Dissemination of a Class I Integron Carrying VIM-2 Carbapenemase in Pseudomonas aeruginosa Clinical Isolates from a Hospital Intensive Care Unit in Annaba, Algeria

Touati, Meriem; Diène, Seydina M.; Dekhil, Mazouz; Djahoudi, Abdelghani; Racherache, Abdelkarim; Rolain, Jean‐Marc

doi:10.1128/aac.00032-13

Cited by 46 publications

(25 citation statements)

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“…Severe antimicrobial resistance in this bacterium has complicated the treatment of infections caused by drug-resistant P. aeruginosa strains among burn patients (15). Recently, the increase of carbapenem resistance in P. aeruginosa has been documented all over the world due to metallo-β-lactamase production, including the VIM type (16). This study revealed that the resistance rates to imipenem and meropenem were very high (96%).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Metallo-β-Lactamase-Production and Carriage of bla-VIM Genes in Pseudomonas aeruginosa Isolated from Burn Wound Infections in Isfahan

et al. 2016

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BackgroundMetallo-β-lactamase-production among Gram-negative bacteria, including Pseudomonas aeruginosa, has become a challenge for treatment of infections due to these resistant bacteria.ObjectivesThe aim of the current study was to evaluate the metallo-β-lactamase-production and carriage of bla-VIM genes among carbapenem-resistant P. aeruginosa isolated from burn wound infections.Patients and MethodsA cross-sectional study was conducted from September 2014 to July 2015. One hundred and fifty P. aeruginosa isolates were recovered from 600 patients with burn wound infections treated at Imam-Musa-Kazem Hospital in Isfahan city, Iran. Carbapenem-resistant P. aeruginosa isolates were screened by disk diffusion using CLSI guidelines. Metallo-β-lactamase-producing P. aeruginosa isolates were identified using an imipenem-EDTA double disk synergy test (EDTA-IMP DDST). For detection of MBL genes including bla-VIM-1 and bla-VIM-2, polymerase chain reaction (PCR) methods and sequencing were used.ResultsAmong the 150 P. aeruginosa isolates, 144 (96%) were resistant to imipenem by the disk diffusion method, all of which were identified as metallo-β-lactamase-producing P. aeruginosa isolates by EDTA-IMP DDST. Twenty-seven (18%) and 8 (5.5%) MBL-producing P. aeruginosa isolates harbored bla-VIM-1 and bla-VIM-2 genes, respectively.ConclusionsOur findings showed a high occurrence of metallo-β-lactamase production among P. aeruginosa isolates in burn patient infections in our region. Also, there are P. aeruginosa isolates carrying the bla-VIM-1 and bla-VIM-2 genes in Isfahan province.

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Section: Discussionmentioning

confidence: 99%

Evaluation of Metallo-β-Lactamase-Production and Carriage of bla-VIM Genes in Pseudomonas aeruginosa Isolated from Burn Wound Infections in Isfahan

et al. 2016

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“…VIM-2-producing P. aeruginosa isolates have been observed in Tunisia (6)(7)(8), Kenya (9), the Ivory Coast (10), Algeria (11), and South Africa (12). Further, reports have shown the import of P. aeruginosa with VIM-2 from African countries (Ghana, Tunisia, and Egypt) into Europe (13)(14)(15).…”

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Identification of VIM-2-Producing Pseudomonas aeruginosa from Tanzania Is Associated with Sequence Types 244 and 640 and the Location of bla _VIM-2 in a TniC Integron

