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JAC Advance Access published online on April 25, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg239
© 2003 by The British Society for Antimicrobial Chemotherapy
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© 2003 The British Society for Antimicrobial Chemotherapy

Brief report

Hospital outbreak of multiple clones of Pseudomonas aeruginosa carrying the unrelated metallo-{beta}-lactamase gene variants blaVIM-2 and blaVIM-4

S. Pournaras 1*, M. Maniati 1, E. Petinaki 1, L. S. Tzouvelekis 2, A. Tsakris 3, N. J. Legakis 2, A. N. Maniatis 1

1 Department of Microbiology, University Hospital of Thessaly, Mezourlo, Larissa 412 22
2 Department of Microbiology, Medical School
3 Department of Microbiology, Faculty of Nursing, School of Health Sciences, University of Athens, Athens 115 27, Greece

* Corresponding author. E-mail: pournaras{at}med.uth.gr.

Received 4 January 2003 ; revised 10 February 2003 ; accepted 6 March 2003

Abstract

Objectives: The possible contribution of metallo-{beta}-lactamases in the frequent detection of carbapenem-resistant Pseudomonas aeruginosa isolates in a tertiary Greek hospital in Central Greece was investigated.

Materials and methods: All carbapenem-resistant (imipenem- and/or meropenem-resistant) P. aeruginosa isolates recovered from separate patients during a 1 year period in the Clinical Microbiology Laboratory at the University Hospital of Thessaly, Larissa, Greece, were studied for metallo-{beta}-lactamases. They were tested by Etest MBL, PCR analysis and nucleotide sequencing. DNA fingerprints were obtained by pulsed-field gel electrophoresis (PFGE) of XbaI-digested chromosomal DNA.

Results: A blaVIM gene was detected in 47 of the 53 (88.7%) carbapenem-resistant P. aeruginosa isolates. PFGE grouped the blaVIM-positive isolates in six unrelated genotypes; one type included two subtypes. Nucleotide sequencing of the PCR amplicons of a randomly selected isolate from each one of the seven subtypes, detected the variant sequences blaVIM-2 in four and blaVIM-4 in three cases, respectively. They were carried as single gene cassettes or along with an aminoglycoside resistance gene (aacA29a) in class 1 integrons.

Conclusions: These findings suggest that different strains of P. aeruginosa carrying unrelated metallo-{beta}-lactamase gene variants predominate in our hospital environment.

Keywords: carbapenemases, polyclonal, outbreak, Greece
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