1887

Abstract

An imipenem-resistant isolate of ZJ163 (MIC 256 μg ml) isolated from a Chinese hospital was investigated. The ZJ163 isolate exhibited high-level resistance to carbapenems, penicillins, cephalosporins, cefoxitin, aztreonam, quinolones and aminoglycosides. Isoelectric focusing (IEF) demonstrated three -lactamases with pIs of 5.4 (TEM-1), 6.7 (KPC-2) and 7.9 (CTX-M-14). Two different transconjugants (types A and B) were obtained by conjugation studies. The type A transconjugant exhibited reduced susceptibility or resistance to penicillins, cephalosporins and aztreonam, but was susceptible to carbapenems, quinolones and aminoglycosides. The antimicrobial susceptibility patterns of the type B transconjugant were similar to that of type A, except for its significantly reduced carbapenem susceptibility (imipenem MIC 2 μg ml). IEF, specific PCRs and DNA sequence analysis indicated that the type A transconjugant produced CTX-M-14 -lactamase with a pI of 7.9, that the type B transconjugant produced KPC-2 -lactamase with a pI of 6.7 and that the -lactamase with a pI of 5.4 was TEM-1. PCR analysis and sequencing confirmed the presence of the gene in the chromosomal DNA from ZJ163, although no activity of AmpC -lactamase was detected by IEF. Urea/SDS-PAGE analysis of outer-membrane proteins revealed that the levels of the 41 and 38 kDa porins were decreased in ZJ163. It was concluded that production of KPC-2 combined with decreased expression of porins contributes to high-level resistance to carbapenems in ZJ163.

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2008-03-01
2019-11-12
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References

