Metallo-beta-lactamases among imipenem-resistant Pseudomonas aeruginosa in a brazilian university hospital

Franco, Maria Renata Gomes; Caiaffa-Filho, Hélio H.; Burattini, Marcelo Nascimento; Rossi, Flávia

doi:10.1590/s1807-59322010000900002

Cited by 96 publications

(89 citation statements)

References 28 publications

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“…Our data suggested that, in our hospital, as well as the SPM clone, there is spread of strains producing MBL of the VIM type. Sporadic reports from Brazil have suggested a similar increase in VIMpositive P. aeruginosa isolates (Franco et al, 2010;Sader et al, 2005), but longitudinal studies that support these data have not been done.…”

Section: Discussionmentioning

confidence: 89%

Molecular epidemiological survey of the quinolone- and carbapenem-resistant genotype and its association with the type III secretion system in Pseudomonas aeruginosa

Ferreira

Dantas

Faria

et al. 2015

Journal of Medical Microbiology

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This study evaluated the predictors of mortality and the impact of inappropriate therapy on the outcomes of patients with bacteraemia and ventilator-associated pneumonia (VAP). Additionally, we evaluated the correlation of the type III secretion system (TTSS) effector genotype with resistance to carbapenems and fluoroquinolones, mutations in the quinolone resistancedetermining regions (QRDRs), metallo-b-lactamase and virulence factors. A retrospective cohort was conducted at a tertiary hospital in patients with multidrug-resistant (MDR) P. aeruginosa bacteraemia (157 patients) and VAP (60 patients). The genes for bla IMP , bla VIM , bla SIM , bla GIM and bla SPM and virulence genes (exoT, exoS, exoY, exoU, lasB, algD and toxA) were detected; sequencing was conducted for QRDR genes on fluoroquinolone-resistant strains. The multivariate analyses showed that the predictors independently associated with death in patients with bacteraemia were cancer and inappropriate therapy. Carbapenem resistance was more frequent among strains causing VAP (53.3 %), and in blood we observed the bla SPM genotype (66.6 %) and bla VIM genotype (33.3 %). The exoS gene was found in all isolates, whilst the frequency was low for exoU (9.4 %). Substitution of threonine to isoleucine at position 83 in gyrA was the most frequent mutation among fluoroquinolone-resistant strains. Our study showed a mutation at position 91 in the parC gene (Glu91Lys) associated with a mutation in gyrA (Thre83Ile) in a strain of extensively drug-resistant P. aeruginosa, with the exoT + exoS + exoU + genotype, that has not yet been described in Brazil to the best of our knowledge. This comprehensive analysis of resistance mechanisms to carbapenem and fluoroquinolones and their association with TTSS virulence genes, covering MDR P. aeruginosa in Brazil, is the largest reported to date. INTRODUCTIONSevere infections such as bloodstream infection and ventilator-associated pneumonia (VAP) due to multidrugresistant (MDR) Pseudomonas aeruginosa result in greater morbidity and mortality, longer hospitalization and higher cost than infections caused by susceptible bacteria (Morales et al., 2012; Suárez et al., 2010;Voor In't Holt et al., 2014), and aspects related to epidemiology and the outcome of patients with these infections may change, resulting in high rates of resistance and as consequence difficulties in treatment (Kang et al., 2005; Lodise et al., 2007).Today, the emergence of MDR P. aeruginosa is a global problem (Sader et al., 2001; Van der Bij et al., 2011, resulting in the ability of this pathogen to develop resistance to almost all available antibiotics, either by selection of mutations in chromosomal genes or from horizontal gene transfer (Breidenstein et al., 2011). In Brazil this problem is hih5ghly significant and some studies show a very high density of antibiotic use, especially of carbapenems and fluoroquinolones (Moreira et al., 2013;Porto et al., 2013). The resistance of P. aeruginosa to carbapenems is higher than 60 % in some Brazilian hospitals ...

