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希腊一家医院中耐碳青霉烯类铜绿假单胞菌分离株中获得性金属β-内酰胺酶的罕见检出情况

Infrequent detection of acquired metallo-beta-lactamases among carbapenem-resistant Pseudomonas isolates in a Greek hospital.

作者信息

Tsakris A, Tassios P T, Polydorou F, Papa A, Malaka E, Antoniadis A, Legakis N J

机构信息

First Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.

出版信息

Clin Microbiol Infect. 2003 Aug;9(8):846-51. doi: 10.1046/j.1469-0691.2003.00642.x.

Abstract

OBJECTIVE

To study the possible distribution of metallo-beta-lactamases among nosocomial Pseudomonas isolates in a Greek hospital with a recent high prevalence of carbapenem-resistant Pseudomonas isolates.

METHODS

All carbapenem-resistant (imipenem- and/or meropenem-resistant) (MICs > 8 mg/L) Pseudomonas non-replicate isolates recovered from clinical infections in the Microbiology Laboratory of Saint Demetrios Hospital, Thessaloniki, Greece, from April 1998 to November 2000 were studied for the presence of metallo-beta-lactamases. They were tested by a disk diffusion test, PCR analysis, and nucleotide sequencing. DNA fingerprints were obtained by pulsed-field gel electrophoresis (PFGE) of XbaI-digested chromosomal DNA.

RESULTS

In total, 24 carbapenem-resistant isolates (23 P. aeruginosa and one P. putida) were recovered. The serotypes observed among the P. aeruginosa isolates were, in order of decreasing frequency, O:11 (52%), O:3 and O:12 (17% each), and O:6 (13%). PFGE grouped 17 of the P. aeruginosa isolates into four clusters, each containing from two to seven isolates, while the remaining isolates exhibited unique genotypes. blaVIM-2 was detected in the P. putida isolate and a P. aeruginosa serotype O:3 isolate. The latter strain was genotypically distinct from other contemporaneous or older carbapenem-resistant P. aeruginosa Greek isolates.

CONCLUSION

These findings suggest that, although the prevalence of metallo-beta-lactamases is low, the integron-associated blaVIM genes can spread to P. aeruginosa serotypes that have not been previously associated with carbapenem resistance in our region, as well as to other pseudomonal species.

摘要

目的

在一家近期耐碳青霉烯类铜绿假单胞菌分离株患病率较高的希腊医院,研究金属β-内酰胺酶在医院获得性铜绿假单胞菌分离株中的可能分布情况。

方法

对1998年4月至2000年11月间从希腊塞萨洛尼基圣德米特里奥斯医院微生物实验室临床感染中分离出的所有耐碳青霉烯类(对亚胺培南和/或美罗培南耐药,最低抑菌浓度>8mg/L)的非重复铜绿假单胞菌分离株进行金属β-内酰胺酶检测。通过纸片扩散试验、聚合酶链反应(PCR)分析和核苷酸测序对其进行检测。通过对经XbaI酶切的染色体DNA进行脉冲场凝胶电泳(PFGE)获得DNA指纹图谱。

结果

共分离出24株耐碳青霉烯类分离株(23株铜绿假单胞菌和1株恶臭假单胞菌)。在铜绿假单胞菌分离株中观察到的血清型,按频率递减顺序依次为:O:11(52%)、O:3和O:12(各17%)以及O:6(13%)。PFGE将17株铜绿假单胞菌分离株分为四个簇,每个簇包含2至7株分离株,而其余分离株表现出独特的基因型。在恶臭假单胞菌分离株和1株血清型为O:3的铜绿假单胞菌分离株中检测到blaVIM-2。后一株菌株在基因型上与其他同期或更早的耐碳青霉烯类希腊铜绿假单胞菌分离株不同。

结论

这些发现表明,尽管金属β-内酰胺酶的患病率较低,但与整合子相关的blaVIM基因可传播至我们地区先前未与碳青霉烯类耐药相关的铜绿假单胞菌血清型,以及其他假单胞菌属物种。

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