  1. Aoyama, H., Fujimaki, K., Sato, K., Fujii, T., Inoue, M., Hirai, K. & Mitsuhashi, S. ( 1988; ). Clinical isolate of Citrobacter freundii highly resistant to new quinolones. Antimicrob Agents Chemother 32, 922–924.[CrossRef]
    [Google Scholar]
  2. Barlow, M. & Hall, B. G. ( 2002; ). Origin and evolution of the AmpC β-lactamases of Citrobacter freundii. Antimicrob Agents Chemother 46, 1190–1198.[CrossRef]
    [Google Scholar]
  3. Bratu, S., Landman, D., Alam, M., Tolentino, E. & Quale, J. ( 2005; ). Detection of KPC carbapenem-hydrolyzing enzymes in Enterobacter spp. from Brooklyn, New York. Antimicrob Agents Chemother 49, 776–778.[CrossRef]
    [Google Scholar]
  4. Chen, G. X., Zhang, R. & Zhou, H. W. ( 2006; ). Heterogeneity of metallo-β-lactamases in clinical isolates of Chryseobacterium meningosepticum from Hangzhou, China. J Antimicrob Chemother 57, 750–752.[CrossRef]
    [Google Scholar]
  5. Hernández-Allés, S., Albertí, S., Alvarez, D., Doménech-Sánchez, A., Martínez-Martínez, L., Gil, J., Tomás, J. M. & Benedí, V. J. ( 1999; ). Porin expression in clinical isolates of Klebsiella pneumoniae. Microbiology 145, 673–679.[CrossRef]
    [Google Scholar]
  6. Hossain, A., Ferraro, M. J., Pino, R. M., Dew, R. B., III, Moland, E. S., Lockhart, T. J., Thomson, K. S., Goering, R. V. & Hanson, N. D. ( 2004; ). Plasmid mediated carbapenem-hydrolyzing enzyme KPC-2 in an Enterobacter sp. Antimicrob Agents Chemother 48, 4438–4440.[CrossRef]
    [Google Scholar]
  7. Koeleman, J. G. M., Stoof, J., Van Der Bijl, M. W., Vandenbroucke-Grauls, C. M. J. E. & Savelkoul, P. H. M. ( 2001; ). Identification of epidemic strains of Acinetobacter baumannii by integrase gene PCR. J Clin Microbiol 39, 8–13.[CrossRef]
    [Google Scholar]
  8. Lévesque, C., Piché, L., Larose, C. & Roy, P. H. ( 1995; ). PCR mapping of integrons reveals several novel combinations of resistance genes. Antimicrob Agents Chemother 39, 185–191.[CrossRef]
    [Google Scholar]
  9. Mathew, A., Harris, A. M., Marshall, M. J. & Ross, G. W. ( 1975; ). The use of analytical isoelectric focusing for detection and identification of β-lactamase. J Gen Microbiol 88, 169–178.[CrossRef]
    [Google Scholar]
  10. Miriagou, V., Tzouvelekis, L. S., Rossiter, S., Tzelepi, E., Angulo, F. J. & Whichard, J. M. ( 2003; ). Imipenem resistance in a Salmonella clinical strain due to plasmid-mediated class A carbapenemase KPC-2. Antimicrob Agents Chemother 47, 1297–1300.[CrossRef]
    [Google Scholar]
  11. Moland, E. S., Hanson, N. D., Herrera, V. L., Black, J. A., Lockhart, T. J., Hossain, A., Johnson, J. A., Goering, R. V. & Thomson, K. S. ( 2003; ). Plasmid-mediated, carbapenem-hydrolysing β-lactamase, KPC-2, in Klebsiella pneumoniae isolates. J Antimicrob Chemother 51, 711–714.[CrossRef]
    [Google Scholar]
  12. Naas, T., Nordmann, P., Vedel, G. & Poyart, C. ( 2005; ). Plasmid-mediated carbapenem-hydrolyzing β-lactamase KPC in a Klebsiella pneumoniae isolate from France. Antimicrob Agents Chemother 49, 4423–4424.[CrossRef]
    [Google Scholar]
  13. NCCLS ( 2006; ). Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically. Approved standard M7-A7, 7th edn. Wayne, PA: National Committee for Clinical Laboratory Standards.
  14. Navon-Venezia, S., Chmelnitsky, I., Leavitt, A., Schwaber, M. J., Schwartz, D. & Carmeli, Y. ( 2006; ). Plasmid-mediated imipenem-hydrolyzing enzyme KPC-2 among multiple carbapenem-resistant Escherichia coli clones in Israel. Antimicrob Agents Chemother 50, 3098–3101.[CrossRef]
    [Google Scholar]
  15. Villegas, M. V., Lolans, K., Correa, A., Suarez, C. J., Lopez, J. A., Vallejo, M. & Quinn, J. P., The Colombian Nosocomial Resistance Study Group ( 2006; ). First detection of the plasmid-mediated class A carbapenemase KPC-2 in clinical isolates of Klebsiella pneumoniae from South America. Antimicrob Agents Chemother 50, 2880–2882.[CrossRef]
    [Google Scholar]
  16. Villegas, M. V., Lolans, K., Correa, A., Kattan, J. N., Lopez, J. A. & Quinn, J. P., The Colombian Nosocomial Resistance Study Group ( 2007; ). First identification of Pseudomonas aeruginosa isolates producing a KPC-type carbapenem-hydrolyzing β-lactamase. Antimicrob Agents Chemother 51, 1553–1555.[CrossRef]
    [Google Scholar]
  17. Wei, Z. Q., Du, X. X., Yu, Y. S., Shen, P., Chen, Y. G. & Li, L. J. ( 2007; ). Plasmid-mediated KPC-2 in a Klebsiella pneumoniae isolate from China. Antimicrob Agents Chemother 51, 763–765.[CrossRef]
    [Google Scholar]
  18. Woodford, N., Tierno, P. M., Young, K., Jr, Tysall, L., Palepou, M.-F. I., Ward, E., Painter, R. E., Suber, D. F., Shungu, D. & other authors ( 2004; ). Outbreak of Klebsiella pneumoniae producing a new carbapenem-hydrolyzing class A β-lactamase, KPC-3, in a New York medical center. Antimicrob Agents Chemother 48, 4793–4799.[CrossRef]
    [Google Scholar]
  19. Yigit, H., Queenan, A. M., Anderson, G. J., Domenech-Sanchez, A., Biddle, J. W., Steward, C. D., Alberti, S., Bush, K. & Tenover, F. C. ( 2001; ). Novel carbapenem-hydrolyzing β-lactamase, KPC-1, from a carbapenem-resistant strain of Klebsiella pneumoniae. Antimicrob Agents Chemother 45, 1151–1161.[CrossRef]
    [Google Scholar]
  20. Yigit, H., Queenan, A. M., Rasheed, J. K., Biddle, J. W., Domenech-Sanchez, A., Alberti, S., Bush, K. & Tenover, F. C. ( 2003; ). Carbapenem-resistant strain of Klebsiella oxytoca harboring carbapenem-hydrolyzing β-lactamase KPC-2. Antimicrob Agents Chemother 47, 3881–3889.[CrossRef]
    [Google Scholar]
  21. Yu, Y., Ji, S., Chen, Y., Zhou, W., Wei, Z., Li, L. & Ma, Y. ( 2007; ). Resistance of strains producing extended-spectrum β-lactamases and genotype distribution in China. J Infect 54, 53–57.[CrossRef]
    [Google Scholar]
  22. Zhang, R., Zhou, H. W., Cai, J. C. & Chen, G. X. ( 2007; ). Plasmid-mediated carbapenem-hydrolysing β-lactamase KPC-2 in carbapenem-resistant Serratia marcescens isolates from Hangzhou, China. J Antimicrob Chemother 59, 574–576.[CrossRef]
    [Google Scholar]
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