Detection of P. aeruginosaharboring bla CTX-M-2, bla GES-1 and bla GES-5, bla IMP-1 and bla SPM-1 causing infections in Brazilian tertiary-care hospital

BMC Infectious Diseases

Mara CL Nogueira⁴  Margarete TG de Almeida⁴  Mauricio L Nogueira¹  Fernando G Rúbio⁴  Maria Gabriela de Lucca Oliveira³  Tiago Casella²  Milena Polotto² 

[1] Laboratório de Pesquisa em Virologia. Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil;Programa de Pós Graduação em Microbiologia, Universidade Estadual Paulista Júlio de Mesquita Filho, UNESP, Campus de São José do Rio Preto, Brazil;Laboratório Central do Hospital de Base de São José do Rio Preto, São José do Rio Preto, SP, Brazil;Laboratório de Microbiologia. Departamento de Doenças Dermatológicas, Infecciosas e Parasitárias, Faculdade de Medicina de São José do Rio Preto, São José do Rio Preto, SP, Brazil

关键词: SPM-1;    IMP-1;    GES-5;    GES-1;    CTX-M-2;    MBL;    ESBL;    Nosocomial infection;    P. aeruginosa;   

Others  :  1175315
DOI  :  10.1186/1471-2334-12-176

 received in 2012-03-13, accepted in 2012-07-24,  发布年份 2012

【 摘 要 】

Background

Nosocomial infections caused by Pseudomonas aeruginosa presenting resistance to beta-lactam drugs are one of the most challenging targets for antimicrobial therapy, leading to substantial increase in mortality rates in hospitals worldwide. In this context, P. aeruginosa harboring acquired mechanisms of resistance, such as production of metallo-beta-lactamase (MBLs) and extended-spectrum beta-lactamases (ESBLs) have the highest clinical impact. Hence, this study was designed to investigate the presence of genes codifying for MBLs and ESBLs among carbapenem resistant P. aeruginosa isolated in a Brazilian 720-bed teaching tertiary care hospital.

Methods

Fifty-six carbapenem-resistant P. aeruginosa strains were evaluated for the presence of MBL and ESBL genes. Strains presenting MBL and/or ESBL genes were submitted to pulsed-field gel electrophoresis for genetic similarity evaluation.

Results

Despite the carbapenem resistance, genes for MBLs (bla_SPM-1 or bla_IMP-1) were detected in only 26.7% of isolates. Genes encoding ESBLs were detected in 23.2% of isolates. The bla_CTX-M-2 was the most prevalent ESBL gene (19.6%), followed by bla_GES-1 and bla_GES-5 detected in one isolate each. In all isolates presenting MBL phenotype by double-disc synergy test (DDST), the bla_SPM-1 or bla_IMP-1 genes were detected. In addition, bla_IMP-1 was also detected in three isolates which did not display any MBL phenotype. These isolates also presented the bla_CTX-M-2 gene. The co-existence of bla_CTX-M-2 with bla_IMP-1 is presently reported for the first time, as like as co-existence of bla_GES-1 with bla_IMP-1.

Conclusions

In this study MBLs production was not the major mechanism of resistance to carbapenems, suggesting the occurrence of multidrug efflux pumps, reduction in porin channels and production of other beta-lactamases. The detection of bla_CTX-M-2,bla_GES-1 and bla_GES-5 reflects the recent emergence of ESBLs among antimicrobial resistant P. aeruginosa and the extraordinary ability presented by this pathogen to acquire multiple resistance mechanisms. These findings raise the concern about the future of antimicrobial therapy and the capability of clinical laboratories to detect resistant strains, since simultaneous production of MBLs and ESBLs is known to promote further complexity in phenotypic detection. Occurrence of intra-hospital clonal dissemination enhances the necessity of better observance of infection control practices.

【 授权许可】

   
2012 Polotto et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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