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Emergence of carbapenem-hydrolysing metallo-β-lactamase VIM-1 in Pseudomonas aeruginosa isolates in France

2006; Elsevier BV; Volume: 12; Issue: 9 Linguagem: Inglês

10.1111/j.1469-0691.2006.1532_1.x

1469-0691

Stéphane Corvec, Laurent Poirel, J.‐W. Decousser, P. Allouch, H Drugeon, Patrice Nordmann,

Vibrio bacteria research studies

Recent articles in CMI have described the dissemination of metallo-β-lactamase (MBL) genes conferring resistance to carbapenems [1Sader HS Reis AO Silbert S Gales AC IMPs, VIMs and SPMs: the diversity of metallo-β-lactamases produced by carbapenem-resistant Pseudomonas aeruginosa in a Brazilian hospital.Clin Microbiol Infect. 2005; 11: 73-76Abstract Full Text Full Text PDF PubMed Scopus (73) Google Scholar,2Viana Vieira V Lourenço da Fonseca É Paulo Vicente AC Metallo-β-lactamases produced by carbapenem-resistant Pseudomonas aeruginosa in Brazil.Clin Microbiol Infect. 2005; 11: 937Abstract Full Text Full Text PDF PubMed Scopus (8) Google Scholar]. Carbapenem-hydrolysing β-lactamases identified in Pseudomonas aeruginosa have mostly been of the IMP and VIM families [3Walsh TR Toleman MA Poirel L Nordmann P Metallo-βlactamases: the quiet before the storm?.Clin Microbiol Rev. 2005; 18: 306-325Crossref PubMed Scopus (1144) Google Scholar]. Although VIM-1 was the first determinant described in Europe (in Italy), VIM-2 determinants have spread worldwide and have been reported in isolates causing outbreaks of infection [4Aubron C Poirel L Fortineau N Nicolas P Collet L Nordmann P Nosocomial spread of Pseudomonas aeruginosa isolates expressing the metallo-β-lactamase VIM-2 in a haematology unit of a French hospital.Microb Drug Resist. 2005; 11: 254-259Crossref PubMed Scopus (32) Google Scholar]. We wish to report the first isolation in France of P. aeruginosa isolates producing the VIM-1 type MBL. A prospective study was carried out among a collection of 1400 P. aeruginosa isolates recovered from 105 French hospitals during 2004–2005. Twenty-three isolates exhibited resistance to ticarcillin, associated with resistance to ceftazidime or imipenem, but only four were recognised as MBL producers using Etest strips for MBL detection (AB Biodisk, Solna, Sweden) [3Walsh TR Toleman MA Poirel L Nordmann P Metallo-βlactamases: the quiet before the storm?.Clin Microbiol Rev. 2005; 18: 306-325Crossref PubMed Scopus (1144) Google Scholar]. Isolates V4 (Saint Germain-en-Laye) and P0510 (Nantes) were from urine, whereas V115 (Le Mans) and V1236 (Vannes) were from bronchial aspirates. MICs were determined by agar dilution and interpreted as recommended by CLSI guidelines [5Clinical and Laboratory Standards InstitutePerformance standards for antimicrobial susceptibility testing. CLSI, Wayne, PA2005Google Scholar], with P. aeruginosa VR-143/97 (VIM-1-positive) as a reference strain [6Lauretti L Riccio ML Mazzariol A et al.Cloning and characterization of blaVIM, a new integron-borne metallo-βlactamase gene from a Pseudomonas aeruginosa clinical isolate.Antimicrob Agents Chemother. 1999; 43: 1584-1590Crossref PubMed Google Scholar]. All four isolates were resistant to all available antibiotics, except colimycin, fosfomycin, amikacin and aztreonam. PCR with blaVIM- and blaIMP-specific primers, followed by sequencing, revealed an identical blaVIM-1 gene in each MBL-positive isolate [7Poirel L Naas T Nicolas D et al.Characterization of VIM-2, a carbapenem-hydrolyzing metallo-β-lactamase and its plasmid and integron-borne gene from a Pseudomonas aeruginosa clinical isolate in France.Antimicrob Agents Chemother. 2000; 44: 891-897Crossref PubMed Scopus (484) Google Scholar]. PCR mapping [8Lévesque C Piche L Larose C Roy PH PCR mapping of integrons reveals several novel combinations of resistance genes.Antimicrob Agents Chemother. 1995; 39: 185-191Crossref PubMed Google Scholar] and sequencing of the flanking regions revealed an integron, In70.2, which was identical to that found in the four P. aeruginosa isolates described by Lauretti et al. [6Lauretti L Riccio ML Mazzariol A et al.Cloning and characterization of blaVIM, a new integron-borne metallo-βlactamase gene from a Pseudomonas aeruginosa clinical isolate.Antimicrob Agents Chemother. 