JAC Advance Access published online on January 15, 2007
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkl527
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Emergence of ArmA and RmtB aminoglycoside resistance 16S rRNA methylases in Belgium
1 Laboratoire de Bactériologie, Cliniques Universitaires UCL de Mont-Godinne, 1 Av. Dr Gaston Thérasse, B-5530 Yvoir, Belgium 2 Unité des Agents Antibactériens, Institut Pasteur, F-75724 Paris Cedex, France 3 Laboratoire de Bactériologie, Hôpital Universitaire Erasme—ULB, B-1070 Brussels, Belgium 4 Unité des Antibiotiques, Institut Pasteur de Bruxelles, B-1180 Brussels, Belgium
Received 15 September 2006; returned 24 November 2006; revised 29 November 2006; accepted 4 December 2006
* Corresponding author. Tel: +32-81-42-32-41; Fax: +32-81-42-32-46; E-mail: pierre.bogaerts{at}mont.ucl.ac.be
OBJECTIVES: 16S rRNA methylase-mediated high-level resistance to aminoglycosides has been reported recently in clinical isolates of Gram-negative bacilli only from a limited number of countries. This study was conducted to investigate the occurrence of this type of resistance in clinical isolates of Enterobacteriaceae from two Belgian hospitals and the characteristics of the strains.
METHODS: We screened for high-level gentamicin, tobramycin and amikacin resistance in clinical isolates of Enterobacteriaceae consecutively collected between 2000 and 2005 at two laboratories by PCR for the armA, rmtA and rmtB 16S rRNA methylase genes. The ß-lactamase presence in the strains was also determined by phenotypic and genotypic methods.
RESULTS: Overall armA genes were detected in 18 Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, Enterobacter cloacae and Citrobacter amalonaticus whereas rmtB was detected in a single E. coli isolate. The rmtA gene was not found. All 16S rRNA methylase-bearing strains produced extended-spectrum ß-lactamases (ESBLs), predominantly type CTX-M-3, as well as various types of ß-lactamases. In the majority of the strains, the armA gene was carried by conjugative plasmids of the IncL/M incompatibility group whereas rmtB was borne by an IncFI plasmid.
CONCLUSIONS: This is the first report of the emergence of 16S rRNA methylases in Enterobacteriaceae in Belgium. The rapid spread of multidrug-resistant isolates producing both ESBLs and 16S rRNA methylases raises clinical concern and may become a major therapeutic threat in the future.
Key Words: Enterobacteriaceae , resistance genes , extended-spectrum ß-lactamases
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