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Journal of Medical Microbiology logo Journal of Medical Microbiology

Volume 63, Issue 3

Outbreak of PER-1 and diversity of β-lactamases among ceftazidime-resistant clinical isolates No Access

Abstract

A growing number of β-lactamases have been reported in clinical isolates. The aim of this study was to investigate the diversity of β-lactamases in the collection of 51 ceftazidime-resistant clinical isolates in four hospitals of southern China. Among these isolates, variable degrees of resistance to other β-lactam and non-β-lactam agents were observed. Pulsed-field gel electrophoresis (PFGE) revealed a high degree of clonality with five main genotypes. Of the 51 isolates tested, 35 (68.6 %) were identified as extended-spectrum β-lactamase (ESBL) producers, with 35 producing PER-1, 1 CTX-M-3, 7 CTX-M-15 and 1 CTX-M-14. Most (82.9 %, 29/35) PER-1-producing isolates were collected from two hospitals between January and April in 2008 and belonged to the same PFGE pattern (pattern B) with similar antibiogram and β-lactamase profiles, which suggested an outbreak of this clone at the time. The prevalence of CTX-M-type ESBL (17.6 %, 9/51) was unexpectedly high. One isolate was identified as producing VIM-2. Furthermore, we also reported an occurrence of a novel OXA-10 variant, OXA-246, in 14 isolates. In addition, AmpC overproduction was found to be the β-lactamase-mediated mechanism responsible for ceftazidime resistance in 6 isolates (11.8 %). Our results revealed an overall diversity of β-lactamases and outbreak of a PER-1-producing clone among ceftazidime-resistant in southern China.

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© 2014 SGM
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2014-03-01
2025-04-28
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References

  1. Akinci E., Vahaboglu H. 2010; Minor extended-spectrum β-lactamases. Expert Rev Anti Infect Ther 8:1251–1258 [View Article][PubMed]
     [Google Scholar]
  2. Al-Agamy M. H., Shibl A. M., Tawfik A. F., Elkhizzi N. A., Livermore D. M. 2012; Extended-spectrum and metallo-beta-lactamases among ceftazidime-resistant Pseudomonas aeruginosa in Riyadh, Saudi Arabia. J Chemother 24:97–100 [View Article][PubMed]
     [Google Scholar]
  3. al Naiemi N., Duim B., Bart A. 2006; A CTX-M extended-spectrum β-lactamase in Pseudomonas aeruginosa and Stenotrophomonas maltophilia.. J Med Microbiol 55:1607–1608 [View Article][PubMed]
     [Google Scholar]
  4. Bert F., Branger C., Lambert-Zechovsky N. 2002; Identification of PSE and OXA β-lactamase genes in Pseudomonas aeruginosa using PCR-restriction fragment length polymorphism. J Antimicrob Chemother 50:11–18 [View Article][PubMed]
     [Google Scholar]
  5. Bou G., Cartelle M., Tomas M., Canle D., Molina F., Moure R., Eiros J. M., Guerrero A. 2002; Identification and broad dissemination of the CTX-M-14 β-lactamase in different Escherichia coli strains in the northwest area of Spain. J Clin Microbiol 40:4030–4036 [View Article][PubMed]
     [Google Scholar]
  6. Brasme L., Nordmann P., Fidel F., Lartigue M. F., Bajolet O., Poirel L., Forte D., Vernet-Garnier V., Madoux J.& other authors ( 2007; Incidence of class A extended-spectrum beta-lactamases in Champagne-Ardenne (France): a 1 year prospective study. J Antimicrob Chemother 60:956–964 [View Article][PubMed]
