JAC Advance Access originally published online on September 6, 2002
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Journal of Antimicrobial Chemotherapy (2002) 50, 503-511
© 2002 The British Society for Antimicrobial Chemotherapy
Metallo-ß-lactamase-producing Enterobacteriaceae isolates in a university hospital in Taiwan: prevalence of IMP-8 in Enterobacter cloacae and first identification of VIM-2 in Citrobacter freundii
Departments of 1 Pathology, 2 Internal Medicine and 3 Medical Technology, College of Medicine, National Cheng Kung University, No. 1 University Road, Tainan 70101, Taiwan
Received 4 March 2002; returned 6 June 2002; revised 2 July 2002; accepted 9 July 2002
A total of 9082 clinical isolates of Enterobacteriaceae other than Klebsiella spp. collected in 1999 and 2000 at a university hospital in Taiwan were investigated for the production of metallo- ß-lactamases (MBLs). Thirty-six (2.9%) of the 1261 Enterobacter cloacae isolates and one (0.3%) of the 340 Citrobacter freundii isolates were found to carry blaIMP-8 and blaVIM-2, respectively, by colony hybridization, PCR and sequence analysis. The IMP-8 producers were recovered from 20 patients and four of them had recently transferred from other hospitals, implying spread of IMP-8-producing E. cloacae among different healthcare settings. Of the 20 non-repetitive IMP-8 producers, 17 (85%) isolates also harboured blaSHV-12, which was on the same transferable plasmids with blaIMP-8. The blaVIM-2-positive isolate and all non-repetitive blaIMP-8-positive isolates appeared susceptible to imipenem (MICs < 8 mg/L) and meropenem (MICs < 4 mg/L), indicating the difficulty in detection of MBLs in Enterobacteriaceae by routine susceptibility testing. Ribotyping of the IMP-8-producing E. cloacae isolates indicated that the dissemination of blaIMP-8 was due largely to the spread of an epidemic clone, but horizontal transfer among unrelated strains also occurred.
* Corresponding author. Tel: +886-6-2353535-5605; Fax: +886-6-2363956; E-mail: jjwu{at}mail.ncku.edu.tw
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