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JAC Advance Access published online on December 1, 2004
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkh512
© 2004 by The British Society for Antimicrobial Chemotherapy
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Received July 21, 2004
Revised October 14, 2004
Accepted October 24, 2004

Original article

Italian metallo-{beta}-lactamases: a national problem? Report from the SENTRY Antimicrobial Surveillance Programme

Mark A. Toleman 1*, Doug Biedenbach 2, David M. C. Bennett 1, Ronald N. Jones 2, and Timothy R. Walsh 1

1 Department of Pathology & Microbiology, University of Bristol, Bristol, UK
2 The JONES Group/JMI Laboratories, North Liberty, IA, USA

* To whom correspondence should be addressed.
Mark A. Toleman, E-mail: mark.toleman{at}bristol.ac.uk


  Abstract

Objectives: As part of the SENTRY Antimicrobial Surveillance Programme, 383 non-replicative randomly collected Pseudomonas aeruginosa isolates were collected during 1999-2002. These strains originated from three geographically distinct hospitals within Italy: Genoa (Northern Italy); Rome and Catania (Sicily), and were further studied to identify the prevalence of metallo-{beta}-lactamase (M{beta}L) alleles across Italy and to determine their genetic details.

Methods: Multidrug-resistant (MDR) strains were identified by MIC analysis followed by genotyping and PCR-based strategies.

Results: Initial MIC analysis identified 31 MDR isolates that displayed an Etest M{beta}L-positive phenotype. Of these, 25 produced either the M{beta}L VIM-1 or IMP-13 as detected by PCR and sequencing. VIM-1-producing isolates were found at all sites, whereas IMP-13-producing isolates were only found in Rome. M{beta}L-producing isolates were found at all Italian SENTRY sites and together amounted to 6.5% of all P. aeruginosa isolates. Genetic analysis indicated that many strains contained multiple integrons and identified two novel M{beta}L integrons, one from the site in Genoa and one from Sicily. Integrons identical in structure and sequence to In70, the first identified and characterized blaVIM-containing integron from Verona, were found in isolates with distinct ribotypes at the Roman and Sicilian sites indicating that this integron has recently disseminated across Italy. All 25 M{beta}L-producing isolates were genetically linked in that all isolates contained Tn5051 sequences and all harboured the insertion sequence IsPa7 which may be involved in the mobilization of these resistance alleles.

Conclusions: Taken together, these results indicate that Italy has a nationwide problem of MDR P. aeruginosa produced by mobile M{beta}L genes.

Keywords: Pseudomonas aeruginosa; IsPa7; Tn5051; integrons; Italy.
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