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D Sirot

Publications and source records attributed to D Sirot.

At least 55 records · Page 3Linked to original sources
PubMed1996

Survey of prevalence of extended spectrum beta-lactamases among enterobacteriaceae.

During the first six months of 1990 and 1994 respectively, 3179 and 2721 non-repetitive strains of Enterobacteriaceae were isolated at the teaching hospital of Clermont-Ferrand. Extended-spectrum beta-lactamases were found in 147 isolates, mainly in Klebsiella pneumoniae (n = 73), Enterobacter aerogenes (n = 37) and Proteus mirabilis (n = 15). TEM-3/CTX-1, SHV-4/CAZ-5 and TEM-24/CAZ-6 were the prevalent enzymes. However, the most frequently involved enzyme in 1990 was TEM-3 (48.6%) whereas in 1994 it was SHV-4 (56.0%). Two salient features emerged from this study: the high frequency of TEM-3 production in P. mirabilis and the production of SHV-4 enzyme, heretofore observed solely in K. pneumoniae, in two other species, E. aerogenes and Escherichia coli.

Anti-Bacterial Agents↗
PubMed1996

Characterization of an inhibitor-resistant enzyme IRT-2 derived from TEM-2 beta-lactamase produced by Proteus mirabilis strains.

Ten clinical isolates of Proteus mirabilis were found to produce an inhibitor-resistant TEM beta-lactamase (IRT) in association with a TEM-1 enzyme. The IRT enzyme was derived from TEM-2. The blaIRT gene differs from blaTEM-2 gene by one point mutation which leads to the amino-acid substitution Arg-->Ser at position 244, as observed for the original IRT-2 enzyme derived from TEM-1 reported in Escherichia coli. This is the first report of an IRT beta-lactamase derived from TEM-2.

Microbial Sensitivity Tests↗
PubMed1996

A new fimbrial antigen harbored by CAZ-5/SHV-4-producing Klebsiella pneumoniae strains involved in nosocomial infections.

We purified and characterized a new fimbria termed KPF-28 (Klebsiella pneumoniae fimbria with a fimbrin molecular mass of 28 kDa) involved in K. pneumoniae adherence to the human carcinoma cell line Caco-2. Electron microscopy of bacterial surface protein preparations and immunogold labeling of bacterial cells showed that KPF-28 was a long, thin, and flexible fimbria about 4 to 5 nm in diameter and 0.5 to 2 microm long. The N-terminal amino acid sequence of the KPF-28 major fimbrial subunit showed no homology with type 1 and type 3 pili of K. pneumoniae but showed 61.7% identity with residues 6 to 19 of the N-terminal amino acid sequence of PapA, the Pap major pilus subunit expressed by uropathogenic Escherichia coli strains. Total amino acid content determination showed that the KPF-28 major subunit composition was close to that of the GVVPQ fimbrial family major subunits expressed by pathogenic E. coli strains. The study of the prevalence of KPF-28 among K. pneumoniae strains involved in nosocomial infections revealed that KPF-28 was found in the great majority of the K. pneumoniae strains producing the CAZ-5/SHV-4 extended-spectrum beta-lactamase. As shown by curing and mating experiments, the R plasmid encoding the CAZ-5/SHV-4 enzyme was found to be involved in but not solely responsible for KPF-28 expression. Hybridization experiments using an oligonucleotide probe corresponding to the N-terminal part of the 28-kDa protein revealed that the structural gene encoding the KPF-28 major subunit was localized on this R plasmid. KPF-28 is a putative colonization factor of the human gut, since the ceftazidine-sensitive derivative strain CF914-1C no longer adhered and since the Fab fragments of antibodies raised against KPF-28 inhibited adhesion of K. pneumoniae CF914-1 to the Caco-2 cell line.

Amino Acid Sequence↗
PubMed1996

[Detection of pneumococci with reduced susceptibility to penicillin G using the ATB++STREP strip].

Antibiotic susceptibility of 104 clinical isolates of Streptococcus pneumoniae was routinely tested using ATB STREP strips (Bio-Mérieux), and interpreted with ATB PLUS Expert V 2.3.1 software. In parallel, CMI of penicillin G was determined by Etest, strains with MIC < or = 0.06 mg/l were classified as penicillin susceptible. ATB system proved to be both sensitive and specific for the detection of strains of reduced susceptibility to penicillin G, accurately detecting 70 out of the 71 susceptible strains, and all of the 33 resistant strains. However the level of resistance cannot be deduced from ATB results.

