caa a22 4500 475832094 CHVBK 20180406123842.0 cr unu---uuuuu 170329e20001101xx s 000 0 eng 10.1007/s100960000363 doi (NATIONALLICENCE)springer-10.1007/s100960000363 Extended-Spectrum TEM- and SHV-Type β-Lactamase-Producing Klebsiella pneumoniae Strains Causing Outbreaks in Intensive Care Units in Italy [Elektronische Daten] [L. Pagani, M. Perilli, R. Migliavacca, F. Luzzaro, G. Amicosante]  The aim of the present study was to investigate the production of extended-spectrum β-lactamases (ESβLs) and the epidemiological correlations in a total of 107 Klebsiella pneumoniae strains resistant to third- and fourth-generation cephalosporins. The strains were collected from patients in four intensive care units (3 neonatal and 1 general) in three hospitals in Italy between March 1996 and July 1997. All strains were found to produce ESβLs. Phenotypic (antibiotyping and ESβL patterns) and genotypic (plasmid profile and pulsed-field gel electrophoresis) analyses showed that a single strain had been responsible for each outbreak in each of the four intensive care units. Isoelectric focusing, activity on substrates and gene sequencing showed that the strains produced SHV-5, SHV-2a, SHV-12 and TEM-52 β-lactamases. This is not only the first time that ESβL-producing Klebsiella pneumoniae strains have been reported as causing epidemics in Italian hospitals, it is also, to the best of our knowledge, the first time that an outbreak caused by a TEM-52 ESβL-producing Klebsiella pneumoniae strain has been reported. The data presented here illustrate the complexity of determining the epidemiological pattern of ESβL producers in large hospitals that do not have an ESβL-monitoring program. Springer-Verlag Berlin Heidelberg, 2000 Pagani L. Department of Morphological and Clinical Sciences, Section of Microbiology, University of Pavia, via Brambilla 74, 27100 Pavia, Italy, IT aut Perilli M. Department of Biomedical Sciences and Technology, University of L'Aquila, Locality Coppito, 67100 L'Aquila, Italy, IT aut Migliavacca R. Department of Morphological and Clinical Sciences, Section of Microbiology, University of Pavia, via Brambilla 74, 27100 Pavia, Italy, IT aut Luzzaro F. Laboratory of Microbiology, Hospital of Varese, viale Borri 57, 21100 Varese, Italy, IT aut Amicosante G. Department of Biomedical Sciences and Technology, University of L'Aquila, Locality Coppito, 67100 L'Aquila, Italy, IT aut https://doi.org/10.1007/s100960000363 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s100960000363 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Pagani L. Department of Morphological and Clinical Sciences, Section of Microbiology, University of Pavia, via Brambilla 74, 27100 Pavia, Italy, IT aut NATIONALLICENCE 700 1- Perilli M. Department of Biomedical Sciences and Technology, University of L'Aquila, Locality Coppito, 67100 L'Aquila, Italy, IT aut NATIONALLICENCE 700 1- Migliavacca R. Department of Morphological and Clinical Sciences, Section of Microbiology, University of Pavia, via Brambilla 74, 27100 Pavia, Italy, IT aut NATIONALLICENCE 700 1- Luzzaro F. Laboratory of Microbiology, Hospital of Varese, viale Borri 57, 21100 Varese, Italy, IT aut NATIONALLICENCE 700 1- Amicosante G. Department of Biomedical Sciences and Technology, University of L'Aquila, Locality Coppito, 67100 L'Aquila, Italy, IT aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer