Extended-spectrum beta-lactamases from Klebsiella pneumoniae strains isolated at an Italian hospital

Eighteen strains of Klebsiella pneumoniae recently isolated from hospitalized patients were resistant or moderately resistant to oxyimino-cephalosporins (ceftazidime and/or cefotaxime), aztreonam, cefoxitin and all but one were susceptible to imipenem. Analysis of enzymes produced by these clinical isolates revealed a wide pattern of extended-spectrum beta-lactamases. All isolates produced one or more beta-lactamases that were characterized preliminarily by their isoelectric point. Strains isolated early were from patients in the Intensive Care Unit and produced an ES beta-lactamase with an apparent pI of 7.6, whereas the later isolates were from surgical and medical wards of the same hospital and produced ES beta-lactamases with apparent pI of 8.2 and 8.4, respectively. This suggests the emergence of SHV-5 and MIR-1 beta-lactamases in our hospital. Agarose gel electrophoresis of plasmid DNA revealed the presence of a similar plasmid of approximate size 60 Kb in all isolates.     

Extended-spectrum beta-lactamases in clinical isolates of Klebsiella pneumoniae from Zagreb, Croatia

Forty clinical isolates of Klebsiella pneumoniae, from various clinical specimens, with reduced susceptibility to ceftazidime, were tested for extended-spectrum beta-lactamase (ESBL) production. ESBL production was demonstrated by an 8-fold reduction in the minimum inhibitory concentration (MIC) of ceftazidime combined with clavulanate (2 mg/L) compared to ceftazidime alone in all strains. The aim of this investigation was the biochemical and molecular characterization of the ESBL produced by K. pneumoniae strains and their Escherichia coli transconjugants. Transfer of ceftazidime resistance was demonstrated in 23 of 40 strains. Thirteen strains produced an ESBL with the isoelectric point of 8.2 which was encoded by a self-transferable multiresistance plasmid of 150 kb. The substrate profile was similar to that of the SHV-5 isolated initially in Chile. Seven of these 12 strains had an additional TEM beta-lactamase. Six isolates and their transconjugants produced a plasmid-encoded ESBL with an isoelectric point close to 5.4. The remaining 21 strains produced an ESBL with an isoelectric point of 7.6 (thus probably SHV-2) which was encoded on a plasmid transferable to E. coli in 4 strains only. Four of those strains possessed an additional plasmid encoded TEM beta-lactamase with an isoelectric point close to 5.4. The transconjugants harbored a multiresistance plasmid of 150 kb. Thus SHV-2 and SHV-5 enzymes appear to have been the most common ESBLs in K. pneumoniae from Zagreb during 1994-1995.     

Energy-dependent accumulation of fluoroquinolones in quinolone-resistant Klebsiella pneumoniae strains

The intracellular accumulation of norfloxacin and pefloxacin in Klebsiella pneumoniae was evaluated. The roles of lipopolysaccharide, capsule, and outer membrane proteins were not important for the intrabacterial accumulation of fluoroquinolones in isogenic strains with known outer membrane alterations. In fluoroquinolone-resistant clinical isolates also expressing GyrA alterations, an active efflux leading to decreased accumulation of the drugs enhanced their resistance to these agents.     

Occurrence of extended spectrum beta-lactamases (ESBL) and inducible beta-lactamases (IBL) in clinical strains of gram-negative rods

Hairy cell leukemia (HCL) is clinically associated with severe T-cell dysfunction. Several new observations have given more insight into the abnormal T-cell responses seen in this disease. T-lymphocytes in the spleen of patients with HCL seem to be abnormally activated. On the other hand, they are non-responsive, possibly as a result of monocytopenia which may lead to inadequate antigen presentation. This, together with the lack of CD28 on T-cells, may cause T-cell dysfunction. Furthermore, there is a very restricted repertoire of the T-cell receptor-beta family, which may also result in non-responsiveness. Otherwise, T-cell clonal excess may be indicative for activated, possibly autoreactive T-cells.     