Anti-Bacterial Agents↗
PubMed1995

Bactericidal effect of beta-lactams and amikacin alone or in association against Klebsiella pneumoniae producing extended spectrum beta-lactamase.

Ten extended spectrum beta-lactamases producing strains of Klebsiella pneumoniae characterized by analytical isoelectric focusing and studied for their susceptibility to beta-lactam antibiotics, either alone or in combination with a beta-lactamase inhibitor (clavulanic acid and sulbactam) and in association with amikacin. The extended spectrum beta-lactamases were derived from either TEM (CTX-1 = TEM-3) or SHV (CAZ-4 = SHV-5). Killing curves were studied with antibiotics at clinical by achievable concentrations, at MIC and MIC x 4. At MIC, cefotetan, cefotaxime and ceftazidime lacked bactericidal activity. Imipenem was more rapidly bactericidal than meropenem or co-amoxiclav. At MIC x 4, cefotetan and cefotaxime exhibited bactericidal effect but this was less than for imipenem which gave a reduction of 4 log10 of the inoculum. Cefotaxime plus sulbactam gave no bactericidal effect compared with cefotaxime plus co-amoxiclav. A bactericidal effect with cefotaxime plus sulbactam was seen with the addition of amikacin. At clinical concentrations cefotaxime plus co-amoxiclav +/- amikacin was as efficient as imipenem +/- amikacin with a rapid bactericidal effect (5-6 log10 in 30-60 min). We proposed that cefotaxime+co-amoxiclav might be considered as an alternative to imipenem for the treatment of extended spectrum beta-lactamase associated K. pneumoniae injections.

Amikacin↗
PubMed1995

Extended-spectrum plasmid-mediated beta-lactamases.

Extended-spectrum beta-lactamases (ESBLs) are mutant enzymes which derive from TEM or SHV (class A) enzymes. They confer variable levels of resistance to cefotaxime, ceftazidime and other broad-spectrum cephalosporins and to monobactams such as aztreonam but have no detectable activity against cephamycins and carbapenems. Recently, new plasmid-mediated ESBLs, not derived from TEM or SHV enzymes but related to cephalosporinases of Enterobacteriaceae (class C enzymes), that confer resistance to all cephalosporins including cephamycins, have been reported. However, to date there have been no reported outbreaks due to strains producing transferable cephalosporinases. Klebsiella pneumoniae is the species in which the ESBL enzymes have been most commonly reported around the world. Most of the clinical isolates that produce TEM- or SHV-derived ESBL, come from hospitalised patients and have frequently caused nosocomial outbreaks. Care should be taken in the selection of a beta-lactam for the treatment of infections because the presence of an ESBL does not prevent other mechanisms of resistance, such as decreased permeability, from emerging. Broad-spectrum cephalosporins including cefepime and cefpirome are hydrolysed by ESBL. However, low level resistance to cefotaxime, ceftriaxone, cefepime and aztreonam does occur in some strains producing certain TEM-derived ESBL. It remains to be seen, therefore, whether such isolates are clinically susceptible to these drugs. The combination of a third-generation cephalosporin and a beta-lactamase inhibitor such as sulbactam could be of interest against some strains producing certain ESBLs. Among the 7-alpha-methoxy cephalosporins, cefotetan and latamoxef are the most active. However, cephamycins should be used with caution to treat infections caused by ESBL-producing K. pneumoniae because of the relative ease with which clinical strains decrease the expression of outer membrane proteins. The most active beta-lactams are the carbapenems, imipenem and meropenem, which are highly resistant to hydrolysis by TEM and SHV related beta-lactamases. Meropenem is intrinsically the more active agent, with MICs (0.03-0.12 mg/L) generally lower than those of imipenem (0.06-0.5 mg/L) and appears stable to all the beta-lactamases belonging to class A or C, including those with an extended-spectrum against third-generation cephalosporins.

Carbapenems↗
PubMed1995

First characterization of inhibitor-resistant TEM (IRT) beta-lactamases in Klebsiella pneumoniae strains.

