Methicillin-Resistant <i>Staphylococcus Aureus</i> in a Tertiary Care Hospital

Navaneeth, B.V.; Sridaran, D; Suganthi, N

doi:10.1177/004947550203200331

Cited by 2 publications

(1 citation statement)

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“…The presence of populations of MDR strains among clinical isolates is a cause for concern for physicians applying empirical treatment, especially in serious cases of P. aeruginosa infections in Asian countries such as Japan (Sekiguchi et al, 2007), Taiwan (Leung et al, 2008), India (Navaneeth et al, 2002) and Iran (Japoni et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

Analysis of integrons and associated gene cassettes of metallo-β-lactamase-positive Pseudomonas aeruginosa in Malaysia

Khosravi

Tay

Vadivelu

2011

Journal of Medical Microbiology

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In this study, 90 non-replicate imipenem-resistant Pseudomonas aeruginosa (IRPA) Malaysian isolates collected between October 2005 and March 2008 were subjected to a screening test for detection of the integron and the gene cassette. Class 1 integrons were detected in 54 IRPA clinical isolates, whilst three isolates contained class 2 integrons. Analysis of the gene cassettes associated with the class 1 integrons showed the detection of accC1 in isolates carrying bla and aacA7 in isolates carrying bla VIM-2 . aadA6 was detected in two isolates carrying bla . Using random amplification of polymorphic DNA analysis, 14 PCR fingerprint patterns were generated from the 32 isolates carrying metallo-b-lactamase (MBL) genes (35.5 %), whilst 20 patterns were generated from the 58 non-MBL gene isolates (64.4 %). Based on the differences in the fingerprinting patterns, two clusters (A and B) were identified among the MBL-producing isolates. Cluster A comprised 18 isolates (56 %) carrying the bla VIM gene, whereas cluster B comprised 14 (44 %) isolates carrying the bla IMP gene. The non-MBL isolates were divided into clusters C and D. Cluster C comprised 22 non-MBL isolates harbouring class 1 integrons, whilst cluster D consisted of three isolates carrying class 2 integrons. These findings suggest that the class 1 integron is widespread among P. aeruginosa isolated in Malaysia and that characterization of cassette arrays of integrons will be a useful epidemiological tool to study the evolution of multidrug resistance and the dissemination of antibiotic resistance genes. INTRODUCTIONThe recent emergence of multidrug-resistant (MDR) Pseudomonas aeruginosa has become a serious problem in healthcare settings worldwide, including in Asian countries (Leung et al., 2008;Raja & Singh, 2007;Sekiguchi et al., 2007). The rapid emergence of antibiotic resistance among clinical isolates of bacteria is due to dissemination of antibiotic resistance genes by horizontal transfer (Leverstein-van Hall et al., 2003). Carbapenems, including imipenem and meropenem, are the most potent antimicrobial agents for the treatment of P. aeruginosa infections (Lee et al., 2011). However, carbapenem resistance due to metallo-b-lactamase (MBL) production of P. aeruginosa has been reported (Varaiya et al., 2008). Several families of MBLs have been documented in P. aeruginosa, including IMP, VIM, SPM, GIM, SIM, KHM, AIM and NDM (Toleman & Walsh, 2008). The genes of both IMP-and VIM-type MBLs (bla IMP and bla VIM ) in clinical isolates of P. aeruginosa are often encoded on mobile gene cassettes inserted into class 1 integrons (Pasteran et al., 2005;Peleg et al., 2004;Yong et al., 2009;Zhao et al., 2009). Integrons have been identified as a primary source of resistance genes and are suspected to serve as reservoirs of antimicrobial resistance genes within microbial populations (Xu et al., 2009). They are able to capture one or more gene cassettes from the environment and incorporate them using site-specific recombination. To date, there are more than nine cla...

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Section: Discussionmentioning

confidence: 99%