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Emergence and persistence of integron structures harbouring VIM genes in the Children's Memorial Health Institute, Warsaw, Poland, 1998-2006

Patzer, Jan A., Walsh, Timothy Rutland, Weeks, Janis Lesley, Dzierzanowska, Danuta and Toleman, Mark Alexander Howard 2009. Emergence and persistence of integron structures harbouring VIM genes in the Children's Memorial Health Institute, Warsaw, Poland, 1998-2006. Journal of Antimicrobial Chemotherapy 63 (2) , pp. 269-273. 10.1093/jac/dkn512

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Abstract

Objectives The aim was to perform a genetically detailed study of the emergence of metallo-β-lactamase (MBL) genes in Pseudomonas spp. in the Children's Memorial Health Institute over a 9 year period. Methods Carbapenem-resistant Pseudomonas spp. isolates were collected from 1998 to 2006 and screened for MBL production. MBL-positive isolates were further investigated by a combination of genetic techniques including PCR, genomic location experiments using pulsed-field gel electrophoresis (PFGE) of I-Ceu1, S1 and SpeI digests, and sequencing. Results Of the 20 MBL-containing Pseudomonas isolates collected from 1998 to 2006, 16 Pseudomonas aeruginosa isolates contained an identical class 1 integron structure. Two P. aeruginosa isolates contained the blaVIM-2 gene, and two Pseudomonas putida isolates harboured the blaVIM-4 gene cassette in different integron structures. PFGE analysis indicated that all blaVIM-4-containing P. aeruginosa isolates were closely related, whereas the P. putida isolates were not. All MBL genes in this study were chromosomally encoded, and all isolates harboured only one class 1 integron. The blaVIM-2 isolates were clonal, and the genetic structure supporting the blaVIM-2 gene was found in an identical chromosomal position. Conclusions MBL gene emergence in this hospital has paralleled a 6-fold increase in carbapenem usage. We have found an increase in MBL gene diversity, MBL host organisms and MBL genetic support structures in the hospital over the 9 year study period. There is also compelling evidence of the persistence of individual strains in the hospital throughout the study period. This suggests that once MBL genes have emerged in a hospital environment, they are difficult to remove.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Systems Immunity Research Institute (SIURI)
Subjects: R Medicine > R Medicine (General)
R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Uncontrolled Keywords: metallo-β-lactamases, class 1 integrons, VIM-2, VIM-4
Publisher: Oxford University Press
ISSN: 0305-7453
Last Modified: 04 Jun 2017 03:47
URI: http://orca.cf.ac.uk/id/eprint/26843

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