New integron gene arrays from multiresistant clinical isolates of members of the Enterobacteriaceae and Pseudomonas aeruginosa from hospitals in Malaysia
This study investigated 147 multidrug-resistant Enterobacteriaceae and Pseudomonas aeruginosa isolates from hospitalized patients in Malaysia. Class 1 integrons were the most dominant class identified (45.6 %). Three isolates were shown to contain class 2 integrons (2.0 %), whilst one isolate harboured both class 1 and 2 integrons. No class 3 integrons were detected in this study. In addition, the sul1 gene was amplified in 35 % of isolates and was significantly associated with the presence of integrase genes in an integron structure. RFLP and DNA sequencing analyses revealed the presence of 19 different cassette arrays among the detected integrons. The most common gene cassettes were those encoding resistance towards aminoglycosides (aad) and trimethoprim (dfr). As far as is known, this study is the first to identify integron-carrying cassette arrays such as aadA2-linF, aacC3-cmlA5 and aacA4-catB8-aadA1 in the Malaysian population. Patients’ age was demonstrated as a significant risk factor for the acquisition of integrons (P = 0.028). Epidemiological typing using PFGE also demonstrated a clonal relationship among isolates carrying identical gene cassettes in Klebsiella pneumoniae and P. aeruginosa but not in Escherichia coli isolates.
BetteridgeT., PartridgeS. R., IredellJ. R., StokesH. W.2011; Genetic context and structural diversity of class 1 integrons from human commensal bacteria in a hospital intensive care unit. Antimicrob Agents Chemother 55:3939–3943 [View Article][PubMed]
BorgianniL., PrandiS., SaldenL., SantellaG., HansonN. D., RossoliniG. M., DocquierJ. D.2011; Genetic context and biochemical characterisation of the IMP-18 metallo-β-lactamase identified in a Pseudomonas aeruginosa isolate from the United States. J Antimicrob Chemother 55:140–145 [View Article]
ChangC.-Y., ChangL.-L., ChangY.-H., LeeT.-M., ChangS.-F.2000; Characterisation of drug resistance gene cassettes associated with class 1 integrons in clinical isolates of Escherichia coli from Taiwan, ROC. J Med Microbiol 49:1097–1102[PubMed]
DoubletB., PraudK., WeillF.-X., CloeckaertA.2009; Association of IS26-composite transposons and complex In4-type integrons generates novel multidrug resistance loci in Salmonella genomic island 1. J Antimicrob Chemother 63:282–289 [View Article][PubMed]
DriscollJ. A., BrodyS. L., KollefM. H.2007; The epidemiology, pathogenesis and treatment of Pseudomonas aeruginosa infections. Drugs 67:351–368 [View Article][PubMed]
Garza-RamosJ. U., Sanchez-MartinezG., BarajasJ. M., SuarezS., Sanchez-PerezA., Rojas-MorenoT., Carrillo-QuirozB., Silva-SanchezJ.2010; Variability of the blaIMP-15-containing integrons, highly related to In95, on an endemic clone of Pseudomonas aeruginosa in Mexico. Microb Drug Resist 16:191–195 [View Article][PubMed]
GoldsteinC., LeeM., SanchezS., HudsonC., PhillipsB., RegisterB., GradyM., LiebertC., SummersA.& other authors (2001; Incidence of class 1 and 2 integrases in clinical and commensal bacteria from livestock, companion animals, and exotics. J Antimicrob Chemother 45:723–726 [View Article]
HeikkiläE., SkurnikM., SundströmL., HuovinenP.1993; A novel dihydrofolate reductase cassette inserted in an integron borne on a Tn21-like element. Antimicrob Agents Chemother 37:1297–1304 [View Article][PubMed]
JeongJ. H., ShinK. S., LeeJ. W., ParkE. J., SonS.-Y.2009; Analysis of a novel class 1 integron containing metallo-β-lactamase gene VIM-2 in Pseudomonas aeruginosa. J Microbiol 47:753–759 [View Article][PubMed]
JuanC., ZamoranoL., MenaA., AlbertíS., PérezJ. L., OliverA.2010; Metallo-β-lactamase-producing Pseudomonas putida as a reservoir of multidrug resistance elements that can be transferred to successful Pseudomonas aeruginosa clones. J Antimicrob Chemother 65:474–478 [View Article][PubMed]
KhosraviY., TayS. T., VadiveluJ.2011; Analysis of integrons and associated gene cassettes of metallo-β-lactamase-positive Pseudomonas aeruginosa in Malaysia. J Med Microbiol 60:988–994 [View Article][PubMed]
