{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T12:56:08Z","timestamp":1762865768360},"reference-count":44,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2011,3,1]],"date-time":"2011-03-01T00:00:00Z","timestamp":1298937600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["J Clin Microbiol"],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Between February 2006 and October 2009, 38 patients in different wards at the A Coru\u00f1a University Hospital (northwest Spain) were either infected with or colonized by an epidemic, multidrug-resistant (MDR), and extended-spectrum-\u03b2-lactamase (ESBL)-producing strain of\n            <jats:named-content content-type=\"genus-species\">Enterobacter cloacae<\/jats:named-content>\n            (EbSF), which was susceptible only to carbapenems. Semiautomated repetitive extragenic palindromic sequence-based PCR (rep-PCR) and pulsed-field gel electrophoresis (PFGE) analysis revealed that all of the\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            isolates belonged to the same clone. Cloning and sequencing enabled the detection of the SFO-1 ESBL in the epidemic strain and the description of its genetic environment. The presence of the\n            <jats:italic>ampR<\/jats:italic>\n            gene was detected upstream of\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>SFO-1<\/jats:sub>\n            , and two complete sequences of IS\n            <jats:italic>26<\/jats:italic>\n            surrounding\n            <jats:italic>ampR<\/jats:italic>\n            and\n            <jats:italic>ampA<\/jats:italic>\n            were detected. These IS\n            <jats:italic>26<\/jats:italic>\n            sequences are bordered by complete left and right inverted repeats (IRL and IRR, respectively), which suggested that they were functional. The whole segment flanked by two IS\n            <jats:italic>26<\/jats:italic>\n            copies may be considered a putative large composite transposon. A gene coding for aminoglycoside acetyltransferase (gentamicin resistance gene [\n            <jats:italic>aac3<\/jats:italic>\n            ]) was found downstream of the 3\u2032 IS\n            <jats:italic>26<\/jats:italic>\n            . Despite the implementation of strict infection control measures, strain EbSF spread through different areas of the hospital. A case-control study was performed to assess risk factors for EbSF acquisition. A multivariate analysis revealed that the prior administration of \u03b2-lactam antibiotics, chronic renal failure, tracheostomy, and prior hospitalization were statistically associated with SFO-1-producing\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            acquisition. This study describes for the first time an outbreak in which an SFO-1-producing\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            strain was involved. Note that so far, this \u03b2-lactamase has previously been isolated in only a single case of\n            <jats:named-content content-type=\"genus-species\">E. cloacae<\/jats:named-content>\n            infection in Japan.\n          <\/jats:p>","DOI":"10.1128\/jcm.01872-10","type":"journal-article","created":{"date-parts":[[2011,1,13]],"date-time":"2011-01-13T03:21:49Z","timestamp":1294888909000},"page":"822-828","update-policy":"http:\/\/dx.doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":48,"title":["Emergence in Spain of a Multidrug-Resistant Enterobacter cloacae Clinical Isolate Producing SFO-1 Extended-Spectrum \u03b2-Lactamase"],"prefix":"10.1128","volume":"49","author":[{"given":"Ana","family":"Fern\u00e1ndez","sequence":"first","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Complejo Hospitalario Universitario A Coru\u00f1a, A Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Pereira","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Preventiva, Complejo Hospitalario Universitario A Coru\u00f1a, A Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 Manuel","family":"Su\u00e1rez","sequence":"additional","affiliation":[{"name":"Servicio de Medicina Preventiva, Complejo Hospitalario Universitario A Coru\u00f1a, A Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarita","family":"Poza","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Complejo Hospitalario Universitario A Coru\u00f1a, A Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mercedes","family":"Trevi\u00f1o","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pilar","family":"Villal\u00f3n","sequence":"additional","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda, Majadahonda, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Antonio","family":"S\u00e1ez-Nieto","sequence":"additional","affiliation":[{"name":"Centro Nacional de Microbiolog\u00eda, Majadahonda, Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benito Jos\u00e9","family":"Regueiro","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Complejo Hospitalario Universitario A Coru\u00f1a, A Coru\u00f1a, 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