Extended spectrum beta-lactamases in Danish Klebsiella isolates

This study presents the first two cases of infections with Klebsiella pneumoniae producing extended spectrum betalactamases (ESBL) that have been recorded in Denmark. They presented as a urinary tract infection and a generalized infection in a patient admitted to an intensive care unit. Both patients had been treated with broad spectrum antibiotics prior to infection. Presumably, one of the strains had been imported from Turkey. The ESBL of the two strains were characterized as SHV-2 and SHV-5, respectively. Patients transferred from hospitals abroad should be screened for Klebsiella producing ESBL, in addition to MRSA and other multiresistant organisms. A restrictive antibiotic policy and strict hygienic precautions are essential measures to control the selection and spread of such organisms in the hospital environment.     

Extended-spectrum beta-lactamase-producing Klebsiella pneumoniae strains causing nosocomial outbreaks of infection in the United Kingdom

Representative isolates from 10 distinct extended-spectrum beta-lactamase-producing strains of Klebsiella pneumoniae that caused hospital outbreaks in the United Kingdom from 1991 to 1994 were examined for relationships between their enzymes and plasmids. The beta-lactamases were identified by a combination of isoelectric focusing and gene sequencing. SHV-2 beta-lactamase was produced by isolates from four outbreaks, SHV-5 was involved in three, and SHV-4, TEM-15, and TEM-26 were involved in one outbreak each. All of the extended-spectrum beta-lactamases were encoded by self-transmissible plasmids, with sizes ranging from about 70 to 160 kb. No similarities between the restriction digest patterns of the extended-spectrum beta-lactamase-encoding plasmids were detected, except to some extent between those that produced TEM-15 and TEM-26. Thus, outbreaks of hospital infection with these organisms in the United Kingdom from 1991 to 1994 involved distinct organisms and resistance plasmids and appeared to be unrelated.     

Variability of chromosomally encoded beta-lactamases from Klebsiella oxytoca

The beta-lactamase genes of Klebsiella oxytoca were previously divided into two main groups: bla(OXY-1) and bla(OXY-2). The two beta-lactamase groups were each represented by beta-lactamases with four different pIs. In each group, one form of beta-lactamase is more frequent than the others combined. The beta-lactamase gene of each representative beta-lactamase with a different pI that was not yet sequenced (pIs 5.7, 6.8 [OXY-2], 7.1, 8.2, and 8.8 [OXY-1]) was cloned and sequenced. The susceptibility patterns as well as relative rates and kinetic parameters for beta-lactam hydrolysis revealed that OXY-2 enzymes hydrolyzed several of the beta-lactams that were examined (carbenicillin, cephalothin, cefamandole, ceftriaxone, and aztreonam) at a greater rate than the OXY-1 enzymes did. Comparison of K. oxytoca beta-lactamases with plasmid-mediated extended-spectrum beta-lactamases MEN-1 and TOHO-1 implied that the threonine at position 168 present in OXY-2 beta-lactamase instead of the alanine in OXY-1 could be responsible for its modified substrate hydrolysis. In each group, the beta-lactamase with a variant pI differs from the main form of beta-lactamase by one to five amino acid substitutions. The substrate profile and the 50% inhibitory concentrations revealed that all substitutions differing from the main form of beta-lactamase were neutral except one difference in the OXY-1 group. This substitution of an Ala to a Gly at position 237 increases the hydrolysis of some beta-lactams, particularly aztreonam; decreases the hydrolysis of benzylpenicillin, cephaloridine, and cefamandole, and decreases the susceptibility to clavulanic acid (fivefold increase in the 50% inhibitory concentration).     

Production and characterization of guluronate lyase from Klebsiella pneumoniae for applications in seaweed biotechnology

Cultures of Klebsiella pneumoniae fermenting sodium alginate produce an extracellular guluronate-specific alginate lyase. This enzyme production was studied in stirred-tank fermentors. Different alginate substrates gave moderate differences in growth and enzyme yield. Alginates with low guluronic content gave reduced biomass but favored enzyme production. Low molecular weight (down to DPn approximately 270) also favored enzyme production. Excessive depolymerization of substrates occurred during heat sterilization of culture media. The enzyme was characterized by its specificity and sensitivity to pH, salt, and calcium. Improved yields of viable protoplasts were documented for Laminaria digitata (Huds.) Lamour.     

