Adler Amos, Assous Marc V, Paikin Svetlana, Shulman Anastasiya, Miller-Roll Tamar, Hillel Sarah, Aronov Rima, Carmeli Yehuda, Schwaber Mitchell J
National Center for Infection Control, Ministry of Health, Tel-Aviv, Israel.
J Antimicrob Chemother. 2014 May;69(5):1211-4. doi: 10.1093/jac/dkt505. Epub 2014 Jan 2.
Resistance to carbapenems in Aeromonas species is rare and mediated mostly by the chromosomal cphA gene. Our aims were to describe the molecular characteristics of the first cases of VIM-producing Aeromonas caviae isolated from human samples.
Carbapenem-resistant Aeromonas (CRA) spp. were isolated from rectal surveillance cultures. Bacterial identification was done by dnaJ sequencing. Detection of metallo-carbapenemase and other β-lactamase genes was done by PCR. Molecular typing was done by PFGE. The genetic environment of the blaVIM gene was determined by sequencing.
Five CRA were isolated from surveillance cultures in 2010-13; four were from Shaare Zedek Medical Center and one was from Laniado Hospital. All five isolates were identified as A. caviae and comprised four different pulsotypes. MICs ranged from 0.5 to 8 mg/L for imipenem and from 0.25 to 8 mg/L for meropenem. All isolates were resistant to gentamicin, susceptible to amikacin and ciprofloxacin (except one), and were positive for carbapenemase production in the modified Hodge and Carba NP tests. The carbapenemase genes blaVIM-1 and blaVIM-35 were located inside a class I integron with two different sizes to its variable region.
This is the first report of blaVIM in A. caviae from human samples and the first report of VIM-producing Gram-negative bacteria in Israel. This finding is alarming as this species may spread via water or sewage systems. Although infection due to Aeromonas spp. is rare, the presence of the gene on a mobile element is of concern due to the potential for dissemination to clinically important Gram-negative pathogens.
气单胞菌属对碳青霉烯类药物耐药较为罕见，主要由染色体上的cphA基因介导。我们的目的是描述从人类样本中分离出的首例产VIM气单胞菌的分子特征。
从直肠监测培养物中分离出耐碳青霉烯类气单胞菌（CRA）。通过dnaJ测序进行细菌鉴定。通过PCR检测金属碳青霉烯酶和其他β-内酰胺酶基因。通过脉冲场凝胶电泳（PFGE）进行分子分型。通过测序确定blaVIM基因的遗传环境。
2010 - 2013年从监测培养物中分离出5株CRA；4株来自沙雷兹德克医学中心，1株来自拉尼亚多医院。所有5株分离株均鉴定为豚鼠气单胞菌，包括4种不同的脉冲型。亚胺培南的最低抑菌浓度（MIC）范围为0.5至8 mg/L，美罗培南的MIC范围为0.25至8 mg/L。所有分离株对庆大霉素耐药，对阿米卡星和环丙沙星敏感（除1株外），改良Hodge试验和Carba NP试验中碳青霉烯酶产生均为阳性。碳青霉烯酶基因blaVIM-1和blaVIM-35位于I类整合子内，其可变区大小不同。
这是关于从人类样本中分离出的豚鼠气单胞菌中blaVIM的首次报告，也是以色列产VIM革兰氏阴性菌的首次报告。这一发现令人担忧，因为该菌种可能通过水或污水系统传播。虽然气单胞菌属引起的感染很少见，但该基因存在于可移动元件上令人担忧，因为它有可能传播给临床上重要的革兰氏阴性病原体。
