%; Klebsiella oxytoca, 5%, and Escherichia coli, 3%) showed a beta-lactamase of point isoelectric 7.6; the susceptibility tests demonstrated more resistance to cefotaxime and ceftriaxone than to ceftazidime and aztreonam. CONCLUSIONS: The biochemical, kinetic and isoelectrofocusing parameters demonstrated the presence of a SHV-2 enzyme. The blind application of NCCLS breakpoints would lead to false "susceptibility" results in over 40% of the cases.
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