Two clinical strains of Klebsiella pneumoniae, TP 01 and TP 02, presented resistance to amoxicillin-clavulanate and were fully susceptible to cephalothin. These strains produced two beta-lactamases, SHV-1 and a TEM enzyme with a pI of 5.2. The previously described changes Arg-244-->Cys and Arg-244-->Ser in IRT-1 and IRT-2 (A. Belaaouaj, C. Lapoumeroulie, M. M. Caniça, G. Vedel, P. Nevot, R. Krishnamoorthy, and G. Paul, FEMS Microbiol. Lett. 120:75-80, 1994) were found in TEM enzymes from the TP 01 and TP 02 strains, respectively. This is the first report of inhibitor-resistant TEM (IRT) in species other than Escherichia coli from the family Enterobacteriaceae.

Amoxicillin↗
PubMed1995

Molecular characterization of nine different types of mutants among 107 inhibitor-resistant TEM beta-lactamases from clinical isolates of Escherichia coli.

DNA-DNA hybridization and sequencing were performed to determine the molecular basis of resistance to clavulanic acid in 107 inhibitor-resistant TEM (IRT) enzymes produced by Escherichia coli clinical isolates. These beta-lactamases derived from TEM-1 enzyme focused at pI 5.2 (n = 68) or 5.4 (n = 39) and were very poorly inhibited by clavulanic acid compared with TEM-1 enzyme. Results showed that the amino acid sequences of 84 of the 107 enzymes differ from TEM-1 by one or two substitutions previously described: Arg-244-->Ser (IRT-2) in 22 strains, Met-69-->Leu (TEM-33) in 17 strains, Met-69-->Val (TEM-34) in 14 strains, Met-69-->Ile (IRT-3) in 6 strains, Met-69-->Leu associated with Asn-276-->Asp (IRT-4) in 13 strains, and Met-69-->Val associated with Asn-276-->Asp (TEM-36) in 12 strains. A new combination, Met-69-->Ile with Asn-276-->Asp, was found in 20 strains and was called IRT-8. Two IRT enzymes not previously described were characterized. The substitution Met-69-->Val associated with a novel substitution Arg-275-->Leu occurred in one strain. The combination Met-69-->Leu and Asn-276-->Asp was associated with the novel substitution Trp-165-->Arg in two strains. These two novel enzymes were called IRT-9 and IRT-10, respectively. The implication of these novel mutated positions, 165 and 275, in resistance to inactivation by clavulanate was supported by crystallographic data on the TEM-1 enzyme and results of site-directed mutagenesis. Molecular characterization of these mutants showed great diversity among the genes coding for inhibitor-resistant TEM enzymes produced by clinical E. coli isolates.

Base Sequence↗
PubMed1995

[Detection of beta-lactamases resistant to inhibitors (IRT) by the disk diffusion method].

UNLABELLED: 85 E. coli strains producing various beta-lactamase were studied: TEM low level: n = 11, TEM high level: n = 4, oxacillinase (OXA): n = 5, céphalosporinase (CASE) +/- TEM: n = 5, inhibitor resistant TEM (IRT) n = 50, IRT+TEM: n = 3, IRT+ CASE: n = 7. Their susceptibility to amoxicillin (AMX), amoxicillin+clavulanate (AMC), ticarcillin (TIC), ticarcillin+clavulanate (TCC), piperacillin (PIP), piperacillin+tazobactam (TAZ), mecillinam (MEC), cephalotin (CF), cefoxitin (FOX) et ceftazidime (CAZ) were evaluated by a disk diffusion method, in order to determine the resistance pattern which allows a reliable detection of IRT-producing strains. The phenotype AMX R, TIC R, AMCI/R, TCCI/R et CFS was observed in 46 out of 53 IRT +/- TEM strains, 4/5 of OXA strains and 1/11 of TEM low level strains. A better sensitivity could be obtained by a modification of breakpoints for AMC, TCC and CF, however OXA-producing strains remain indistinguishable from IRT-strains.

Anti-Bacterial Agents↗
PubMed1994

Clinical isolates of Escherichia coli producing multiple TEM mutants resistant to beta-lactamase inhibitors.

