Production of CTX-M-3 extended-spectrum beta-lactamase and IMP-1 metallo beta-lactamase by five Gram-negative bacilli: survey of clinical isolates from seven laboratories collected in 1998 and 2000, in the Kinki region of Japan

Yamasaki, Katsutoshi; Komatsu, Masaru; Yamashita, Tomonari; Shimakawa, Koichi; Ura, Toshiro; Nishio, Hisaaki; Satoh, Kaori; Washidu, Ryoudou; Kinoshita, Shohiro; Aihara, Masanori

doi:10.1093/jac/dkg103

Cited by 63 publications

(49 citation statements)

References 40 publications

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“…The rapid emergence of the CTX-Ms as the predominant ESBL type is not an isolated Lebanese phenomenon. A recent report on ESBL types in Enterobacteriaceae in Argentinean public hospitals found that CTX-Ms accounted for roughly 70% of all ESBLs found (31), with similar findings in studies conducted in Japan (35), China (23), the United Kingdom (22), and Spain (33). CTX-M-15 has already been identified in several countries, including Taiwan (36), Turkey (16), France (8), and United Kingdom (24).…”

Section: Discussionsupporting

confidence: 63%

Countrywide Spread of Community- and Hospital-Acquired Extended-Spectrum β-Lactamase (CTX-M-15)-Producing Enterobacteriaceae in Lebanon

et al. 2005

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A prospective study was carried out to assess the extent of carriage of extended-spectrum ␤-lactamase (ESBL)-producing Enterobacteriaceae at both hospital and community levels in Lebanon. A total of 1,442 fecal samples were collected from hospital-based patients and 58 from health care workers of six Lebanese tertiary care general hospitals located in different areas of Lebanon between January and March 2003. A total of 382 fecal samples were also collected from healthy subjects between April and June 2003. The samples analysis led to the identification of 118 strains as ESBL producers based on the synergistic effects between clavulanate and selected ␤-lactams (ceftazidime and cefotaxime). These strains were isolated from 72 subjects: 61 patients, 2 health care workers, and 9 healthy subjects. One representative strain per subject was selected, and a total of 72 nonduplicate ESBL producers, including a high majority of Escherichia coli (n ‫؍‬ 56), Klebsiella pneumoniae (n ‫؍‬ 9), Enterobacter cloacae (n ‫؍‬ 6), and Citrobacter freundii (n ‫؍‬ 1), were characterized. The molecular analysis revealed that the majority of the strains (83%) express CTX-M-15 ESBL (pI 8.6). SHV-5a ESBL (pI 8.2) was produced by 18% of the strains. DNA macrorestriction analysis of ESBL-producing E. coli presented 38 different genotypes, revealing the absence of clonal link among these strains. In addition to the fact that the present study highlights the emergence and the countrywide dissemination of CTX-M-15-producing E. coli in Lebanon, it represents the first report of an SHV-5a-producing C. freundii.

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Section: Discussionsupporting

confidence: 63%

Countrywide Spread of Community- and Hospital-Acquired Extended-Spectrum β-Lactamase (CTX-M-15)-Producing Enterobacteriaceae in Lebanon

et al. 2005

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“…Several researchers have reported an incidence of metallo-␤-lactamase-producing P. aeruginosa of between 0.4 and 1.3% in Japan from 1992 to 2002 (5,7,14,16). In this study, we isolated 1.9% metallo-␤-lactamase-producing P. aeruginosa strains from geographically diverse regions in Japan.…”

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confidence: 67%

Clonal Diversity of Metallo-β-Lactamase-Possessing Pseudomonas aeruginosa in Geographically Diverse Regions of Japan

et al. 2005

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The aim of this study was to determine the distribution of metallo-␤-lactamase-producing Pseudomonas aeruginosa in Japan and to investigate the molecular characteristics of resistance gene cassettes including the gene encoding this enzyme. A total of 594 nonduplicate strains of P. aeruginosa isolated from 60 hospitals throughout Japan in 2002 were evaluated. This study indicated that although the prevalence of imipenemresistant P. aeruginosa has not increased compared to that found in previous studies, clonal distribution of the same strain across Japan is evident.Class A, B, and D ␤-lactamases, as defined by Ambler et al., can hydrolyze carbapenems (1, 9). In particular, class B ␤-lactamases, termed metallo-␤-lactamases, are an increasingly serious clinical problem because they have a very broad substrate profile that includes penicillins, expanded-spectrum cephalosporins, and carbapenems and excludes only monobactams, such as aztreonam. It has been reported that IMP-1 metallo-␤-lactamase-producing Serratia marcescens was first isolated in Japan in 1991 (10). Recently, metallo-␤-lactamase-producing Pseudomonas aeruginosa and S. marcescens probably have the highest incidence of isolation in Japan (7).Most metallo-␤-lactamase genes are located on integrons, which are genetic elements containing gene cassettes that can facilitate their spread and mobilize the genes to other integrons or to other sites. The gene cassettes often encode clinically important antibiotic resistance genes, including those encoding ␤-lactamases such as extended-spectrum ␤-lactamases and carbapenemases, and also aminoglycoside-modifying enzymes (12).Little is known about the distribution of the clone(s) that produces metallo-␤-lactamases in Japan. Therefore, we conducted a surveillance study covering a wide geographic area with the aim of determining the distribution of metallo-␤-lactamase producers in Japan and to investigate the molecular characteristics of the resistance gene cassettes that included the gene encoding a metallo-␤-lactamase.A total of 594 nonduplicate strains of P. aeruginosa isolated from 60 hospitals throughout Japan in the year 2002 were evaluated. The susceptibility of P. aeruginosa to several antibiotics was measured with the Etest strip, and the strains were stored on Casitone medium (Eiken Chemical Co. Ltd., Tokyo, Japan) (data not shown). After 6 months, the antibiotic susceptibility of these isolates was reassessed by the National Committee for Clinical Laboratory Standards broth microdilution method with cation-adjusted Mueller-Hinton broth (Difco, Detroit, Mich.). The isolates were screened for the presence of metallo-␤-lactamase by a double-disk synergy test reported by Arakawa et al. (2). Integron analysis was performed by PCR mapping (5Ј-conserved segment intI to 3Ј-conserved segment qacE⌬1) of the typical antibiotic resistance genes and integron with specific primer sets ( Table 1). The specificity of the primer sets for bla IMP-1 -like and bla VIM-2 -like gene was confirmed with positive-control strains pr...

