VIM-4 carbapenemase-producing Enterobacter cloacae in the United Arab Emirates

Sonnevend, Ágnes; Ghazawi, Akela; Yahfoufi, Nour; Al-Baloushi, A.; Hashmey, Rayhan; Mathew, Merlin Mary; Tariq, W.Z.; Pál, Tibor

doi:10.1111/1469-0691.12051

Cited by 29 publications

(27 citation statements)

References 18 publications

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“…Isolates producing KPC-2 and VIM-type MBLs (36)(37)(38)(39)(40)(41)(42)(43) and K. pneumoniae carrying NDM-1 and OXA-48 or OXA-232 (44-47) have been reported previously. Although E. cloacae isolates carrying VIM-31, VIM-4 and CMY-4, or OXA-48 are known, this is the first report of isolates carrying OXA-48 in combination with those VIM types (48)(49)(50).…”

Section: Discussionmentioning

confidence: 87%

Multiyear, Multinational Survey of the Incidence and Global Distribution of Metallo-β-Lactamase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

Kazmierczak¹,

Rabine²,

Hackel³

et al. 2016

Antimicrob Agents Chemother

189

117

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T he worldwide dissemination of Gram-negative bacteria producing extended-spectrum ␤-lactamases (ESBLs) in the late 20th century resulted in a dearth of treatment options and an increase in the therapeutic use of carbapenems (1, 2). In turn, reports of carbapenem-resistant and carbapenemase-producing bacteria became more frequent (3-5). One important group of carbapenemases of special concern is the metallo-␤-lactamases (MBLs). These enzymes belong to Ambler class B and require 1 or 2 zinc ions for enzyme activity (6). Many MBLs are chromosomally encoded in environmental bacteria or species that can act as opportunistic pathogens. However, a number of MBLs, including the NDM-type, IMP-type, and VIM-type MBLs, are plasmid encoded and readily transferable among clinically significant bacterial species, including Klebsiella pneumoniae and Escherichia coli (3). Notably, MBLs are often coproduced with Ambler class A and C serine ␤-lactamases, including ESBLs and AmpC enzymes (7).MBLs hydrolyze all ␤-lactams except monobactams, including aztreonam, and are not inhibited by any of the commercially available ␤-lactamase inhibitors. Although aztreonam is active against many Gram-negative bacteria, it is inactive against isolates that produce ESBLs, KPC carbapenemases, or plasmid-encoded or stably derepressed, chromosomally encoded AmpC ␤-lactamases, thereby limiting its potential utility against MBL-producing isolates that also contain one or more of these serine ␤-lactamases (8). Avibactam is a non-␤-lactam ␤-lactamase inhibitor that is active against Ambler class A and C and some class D (OXA-48) enzymes (9, 10). Aztreonam combined with avibactam has demonstrated activity against Enterobacteriaceae that coproduce MBLs and class A or class C ␤-lactamases (11, 12).As part of a global surveillance program, the molecular basis of carbapenem resistance in Gram-negative pathogens was investigated in order to determine the incidence of acquired MBLs and the geographic regions in which these ␤-lactamases are most problematic. This report describes the isolation and regional distribution of MBL-positive Enterobacteriaceae and Pseudomonas aeruginosa isolates collected from 2012 to 2014. MATERIALS AND METHODSNonduplicate bacterial isolates from intra-abdominal, urinary tract, skin and soft tissue, lower respiratory tract, and bloodstream infections were collected from 202 sites in 40 countries located in five major geographic regions (Asia-Pacific, Europe, Latin America, the Middle East-Africa, and North America). A predefined number of isolates of selected bacterial species were collected from each site regardless of antibiotic susceptibility. Organism collection, transport, confirmation of organism identification, susceptibility testing, molecular characterization, quality assurance of

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Section: Discussionmentioning

confidence: 87%

Multiyear, Multinational Survey of the Incidence and Global Distribution of Metallo-β-Lactamase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

Kazmierczak¹,

Rabine²,

Hackel³

et al. 2016

Antimicrob Agents Chemother

189

117

View full text Add to dashboard Cite

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“…It is noteworthy that none of the patients who harboured carbapenemase-producing isolates had a history of recent travel outside Kuwait. Interestingly, a recent report identified a single VIM-4-producing Enterobacter cloacae isolate recovered in a patient in Abu Dhabi, United Arab Emirates (Sonnevend et al, 2012). This may suggest that the VIM-4 determinant could be widely disseminated throughout countries of the Arabian Gulf region.…”

