PubMed · 12486243
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S W Michnick, F-X Campbell Valois. 2002-12-16. Gene function: getting specific, generally speaking.. https://doi.org/10.1073/pnas.012697899
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Because a multiresistant K. pneumoniae outbreak detected in an intensive care unit of a parisian hospital, combined to the production of the plasmid-encoded cephalosporinase ACC-1, a probable importation via a patient was suggested from another country (Tunisia). The investigation was conducted to examine 35 clinical strains of enterobacteria resistant to ceftazidime without synergy towards Augmentin. Other test of synergy with two inhibitors, BRL 42715, Ro 48-5545 was performed by diffusion method and deposit of 10 micrograms of inhibitor on disks containing ceftazidime, cefoxitin and cefotetan. Synergies were obtained suggesting a probable production of ACC-1 type among six isolates of K. pneumoniae (two), Proteus mirabilis (one) and Salmonella (three) issued from different units. The isoelectric focusing on gel revealed at least one band of beta-lactamase activity at 7.8 but also demonstrated the simultaneous production of several probable beta-lactamases including TEM-type, SHV-2 and ACC-1 among S. enterica ser. Livingstone. The PCR of the gene blaacc-1 was positive. The sequencing (1160 pb) of two products showed high identity (99-100%) with the gene blaacc-1 deposited in 1999. Finally the ACC-1 type reported in Tunisia was probably imported in France via a patient. Because a simultaneous synthesis of ESBL and ACC-1 type, its presence may be invisible and need more investigation.
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From the beginning of the year 1996, an increase of multiresistant Enterobacter aerogenes isolates was observed. These strains overproduced their chromosomally cephalosporinase. From February to September 1996, we studied the genotypic diversity of multiresistant E. aerogenes isolates. Fifty-seven strains were analysed with the RAPD technique. These strains were isolated from 38 patients in 25 different units. These isolates were collected from urines (37), respiratory tracts (14) and wounds (6). We have observed two distinct profiles. The predominant profile (A) was recovered from 55 strains (36 patients) and the second profile (B) from 2 strains (2 patients). The clonal relatedness of strains isolated (profile A) showed an epidemic spread in our hospital. The RAPD technique is easy to perform and gives results in less than 48 h with a good discriminatory power.