Ceftazidime-resistant Klebsiella pneumoniae and Escherichia coli isolates producing TEM-10 and TEM-43 beta-lactamases from St. Louis, Missouri

Ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae (49 and 102 isolates, respectively) were collected from Barnes-Jewish Hospital, St. Louis, Mo., from 1992 to 1996. They were uniformly resistant to ceftazidime, generally resistant to aztreonam, and variably susceptible to cefotaxime. Four representative E. coli strains and 15 Klebsiella strains were examined. From one to four beta-lactamases were produced per strain, with three possible enzymes related to ceftazidime resistance: enzymes with pI values of 5.6, 6.1, or 7.6. By pulsed-field gel electrophoresis there were at least 13 different Klebsiella strain types and 3 different E. coli strain types, indicating that the outbreak was not clonal. After cloning and sequencing of the beta-lactamase-encoding genes, the enzyme with a pI of 5.6 was identified as TEM-10. The enzyme with a pI of 6.1 was a novel TEM variant (TEM-43) with Lys at 104, His at 164, and Thr at 182. TEM-43 showed broad-spectrum hydrolytic activity against all penicillins, with the highest hydrolysis rate for ceftazidime compared to those for the other expanded-spectrum cephalosporins. Aztreonam was also a good substrate for TEM-43, with hydrolytic activity similar to that of ceftazidime and affinity higher than that of ceftazidime. The TEM-43 beta-lactamase was well inhibited by clavulanic acid and tazobactam at concentrations of < 10 nM. Sulbactam was less effective than the other inhibitors. The Thr182 mutation previously reported in an inhibitor-resistant beta-lactamase did not cause the TEM-43 enzyme to become resistant to any of the inhibitors.     

Methodological aspects of Klebsiella pneumoniae serotyping and its use for characterization of clinical isolates

The method for serological typing of Klebsiella pneumoniae making use of Russian commercial K-sera manufactured by the Ilya Metchnikoff firm has been used to characterize 85 strains isolated from newborns at an obstetrical hospital and department of newborn diseases and from children with acute enteric infections hospitalized at the hospital for infectious diseases. The authors emphasize that their methods of serotyping are to be accurately performed, specifically, the selection of capsular forms and identification of serovars in strains which can be agglutinated by several sera. Serovars were identified by the proposed serotyping method in 89.4% of the studied strains. A wide spectrum of K-serovars typical of this or that hospital has been defined for each institution. K. pneumoniae K2 predominated in the obstetrical hospital, K. pneumoniae K24 and K25 prevailed in department for newborn diseases, and the K14 variant in the infectious diseases hospital.     

Purification and biochemical characterization of gentisate 1,2-dioxygenase from Klebsiella pneumoniae M5a1

Fas Ag is a cell surface molecule that transduces the signal for apoptosis. Since mesangial cells (MC) play important roles in regulating glomerulonephritis, we investigated regulatory mechanisms of Fas system in MC. Fas Ag was expressed on MC from normal mice. This Fas Ag expression was down-regulated by inducing proliferation with platelet-derived growth factor or 18% fetal bovine serum, but was reversed when cycloheximide was added to the culture. Anti-Fas Ab alone did not induce apoptosis in MC, but MC became susceptible to apoptosis induced by anti-Fas Ab is actinomycin D or cycloheximide was added. Noteworthy findings are that mRNA of Fas ligand was expressed in MC. Taken together, MC appears to control the proliferation by regulating Fas system-mediated apoptosis, at least in part, through an autoregulatory mechanism with Fas Ag Fas ligand expressed on their own MC.     

Salicylate-enhanced exposure of Klebsiella pneumoniae subcapsular components

Viable and non-viable cells in coronary and internal thoracic arteries, collected at autopsy 7-24 h post-mortem from individuals 15-81 years of age, were detected using the fixable fluoroprobes 5-chloromethylfluorescein diacetate (green) and ethidium homodimer-1 (orange/red). Viability status of individual endothelial and smooth muscle cells was confirmed by simultaneous autoradiographic detection of incorporated [3H]glucosamine. Twenty-five percent of coronary and 42% of internal thoracic arteries contained viable cells up to 24 h following death. For the majority of viable vessels the mean percentage of viable cells ranged between 60 and 80% with no significant difference between coronary and internal thoracic arteries and no relationship with either age of the donor or with time to autopsy. Non-viable cells were usually distributed fairly evenly amongst viable cells but this pattern could not be assumed. In a number of vessels non-viable cells were variably clustered in different regions of vessel wall. These findings confirm that vessels sampled at autopsy can be used for metabolic studies with the caveat that assessment of cell viability is a necessary prerequisite for interpretation of results.     