Moyo

Haldorsen

Aboud

et al. 2015

Antimicrob Agents Chemother

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e Epidemiological data on carbapenemase-producing Gram-negative bacteria on the African continent are limited. Here, we report the identification of VIM-2-producing Pseudomonas aeruginosa isolates in Tanzania. Eight out of 90 clinical isolates of P. aeruginosa from a tertiary care hospital in Dar es Salaam were shown to harbor bla VIM-2 . The bla VIM-2 -positive isolates belonged to two different sequence types (ST), ST244 and ST640, with bla VIM-2 located in an unusual integron structure lacking the 3= conserved region of qac⌬E1-sul1. Pseudomonas aeruginosa is an opportunistic pathogen associated with a number of nosocomial infections. Carbapenems (i.e., meropenem and imipenem) are often the treatment of choice for infections caused by P. aeruginosa that is resistant to other antipseudomonal ␤-lactams (1). However, the emergence and spread of acquired carbapenemases, particularly metallo-␤-lactamases (MBLs), among P. aeruginosa are threatening the usefulness of carbapenems (2). Resistance to carbapenems in P. aeruginosa can also occur due to impermeability, efflux mechanisms, and other ␤-lactamases, including overexpression of the chromosomal AmpC (3).Several acquired MBLs have been identified in P. aeruginosa, including the VIM, IMP, SPM, GIM, AIM, FIM, and NDM enzymes (2, 4). The genes encoding these MBLs are associated with mobile genetic elements, such as insertion sequence common region (ISCR) elements, transposons, and plasmids, and as gene cassettes in integron structures. The dissemination of the various MBLs among P. aeruginosa isolates has been shown to occur in many different genetic backgrounds (5). However, two major clonal complexes (CC), CC235 and CC111, predominate, particularly with respect to the dissemination of VIM enzymes (5).On the African continent, an increasing number of reports indicates that MBL-producing, and in particular VIM-2-producing, P. aeruginosa is widespread in Africa. VIM-2-producing P. aeruginosa isolates have been observed in Tunisia (6-8), Kenya (9), the Ivory Coast (10), Algeria (11), and South Africa (12). Further, reports have shown the import of P. aeruginosa with VIM-2 from African countries (Ghana, Tunisia, and Egypt) into Europe (13-15).(Part of this study was presented at the 22nd European Congress of Microbiology and Infectious Diseases, 31 March to 3 April 2012, London, United Kingdom.)The aim of this study was to determine the occurrence and molecular epidemiology of MBL-producing P. aeruginosa isolates identified from clinical specimens at a tertiary hospital in Dar es Salaam, Tanzania. This was a cross-sectional study conducted at the Central Pathology Laboratory, Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania. MNH is the largest tertiary health care facility in Tanzania and serves as a university teaching and referral hospital to the population of Dar es Salaam and the whole country. The study included 90 clinical isolates of P. aeruginosa consecutively collected from May 2010 to July 2011. Duplicate isolates were excluded from the study. Only i...

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“…In contrast to other countries, where the bla NDM gene has been identified mainly in Enterobacteriaceae, the bla NDM gene has been reported only in A. baumannii clinical isolates from Algeria (3, 7). However, other types of carbapenemase-acquiring isolates have been reported in Algeria, such as bla VIM in Enterobacteriaceae (8) and P. aeruginosa (9). The bla OXA-24 , bla OXA-23 , and bla OXA-58 genes have been also reported in Annaba and Tlemcen, Algeria (3, 10, 11).…”

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NDM-5 Carbapenemase-Encoding Gene in Multidrug-Resistant Clinical Isolates of Escherichia coli from Algeria

