1887

Abstract

This study was designed to investigate the prevalence of carbapenem-resistant complex ( complex) and to type carbapenemases. The relatedness of 45 isolates of carbapenem-resistant complex collected from a clinical setting was analysed by PFGE. The carbapenemases produced by these isolates were typed by IEF, a three-dimensional test, 2-mercaptopropanoic acid inhibition assay, PCR and DNA cloning and sequencing. Results showed that all 45 isolates were resistant to multiple antibiotics including meropenem. The resistance rates to cefoperazone/sulbactam and ampicillin/sulbactam were 2.2 and 6.5 %, respectively. About 71.7–78.3 % of these isolates were intermediately resistant to cefepime, ceftazidime and cefotaxime. Forty-five isolates were classified into type A (98 %) and B (2 %) based on their PFGE patterns. Most of type A isolates were from the ICU. Type A was the dominant isolate, including subtypes A1 (22 %), A2 (71 %), A3 (2 %) and A4 (2 %). Only one isolate, from the haematology department, belonged to type B. Forty-three isolates (96 %) were positive for carbapenemase. One isolate had two bands by IEF, the pIs of which were 6.64 and 7.17. The band with the pI of 6.64 was OXA-23. The other 42 isolates produced two bands with pIs of 6.40 and 7.01 which could not be inhibited by clavulanic acid, cloxacillin or 2-mercaptopropanoic acid. It can be concluded that the prevalent carbapenem-resistant complex isolates from this hospital all had similar β-lactamase patterns.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.05513-0
2004-07-01
2020-10-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/53/7/JM530711.html?itemId=/content/journal/jmm/10.1099/jmm.0.05513-0&mimeType=html&fmt=ahah

