JAC Advance Access originally published online on December 18, 2008
Journal of Antimicrobial Chemotherapy 2009 63(2):269-273; doi:10.1093/jac/dkn512
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Original research |
Emergence and persistence of integron structures harbouring VIM genes in the Children's Memorial Health Institute, Warsaw, Poland, 1998–2006
anowska11 Department of Clinical Microbiology and Immunology, The Children's Memorial Health Institute, Warsaw, Poland 2 Department of Medical Microbiology, University of Cardiff, Cardiff CF14 4XN, UK
Received 18 August 2008; returned 3 October 2008; revised 24 November 2008; accepted 24 November 2008
* Corresponding author. Tel: +44-2920-743129; E-mail: tolemanma{at}cardiff.ac.uk
Objectives: The aim was to perform a genetically detailed study of the emergence of metallo-β-lactamase (MBL) genes in Pseudomonas spp. in the Children's Memorial Health Institute over a 9 year period.
Methods: Carbapenem-resistant Pseudomonas spp. isolates were collected from 1998 to 2006 and screened for MBL production. MBL-positive isolates were further investigated by a combination of genetic techniques including PCR, genomic location experiments using pulsed-field gel electrophoresis (PFGE) of I-Ceu1, S1 and SpeI digests, and sequencing.
Results: Of the 20 MBL-containing Pseudomonas isolates collected from 1998 to 2006, 16 Pseudomonas aeruginosa isolates contained an identical class 1 integron structure. Two P. aeruginosa isolates contained the blaVIM-2 gene, and two Pseudomonas putida isolates harboured the blaVIM-4 gene cassette in different integron structures. PFGE analysis indicated that all blaVIM-4-containing P. aeruginosa isolates were closely related, whereas the P. putida isolates were not. All MBL genes in this study were chromosomally encoded, and all isolates harboured only one class 1 integron. The blaVIM-2 isolates were clonal, and the genetic structure supporting the blaVIM-2 gene was found in an identical chromosomal position.
Conclusions: MBL gene emergence in this hospital has paralleled a 6-fold increase in carbapenem usage. We have found an increase in MBL gene diversity, MBL host organisms and MBL genetic support structures in the hospital over the 9 year study period. There is also compelling evidence of the persistence of individual strains in the hospital throughout the study period. This suggests that once MBL genes have emerged in a hospital environment, they are difficult to remove.
Keywords: metallo-β-lactamases , class 1 integrons , VIM-2 , VIM-4
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