VIM-1, VIM-2, and GES-5 Carbapenemases Among Pseudomonas aeruginosa Isolates at a Tertiary Hospital in Istanbul, Turkey

Abstract

Worldwide increase in carbapenem resistance and transferable carbapenemases are significant challenges in treatment of Pseudomonas aeruginosa infections. In this study, investigation of carbapenemase production in carbapenem-resistant P. aeruginosa isolates recovered from clinical specimens in a tertiary hospital was aimed. A total of 84 carbapenem-resistant P. aeruginosa isolates were examined. "Carbapenem inactivation method" (CIM) was used for phenotypic detection of carbapenemase production. The existence of bla, bla, bla, bla, bla, and bla genes was investigated by polymerase chain reaction (PCR). Subtypes of the detected genes were identified by sequence analysis. Arbitrarily primed PCR (AP-PCR) was performed to evaluate the clonal relationship among the isolates. The presence of high-risk clones in carbapenemase producers was investigated by Matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS). Three isolates (3.5%) were identified as carbapenemase producers by CIM tests, while PCR tests demonstrated three isolates carrying carbapenemase genes as well. bla gene was found in two isolates and bla gene was found in one isolate. Sequence analysis demonstrated that the carbapenemases were VIM-1, VIM-2, and GES-5. AP-PCR yielded high clonal diversity among the isolates. According to MALDI-TOF MS analysis, none of the carbapenemase-producing strains belonged to the high-risk clones. In conclusion, the presence of VIM-1, VIM-2, and GES-5 type carbapenemases in P. aeruginosa isolates was demonstrated for the first time in our hospital, GES-5 being reported for the second time in Turkey. Our results will lead strategies for controlling the spread of carbapenemases and contribute to epidemiological data from Turkey.

Molecular Epidemiology and Clinical Characteristics of Metallo-beta-lactamase Producing Pseudomonas aeruginosa Isolates

“…Carbapenemases are responsible for an important part of carbapenem resistance and are a source of concern worldwide. Various types of carbapenemases have been increasingly reported in P. aeruginosa strains over the years [2,3,19,20] . The distribution of carbapenemases varies according to geographical region, but the most prevalent MBL enzyme types are VIM and IMP [2] .…”

“…The distribution of carbapenemases varies according to geographical region, but the most prevalent MBL enzyme types are VIM and IMP [2] . Verona integron-encoded metallo-beta-lactamase-type MBLs in P. aeruginosa have been the most commonly reported carbapenemases in Turkey to date, whereas P. aeruginosa producing IMP-type MBLs have only been reported from Trabzon and Muş [3][4][5][6][7][8] . Include imipenemase-type MBLs have not yet been reported in Enterobacteriaceae or Acinetobacter baumannii isolates in Turkey [21][22][23][24][25] .…”

“…By precisely determining the clinical and molecular characteristics of the isolates involved, we may better understand their epidemiology, since these characteristics form the basis for effective epidemiological surveillance. The surveillance in turn helps us to gauge the effectiveness of infection control measures and to guide correctly targeted and timely treatment measures [1][2][3] . According to the hitherto limited research conducted in this field in Turkey, VIM-type MBLs are the most commonly reported MBL types in P. aeruginosa isolates [3][4][5][6][7][8] .…”

“…The surveillance in turn helps us to gauge the effectiveness of infection control measures and to guide correctly targeted and timely treatment measures [1][2][3] . According to the hitherto limited research conducted in this field in Turkey, VIM-type MBLs are the most commonly reported MBL types in P. aeruginosa isolates [3][4][5][6][7][8] . More comprehensive research on this subject is required to reveal the absolute epidemiology of resistance and the clinical and molecular characteristics of MBL-PA in Turkey [3] .…”

Emergence of Antimicrobial Resistance among Pseudomonas aeruginosa: Implications for Therapy

“…A new group of ESBLs termed GES, first detected on PA in 2000 in South Africa 247 and France 248 was soon detected in Greece, 249 Brazil, 250 Argentina, 251 Germany, 252 China, 253 South Africa, 254 Turkey, 255,256 Canada, 31 Mexico, 257 South Korea, 258 Japan, 259 and globally. 31,137 GES are encoded in plasmids and thus are transferrable.…”