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VIM-4 in a Carbapenem-Resistant Strain of Pseudomonas aeruginosa Isolated in Sweden

2003; American Society for Microbiology; Volume: 47; Issue: 9 Linguagem: Inglês

10.1128/aac.47.9.3034-3035.2003

1098-6596

Christian G. Giske, Margareta Rylander, Göran Kronvall,

Antibiotic Use and Resistance

VIM-4 in a Carbapenem-Resistant Strain of Pseudomonas aeruginosa Isolated in SwedenThe first VIM metallo-␤-lactamase (MBL), VIM-1, was described in Verona in 1997 for a Pseudomonas aeruginosa isolate (2).Since then VIM-2 has been identified in Marseille in 2000 (1), VIM-3 has been identified in Taiwan (7) in 2001, and VIM-4 has been identified in Greece in 2001 (5).Worldwide spread of the VIM and IMP MBLs is now well documented (3), but MBLs have not been described in all parts of the world.In this letter we report a P. aeruginosa strain isolated in Sweden producing VIM-4.This is the first description of an MBL-producing P. aeruginosa isolate in Scandinavia.Eighty imipenem-resistant clinical isolates of P. aeruginosa from the years 2000 to 2003 were collected from Karolinska Hospital to evaluate the presence of MBL production.Imipenem susceptibility was determined by the disk-diffusion method (4) (http://www.srga.org).All replicate isolates were excluded from the study.Seventy-three of eighty isolates (91.3%) were hospital derived, and out of these, 15 isolates (20.5%) came from intensive care units.Six of the isolates (7.5%) were derived from patients with cystic fibrosis.There were no reports of outbreaks of carbapenem-resistant P. aeruginosa at Karolinska Hospital during the three years when the strains were collected.The strains were screened for MBL production, using the imipenem-EDTA E-test synergy test (6).E-tests were purchased from AB Biodisk (Solna, Sweden).Positive control strains were P. aeruginosa CP99-24 and Serratia marcescens CI 10-4-9, while P. aeruginosa ATCC 27983 was used as a negative control.One strain, P. aeruginosa PA 66, showed a reduction in the MIC for imipenem-MIC from Ͼ256 mg/liter to 6 mg/liter, indicating a strong inhibitory effect of EDTA.The strain was further investigated with primers for IMP and VIM (Table 1).Primers were purchased from Cybergene (Huddinge, Sweden).One amplicon was generated with the VIM primers, and the amplicon was sequenced on the Gene-Amp PCR System 9700 (AB Applied Biosystems, Foster City, Calif.), using the same VIM primers as for PCR.Sample electrophoresis was performed on an ABI PRISM 310 genetic analyzer (AB Applied Biosystems).Sequencing of both strands generated a 640-bp sequence, which was compared to sequence databases with BLAST (http://www.ncbi.nlm.nih.gov/blast), showing 100% identity to bla VIM-4 .Sequencing with a new set of primers based on published VIM-4 sequences (Ta-