Survey for beta-lactamase among bacterial isolates from Guangzhou, China hospitals between 2005-2006.

The beta-lactamase genes, which confer multi-drug resistance, are spreading among clinical bacterial isolates. As part of a routine surveillance program, we collected 302 bacilli isolates between June 2005 and October 2006 from four hospitals in Guangzhou, China. The isolates were screened for multidrug resistance and for the presence of beta-lactamases. In all, 80 isolates were identified as multidrug-resistant with the K-B method. These isolates were phenotypically screened for beta-lactamase activity by disk diffusion prescreening, diffusion confirmation, the cefoxitin three-dimensional test and the metallo-beta-lactamase (MBL) synergy test. Bacteria were genotypically screened for beta-lactamase genes by PCR and DNA sequencing. Among the 80 strains, drug resistance was lowest to amikacin (18.75%) and highest to ampicillin (97.50%), 26.49% had a beta-lactamase phenotype, 16.56% had the extended-spectrum beta-lactamase (ESBL) phenotype, 24.83% had a beta-lactamase genotype, 51 carried integrons, 30 carried class I integrons and 18.75% had the ISEcp1B insertion sequence. Sequencing also detected a new CTX-M ESBL gene subtype, which had an ISEcp1B element upstream of bla(CTX-M-Like), and an IS903 element downstream, forming a composite transposon. Multidrug resistance and beta-lactamases continue to be prevalent in Guangzhou. Our results suggest that resistance genes are evolving and being horizontally transmitted between species.