Characterization of a new integron containing VIM-2, a metallo- beta-lactamase gene cassette, in a clinical isolate of Enterobacter cloacae

Jeong, Seok Hoon; Lee, Kyungwon; Chong, Yunsop; Yum, Jong Hwa; Lee, Sangeun; Choi, Hyuk Jin; Kim, Jeong Man; Park, Kil Ho; Han, Byung Hoon; Lee, Sang Wook; Jeong, Tae Sik

doi:10.1093/jac/dkg047

Cited by 68 publications

(38 citation statements)

References 8 publications

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“…The primers are described in Table 1. PCR amplifications were carried out as described previously (9,10). For the cloning of bla OXA-23 gene, the PCR products were cloned into pGEM-T (Promega), and the recombinant plasmids were transformed into chemically competent cell of E. coli DH5␣ by heat shock as detailed in the supplier's instructions.…”

Section: Methodsmentioning

confidence: 99%

Investigation of a Nosocomial Outbreak of Imipenem-Resistant Acinetobacter baumannii Producing the OXA-23 β-Lactamase in Korea

Jeon¹,

et al. 2005

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We investigated an outbreak of Acinetobacter baumannii in an intensive care unit and in the surgery, medicine, neurology, and urology wards of the Kosin University Gospel Hospital in Busan, Korea. The outbreak involved 36 cases of infection by A. baumannii producing the OXA-23 ␤-lactamase over an 8-month period and was caused by a single pulsed-field gel electrophoresis clone. The epidemic isolates were characterized by a modified cloverleaf synergy test. Isoelectric focusing of crude bacterial extracts detected one nitrocefin-positive band with a pI value of 6.65. PCR amplification and characterization of the amplicons by direct sequencing indicated that the epidemic isolates carried a bla OXA-23 determinant. The epidemic isolates were characterized by a multidrug resistance phenotype that remained unchanged over the outbreak, including penicillins, cephamycins, extended-spectrum cephalosporins, carbapenems, monobactams, and aminoglycosides. This study shows that the bla OXA-23 resistance determinant may become an emerging therapeutic problem.Acinetobacter baumannii has emerged as an important nosocomial pathogen in outbreaks of hospital infections and is ranked second after Pseudomonas aeruginosa among nosocomial pathogens of aerobic nonfermentative gram-negative bacilli (17,19). A. baumannii causes respiratory and urinary tract infections, meningitis, endocarditis, burn infections, and wound sepsis, especially in intensive care units (ICUs) (4). A. baumannii infections are often difficult to eradicate due to high-level resistance to many antibiotics as a result of both intrinsic and acquired mechanisms. ␤-Lactamase production is the most important mechanism of acquired ␤-lactam resistance in gram-negative pathogens (21). Carbapenems (e.g., imipenem and meropenem) have become the drugs of choice against Acinetobacter infections in many centers but are being compromised by the emergence of carbapenem-hydrolyzing ␤-lactamase (carbapenemase) of molecular classes B and D (14). Class B carbapenemases found thus far in Acinetobacter spp. include various IMP-and VIM-type metallo-␤-lactamases (http: //www.lahey.org/studies/webt.asp), but most Acinetobacter spp. produce zinc-independent members of ␤-lactamase molecular class D (1). Sequenced carbapenemases of this latter class from that species include the following two distinct clusters: (i) the OXA-23-like cluster (OXA-23 and -27) and (ii) the OXA-24-like cluster . OXA-23 and OXA-27 have 99% amino acid identity, whereas they have only 60% identity with those of OXA-24-like cluster (1,3,6,7).Over an 8-month period from January to August 2003, 193 A. baumannii isolates were isolated from 193 patients hospitalized at the Kosin University Gospel Hospital. The purpose of the present study was to investigate an outbreak of A. baumannii in Korea and to characterize the imipenem resistance mechanism of the outbreak isolates. MATERIALS AND METHODS Bacterial strains and susceptibility tests. A total of 193 nonrepetitive clinical isolates of A. baumannii were isolated from Ja...

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Section: Methodsmentioning

confidence: 99%

Investigation of a Nosocomial Outbreak of Imipenem-Resistant Acinetobacter baumannii Producing the OXA-23 β-Lactamase in Korea

Jeon¹,

et al. 2005

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“…The VIM-2-producing P. aeruginosa isolates from the other cases were often involved in serious infections, such as septicemia and pneumonia in different patients, and they exhibited a high level of resistance to imipenem. In addition, VIM-2 has been detected in Citrobacter freundii in Taiwan, in S. marcescens in South Korea, and in Enterbacter cloacae in South Korea (70,193,203). In the last strain, the MICs of imipenem and meropenem were 4 g/ml.…”

Section: Vim-type Mblsmentioning

confidence: 99%

Metallo-β-Lactamases: the Quiet before the Storm?

et al. 2005

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SUMMARY The ascendancy of metallo-β-lactamases within the clinical sector, while not ubiquitous, has nonetheless been dramatic; some reports indicate that nearly 30% of imipenem-resistant Pseudomonas aeruginosa strains possess a metallo-β-lactamase. Acquisition of a metallo-β-lactamase gene will invariably mediate broad-spectrum β-lactam resistance in P. aeruginosa, but the level of in vitro resistance in Acinetobacter spp. and Enterobacteriaceae is less dependable. Their clinical significance is further embellished by their ability to hydrolyze all β-lactams and by the fact that there is currently no clinical inhibitor, nor is there likely to be for the foreseeable future. The genes encoding metallo-β-lactamases are often procured by class 1 (sometimes class 3) integrons, which, in turn, are embedded in transposons, resulting in a highly transmissible genetic apparatus. Moreover, other gene cassettes within the integrons often confer resistance to aminoglycosides, precluding their use as an alternative treatment. Thus far, the metallo-β-lactamases encoded on transferable genes include IMP, VIM, SPM, and GIM and have been reported from 28 countries. Their rapid dissemination is worrisome and necessitates the implementation of not just surveillance studies but also metallo-β-lactamase inhibitor studies securing the longevity of important anti-infectives.

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“…Spread of VIM-encoding integrons occurs mainly among Pseudomonas aeruginosa strains in southern Europe and the Far East (11). However, sporadic isolation of enterobacteria carrying bla VIM genes has also been reported in these geographic areas (4,5,7,12,14,15).…”

mentioning

confidence: 99%

Discrepancies and Interpretation Problems in Susceptibility Testing of VIM-1-Producing Klebsiella pneumoniae Isolates

Giakkoupi

Tzouvelekis²,

Daikos³

et al. 2005

J Clin Microbiol

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Characterization of a new integron containing VIM-2, a metallo- beta-lactamase gene cassette, in a clinical isolate of Enterobacter cloacae

Cited by 68 publications

References 8 publications

Investigation of a Nosocomial Outbreak of Imipenem-Resistant Acinetobacter baumannii Producing the OXA-23 β-Lactamase in Korea

Investigation of a Nosocomial Outbreak of Imipenem-Resistant Acinetobacter baumannii Producing the OXA-23 β-Lactamase in Korea

Metallo-β-Lactamases: the Quiet before the Storm?

Discrepancies and Interpretation Problems in Susceptibility Testing of VIM-1-Producing Klebsiella pneumoniae Isolates

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