Sassi

Loucif

Gupta

et al. 2014

Antimicrob Agents Chemother

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c Here, we report the first autochthonous cases of infections caused by bla NDM-5 New Delhi metallo-␤-lactamase-producing Escherichia coli strains recovered from urine and blood specimens of three patients from Algeria between January 2012 and February 2013. The three isolates belong to sequence type 2659 and they coexpress bla CTX-M-15 with the bla TEM-1 and bla aadA2 genes. Escherichia coli is one of the most common causative agents of infection in humans, and the emergence of resistance to thirdgeneration cephalosporins by extended-spectrum ␤-lactamases (ESBLs) has led to an increased use of carbapenem compounds (1). The growing incidence of resistance to carbapenems among Enterobacteriaceae is of major concern worldwide (1). Carbapenemase producers are mainly identified in Klebsiella pneumoniae and, to a lesser extent, in E. coli and other enterobacterial species. Carbapenemases are classified into three different classes (A, B, and D) and are now a serious problem due to their rapid spread in Enterobacteriaceae (1). Among the newly emerged ␤-lactamases in the world, New Delhi metallo-␤-lactamase (NDM) represents the latest threat for public health (2). It was first reported from K. pneumoniae and E. coli isolates recovered from a Swedish patient previously hospitalized in India (2). Since then, seven additional NDM variants have been described worldwide (2) (Fig. 1). New Delhi metallo-␤-lactamase 1 (NDM-1), which can be produced by different Enterobacteriaceae, has been reported worldwide, including recently in Acinetobacter baumannii clinical isolates in Algeria (3). In this report, we describe the first detection of bla NDM-5 -containing New Delhi metallo-␤-lactamase-producing E. coli clinical isolates in Algeria.A total of 105 consecutive and nonduplicate E. coli clinical isolates were recovered from hospitalized and nonhospitalized patients at the University Hospital of Annaba, Algeria, and were screened for carbapenem resistance between January 2012 and February 2013. During the study period, out of the 105 isolates, a total of 3 isolates harbored the bla NDM-5 gene. Out of these 3 bla NDM-5 -positive isolates, one was isolated from the blood of a 5-month-old child hospitalized in the pediatric ward, while two were isolated from urine samples from a 63-year-old man and a 75-year-old man. The isolates were identified using the Bruker Daltonics Microflex matrix-assisted laser desorption ionizationtime of flight (MALDI-TOF) mass spectrometer (Bremen, Germany), as previously described (3).These three isolates were resistant to all ␤-lactams, with an imipenem MIC of Ͼ32 g/ml and a high level of resistance to aminoglycosides and fluoroquinolones. They were susceptible only to tigecycline, fosfomycin, and colistin. Thus, NDM-5-harboring strains might be highly multidrug resistant, and a previous report on NDM-5-producing E. coli sequence type 648 (ST648) (GenBank accession no. JN104597) demonstrated that the strain was resistant to all available antimicrobials except tigecycline and colistin (4), and we obser...

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Dissemination of a Class I Integron Carrying VIM-2 Carbapenemase in Pseudomonas aeruginosa Clinical Isolates from a Hospital Intensive Care Unit in Annaba, Algeria

Cited by 46 publications

References 18 publications

Evaluation of Metallo-β-Lactamase-Production and Carriage of bla-VIM Genes in Pseudomonas aeruginosa Isolated from Burn Wound Infections in Isfahan

Evaluation of Metallo-β-Lactamase-Production and Carriage of bla-VIM Genes in Pseudomonas aeruginosa Isolated from Burn Wound Infections in Isfahan

Identification of VIM-2-Producing Pseudomonas aeruginosa from Tanzania Is Associated with Sequence Types 244 and 640 and the Location of bla _VIM-2 in a TniC Integron

NDM-5 Carbapenemase-Encoding Gene in Multidrug-Resistant Clinical Isolates of Escherichia coli from Algeria

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Dissemination of a Class I Integron Carrying VIM-2 Carbapenemase in Pseudomonas aeruginosa Clinical Isolates from a Hospital Intensive Care Unit in Annaba, Algeria

Cited by 46 publications

References 18 publications

Evaluation of Metallo-β-Lactamase-Production and Carriage of bla-VIM Genes in Pseudomonas aeruginosa Isolated from Burn Wound Infections in Isfahan

Evaluation of Metallo-β-Lactamase-Production and Carriage of bla-VIM Genes in Pseudomonas aeruginosa Isolated from Burn Wound Infections in Isfahan

Identification of VIM-2-Producing Pseudomonas aeruginosa from Tanzania Is Associated with Sequence Types 244 and 640 and the Location of bla VIM-2 in a TniC Integron

NDM-5 Carbapenemase-Encoding Gene in Multidrug-Resistant Clinical Isolates of Escherichia coli from Algeria

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Identification of VIM-2-Producing Pseudomonas aeruginosa from Tanzania Is Associated with Sequence Types 244 and 640 and the Location of bla _VIM-2 in a TniC Integron