Molecular epidemiology of an SHV-5 extended-spectrum beta-lactamase in enterobacteriaceae isolated from infants in a neonatal intensive care unit

Clin Infect Dis. 1995 Oct;21(4):915-23. doi: 10.1093/clinids/21.4.915.


Klebsiella oxytoca that produced extended-spectrum beta-lactamase (ESBL) and were resistant to ceftazidime were isolated from infants in a neonatal intensive care unit (NICU). During a 30-week period, 3 infants developed infections and an additional 60 infants were colonized with these bacteria. The molecular typing data suggested transmission of a single strain of ceftazidime-resistant K. oxytoca among 48 of the 63 infants. The ESBL of 46 of the 48 similar isolates, 14 of the remaining 15 isolates, and 6 other Enterobacteriaceae appeared to be associated with a conjugative plasmid of approximately 85 kb. The ESBL gene was cloned, and DNA sequencing confirmed that the ESBL was an SHV-5. Hybridization data suggested that the SHV-5 gene was transmitted to other Enterobacteriaceae in vivo. The spread of the ESBL was reduced through adherence to infection control practices.

Publication types

  • Case Reports

MeSH terms

  • Bacterial Typing Techniques
  • Ceftazidime / therapeutic use
  • Cephalosporin Resistance / genetics
  • Cephalosporins / therapeutic use
  • Cloning, Molecular
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology*
  • Cross Infection / microbiology
  • Disease Outbreaks
  • Fatal Outcome
  • Genes, Bacterial
  • Humans
  • Infant
  • Infant, Newborn
  • Intensive Care, Neonatal*
  • Isoelectric Focusing
  • Klebsiella / enzymology*
  • Klebsiella / isolation & purification
  • Klebsiella Infections / drug therapy
  • Klebsiella Infections / epidemiology*
  • Klebsiella Infections / microbiology
  • Plasmids
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism*


  • Cephalosporins
  • Ceftazidime
  • beta-Lactamases