     [Google Scholar]
  7. Celenza G., Pellegrini C., Caccamo M., Segatore B., Amicosante G., Perilli M. 2006; Spread of blaCTX-M-type and blaPER-2 β-lactamase genes in clinical isolates from Bolivian hospitals. J Antimicrob Chemother 57:975–978 [View Article][PubMed]
     [Google Scholar]
  8. CLSI 2012; Performance Standards for Antimicrobial Susceptibility Testing; 22nd Informational Supplement M100-S22. Wayne, PA: Clinical and Laboratory Standards Institute;
     [Google Scholar]
  9. Dallenne C., Da Costa A., Decré D., Favier C., Arlet G. 2010; Development of a set of multiplex PCR assays for the detection of genes encoding important β-lactamases in Enterobacteriaceae.. J Antimicrob Chemother 65:490–495 [View Article][PubMed]
     [Google Scholar]
  10. Danel F., Hall L. M., Gur D., Akalin H. E., Livermore D. M. 1995; Transferable production of PER-1 β-lactamase in Pseudomonas aeruginosa.. J Antimicrob Chemother 35:281–294 [View Article][PubMed]
     [Google Scholar]
  11. De Champs C., Poirel L., Bonnet R., Sirot D., Chanal C., Sirot J., Nordmann P. 2002; Prospective survey of β-lactamases produced by ceftazidime-resistant Pseudomonas aeruginosa isolated in a French hospital in 2000. Antimicrob Agents Chemother 46:3031–3034 [View Article][PubMed]
     [Google Scholar]
  12. Dong F., Xu X. W., Song W. Q., Lü P., Yu S. J., Yang Y. H., Shen X. Z. 2008; Characterization of multidrug-resistant and metallo-beta-lactamase-producing Pseudomonas aeruginosa isolates from a paediatric clinic in China. Chin Med J (Engl) 121:1611–1616[PubMed]
     [Google Scholar]
  13. Dumas J.-L., van Delden C., Perron K., Köhler T. 2006; Analysis of antibiotic resistance gene expression in Pseudomonas aeruginosa by quantitative real-time-PCR. FEMS Microbiol Lett 254:217–225 [View Article][PubMed]
     [Google Scholar]
  14. Ellington M. J., Kistler J., Livermore D. M., Woodford N. 2007; Multiplex PCR for rapid detection of genes encoding acquired metallo-β-lactamases. J Antimicrob Chemother 59:321–322 [View Article][PubMed]
     [Google Scholar]
  15. Empel J., Filczak K., Mrówka A., Hryniewicz W., Livermore D. M., Gniadkowski M. 2007; Outbreak of Pseudomonas aeruginosa infections with PER-1 extended-spectrum β-lactamase in Warsaw, Poland: further evidence for an international clonal complex. J Clin Microbiol 45:2829–2834 [View Article][PubMed]
     [Google Scholar]
  16. Fournier D., Hocquet D., Dehecq B., Cholley P., Plésiat P. 2010; Detection of a new extended-spectrum oxacillinase in Pseudomonas aeruginosa. J Antimicrob Chemother 65:364–365 [View Article][PubMed]
     [Google Scholar]
  17. Gupta V. 2008; Metallo beta lactamases in Pseudomonas aeruginosa and Acinetobacter species. Expert Opin Investig Drugs 17:131–143 [View Article][PubMed]
     [Google Scholar]
  18. Hou T. W., Yin X. L., Jiang C. Y., Wang Z. H., Chen Q. K., Chen X., Li W., Bai Y. 2007; [Microbiology and clinical analysis of six cases of hospital-acquired pneumonia caused by Acinetobacter baumannii.]. Zhonghua Jie He He Hu Xi Za Zhi 30:35–39[PubMed]
     [Google Scholar]
  19. Jeong S. H., Bae I. K., Kwon S. B., Lee K., Yong D., Woo G. J., Lee J. H., Jung H. I., Jang S. J.& other authors ( 2005; Investigation of a nosocomial outbreak of Acinetobacter baumannii producing PER-1 extended-spectrum β-lactamase in an intensive care unit. J Hosp Infect 59:242–248 [View Article][PubMed]