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“…Among the clinically isolated P. aeruginosa, 1.7% in 1,058 isolates had metallo-β-lactamase genes with integron1, which could frequently form cassettes consisting of the genes of aminoglycoside modifying enzymes, or other β-lactamases resulting in several drug resistances (24). In a laboratory-based surveillance in Japan conducted during 1992-2002, metallo-β-lactamase-producing P. aeruginosa were identified at a rate of 0.4-1.9% (3,4,12,26). These results together with our observation suggest that the incidence of metallo-β-lactamase-positive P. aeruginosa has not increased in Japan.…”

Section: Discussionmentioning

confidence: 99%

Molecular Characterization of Imipenem‐Resistant Pseudomonas aeruginosa in Hiroshima, Japan

Ohara

Kouda

Onodera

et al. 2007

Microbiology and Immunology

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Nosocomial infections by Pseudomonas aeruginosa continue to be a widespread problem in Asia, North and South America, and Europe. Carbapenems are the most potent β-lactams against P. aeruginosa because its strong affinity to penicillin binding proteins, stability against most serine β-lactamases and high permeability across the outer membrane (7,8). However, intensive use of the carbapenems facilitated the emergence of carbapenem-resistant P. aeruginosa. Low level resistance to imipenem (MIC, 8 to 32 µg/ml) in P. aeruginosa is mostly due to reduced uptake of the drug as a result of loss of the porin OprD (8). This mechanism correlates with continued expression of AmpC β-lactamase. Resistance to meropenem but not imipenem may also arise via overexpression of the MexA-MexBOprM efflux pump (14). High level resistance to carbapenems (MICϾ32 µg/ml) can be caused by the presence of metallo-β-lactamase, which exhibits a broadspectrum resistance to β-lactams including carbapenems. Metallo-β-lactamase-producing P. aeruginosa Abstract: Pseudomonas aeruginosa showing resistance to imipenem were found in 100 of 1,058 strains (9.5%) from six hospitals (a-f) in Hiroshima City, Japan. Of the 100 strains, 14 (14%) were double disk synergy test positive using sodium mercaptoacetic acid disks, and 18 (18%) were bla IMP-1 or blaVIM-2 allele positive by polymerase chain reaction (PCR). Among 100 imipenem-resistant strains, 32 were categorized into multi-drug resistant strains, in which 13 were positive for the metallo-␤-lactamase gene. Fifty-one strains (51%) among the 100 imipenem-resistant strains had elevated RND efflux pump activity against levofloxacin. But only 6 of 51 strains were classified as multi-drug resistant strains. The pulsed field gel electrophoresis analysis of the SpeI-digested DNA from the 100 isolates suggested not only clonal spread but spread of heterogeneous clones started to contribute to the prevalence of metallo-␤-lactamase producing P. aeruginosa strains in Japanese hospitals.

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Production of CTX-M-3 extended-spectrum beta-lactamase and IMP-1 metallo beta-lactamase by five Gram-negative bacilli: survey of clinical isolates from seven laboratories collected in 1998 and 2000, in the Kinki region of Japan

Cited by 63 publications

References 40 publications

Countrywide Spread of Community- and Hospital-Acquired Extended-Spectrum β-Lactamase (CTX-M-15)-Producing Enterobacteriaceae in Lebanon

Countrywide Spread of Community- and Hospital-Acquired Extended-Spectrum β-Lactamase (CTX-M-15)-Producing Enterobacteriaceae in Lebanon

Clonal Diversity of Metallo-β-Lactamase-Possessing Pseudomonas aeruginosa in Geographically Diverse Regions of Japan

Molecular Characterization of Imipenem‐Resistant Pseudomonas aeruginosa in Hiroshima, Japan

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