1999; 43: 1584-1590Crossref PubMed Google Scholar]. Conjugation experiments [7Poirel L Naas T Nicolas D et al.Characterization of VIM-2, a carbapenem-hydrolyzing metallo-β-lactamase and its plasmid and integron-borne gene from a Pseudomonas aeruginosa clinical isolate in France.Antimicrob Agents Chemother. 2000; 44: 891-897Crossref PubMed Scopus (484) Google Scholar], using the four VIM-1-producing isolates as donors, failed to yield transconjugants. To search for a possible chromosomal location of the MBL gene, the I-CeuI endonuclease technique was used [9Riccio ML Pallecchi L Docquier JD et al.Clonal relatedness and conserved integron structures in epidemiologically unrelated Pseudomonas aeruginosa strains producing the VIM-1 metallo-β-lactamase from different Italian hospitals.Antimicrob Agents Chemother. 2005; 49: 104-110Crossref PubMed Scopus (59) Google Scholar]. The internal blaVIM-1 probe hybridised with a very large fragment that co-hybridised with the 16SrRNA probe, indicating a chromosomal location for the blaVIM-1 gene, as reported previously for P. aeruginosa VR-143/97 [6Lauretti L Riccio ML Mazzariol A et al.Cloning and characterization of blaVIM, a new integron-borne metallo-βlactamase gene from a Pseudomonas aeruginosa clinical isolate.Antimicrob Agents Chemother. 1999; 43: 1584-1590Crossref PubMed Google Scholar]. Pulsed-field gel electrophoresis analysis was also performed in order to genotype the four VIM-1-positive isolates [4Aubron C Poirel L Fortineau N Nicolas P Collet L Nordmann P Nosocomial spread of Pseudomonas aeruginosa isolates expressing the metallo-β-lactamase VIM-2 in a haematology unit of a French hospital.Microb Drug Resist. 2005; 11: 254-259Crossref PubMed Scopus (32) Google Scholar]. Although V4, V115 and V1236 had been recovered from different hospitals located at least 200 km from each other, these isolates were clonally related, while isolate P0510 belonged to a distinct clone. Pulsed-field gel electrophoresis analysis also indicated that those two pulsotypes were different from that of the P. aeruginosa VR143/97 strain from Italy [6Lauretti L Riccio ML Mazzariol A et al.Cloning and characterization of blaVIM, a new integron-borne metallo-βlactamase gene from a Pseudomonas aeruginosa clinical isolate.Antimicrob Agents Chemother. 1999; 43: 1584-1590Crossref PubMed Google Scholar]. VIM-1 is the second MBL (after VIM-2) that has been identified as a cause of carbapenem resistance in P. aeruginosa isolates in France. In nearby European countries (Greece and Italy), VIM-1 is predominant and has been associated with large outbreaks of multidrug-resistant P. aeruginosa or Enterobacteriaceae [3Walsh TR Toleman MA Poirel L Nordmann P Metallo-βlactamases: the quiet before the storm?.Clin Microbiol Rev. 2005; 18: 306-325Crossref PubMed Scopus (1144) Google Scholar]. In Spain, following the discovery of VIM-2 in P. aeruginosa, strains of Escherichia coli and Klebsiella pneumoniae producing VIM-1 have recently been isolated [3Walsh TR Toleman MA Poirel L Nordmann P Metallo-βlactamases: the quiet before the storm?.Clin Microbiol Rev. 2005; 18: 306-325Crossref PubMed Scopus (1144) Google Scholar]. Thus, VIM-1 and VIM-2 may coexist in southern Europe in P. aeruginosa strains. Interestingly, the genetic structure surrounding blaVIM-1 was identical to that reported previously in Italy [6Lauretti L Riccio ML Mazzariol A et al.Cloning and characterization of blaVIM, a new integron-borne metallo-βlactamase gene from a Pseudomonas aeruginosa clinical isolate.Antimicrob Agents Chemother. 1999; 43: 1584-1590Crossref PubMed Google Scholar], which suggests the possibility of a conserved blaVIM-1 integron structure in non-clonally related P. aeruginosa isolates, as has also been suggested recently by Riccio et al. [9Riccio ML Pallecchi L Docquier JD et al.Clonal relatedness and conserved integron structures in epidemiologically unrelated Pseudomonas aeruginosa strains producing the VIM-1 metallo-β-lactamase from different Italian hospitals.Antimicrob Agents Chemother. 2005; 49: 104-110Crossref PubMed Scopus (59) Google Scholar]. This work was funded by a grant from the Ministère de l'Education Nationale et de la Recherche (UPRES-EA3539), Université Paris XI, Paris, France, and by grants from the European Community (6th PCRD; LSHM-CT-2003-503-335 and LSHM-CT-2005-018705). We thank G. M. Rossolini for the gift of the P. aeruginosa VR143/97 strain. LP is a researcher from the INSERM, France.