Twenty clinical isolates of Escherichia coli resistant to amoxycillin and ticarcillin, both in combination with clavulanic acid, were studied. The ranges of MICs for these strains as determined by the agar dilution method were as follows: amoxycillin, 2048- > 4096 mg/L; ticarcillin, 512- > 4096 mg/L; piperacillin, 32-256 mg/L; mecillinam, 0.5-8 mg/L; and cephalothin 4-16 mg/L. Combining amoxycillin with beta-lactamase inhibitors, each at a fixed concentration of 4 mg/L, had only modest potentiating effects on the activities of this agent, the ranges of MICs falling to 256- > 2048 mg/L in the presence of clavulanic acid or sulbactam and to 64-1024 mg/L and 128-2048 mg/L in the presence of tazobactam and brobactam respectively. The pI values for the beta-lactamases produced by the 20 isolates were 5.2 for 15 strains, 5.4 for four strains and 7.4 for a single strain. Colony hybridization with oligonucleotides was performed in order to detect substitutions of arginine at position 241 (Arg-241) and methionine at position 67 (Met-67). Based on this technique, the four beta-lactamases with pI values of 5.4 were grouped into two oligotypes (+ = hybridization, - = non-hybridization)-Arg-241+, Met-67- (n = 3) and Arg-241+, Met-67+ (n = 1); in one of the three mutants which did not hybridize with the Met-67 probe, leucine had been substituted for methionine at position 67. The beta-lactamases with pI values of 5.2 which were identified in 15 strains were grouped into the following three oligotypes: Arg-241-, Met-67+ (n = 7); Arg-241-, Met-67- (n = 6); and Arg-241+, Met-67- (n = 2). In three of the 13 mutants which failed to hybridize with the Arg-241 probe, serine residues had replaced arginine residues at position 241. Substitutions of Arg-241 or Met-67 led to reduced affinities of the mutant enzymes for the beta-lactams tested. The results of the hybridization studies demonstrate that, amongst E. coli clinical isolates, there is a diversity of mutant TEM enzymes mediating resistance to beta-lactamase inhibitors.

Amoxicillin↗
PubMed1994

Frequency of inhibitor-resistant TEM beta-lactamases in Escherichia coli isolates from urinary tract infections in France.

Over a six-month period in 1993, 2972 non-duplicated isolates of Escherichia coli causing urinary tract infections were collected in a French teaching hospital (n = 785) and in three private laboratories (n = 2187). The resistance rate to amoxycillin-clavulanate combination (MIC > 16 mg/l) was 25.0% in the hospital isolates and 10.0% in the community isolates. Respectively, 27.5% and 45.0% of hospital and community isolates resistant to amoxycillin-clavulanate exhibited an unusual beta-lactam resistance pattern, suggesting inhibitor-resistant TEM (IRT) beta-lactamase production. These isolates were highly resistant to amoxycillin-clavulanate (MIC90 > 1024 mg/L), but were susceptible to cephalosporins (MIC < 32 mg/L). Enzyme extracts of these IRT-producing strains focused at pI 5.2 (n = 100) or 5.4 (n = 53). DNA-DNA hybridization confirmed that the beta-lactamases involved in this resistance mechanism were TEM-1 derived and contained variations in the altered positions described in IRT enzymes. This study shows a total frequency of 4.9% of IRT-producing isolates among E. coli isolated from urine specimens.

Amoxicillin↗
PubMed1994

Sequences of CAZ-3 and CTX-2 extended-spectrum beta-lactamase genes.

The nucleotide sequences of blaTEM genes coding for the extended-spectrum beta-lactamases CAZ-3 and CTX-2 were determined. The gene for CAZ-3 is identical to blaTEM-12b. The gene for CTX-2 differs from characterized blaTEM genes for extended-spectrum beta-lactamases by a new combination of already known mutations. We propose for CTX-2 the designation TEM-25.

Amino Acid Sequence↗
PubMed1994

Emergence of clinical isolates of Escherichia coli producing TEM-1 derivatives or an OXA-1 beta-lactamase conferring resistance to beta-lactamase inhibitors.