References

  1. Afzal-Shah M., Livermore D. M. 1998; Worldwide emergence of carbapenem-resistant Acinetobacter spp. J Antimicrob Chemother 41:576–577 [CrossRef]
    [Google Scholar]
  2. Afzal-Shah M., Woodford N., Livermore D. M. 2001; Characterization of OXA-25, OXA-26, and OXA-27, molecular class D β-lactamases associated with carbapenem resistance in clinical isolates of Acinetobacter baumannii . Antimicrob Agents Chemother 45:583–588 [CrossRef]
    [Google Scholar]
  3. Arakawa Y., Shibata N., Shibayama K., Kurokawa H., Yagi T., Fujiwara H., Goto M. 2000; Convenient test for screening metallo-β-lactamase-producing Gram-negative bacteria by using thiol compounds. J Clin Microbiol 38:40–43
    [Google Scholar]
  4. Bou G., Oliver A., Martínez-Beltrán J. 2000; OXA-24, a novel class D β-lactamase with carbapenemase activity in an Acinetobacter baumannii clinical strain. Antimicrob Agents Chemother 44:1556–1561 [CrossRef]
    [Google Scholar]
  5. Chu Y. W., Afzal-Shah M., Houang E. T. S., Palepou M.-F. I., Lyon D. J., Woodford N., Livermore D. M. 2001; IMP-4, a novel metallo-β-lactamase from nosocomial Acinetobacter spp.collected in Hong Kong between 1994 and 1998. Antimicrob Agents Chemother 45:710–714 [CrossRef]
    [Google Scholar]
  6. Clark R. B. 1996; Imipenem resistance among Acinetobacter baumannii : association with reduced expression of a 33–36 kDa outer membrane protein. J Antimicrob Chemother 38:245–251 [CrossRef]
    [Google Scholar]
  7. Cornaglia G., Riccio M. L., Mazzariol A., Lauretti L., Fontana R., Rossolini G. M. 1999; Appearance of IMP-1 metallo-β-lactamase in Europe. Lancet 353:899– 899 [CrossRef]
    [Google Scholar]
  8. Donald H. M., Scaife W., Amyes S. G., Young H. K. 2000; Sequence analysis of ARI-1, a novel OXA β-lactamase, responsible for imipenem resistance in Acinetobacter baumannii 6B92. Antimicrob Agents Chemother 44:196–199 [CrossRef]
    [Google Scholar]
  9. Forster D. H., Daschner F. D. 1998; Acinetobacter species as nosocomial pathogens. Eur J Clin Microbiol Infect Dis 17:73–77 [CrossRef]
    [Google Scholar]
  10. Gehrlein M., Leying H., Cullmann W., Wendt S., Opferkuch W. 1991; Imipenem resistance in Acinetobacter baumannii is due to altered penicillin binding protein. Chemotherapy 37:405–412 [CrossRef]
    [Google Scholar]
  11. Héritier C., Poirel L., Aubert D., Nordmann P. 2003; Genetic and functional analysis of the chromosome-encoded carbapenem-hydrolyzing oxacillinase OXA-40 of Acinetobacter baumannii . Antimicrob Agents Chemother 47:268–273 [CrossRef]
    [Google Scholar]
  12. Hornstein M., Sautjeau-Rostoker C., Peduzzi J., Vessieres A., Hong L. T. H., Barthelemy M., Scavizzi M., Labia R. 1997; Oxacillin-hydrolyzing β-lactamase involved in resistance to imipenem in Acinetobacter baumannii . FEMS Microbiology Lett 153:333–339 [CrossRef]
    [Google Scholar]
  13. Levin A. S., Levy C. E., Manrique A. E., Medeiros E. A., Costa S. F. 2003; Severe nosocomial infections with imipenem-resistant Acinetobacter baumannii treated with ampicillin/sulbactam. Int J Antimicrob Agents 21:58–62 [CrossRef]
    [Google Scholar]
  14. Nakae T., Nakajima A., Ono T., Saito K., Yoneyama H. 1999; Resistance to β-lactam antibiotics in Pseudomonas aeruginosa due to interplay between the MexAB-OprM efflux pump and β-lactamase. Antimicrob Agents Chemother 43:1301–1303
    [Google Scholar]
  15. Nordmann P., Poirel L. 2002; Emerging carbapenemases in Gram-negative aerobes. Clin Microbiol Infect 8:321–331 [CrossRef]
    [Google Scholar]
  16. Paton R., Miles R. S., Hood J., Amyes S. G. B. 1993; ARI-1: β-lactamase-mediated imipenem resistance in Acinetobacter baumannii . Int J Antimicrob Agents 2:81–87 [CrossRef]
    [Google Scholar]
  17. Perez A. N., Bonet I. G., Robledo E. H., Rabascal R., Plous C. V. 1996; Metallo-β-lactamases in Acinetobacter calcoaceticus ?. Med Sci Res 24:315–317
    [Google Scholar]
  18. Seifert H., Gerner-Smidt P. 1995; Comparison of ribotyping and pulsed-field gel electrophoresis for molecular typing of Acinetobacter isolates. J Clin Microbiol 33:1402–1407
    [Google Scholar]
  19. Takahashi A., Yomoda S., Kobayashi I., Okubo T., Tsunoda M., Iyobe S. 2000; Detection of carbapenemase-producing Acinetobacter baumannii in a hospital. J Clin Microbiol 38:526–529
    [Google Scholar]
  20. Tenover F. C., Arbeit R. D., Goering R. V., Mickelsen P. A., Murray B. E., Persing D. H., Swaminathan B. 1995; Interpreting chromosomal DNA restriction patterns produced by pulsed-field gel electrophoresis: criteria for bacterial isolate typing. J Clin Microbiol 33:2233–2239
    [Google Scholar]
  21. Urban C., Go E., Mariano N., Rahal J. J. 1995; Interaction of sulbactam, clavulanic acid and tazobactam with penicillin-binding proteins of imipenem-resistant and susceptible Acinetobacter baumannii . FEMS Microbiol Lett 125:193–197 [CrossRef]
    [Google Scholar]
  22. Yum J. H., Yi K., Lee H., Yong D., Lee K., Kim J. M., Rossolini G. M., Chong Y. 2002; Molecular characterization of metallo-β-lactamase-producing Acinetobacter baumannii and Acinetobacter genomospecies 3 from Korea: identification of two new integrons carrying the bla VIM−2 gene cassettes. J Antimicrob Chemother 49:837–840 [CrossRef]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.05513-0
Loading
/content/journal/jmm/10.1099/jmm.0.05513-0
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF

Most cited this month Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error