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Section: Discussionmentioning

confidence: 89%

Molecular epidemiological survey of the quinolone- and carbapenem-resistant genotype and its association with the type III secretion system in Pseudomonas aeruginosa

Ferreira

Dantas

Faria

et al. 2015

Journal of Medical Microbiology

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“…15 Among β-lactamases, imipenem is the chosen antibiotic for fighting against this bacterium, however P. aeruginosa can disintegrate this antibiotic through MBL enzyme. 16 The rate of imipenem-resistant isolates (46.4%) in our study indicated a menace regarding therapy alternatives in our clinics.…”

Section: Discussionmentioning

confidence: 99%

Detection Rate of Metallo-β-Lactamase-Expressing Genes; blaVIM-1, blaVIM-2 and blaSPM-1 in Pseudomonas aeruginosa Isolates

Amini¹,

Mobasseri²

2017

Int J Basic Sci Med

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“…The first MBL (IMP1) was detected in Serratiam arcescens in Japan, 1991 (6). Since then, other kinds of MBLs including VIM, SIM, SPM, GIM, AIM were detected around the world (7,8). This type of MBLs naming is based on detection location.…”

Section: Introductionmentioning

confidence: 99%

Dissemination of Pseudomonas aeruginosa Producing blaIMP1, blaVIM2, blaSIM1, blaSPM1 in Shiraz, Iran

Sarhangi

Motamedifar

Sarvari

2013

Jundishapur J Microbiol

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Background: Metallo-β-lactamase (MBL) producing Pseudomonas aeruginosa is responsible for many important nosocomial outbreaks including pneumonia and septicemia. Various studies have reported the separation of P. aeruginosa producing MBLs enzymes resulted in increases in multiple traditional antibiotics resistance including carbapenems, cephalosporins and penicillins. Objectives: In this study, based on the standard phenotypic and genotypic methods, we examined the MBLs possible production of a P. aeruginosa isolate. The main objective was exploring the dissemination of resistant MBL P. aeruginosa in south-west of Iran, Shiraz. Materials and Methods: During a six-month period-from October 2011 to March 2012-240 P. aeruginosa isolates, collected from four teaching hospitals in Shiraz located in southwest of Iran, were examined. The isolates were mainly collected from wound, urine, and sputum. Minimum inhibitory concentration (MIC) ≥4 µg/mL to imipenem was determined by micro-dilution broth. Identification of P. aeruginosa with MBL was detected using double disk synergy test (DDST) and polymerase chain reaction (PCR) using specific primers for blaIMP1, blaVIM2, blaSIM1, blaSPM1. All laboratory procedures was according to clinical and laboratory standards institute (CLSI) recommendations. Results: From 240 P. aeruginosa isolates, 82 (34.16%) isolates were imipenem-resistant (minimum inhibitory concentration (MIC) ≥4 µg/ mL). Among these imipenem-resistant isolates, 19 (23.3%) MBL-producing P. aeruginosa isolates were screened using DDST. A specific PCR test confirmed the presence of 18 (21.95%) P. aeruginosa producing blaIMP1 and blaVIM2. Conclusions: Beside our study, the detection of MBL genes were reported in a few studies conducted in Iran. The spread of detected MBLs producing P. aeruginosa were unprecedented in the region due to the lack of independent related researches or the novel incidence of these genes. This detection must be noted by associated clinical and health care services.

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Metallo-beta-lactamases among imipenem-resistant Pseudomonas aeruginosa in a brazilian university hospital

Cited by 96 publications

References 28 publications

Molecular epidemiological survey of the quinolone- and carbapenem-resistant genotype and its association with the type III secretion system in Pseudomonas aeruginosa

Molecular epidemiological survey of the quinolone- and carbapenem-resistant genotype and its association with the type III secretion system in Pseudomonas aeruginosa

Detection Rate of Metallo-β-Lactamase-Expressing Genes; blaVIM-1, blaVIM-2 and blaSPM-1 in Pseudomonas aeruginosa Isolates

Dissemination of Pseudomonas aeruginosa Producing blaIMP1, blaVIM2, blaSIM1, blaSPM1 in Shiraz, Iran

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