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For 62 representative isolates from 58 patients, 31 clonal types harboring TEM-4 (<jats:italic>n<\/jats:italic>= 5), SHV-2 (<jats:italic>n<\/jats:italic>= 7), SHV2a (<jats:italic>n<\/jats:italic>= 4), SHV-5 (<jats:italic>n<\/jats:italic>= 1), CTX-M-10 (<jats:italic>n<\/jats:italic>= 13), or CTX-M-9 (<jats:italic>n<\/jats:italic>= 1) \u03b2-lactamases were identified by pulsed-field gel electrophoresis. This is the first report to document the presence of the CTX-M-10 or the CTX-M-9 \u03b2-lactamase in<jats:italic>K. pneumoniae<\/jats:italic>. These \u03b2-lactamases were previously identified in<jats:italic>Escherichia coli<\/jats:italic>isolates from Spain. Only two of five<jats:italic>K. pneumoniae<\/jats:italic>TEM-4 clones caused more than a single case of infection, with one of them spreading for 9 months. A single plasmid was detected among these TEM-4 clones. Only two of seven<jats:italic>K. pneumoniae<\/jats:italic>clones containing SHV-2 and three of four strains harboring SHV-2a were detected in more than one case of infection. Plasmids encoding SHV-2 or SHV-2a were unrelated. Four of 13<jats:italic>K. pneumoniae<\/jats:italic>CTX-M-10 clones were found in more than one patient, with two of them recovered 2 and 5 years apart. As in the case of the SHV-2 isolates, we were unable to document a common transmissible genetic element that could explain the polyclonal structure of our isolates. Nevertheless, the spread of a single gene may be suggested by the presence of a conserved set of noncoding polymorphisms in the sequences. Most ESBL-producing<jats:italic>K. pneumoniae<\/jats:italic>clones were ephemeral, being poorly selected and maintained in the hospital setting, but the genes encoding ESBL persisted successfully over the years that the strains were recovered, probably as a minority gene population in the hospital metagenome.<\/jats:p>","DOI":"10.1128\/aac.46.2.500-510.2002","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:06:42Z","timestamp":1027764402000},"page":"500-510","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":162,"title":["Genes Encoding TEM-4, SHV-2, and CTX-M-10 Extended-Spectrum \u03b2-Lactamases Are Carried by Multiple<i>Klebsiella pneumoniae<\/i>Clones in a Single Hospital (Madrid, 1989 to 2000)"],"prefix":"10.1128","volume":"46","author":[{"given":"Teresa M.","family":"Coque","sequence":"first","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Ramo\u0301n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Oliver","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Ramo\u0301n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jose\u0301 Claudio","family":"Pe\u0301rez-Di\u0301az","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Ramo\u0301n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Baquero","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Ramo\u0301n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"Canto\u0301n","sequence":"additional","affiliation":[{"name":"Servicio de Microbiologi\u0301a, Hospital Ramo\u0301n y Cajal, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.32.10.2553-2558.1994"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1086\/313590"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/jb.135.2.342-347.1978"},{"key":"e_1_3_2_5_2","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1093\/jac\/45.5.611","volume":"45","year":"2000","unstructured":"Barroso, H., A. 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