     [Google Scholar]
  20. Kouda S., Ohara M., Onodera M., Fujiue Y., Sasaki M., Kohara T., Kashiyama S., Hayashida S., Harino T.& other authors ( 2009; Increased prevalence and clonal dissemination of multidrug-resistant Pseudomonas aeruginosa with the blaIMP-1 gene cassette in Hiroshima. J Antimicrob Chemother 64:46–51 [View Article][PubMed]
     [Google Scholar]
  21. Lee K., Park A. J., Kim M. Y., Lee H. J., Cho J. H., Kang J. O., Yong D., Chong Y.KONSAR group 2009; Metallo-β-lactamase-producing Pseudomonas spp. in Korea: high prevalence of isolates with VIM-2 type and emergence of isolates with IMP-1 type. Yonsei Med J 50:335–339 [View Article][PubMed]
     [Google Scholar]
  22. Lister P. D., Wolter D. J., Hanson N. D. 2009; Antibacterial-resistant Pseudomonas aeruginosa: clinical impact and complex regulation of chromosomally encoded resistance mechanisms. Clin Microbiol Rev 22:582–610 [View Article][PubMed]
     [Google Scholar]
  23. Livermore D. M. 2002; Multiple mechanisms of antimicrobial resistance in Pseudomonas aeruginosa: our worst nightmare?. Clin Infect Dis 34:634–640 [View Article][PubMed]
     [Google Scholar]
  24. Mugnier P., Podglajen I., Goldstein F. W., Collatz E. 1998; Carbapenems as inhibitors of OXA-13, a novel, integron-encoded β-lactamase in Pseudomonas aeruginosa.. Microbiology 144:1021–1031 [View Article][PubMed]
     [Google Scholar]
  25. Naas T., Bogaerts P., Bauraing C., Degheldre Y., Glupczynski Y., Nordmann P. 2006; Emergence of PER and VEB extended-spectrum β-lactamases in Acinetobacter baumannii in Belgium. J Antimicrob Chemother 58:178–182 [View Article][PubMed]
     [Google Scholar]
  26. Naas T., Nordmann P., Heidt A. 2007; Intercountry transfer of PER-1 extended-spectrum β-lactamase-producing Acinetobacter baumannii from Romania. Int J Antimicrob Agents 29:226–228 [View Article][PubMed]
     [Google Scholar]
  27. Nordmann P., Ronco E., Naas T., Duport C., Michel-Briand Y., Labia R. 1993; Characterization of a novel extended-spectrum β-lactamase from Pseudomonas aeruginosa.. Antimicrob Agents Chemother 37:962–969 [View Article][PubMed]
     [Google Scholar]
  28. Pagani L., Mantengoli E., Migliavacca R., Nucleo E., Pollini S., Spalla M., Daturi R., Romero E., Rossolini G. M. 2004; Multifocal detection of multidrug-resistant Pseudomonas aeruginosa producing the PER-1 extended-spectrum β-lactamase in northern Italy. J Clin Microbiol 42:2523–2529 [View Article][PubMed]
     [Google Scholar]
  29. Picão R. C., Poirel L., Gales A. C., Nordmann P. 2009a; Diversity of β-lactamases produced by ceftazidime-resistant Pseudomonas aeruginosa isolates causing bloodstream infections in Brazil. Antimicrob Agents Chemother 53:3908–3913 [View Article][PubMed]
     [Google Scholar]
  30. Picão R. C., Poirel L., Gales A. C., Nordmann P. 2009b; Further identification of CTX-M-2 extended-spectrum β-lactamase in Pseudomonas aeruginosa.. Antimicrob Agents Chemother 53:2225–2226 [View Article][PubMed]
     [Google Scholar]
  31. Pitout J. D., Gregson D. B., Poirel L., McClure J. A., Le P., Church D. L. 2005; Detection of Pseudomonas aeruginosa producing metallo-β-lactamases in a large centralized laboratory. J Clin Microbiol 43:3129–3135 [View Article][PubMed]
     [Google Scholar]