Molecular cloning, sequencing and characterization of the genes for adenosylcobalamin-dependent diol dehydratase of Klebsiella pneumoniae

Klebsiella pneumoniae and some of the other Enterobacteriaceae form both diol dehydratase and glycerol dehydratase in response to growth substrates. To compare these enzymes produced by the same bacterium, the pdd genes of K. pneumoniae encoding adenosylcobalamin-dependent diol dehydratase were cloned and sequenced. The sequential three open reading frames (pddA, pddB, and pddC genes) encoded polypeptides of 554, 228, and 174 amino acid residues with predicted molecular weights of 60,379(alpha), 24,401(beta), and 19,489(gamma), respectively. The deduced amino acid sequences of the subunits were 84-100% and 54-71% identical with those reported for diol dehydratases and glycerol dehydratases, respectively.     

Plasmid profiles of Klebsiella pneumoniae isolated from horses

Plasmid profiles of Klebsiella pneumoniae isolated from horses were examined. Thirty-nine strains of K. pneumoniae capsular type 1 (K1) isolated from cervical swabs of mares suffering from metritis, and from semen of stallions showed similar plasmid profile patterns, and all strains possessed a 125 megadaltons (Md) plasmid. There was no difference in plasmid profiles between the heavily-encapsulated and the less heavily-encapsulated strains of K. pneumoniae K1. Non-capsulated variants derived from the strains of K1 showed the same plasmid profile pattern as the parent strains. Plasmid profiles of K. pneumoniae other than K1 were various, and none of these strains possessed the 125 Md plasmid.     

Effects of aspirin on arylamine N-acetyltransferase activity in Klebsiella pneumoniae

This study was designed to assess the effects of aspirin on arylamine N-acetyltransferase (NAT) activities in the bacterium Klebsiella pneumoniae using high performance liquid chromatography to measure the acetylation of 2-aminofluorene (2-AF) with or without aspirin. Cytosols or suspensions of K. pneumoniae with or without specific concentrations of aspirin co-treatment showed different percentages of 2-AF acetylation. The data indicated that there was decreased NAT activity associated with increased levels of aspirin in K. pneumoniae cytosols and in intact bacteria. For the cytosol examination, the apparent values of Km and Vmax decreased 0.59- and 0.58-fold after co-treated with 40 microM aspirin, respectively, for 2-AF. For the intact bacteria examination, the apparent values of Km and Vmax decreased 0.60- and 0.67-fold after co-treated with 40 microM aspirin, respectively, for 2-AF. This report is the first demonstration to show that aspirin can decrease N-acetyltransferase activity in the bacterium K. pneumoniae.     

A case of Klebsiella pneumoniae endophthalmitis metastasized from prostatitis

A case of Klebsiella pneumoniae endophthalmitis metastasized from prostatitis is reported. A 58-year-old alcoholismic man with diabetic diathesis suffered from endophthalmitis which required enucleation of his left eye, when he interrupted the treatment of prostatitis. Metastatic bacterial endophthalmitis from urinary tract infection is rare.     

Antibodies to Klebsiella pneumoniae lipopolysaccharide in patients with ankylosing spondylitis

The role of microbial lipopolysaccharides (LPS) in the aetiopathogenesis of ankylosing spondylitis (AS) is a matter of continuing debate. In this study, class-specific IgG, IgA and IgM antibodies against Klebsiella pneumoniae, Escherichia coli, Salmonella typhimurium and Salmonella enteritidis LPS were measured by enzyme-linked immunosorbent assay (ELISA) in 100 AS patients, 50 rheumatoid arthritis (RA) patients and 50 healthy control subjects. The AS patients had significantly elevated levels of IgG and IgA antibodies against K. pneumoniae LPS (P < 0.001) and IgA antibodies against E. coli LPS (P < 0.05) compared to healthy controls. There were no significant elevations of antibody levels against S. typhimurium and S. enteritidis in the three study groups. In addition, there was a correlation between IgG and IgA anti-K. pneumoniae LPS antibody levels and the acute-phase reactant C-reactive protein (P < 0.001).     

Accumulation of factor F395 in nifNE mutants of Klebsiella pneumoniae

This paper describes a rapid and accurate method for measuring T1 in vivo using an echo-planar imaging version of the Look-Locher sequence. T1 values from 76 to 1330 ms have been measured in 3 s with a mean accuracy of 4.6%.