Emergence of NDM-1 Metallo-β-Lactamase in
            <i>Pseudomonas aeruginosa</i>
            Clinical Isolates from Serbia

Jovčić, Branko; Lepsanovic, Zorica; Šuljagić, Vesna; Rackov, Gorjana; Begović, Jelena; Topisirović, Ljubiša; Kojić, Milan

doi:10.1128/aac.00226-11

Cited by 171 publications

(109 citation statements)

References 13 publications

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“…In addition to VIM, NDM is another leading cause of a high-level of resistance to all carbapenems. P. aeruginosa isolates with blaNDM-1 have been detected also in Serbia [33], France [34], and India [35]. NDM-1 was reported in Egypt with low prevalence among P. aeruginosa isolates where only two out of 33 carbapenem-resistant P. aeruginosa isolates harbor NDM [36].…”

Section: Discussionmentioning

confidence: 99%

Molecular characterization of resistance mechanisms in Pseudomonas aeruginosa isolates resistant to carbapenems

Shaaban

Al‐Qahtani

Al‐Ahdal

et al. 2018

J Infect Dev Ctries

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Introduction: Emergence of carbapenem resistance in Pseudomonas aeruginosa increases the therapeutic dilemma. In this study, we investigated various mechanisms involved in the resistance of P. aeruginosa clinical isolates to carbapenems. Methodology: P. aeruginosa isolates were isolated from different clinical samples. The antimicrobial susceptibility was evaluated by disc diffusion method. Carbapenemases were detected among carbapenem resistant isolates. Expression level of mexB and oprD was determined by real-time PCR. Molecular relatedness among isolates was detected based on pulsed-field gel electrophoresis (PFGE). Results: Ninety P. aeruginosa isolates were purified from clinical specimens. High levels of resistance to imipenem and meropenem were detected in 16 isolates. PCR analysis of carbapenemases indicated the prevalence of Verona integron-encoded metallo-beta-lactamase (VIM); four isolates produced only VIM enzymes (VIM-1 or VIM-2), while the remaining twelve co-produced both VIM-1 or VIM-2 and NDM enzymes. Additionally, real-time PCR analysis elucidated high expression levels of mexB in seven of the carbapenem resistant isolates and low expression of oprD in seven isolates. The identified carbapenem-resistant isolates were clustered into eleven PFGE profiles where clusters E1 and E2 involved isolates exhibiting multiple carbapenemase genes (blaNDM-1, blaVIM-1 and blaVIM-2). Conclusion: Various mechanisms underlying carbapenem resistance have been detected in our P. aeruginosa cohort of isolates. Emergence of P. aeruginosa as a reservoir of multiple carbapenemases is increasing over time limiting the treatment options to this serious infection. This increases the urgency for infection control practices to reduce the incidence of this infection.

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Section: Discussionmentioning

confidence: 99%

Molecular characterization of resistance mechanisms in Pseudomonas aeruginosa isolates resistant to carbapenems

Shaaban

Al‐Qahtani

Al‐Ahdal

et al. 2018

J Infect Dev Ctries

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“…In addition to identifying the newly described resistance mechanism of NDM-1 for the first time in the United States, a report in 2010 described, also for the first time in the United States, MLB-producing Enterobacteriaceae [19] . And, NDM-1 was isolated for the first time from a (carbapenem-resistant) strain of P. aeruginosa (which is of the Pseudomonadaceae family and therefore, while a superbug, it is not CRE) in Serbia [40] , in 2011, and in the United States (Delaware) [41] , in 2014. The most common CRE that produce the NDM-1 enzyme include NDM-1-producing K. pneumoniae, the resistance of which is conferred by the blaNDM-1 gene; and NDM-1-producing Enterobacter cloacae (the resistance of which is also conferred by the blaNDM-1 gene).…”

Section: Kpc-producing Enterobacteriaceaementioning

confidence: 99%

Risk of transmission of carbapenem-resistantEnterobacteriaceaeand related “superbugs” during gastrointestinal endoscopy

