Dissemination in distinct Brazilian regions of an epidemic carbapenem-resistant Pseudomonas aeruginosa producing SPM metallo-β-lactamase
Dissemination in distinct Brazilian regions of an epidemic carbapenem-resistant Pseudomonas aeruginosa producing SPM metallo-β-lactamase
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DOI：
10.1093/jac/dkg416
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发表时间：
2003-10-01
影响因子：
5.2
通讯作者：
Sader, HS
中科院分区：
文献类型：
--
作者：
Gales, AC;Menezes, LC;Sader, HS
背景资料：在巴西，碳青霉烯类抗生素的使用一直受到限制的高碳青霉烯类抗生素耐药率之间的铜绿假单胞菌solutions.Objective：本研究的主要目的是评估存在的流行性铜绿假单胞菌菌株在无关的巴西医院。方法：采用微量肉汤稀释法进行药敏试验。通过核糖体分型和脉冲场凝胶电泳（PFGE）对分离株进行分型。使用MBL抑制剂的圆盘近似测试用于筛选MBL生产的分离株。结果：12家医院共分离出43株耐碳青霉烯类药物的铜绿假单胞菌。黏菌素在体外保持最大活性。一个单一的核糖体组包括17个铜绿假单胞菌分离株（39.5%），收集自位于巴西五个州的七家无关医院。其中16个分离株表现出相同的PFGE图谱，15个分离株产生类似SPM-1的MBL。其余26株分离株被分为25个不同的核糖基;没有一个是MBL生产者。结论：流行性克隆的出现和传播导致了巴西铜绿假单胞菌分离株的高碳青霉烯类耐药率。此外，SPM MBL的产生在该区域的碳青霉烯耐药中具有重要作用。这是第一份关于产SPM-1样MBL的铜绿假单胞菌菌株在无关的巴西医院中传播的报告。
Background: In Brazil, carbapenem use has been limited by high carbapenem-resistance rates among Pseudomonas aeruginosa isolates.Objective: The main objective of this study was to evaluate the presence of an epidemic P. aeruginosa strain in unrelated Brazilian hospitals. We also aimed to search for the gene bla(SPM), which encodes production of SPM, a novel metallo-beta-lactamase (MBL).Methods: A reference broth microdilution method was used for antimicrobial susceptibility testing. The isolates were typed by ribotyping and pulsed-field gel electrophoresis (PFGE). A disc-approximation test using MBL inhibitors was employed to screen isolates for MBL production. PCR was used to search for the gene bla(SPM).Results: A total of 43 clinical isolates of carbapenem-resistant P. aeruginosa were collected from 12 hospitals. Colistin retained greatest activity in vitro. A single ribogroup included 17 P. aeruginosa isolates (39.5%) collected from seven unrelated hospitals located in five Brazilian states. Sixteen of these isolates showed an identical PFGE pattern, and 15 produced an SPM-1-like MBL. The remaining 26 isolates were grouped into 25 diverse ribogroups; none were MBL producers.Conclusions: The emergence and dissemination of an epidemic clone has contributed to the high carbapenem resistance rates among P. aeruginosa isolates in Brazil. In addition, the production of SPM MBL has an important role in carbapenem resistance in this region. This is the first report of dissemination of an SPM-1-like-MBL-producing strain of P. aeruginosa among unrelated Brazilian hospitals.