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JAC Advance Access published online on January 28, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh095
© 2004 by The British Society for Antimicrobial Chemotherapy
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© 2004 The British Society for Antimicrobial Chemotherapy

Original article

Pseudomonas aeruginosa strains harbouring an unusual blaVIM-4 gene cassette isolated from hospitalized children in Poland (1998-2001)

Jan Patzer 1 , Mark A. Toleman 2 *, Lalitagauri M. Deshpande 3 , Wanda Kaminska 1 , Danuta Dzierzanowska 1 , Peter M. Bennett 2 , Ronald N. Jones 3 , and Timothy R. Walsh 2

1 The Children’s Memorial Health Institute, Warsaw, Poland;
2 Department of Pathology and Microbiology, The Medical Building, University Walk, The University of Bristol, Bristol BS8 1TD, UK;
3 The Jones Group, JMI Laboratories, North Liberty, Iowa, USA

* Corresponding author. E-mail: mark.toleman{at}bris.ac.uk.

Received 10 October 2003 ; revised 1 December 2003 ; accepted 1 December 2003

Abstract

Objectives: During 1997-2001, 151 isolates of imipenem-resistant Pseudomonas aeruginosa were obtained from clinical specimens taken from children hospitalized in Warsaw, Poland. These strains were investigated further to determine the mechanism of resistance.

Methods: The strains were analysed by a combination of genotyping and PCR-based strategies.

Results: Eleven of these strains were found to contain the metallo-{beta}-lactamase (M{beta}L) gene blaVIM-4. The first strain appeared in 1998, and P. aeruginosa strains harbouring this M{beta}L have become endemic in this hospital since then. All P. aeruginosa strains belonged to serotype O:6, and PFGE analysis revealed four different patterns and three sub-types. All 11 M{beta}L-producing strains contained an identical class 1 integron with the usual 5' and 3' conserved sequences. The integron included two resistance cassettes, aacA4 in the first position and the blaVIM-4 cassette in the second position. The blaVIM-4 gene included an unusual direct repeat of 169 bp of the 3' portion of the blaVIM-4 gene.

Conclusions: An unusual blaVIM-4 M{beta}L has become endemic in P. aeruginosa isolates infecting Polish children hospitalized on surgical wards. The formation of this unusual blaVIM-4 gene cassette could be explained by a mechanism involving deletion of a segment of an ancestral tandem repeat of blaVIM-4 via slipped strand replication, mediated by a combination of polymerase and integrase.

Keywords: metallo-{beta}-lactamases, serotypes, PFGE, {beta}-lactams, carbapenems
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