Corvec S, Poirel L, Espaze E, Giraudeau C, Drugeon H, Nordmann P
Service de Bactériologie-Virologie, INSERM U914 Emerging Resistance to Antibiotics Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine Paris-Sud, K-Bicêtre, France.
J Hosp Infect. 2008 Jan;68(1):73-82. doi: 10.1016/j.jhin.2007.10.016.
From April 1996 to July 2004, an outbreak of metallo-beta-lactamase-positive (MBL) Pseudomonas aeruginosa occurred in the haematology ward at Nantes University Hospital in France. Fifty-nine patients were carriers of VIM-2-positive strains of whom 14 were infected (mostly urinary tract infections and pneumonia). Pulsed-field gel electrophoresis identified related isolates demonstrating resistance to all beta-lactams, aminoglycosides, fluoroquinolones, fosfomycin, rifampicin but not colistin. The bla(VIM-2) gene responsible for VIM-2 MBL was not plasmid-encoded but part of a novel type of class 1 integron. VIM-2-positive strains were mostly from urine samples and clinical data suggest that in the absence of therapeutic guidelines, piperacillin-tazobactam or aztreonam may be a reliable choice for treating infections with MBL-producing strains.
1996年4月至2004年7月，法国南特大学医院血液科发生了一起金属β-内酰胺酶阳性（MBL）铜绿假单胞菌的暴发。59名患者是VIM-2阳性菌株的携带者，其中14人受到感染（主要是尿路感染和肺炎）。脉冲场凝胶电泳鉴定出相关分离株，这些分离株对所有β-内酰胺类、氨基糖苷类、氟喹诺酮类、磷霉素、利福平耐药，但对黏菌素不耐药。负责VIM-2 MBL的bla(VIM-2)基因不是质粒编码的，而是新型1类整合子的一部分。VIM-2阳性菌株大多来自尿液样本，临床数据表明，在缺乏治疗指南的情况下，哌拉西林-他唑巴坦或氨曲南可能是治疗产MBL菌株感染的可靠选择。
