Molecular typing indicates an important role for two international clonal complexes in dissemination of VIM-producing Pseudomonas aeruginosa clinical isolates in Hungary

Libisch, Balázs; Watine, Joseph; Balogh, Boglárka; Gacs, M; Muzslay, M.; Szabó, Gitta; Füzi, M

doi:10.1016/j.resmic.2007.12.008

Cited by 55 publications

(41 citation statements)

References 33 publications

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“…This lineage belongs to the O12 serotype, which has been associated with multidrug resistance and expansion in hospitals for decades (1,11). It has been described in many European and Mediterranean countries, including France, Italy, Greece, the Netherlands, Spain and the Canary islands, Hungary, Scandinavia, Croatia, Austria, and Germany (6,(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) as well as in the United Kingdom (22,23). It has been frequently associated with VIM-2 or less commonly with VIM-4 or IMP-type MBLs but sometimes only with noncarbapenemase beta-lactamases, such as VEB-1 and OXA extendedspectrum beta-lactamases (24,25).…”

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High-Resolution Analysis by Whole-Genome Sequencing of an International Lineage (Sequence Type 111) of Pseudomonas aeruginosa Associated with Metallo-Carbapenemases in the United Kingdom

et al. 2015

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(1); one isolate had VIM-2 and IMP-18, and 7 carried no metallo-beta-lactamase (MBL) gene. Single nucleotide polymorphism analysis divided the isolates into distinct clusters; the NDM-1 isolate was an outlier, and the IMP isolates and 6/7 MBL-negative isolates clustered separately from the main set of 73 VIM-2 isolates. Within the VIM-2 set, there were at least 3 distinct clusters, including a tightly clustered set of isolates from 3 hospital laboratories consistent with an outbreak from a single introduction that was quickly brought under control and a much broader set dominated by isolates from a long-running outbreak in a London hospital likely seeded from an environmental source, requiring different control measures; isolates from 7 other hospital laboratories in London and southeast England were also included. Bayesian evolutionary analysis indicated that all the isolates shared a common ancestor dating back ϳ50 years (1960s), with the main VIM-2 set separating approximately 20 to 30 years ago. Accessory gene profiling revealed blocks of genes associated with particular clusters, with some having high similarity (>95%) to bacteriophage genes. WGS of widely found international lineages such as ST-111 provides the necessary resolution to inform epidemiological investigations and intervention policies. Concern over the increasing prevalence in hospitals of multiresistant bacteria, especially those that are resistant to carbapenem antibiotics, has prompted the use of typing methods that easily allow interlaboratory comparison of isolates. As a result, it has become clear that (i) high-risk clones of various Gram-negative bacteria, including Pseudomonas aeruginosa, can be found in many disparate locations, often with no obvious epidemiological links between the affected patients, and (ii) many of these clones are adept at acquiring various antibiotic resistance determinants (1, 2). These clones are commonly referred to as international lineages since they have been described in many countries across the globe. Epidemiological investigations of apparent outbreaks and interhospital spread of such lineages are confounded by the fact that they are so widely found; microbiological evidence of the same type must be considered alongside information about patient location and movement, for example, and patient location and movement information should be sufficiently robust to allow firm conclusions to be drawn. Greater resolution than that provided by conventional molecular typing methods, such as multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), and variable-number tandem repeat (VNTR) analysis, is essential if we are to infer or discount potential transmission pathways with confidence. Understanding these pathways will be critical for precise public health interventions to contain these highrisk clones effectively. Whole-genome sequencing (WGS) can provide this resolution and has been used to investigate outbreaks of Klebsiella pneumoniae ST-258 producing K. pneumoniae carbapenemase (KPC) enz...

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High-Resolution Analysis by Whole-Genome Sequencing of an International Lineage (Sequence Type 111) of Pseudomonas aeruginosa Associated with Metallo-Carbapenemases in the United Kingdom

et al. 2015

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“…Random amplified polymorphic DNA (RAPD) was performed by the method described by Libisch and others 15 using primer 5-(AACGCGCAAC) with some modification. Amplification products were separated by electrophoresis in 2% agarose and visualized by ethidium bromide staining.…”

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First Report of a Foodborne Providencia alcalifaciens Outbreak in Kenya

Shah¹,

Odoyo²,

Larson³

et al. 2015

The American Society of Tropical Medicine and Hygiene

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Abstract. Providencia alcalifaciens is an emerging bacterial pathogen known to cause acute gastroenteritis in children and travelers. In July 2013, P. alcalifaciens was isolated from four children appearing for diarrhea at Kiambu District Hospital (KDH) in Kenya. This study describes the outbreak investigation, which aimed to identify the source and mechanisms of infection. We identified seven primary and four secondary cases. Among primary cases were four mothers who had children and experienced mild diarrhea after eating mashed potatoes. The mothers reported feeding children after visiting the toilet and washing their hands without soap. P. alcalifaciens was detected from all secondary cases, and the isolates were found to be clonal by random amplified polymorphic DNA (RAPD) fingerprinting. Our study suggests that the outbreak was caused by P. alcalifaciens, although no fluid accumulation was observed in rabbit ileal loops. The vehicle of the outbreak was believed to be the mashed potato dish, but the source of P. alcalifaciens could not be confirmed. We found that lack of hygiene, inadequate food storage, and improper hand washing before food preparation was the likely cause of the current outbreak. This is the first report of a foodborne infection caused by P. alcalifaciens in Kenya.

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“…While ST621 is a singleton, ST620 has single-locus variants from other countries (ST320, ST338, and ST520). The isolates 22843 and 27135 (VIM-2) were classified into ST111, a founder of the clonal complex CC4, corresponding to the major European P. aeruginosa clone P12 (9). P12 members express various resistance mechanisms, including MBLs (2,7,9,10,12).…”

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“…The isolates 22843 and 27135 (VIM-2) were classified into ST111, a founder of the clonal complex CC4, corresponding to the major European P. aeruginosa clone P12 (9). P12 members express various resistance mechanisms, including MBLs (2,7,9,10,12). Interestingly, the "GreekSwedish" isolate with In59 represented ST229, which also belongs to CC4 (7).…”

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First Organisms with Acquired Metallo-β-Lactamases (IMP-13, IMP-22, and VIM-2) Reported in Austria

Duljasz

Gniadkowski

Sitter

et al. 2009

Antimicrob Agents Chemother

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Molecular typing indicates an important role for two international clonal complexes in dissemination of VIM-producing Pseudomonas aeruginosa clinical isolates in Hungary

Cited by 55 publications

References 33 publications

High-Resolution Analysis by Whole-Genome Sequencing of an International Lineage (Sequence Type 111) of Pseudomonas aeruginosa Associated with Metallo-Carbapenemases in the United Kingdom

High-Resolution Analysis by Whole-Genome Sequencing of an International Lineage (Sequence Type 111) of Pseudomonas aeruginosa Associated with Metallo-Carbapenemases in the United Kingdom

First Report of a Foodborne Providencia alcalifaciens Outbreak in Kenya

First Organisms with Acquired Metallo-β-Lactamases (IMP-13, IMP-22, and VIM-2) Reported in Austria

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