A nosocomial outbreak of Pseudomonas aeruginosa isolates expressing the extended-spectrum beta-lactamase GES-2 in South Africa

Abstract

Eight Pseudomonas aeruginosa clinical strains that produce the clavulanic-acid-inhibited beta-lactamase GES-2 were isolated from patients of a South African hospital from March to July 2000. They were clonally related and each harboured a 150 kb conjugative plasmid carrying a class 1 integron containing a gene cassette encoding GES-2, followed by those for beta-lactamase OXA-5 and an aminoglycoside modifying AAC(3)I-like enzyme. Hence, incidences of infection, several fatal, due to bacteria displaying clavulanate-inhibited resistance to extended-spectrum cephalosporins and reduced susceptibility to imipenem in Pretoria Academic Hospital, South Africa, can be explained, at least in part, by the spread of P. aeruginosa expressing the GES-2 beta-lactamase.

Molecular characterisation of multidrug-resistant Pseudomonas aeruginosa from a private hospital in Durban, South Africa

“…GES-2 was described originally in multidrug-resistant P. aeruginosa isolates collected from a South African teaching hospital, were associated with a nosocomial outbreak and displayed expanded hydrolysis to carbapenems. 19 The detection of class B MBL, VIM-2 in these isolates is in agreement with results from other studies indicating that VIM-2 is amongst the most widespread MBLs associated with P. aeruginosa. 26 VIM-2 has also been implicated in outbreaks of nosocomial infections as a result of MBL-producing P. aeruginosa.…”

“…18 In another South African hospital, eight P. aeruginosa clinical strains involved in nosocomial outbreak were all isolated from the ICU. 19 Pitout et al reported that majority of isolates recovered in a large tertiarycare centre in Nairobi, Kenya were P. aeruginosa isolates (33/57, 58%) and they originated from the ICU. 20 In a study on an outbreak of multidrug-resistant P. aeruginosa (MDRPA) infections in a Greece university hospital, it was shown that after phenotypic and genotypic analysis of 240 isolates mainly in ICU, 152 patients were colonised or infected with MDRPA.…”

Detection of GES-2, a Class A β-Lactamase Produced by Pseudomonas aeruginosa in a Teaching Hospital in Iran

“…GES-2 was identified from a P. aeruginosa isolate in South Africa and later from eight more strains involved in the outbreak. GES-2 β-lactamase may supply partly to the decreased susceptibility of P. aeruginosa to imipenem (6,7,11). GES-2 β-lactamase belongs to the class A carbapenemase, the emergence of which is an alarm in P. aeruginosa as the enzyme confers resistance to carbapenem antibiotics.…”

“…For the first time, GES-2 was reported in MDR clinical isolates of P. aeruginosa, originating from a university hospital in South Africa (6). Poirel et al reported that GES-2 was associated with an outbreak occurring in the same hospital in 2000 (7). Rapid recognition of resistant strains and detection of resistance genes is necessary to succeed in antimicro-bial therapy and infection control policy.…”

Susceptibilidad antimicrobiana de cepas de Pseudomonas aeruginosa aisladas en el laboratoriodel Hospital Regional Dr. Leonardo Guzmán de Antofagasta, Chile

“…En este contexto, el incremento emergente de cepas resistentes a antimicrobianos es un problema mayor en la práctica clínica 32,33,39 . Dentro de los mecanismos de resistencia a los antimicrobianos se incluyen: capacidad de formar biopelículas, gracias a la producción de alginato (ej: resistencia a β-lactámicos, aminoglucósidos, fluoroquinolonas); disminución de la permeabilidad de la membrana externa; bombas de eflujo para multiples fármacos (aminoglucósidos, imipenem, tetraciclina, fluoroquinolonas) 37 y enzimas que modifican los antibacterianos (β-lactámicos, aminoglucósidos).…”