Sixteen Escherichia coli clinical isolates which were resistant to ampicillin and amoxicillin-clavulanate but susceptible to cephalothin were studied. Eight strains showed the presence of a beta-lactamase which comigrates with reference OXA-1 enzyme. The eight other strains produced different TEM-1 derivatives which had in common a higher Km for penicillins and a higher 50% inhibitory concentration for the beta-lactamase inhibitors. By oligotyping and sequencing of PCR products, it was shown that Ser (AGC) (TEM-30; also called TRI-1) in three strains and Cys (TGC) (TEM-31; also called TRI-2) in one strain were substituted for Arg-241 (CGC), that Leu (CTG) (TEM-33) and Val (GTG) (TEM-34) in one strain each were substituted for Met-67 (ATG), and that in other mutants the two latter substitutions occurred together with the substitution of Asp (GAT) (TEM-35 and TEM-36) for Asn-272 (AAT). Therefore, different sets of amino acid substitutions of TEM-1 can be found in clinical isolates and lead to resistance to beta-lactamase inhibitors.

Amoxicillin↗
PubMed1994

Clonal outbreaks of extended-spectrum beta-lactamase-producing strains of Klebsiella pneumoniae demonstrated by antibiotic susceptibility testing, beta-lactamase typing, and multilocus enzyme electrophoresis.

Nineteen extended-spectrum beta-lactamase (ESBla)-producing Klebsiella pneumoniae isolates from Rouen Hospital were investigated for their implication in nosocomial outbreaks: in addition to antibiotic susceptibility testing, the ESBlas were characterized by isoelectric focusing, and the genetic relationships between the strains were analyzed by multilocus enzyme electrophoresis using a combined polyacrylamide electrophoresis-electrophoretic transfer technique. Four isoelectric focusing beta-lactamase patterns and 11 enzyme electrophoretic types (ETs) among the strains tested were described. Three strains isolated in the same neurological unit over a 7-day period exhibited an SHV 3 beta-lactamase (pI 7.0) and were assigned to a common ET. Three of five strains isolated from patients in a rehabilitation center over a 6-week period harbored an SHV 4 beta-lactamase (pI 7.8) and exhibited the same ET. These results differentiate nosocomial transmission from sporadic cases and provide evidence that multilocus enzyme electrophoresis is a potential tool for studying genetic relationships between strains harboring a common ESBla.

Cross Infection↗
PubMed1993

[Haemophilus parainfluenzae meningitis in an 8-year-old boy].

Invasive infections caused by Haemophilus parainfluenzae, a saprophyte of the respiratory tract, are exceptional and should arise suspicion of abnormalities in immunocompetence. So far, about thirty cases of H. parainfluenzae meningitis affecting neonates, infants or adults have been published. A case of such meningitis in an 8-year old boy without any risk factor is reported here.

Child↗
PubMed1993

Clinical and bacteriological study of nosocomial infections due to Enterobacter aerogenes resistant to imipenem.

Enterobacter aerogenes strains resistant to imipenem were isolated in 10 patients, 7 of whom had received imipenem-cilastatin. The strains were differentiated by biotype, antibiotype, and plasmid content. All of the strains overproduced a chromosomal cephalosporinase and lost a major outer membrane protein with a size of about 40 kDa. In 5 of the 10 patients, E. aerogenes strains resistant to extended-spectrum cephalosporin were isolated during the same stay. In three patients, the similarity between the imipenem-susceptible and -resistant strains suggests the occurrence of mutation and reversion in vivo. The combination imipenem-cilastatin has been critically important for use with multiresistant strains of Enterobacter spp., but its use increases the risk of selection of imipenem-resistant strains.

Bacterial Outer Membrane Proteins↗
PubMed1993

[Multifactorial analysis of the phenotypes for beta-lactams of 1044 Escherichia coli strains].

1,044 E. coli strains were randomly collected by the beginning of 1992. Their susceptibility for seven beta-lactam antibiotics: amoxycillin, augmentin, ticarcillin, claventin, cephalothin, cefoxitin and cefotaxime, was studied routinely by the agar diffusion method. The datas were analyzed by the CERIB multifactorial analysis package which yields to homogeneous populations. This analysis showed four well defined populations: 1) 588 strains (56.4%) susceptible to all antibiotics; 2) 410 strains (39.3%) present a penicillinase phenotype; 3) 11 strains (1.05%) are cephalosporinase producer; 4) 7 strains (0.67%) were identified as producing an extended-spectrum beta-lactamase. The remaining strains: 28 (2.68%) had a reduced susceptibility to all antibiotics, which suggests the combination of few resistance mechanisms or other hypothesis.

Anti-Bacterial Agents↗