KumaiY., SuzukiY., TanakaY., ShimaK., BhadraR. K., YamasakiS., KurodaK., EndoG.2005; Characterization of multidrug-resistance phenotypes and genotypes of Escherichia coli strains isolated from swine from an abattoir in Osaka, Japan. Epidemiol Infect 133:59–70 [View Article][PubMed]
LabbateM., Roy ChowdhuryP., StokesH. W.2008; A class 1 integron present in a human commensal has a hybrid transposition module compared to Tn402: evidence of interaction with mobile DNA from natural environments. J Bacteriol 190:5318–5327 [View Article][PubMed]
LiX., ShiL., YangW., LiL., YamasakiS.2006; New array of aacA4-catB3-dfrA1 gene cassettes and a noncoding cassette from a class-1-integron-positive clinical strain of Pseudomonas aeruginosa. J Antimicrob Chemother 50:2278–2279 [View Article]
LimK. T., YasinR. M., YeoC. C., PuthuchearyS. D., BalanG., ManingN., WahabZ. A., IsmailN., TanE. A.& other authors (2009; Genetic fingerprinting and antimicrobial susceptibility profiles of Pseudomonas aeruginosa hospital isolates in Malaysia. J Microbiol Immunol Infect 42:197–209[PubMed]
LimK.-T., YeoC.-C., YasinR. M., BalanG., ThongK.-L.2009a; Characterization of multidrug-resistant and extended-spectrum β-lactamase-producing Klebsiella pneumoniae strains from Malaysian hospitals. J Med Microbiol 58:1463–1469 [View Article][PubMed]
Martinez-FreijoP., FluitA. C., SchmitzF. J., GrekV. S. C., VerhoefJ., JonesM. E.1998; Class I integrons in Gram-negative isolates from different European hospitals and association with decreased susceptibility to multiple antibiotic compounds. J Antimicrob Chemother 42:689–696 [View Article][PubMed]
Martinez-FreijoP., FluitA. C., SchmitzF. J., VerhoefJ., JonesM. E.1999; Many class I integrons comprise distinct stable structures occurring in different species of Enterobacteriaceae isolated from widespread geographic regions in Europe. Antimicrob Agents Chemother 43:686–689[PubMed]
MouraA., HenriquesI., RibeiroR., CorreiaA.2007; Prevalence and characterization of integrons from bacteria isolated from a slaughterhouse wastewater treatment plant. J Antimicrob Chemother 60:1243–1250 [View Article][PubMed]
MukherjeeS., ChakrabortyR.2006; Incidence of class 1 integrons in multiple antibiotic-resistant Gram-negative copiotrophic bacteria from the River Torsa in India. Res Microbiol 157:220–226 [View Article][PubMed]
ShahcheraghiF., BadmastiF., FeizabadiM. M.2010; Molecular characterization of class 1 integrons in MDR Pseudomonas aeruginosa isolated from clinical settings in Iran, Tehran. FEMS Immunol Med Microbiol 58:421–425[PubMed]
StokesH. W., HallR. M.1989; A novel family of potentially mobile DNA elements encoding site-specific gene-integration functions: integrons. Mol Microbiol 3:1669–1683 [View Article][PubMed]
TurtonJ. F., KaufmannM. E., GloverJ., CoelhoJ. M., WarnerM., PikeR., PittT. L.2005; Detection and typing of integrons in epidemic strains of Acinetobacter baumannii found in the United Kingdom. J Clin Microbiol 43:3074–3082 [View Article][PubMed]
WalshT. R., TolemanM. A., PoirelL., NordmannP.2005; Metallo-β-lactamases: the quiet before the storm?. Clin Microbiol Rev 18:306–325 [View Article][PubMed]
WaturangiD. E., SuwantoA., SchwarzS., ErdelenW.2003; Identification of class 1 integrons-associated gene cassettes in Escherichia coli isolated from Varanus spp. in Indonesia. J Antimicrob Chemother 51:175–177 [View Article][PubMed]
WhiteP. A., McIverC. J., DengY.-M., RawlinsonW. D.2000; Characterisation of two new gene cassettes, aadA5 and dfrA17. FEMS Microbiol Lett 182:265–269 [View Article][PubMed]
YuH. S., LeeJ. C., KangH. Y., RoD. W., ChungJ. Y., JeongY. S., TaeS. H., ChoiC. H., LeeE. Y.& other authors (2003; Changes in gene cassettes of class 1 integrons among Escherichia coli isolates from urine specimens collected in Korea during the last two decades. J Clin Microbiol 41:5429–5433 [View Article][PubMed]
New integron gene arrays from multiresistant clinical isolates of members of the Enterobacteriaceae and Pseudomonas aeruginosa from hospitals in Malaysia