Section: Discussionmentioning

confidence: 99%

“…Reports of emerging carbapenemases among Enterobacteriaceae have been published worldwide including Middle East countries such as Kuwait (Jamal et al, 2012), Oman (Dortet et al, 2012), United Arab Emirates (Sonnevend et al, 2012), Iraq (Poirel et al, 2011b), Egypt (Poirel et al, 2013), Lebanon (El-Herte et al, 2012), Tunisia (Ktari et al, 2006), Turkey (Poirel et al, 2012) and Israel (Marchaim et al, 2008). In particular, two NDM-1-producing K. pneumoniae were identified in Kuwait between 2010 and 2011 (Jamal et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

High prevalence of VIM-4 and NDM-1 metallo-β-lactamase among carbapenem-resistant Enterobacteriaceae

Jamal

Rotimi

Albert

et al. 2013

Journal of Medical Microbiology

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The purpose of this study was to identify the mechanisms leading to carbapenem resistance among multidrug-resistant Enterobacteriaceae isolates recovered from hospitalized patients with nosocomial infections in Mubarak Al Kabeer Hospital, Kuwait. Fourteen carbapenem-resistant Enterobacteriaceae isolates were obtained from inpatients in different wards and intensive care units between April 2009 and February 2011. Antibiotic susceptibilities were determined using the E-test method. Genes encoding b-lactamases were characterized by specific PCR amplification, sequencing and conjugation assays. All isolates were identified as metallo-blactamase (MBL) producers using phenotypic and molecular methods. Eleven of the 14 isolates produced VIM-4 (six Klebsiella pneumoniae, three Escherichia coli, one Enterobacter cloacae and one Klebsiella oxytoca). Three K. pneumoniae isolates produced the MBL NDM-1 and coproduced the plasmid-encoded AmpC CMY-4. The VIM-4-producing isolates co-produced extended-spectrum b-lactamases including CTX-M-15 and some SHV derivatives. The VIM-4 gene was not transferable by conjugation studies of six selected strains. We demonstrated here the emergence of VIM-4-and NDM-1-producing isolates in the largest teaching hospital in Kuwait.

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“…The bla VIM genes are often located in class 1 integrons as gene cassettes that reside on plasmids with different replicon types, for example, IncN, IncA/C, and IncI . In K. pneumonia , many of the VIM‐1/4 genes are carried on plasmids with Inc group N, whereas those genes carried by E. coli are often IncFI/II .…”

Section: Metallo‐beta Lactamases: Ndm and Vimmentioning

confidence: 99%

“…[78][79][80] The bla VIM genes are often located in class 1 integrons as gene cassettes that reside on plasmids with different replicon types, for example, IncN, IncA/C, and IncI. 78,79,[81][82][83] In K. pneumonia, many of the VIM-1/4 genes are carried on plasmids with Inc group N, whereas those genes carried by E. coli are often IncFI/II. 84 Isolates of K. pneumoniae carrying both bla VIM-1 and bla KPC-2 were reported initially from Greece and, later, from other countries including Italy, Germany, and Colombia.…”

Section: Ndm-1mentioning

confidence: 99%

Carbapenem‐resistant Enterobacteriaceae: biology, epidemiology, and management

Temkin

Adler

Lerner

et al. 2014

Annals of the New York Academy of Sciences

196

167

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Introduced in the 1980s, carbapenem antibiotics have served as the last line of defense against multidrug-resistant Gram-negative organisms. Over the last decade, carbapenem-resistant Enterobacteriaceae (CRE) have emerged as a significant public health threat. This review summarizes the molecular genetics, natural history, and epidemiology of CRE and discusses approaches to prevention and treatment.

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VIM-4 carbapenemase-producing Enterobacter cloacae in the United Arab Emirates

Cited by 29 publications

References 18 publications

Multiyear, Multinational Survey of the Incidence and Global Distribution of Metallo-β-Lactamase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

Multiyear, Multinational Survey of the Incidence and Global Distribution of Metallo-β-Lactamase-Producing Enterobacteriaceae and Pseudomonas aeruginosa

High prevalence of VIM-4 and NDM-1 metallo-β-lactamase among carbapenem-resistant Enterobacteriaceae

Carbapenem‐resistant Enterobacteriaceae: biology, epidemiology, and management

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