Nosocomial outbreak of imipenem-resistant Pseudomonas aeruginosa producing VIM-2 metallo-β-lactamase in a kidney transplantation unit

Abstract

BackgroundTwenty four non replicate imipenem resistant P. aeruginosa were isolated between January and November 2008, in the kidney transplantation unit of Charles Nicolle Hospital of Tunis (Tunisia). This study was conducted in order to establish epidemiological relationship among them and to identify the enzymatic mechanism involved in imipenem resistance.MethodsAnalysis included antimicrobial susceptibility profile, phenotypic (imipenem-EDTA synergy test) and genotypic detection of metallo-β-lactamase (MBL) (PCR), O-serotyping and pulsed-field gel electrophoresis.ResultsAll strains showed a high level of resistance to all antimicrobials tested except to colistin. The presence of MBL showed concordance between phenotypic and genotypic methods. Sixteen isolates were identified as VIM-2 MBL-producers and 13 of them were serotype O4 and belonged to a single pulsotype (A).ConclusionsThis study describes an outbreak of VIM-2-producing P. aeruginosa in a kidney transplantation unit. Clinical spread of blaVIM-2 gene is a matter of great concern for carbapenem resistance in Tunisia.

Epidemiological characteristics and antimicrobial susceptibility among carbapenem-resistant non-fermenting bacteria in Brazil

“…According to the literature, colonization and infection by multidrug-resistant bacteria, especially Pseudomonas and Acinetobacter, is an important and predictive factor for intra-hospital patient death, mainly of immunocompromised individuals [14,34,35]. Our results corroborate data in the literature; high mortality was observed among patients from whom multidrugresistant P. aeruginosa and Acinetobacter spp.…”

“…Considering P. aeruginosa, as the isolation of carbapenem-resistant strains has been growing increasingly in Brazilian hospitals, literature data corroborate our findings that resistance was observed against piperacillin-tazobactam, ceftazidime, cefepime, aztreonam, and ciprofloxacin, but no resistance was observed against polymyxin B [6,8,34,37]. In this context, our results may support, on a regional scale, the reports by the SENTRY program, which pointed out polymyxin B as an alternative drug against multidrugresistant P. aeruginosa [40].…”

“…Similar age range and gender associated with carbapenem-resistant Acinetobacter was previously reported [14], as was a similar patient age range in cases of Pseudomonas isolation [35]. Our data may reflect the actual scenario of patients admitted to the evaluated tertiary hospital with high risks of NFGN colonization and infection [34].…”

Identification of bla OXA-51-like , bla OXA-58 , bla DIM-1 , and bla VIM Carbapenemase Genes in Hospital Enterobacteriaceae Isolates from Sierra Leone

“…Sixty percent of the isolates carried identical bla VIM sequences (which, based on the amplicon sequence, were consistent with bla VIM-2 or four other, less frequently observed variants: bla VIM-10 , bla , bla , and bla VIM-30 ), and 40% of the isolates were found to contain bla DIM-1 . While bla VIM (and especially bla VIM-2 ) is acknowledged as one of the most commonly isolated MBLs in Africa and throughout the world (19)(20)(21)(22), the presence of bla DIM-1 has been reported only once before, for a Pseudomonas stutzeri isolate from The Netherlands (23). In this study, bla DIM-1 was found in hospital isolates belonging to the families Enterobacteriaceae, Pseudomonadaceae, Burkholderiaceae, and Comamonadaceae.…”

Phenotypic and Genotypic Diversity of Multidrug-Resistant Pseudomonas aeruginosa Isolates from Bloodstream Infections Recovered in the Hospitals of Belo Horizonte, Brazil

“…P. aeruginosa populations undergo frequent recombination events contributing to the evolution of successful epidemic clones [6]. These populations are dominated by common clones that can be isolated from diverse clinical and environmental sources [7].…”