Muscarella¹

2014

WJGE

119

112

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To evaluate the risk of transmission of carbapenemresistant Enterobacteriaceae (CRE) and their related superbugs during gastrointestinal (GI) endoscopy. Reports of outbreaks linked to GI endoscopes contaminated with different types of infectious agents, including CRE and their related superbugs, were reviewed. Published during the past 30 years, both prior to and since CRE's emergence, these reports were obtained by searching the peer-reviewed medical literature (via the United States National Library of Medicine's "MEDLINE" database); the Food and Drug Administration's Manufacturer and User Facility Device Experience database, or "MAUDE"; and the Internet (via Google's search engine). This review focused on an outbreak of CRE in 2013 following the GI endoscopic procedure known as endoscopic retrograde cholangiopancreatography, or ERCP, performed at "Hospital X" located in the suburbs of Chicago (IL; United States). Part of the largest outbreak of CRE in United States history, the infection and colonization of 10 and 28 of this hospital's patients, respectively, received considerable media attention and was also investigated by the Centers for Disease Control and Prevention (CDC), which published a report about this outbreak in Morbidity and Mortality Weekly Report (MMWR), in 2014. This report, along with the results of an independent inspection of Hospital X's infection control practices following this CRE outbreak, were also reviewed. While this article focuses primarily on the prevention of transmissions of CRE and their related superbugs in the GI endoscopic setting, some of its discussion and recommendations may also apply to other healthcare settings, to other types of flexible endoscopes, and to other types of transmissible infectious agents. This review found that GI endoscopy is an important risk factor for the transmission of CRE and their related superbugs, having been recently associated with patient morbidity and mortality following ERCP. The CDC reported in MMWR that the type of GI endoscope, known as an ERCP endoscope, that Hospital X used to perform ERCP in 2013 on the 38 patients who became infected or colonized with CRE might be particularly challenging to clean and disinfect, because of the complexity of its physical design. If performed in strict accordance with the endoscope manufacturer's labeling, supplemented as needed with professional organizations' published guidelines, however, current practices for reprocessing GI endoscopes, which include high-level disinfection, are reportedly adequate for the prevention of transmission of CRE and their related superbugs. Several recommendations are provided to prevent CRE transmissions in the healthcare setting. CRE transmissions are not limited to contaminated GI endoscopes and also have been linked to other reusable flexible endoscopic instrumentation, including bronchoscopes and cystoscopes. In conclusion, contaminated GI endoscopes, particularly those used during ERCP, have been causally linked to outbreaks of CRE and their related su...

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“…First identified from Enterobacteriaceae, the bla NDM gene has since been identified in non-fermenting bacterial species such as Pseudomonas aeruginosa and Acinetobacter baumannii [2,3]. Considering its ability to be the source of nosocomial outbreaks, carbapenem-resistant A. baumannii (AB) represents a threat for critically ill hospitalised patients [4].…”

Section: Introductionmentioning

confidence: 99%

Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

et al. 2013

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We report the first outbreak of carbapenem-resistant NDM-1-producing Acinetobacter baumannii in Europe, in a French intensive-care unit in January to May 2013. The index patient was transferred from Algeria and led to the infection/colonisation of five additional patients. Concurrently, another imported case from Algeria was identified. The seven isolates were genetically indistinguishable, belonging to ST85. The blaNDM-1 carbapenemase gene was part of the chromosomally located composite transposon Tn125. This report underscores the growing concern about the spread of NDM-1-producing A. baumannii in Europe.

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Emergence of NDM-1 Metallo-β-Lactamase in Pseudomonas aeruginosa Clinical Isolates from Serbia

Cited by 171 publications

References 13 publications

Molecular characterization of resistance mechanisms in Pseudomonas aeruginosa isolates resistant to carbapenems

Molecular characterization of resistance mechanisms in Pseudomonas aeruginosa isolates resistant to carbapenems

Risk of transmission of carbapenem-resistantEnterobacteriaceaeand related “superbugs” during gastrointestinal endoscopy

Outbreak of NDM-1-producing Acinetobacter baumannii in France, January to May 2013

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