Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology

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pISSN 2288-0585 eISSN 2288-6850

Isolation of Klebsiella Oxytoca Clinical Isolate Producing AmpC β-lactamase, DHA-1

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2004 December Volume 7, Issue 2, pages 124-129.


https://doi.org/10.5145/ACM.2004.07.2.124

Isolation of Klebsiella Oxytoca Clinical Isolate Producing AmpC β-lactamase, DHA-1

Wonkeun Song1, Jae-Seok Kim1, Han-Sung Kim1, Tae Jae Lee1, Min-Jeong Park1, In-Heon Park2, and Kyu Man Lee1
Department of Laboratory Medicine1and Orthopedic Surgery2, Hallym University College of Medicine, Seoul, Korea

Abstract

Background : Klebsiella oxytoca strain exhibiting an unusual inducible β-lactam resistance phenotype was isolated from a wound specimen of a patient at a university hospital in August 2002. The isolate was resistant to ampicillin, ampicillin-sulbactam, cephalothin, cefoxitin, and demonstrated reduced inhibition zone diameters for ceftazidime in combination with clavulanate versus those for ceftazidime when tested alone.

Methods : Antimicrobial susceptibilities were tested using the Etest and disk diffusion method. AmpC β-lactamase production was determined by modified Hodge test. The disk antagonism method was used to detect inducibility of β-lactamase. Conjugation experiments were performed by the filter mating method using the recipient Escherichia coli J53 Azir strain. PCR and DNA sequencing of DHA-specific PCR products were tested.

Results : The double disk synergy test was negative and the modified Hodge test was positive for the K. oxytoca isolate. Antagonism was observed between cefoxitin and oxyimino-cephalosporins. Sequence analysis of the DHA-specific PCR products revealed that they were identical to the amino acid sequence of the DHA-1 β-lactamase. Transfer of the resistance by conjugation experiments was successful.

Conclusions : We found a plasmid-mediated DHA-1 β-lactamase-producing K. oxytoca possessing an unusual inducible β-lactam resistance phenotype was found in a university hospital in Korea. The resistance phenotype was conferred by DHA-1 encoded by a self-transferable plasmid. (Korean J Clin Microbiol 2004;7(2):124-129)

Keywords

Klebsiella oxytoca, inducible, AmpC β-lactamase, DHA-1