NmcA Carbapenem-hydrolyzing Enzyme in<i>Enterobacter cloacae</i>in North America1

Pottumarthy, Sudha; Moland, Ellen Smith; Juretschko, Stefan; Swanzy, Susan R.; Thomson, Kenneth S.; Fritsche, Thomas R.

doi:10.3201/eid0908.030096

Cited by 49 publications

(29 citation statements)

References 19 publications

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“…Since the completion of this study, there have been several reports of United States isolates of Enterobacteriaceae producing class A carbapenemases (4,5,12,13,33,45) and also reports of rare P. aeruginosa isolates producing a metallo-␤-lactamase (11,16,42). These are formidable enzymes that clinical laboratories should detect.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Newer β-Lactamases in Gram-Negative Clinical Isolates Collected in the United States from 2001 to 2002

et al. 2006

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Newer ␤-lactamases such as extended-spectrum ␤-lactamases (ESBLs), transferable AmpC ␤-lactamases, and carbapenemases are associated with laboratory testing problems of false susceptibility that can lead to inappropriate therapy for infected patients. Because there appears to be a lack of awareness of these enzymes, a study was conducted during 2001 to 2002 in which 6,421 consecutive, nonduplicate clinical isolates of aerobically growing gram-negative bacilli from patients at 42 intensive care unit (ICU) and 21 non-ICU sites across the United States were tested on-site for antibiotic susceptibility. From these isolates, 746 screenpositive isolates (11.6%) were referred to a research facility and investigated to determine the prevalence of ESBLs in all gram-negative isolates, transferable AmpC ␤-lactamases in Klebsiella pneumoniae, and carbapenemases in Enterobacteriaceae. The investigations involved phenotypic tests, isoelectric focusing, ␤-lactamase inhibitor studies, spectrophotometric assays, induction assays, and molecular analyses. ESBLs were detected only in Enterobacteriaceae (4.9% of all Enterobacteriaceae) and were found in species other than those currently recommended for ESBL testing by the CLSI (formerly NCCLS). These isolates occurred at 74% of the ICU sites and 43% of the non-ICU sites. Transferable AmpC ␤-lactamases were detected in 3.3% of K. pneumoniae isolates and at 16 of the 63 sites (25%) with no difference between ICU and non-ICU sites. Three sites submitted isolates that produced class A carbapenemases. No class B or D carbapenemases were detected. In conclusion, organisms producing ESBLs and transferable AmpC ␤-lactamases were widespread. Clinical laboratories must be able to detect important ␤-lactamases to ensure optimal patient care and infection control.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Newer β-Lactamases in Gram-Negative Clinical Isolates Collected in the United States from 2001 to 2002

et al. 2006

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“…M␤L screening was performed using imipenem, meropenem, and ceftazidime as substrates and using EDTA and 2-mercaptopropionic acid as enzyme inhibitors (1). Screening for serine carbapenemases was carried out by a method described by Pottumarthy et al (14), in which imipenem and meropenem were used as substrates and clavulanic acid as the ␤-lactamase inhibitor.…”

Section: Methodsmentioning

confidence: 99%

Antimicrobial Activities of Tigecycline and Other Broad-Spectrum Antimicrobials Tested against Serine Carbapenemase- and Metallo-β-Lactamase-Producing Enterobacteriaceae : Report from the SENTRY Antimicrobial Surveillance Program

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Deshpande

et al. 2008

Antimicrob Agents Chemother

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A total of 104 carbapenemase (serine-and metallo-␤-lactamase [M␤L])-producing strains of theEnterobacteriaceae family collected from 2000 to 2005 in medical centers distributed worldwide were tested against tigecycline and 25 comparators by reference broth microdilution methods. The most frequent carbapenemase was KPC-2 or -3 (73 strains), followed by VIM-1 (14), IMP-1 (11), SME-2 (5), and NMC-A (1). All serine carbapenemases were detected in the United States, while M␤L-producing strains were isolated in Europe. Carbapenemase-producing Enterobacteriaceae showed high rates of resistance to most antimicrobial agents tested. The rank order of in vitro activity against these strains was as follows: tigecycline (100.0% susceptible) > polymyxin B (88.1%) > amikacin (73.0%) > imipenem (37.5%). Tigecycline was very active (MIC 90 , 1 g/ml) against this significant, contemporary collection of wellcharacterized strains and appears to be an excellent option compared to the polymyxins for treatment of infections caused by these multidrug-resistant Enterobacteriaceae.

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“…The IMI (for "imipenem-hydrolyzing ␤-lactamase") and NMC-A (for "not metalloenzyme carbapenemase") enzymes have been detected in rare clinical isolates of E. cloacae in the United States, France, and Argentina (149,175,181,183). NMC-A and IMI-1 have 97% amino acid identity and are related to SME-1, with approximately 70% amino acid identity (146,183).…”

Section: Chromosomally Encoded Enzymes: Sme Nmc and Imimentioning

confidence: 99%

Carbapenemases: the Versatile β-Lactamases

2007

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SUMMARY Carbapenemases are β-lactamases with versatile hydrolytic capacities. They have the ability to hydrolyze penicillins, cephalosporins, monobactams, and carbapenems. Bacteria producing these β-lactamases may cause serious infections in which the carbapenemase activity renders many β-lactams ineffective. Carbapenemases are members of the molecular class A, B, and D β-lactamases. Class A and D enzymes have a serine-based hydrolytic mechanism, while class B enzymes are metallo-β-lactamases that contain zinc in the active site. The class A carbapenemase group includes members of the SME, IMI, NMC, GES, and KPC families. Of these, the KPC carbapenemases are the most prevalent, found mostly on plasmids in Klebsiella pneumoniae. The class D carbapenemases consist of OXA-type β-lactamases frequently detected in Acinetobacter baumannii. The metallo-β-lactamases belong to the IMP, VIM, SPM, GIM, and SIM families and have been detected primarily in Pseudomonas aeruginosa; however, there are increasing numbers of reports worldwide of this group of β-lactamases in the Enterobacteriaceae. This review updates the characteristics, epidemiology, and detection of the carbapenemases found in pathogenic bacteria.

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NmcA Carbapenem-hydrolyzing Enzyme inEnterobacter cloacaein North America1

Cited by 49 publications

References 19 publications

Prevalence of Newer β-Lactamases in Gram-Negative Clinical Isolates Collected in the United States from 2001 to 2002

Prevalence of Newer β-Lactamases in Gram-Negative Clinical Isolates Collected in the United States from 2001 to 2002

Antimicrobial Activities of Tigecycline and Other Broad-Spectrum Antimicrobials Tested against Serine Carbapenemase- and Metallo-β-Lactamase-Producing Enterobacteriaceae : Report from the SENTRY Antimicrobial Surveillance Program

Carbapenemases: the Versatile β-Lactamases

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