  32. Poirel L., Weldhagen G. F., Naas T., De Champs C., Dove M. G., Nordmann P. 2001; GES-2, a class A β-lactamase from Pseudomonas aeruginosa with increased hydrolysis of imipenem. Antimicrob Agents Chemother 45:2598–2603 [View Article][PubMed]
     [Google Scholar]
  33. Poirel L., Naas T., Nordmann P. 2010; Diversity, epidemiology, and genetics of class D β-lactamases. Antimicrob Agents Chemother 54:24–38 [View Article][PubMed]
     [Google Scholar]
  34. Qu T. T., Zhang J. L., Wang J., Tao J., Yu Y. S., Chen Y. G., Zhou J. Y., Li L. J. 2009; Evaluation of phenotypic tests for detection of metallo-β-lactamase-producing Pseudomonas aeruginosa strains in China. J Clin Microbiol 47:1136–1142 [View Article][PubMed]
     [Google Scholar]
  35. Rossolini G. M., D’Andrea M. M., Mugnaioli C. 2008; The spread of CTX-M-type extended-spectrum β-lactamases. Clin Microbiol Infect 14:Suppl. 133–41 [View Article][PubMed]
     [Google Scholar]
  36. Scoulica E., Aransay A., Tselentis Y. 1995; Molecular characterization of the OXA-7 β-lactamase gene. Antimicrob Agents Chemother 39:1379–1382 [View Article][PubMed]
     [Google Scholar]
  37. Upadhyay S., Sen M. R., Bhattacharjee A. 2010; Presence of different beta-lactamase classes among clinical isolates of Pseudomonas aeruginosa expressing AmpC beta-lactamase enzyme. J Infect Dev Ctries 4:239–242[PubMed]
     [Google Scholar]
  38. Vahaboglu H., Oztürk R., Aygün G., Coşkunkan F., Yaman A., Kaygusuz A., Leblebicioglu H., Balik I., Aydin K., Otkun M. 1997; Widespread detection of PER-1-type extended-spectrum beta-lactamases among nosocomial Acinetobacter and Pseudomonas aeruginosa isolates in Turkey: a nationwide multicenter study. Antimicrob Agents Chemother 41:2265–2269[PubMed]
     [Google Scholar]
  39. Walsh T. R., Toleman M. A., Poirel L., Nordmann P. 2005; Metallo-β-lactamases: the quiet before the storm?. Clin Microbiol Rev 18:306–325 [View Article][PubMed]
     [Google Scholar]
  40. Weldhagen G. F., Poirel L., Nordmann P. 2003; Ambler class A extended-spectrum β-lactamases in Pseudomonas aeruginosa: novel developments and clinical impact. Antimicrob Agents Chemother 47:2385–2392 [View Article][PubMed]
     [Google Scholar]
  41. Xavier D. E., Picão R. C., Girardello R., Fehlberg L. C., Gales A. C. 2010; Efflux pumps expression and its association with porin down-regulation and β-lactamase production among Pseudomonas aeruginosa causing bloodstream infections in Brazil. BMC Microbiol 10:217 [View Article][PubMed]
     [Google Scholar]
  42. Yamano Y., Nishikawa T., Fujimura T., Yutsudou T., Tsuji M., Miwa H. 2006; Occurrence of PER-1 producing clinical isolates of Pseudomonas aeruginosa in Japan and their susceptibility to doripenem. J Antibiot (Tokyo) 59:791–796 [View Article][PubMed]
     [Google Scholar]
  43. Yatsuyanagi J., Saito S., Harata S., Suzuki N., Ito Y., Amano K., Enomoto K. 2004; Class 1 integron containing metallo-β-lactamase gene blaVIM-2 in Pseudomonas aeruginosa clinical strains isolated in Japan. Antimicrob Agents Chemother 48:626–628 [View Article][PubMed]
     [Google Scholar]
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Outbreak of PER-1 and diversity of β-lactamases among ceftazidime-resistant Pseudomonas aeruginosa clinical isolates
J. Med. Microbiol. 63, 386 (2014); https://doi.org/10.1099/jmm.0.069427-0
/content/journal/jmm/10.1099/jmm.0.069427-0
/content/journal/jmm/10.1099/jmm.0.069427-0
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