Isolation of an Integron-Borne blaVIM-4 Type Metallo-β-Lactamase Gene from a Carbapenem-Resistant Pseudomonas aeruginosa Clinical Isolate in Hungary | Antimicrobial Agents and Chemotherapy

Isolation of an Integron-Borne blaVIM-4 Type Metallo-β-Lactamase Gene from a Carbapenem-Resistant Pseudomonas aeruginosa Clinical Isolate in Hungary | Antimicrobial Agents and Chemotherapy

Isolation of an Integron-Borne blaVIM-4 Type Metallo-β-Lactamase Gene from a Carbapenem-Resistant Pseudomonas aeruginosa Clinical Isolate in Hungary

Balázs Libisch, Mária Gacs, Károly Csiszár, Mónika Muzslay, László Rókusz, Miklós Füzi

DOI: 10.1128/AAC.48.9.3576-3578.2004

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ABSTRACT

The first integron-borne metallo-β-lactamase gene was isolated in Hungary. The blaVIM-4 gene is located on a class 1 integron that also carries a novel blaOXA-like gene. The integron is harbored by a serotype O12 Pseudomonas aeruginosa strain and shows high structural similarity to integrons isolated in Greece and Poland.

Acquired metallo-β-lactamases (MBLs) are mostly encoded by integron-borne genes and confer resistance against all β-lactams except for the monobactams. VIM-type MBLs were reported from several European countries and also from countries outside Europe such as Korea and the United States (10, 20). An outbreak involving 47 VIM-producing Pseudomonas aeruginosa isolates was reported from the University Hospital of Thessaly, Greece, in 2001 to 2002, where the blaVIM-4 gene had originally been identified (14, 15).

During this study 226 carbapenem-resistant P. aeruginosa isolates from Hungary were screened for MBL production by phenotypic tests. The isolates were obtained from clinical microbiology laboratories between January 2001 and September 2003. P. aeruginosa strains PA396 and PA450 were isolates from the intensive care unit of the Central Military Hospital in Budapest. Strain PA396 was isolated in August 2002 from the urine of a Greek citizen polytraumatic patient 2 days before his death. The patient died due to multiorganic failure as part of a severe septic shock. The antibiotic treatment of the patient included piperacillin-tazobactam, meropenem, vancomycin, and amikacin. According to the anamnesis, the patient's previous clinical history included tonsillectomy and appendectomy. Strain PA450 was isolated in September 2002 from the urine of a Hungarian citizen polytraumatic patient 1 day before his death. The applied antibiotic therapy included cefuroxime, imipenem-cilastatin, and vancomycin.