Characterisation of VIM-2-producing <Emphasis Type="Italic">Pseudomonas aeruginosa</Emphasis> isolates from lower tract respiratory infections in a Spanish hospital |
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Authors: | Alba Bellés Jessica Bueno Beatriz Rojo-Bezares Carmen Torres F Javier Castillo Yolanda Sáenz Cristina Seral |
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Institution: | 1.Servicio de Microbiología, IIS Aragón,Hospital Clínico Universitario Lozano Blesa,Zaragoza,Spain;2.Sección de Microbiología,Hospital Universitario Arnau de Vilanova,Lérida,Spain;3.área de Microbiología Molecular,Centro de Investigación Biomédica de La Rioja (CIBIR),Logro?o,Spain;4.área de Bioquímica y Biología Molecular,Universidad de La Rioja,Logro?o,Spain;5.Departamento de Microbiología, Facultad de Medicina,Universidad de Zaragoza,Zaragoza,Spain |
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Abstract: | To analyse the antimicrobial phenotype, carbapenem mechanisms, integrons, virulence factors and molecular typing of 164 Pseudomonas aeruginosa isolates recovered from lower tract respiratory samples in a Spanish hospital (1 year) as well as the patients’ clinical data. Susceptibility testing to 12 antipseudomonal agents was determined by microdilution and metallo-beta-lactamase (MBL) phenotype by double disc method. The oprD gene was studied by PCR, sequencing and comparison with P. aeruginosa PAO1 sequence. Detection and characterisation of MBLs, class 1, 2 and 3 integrons, and virulence genes were studied by PCR and sequencing. The prevalence of carbapenem-resistant P. aeruginosa (CRPA) was 26.8%. MBL phenotype was detected in 52.3% CRPA, and all of them were disseminated throughout the intensive care unit. Most of the MBL-carrying patients presented respiratory disease, mechanical ventilation, tracheostomy, bacteraemia, ≥?30 hospitalisation days and previous treatment with carbapenems and/or ≥?3 different antimicrobial families. The blaVIM-2 gene was the unique MBL encoding gene and was detected inside class 1 integrons. The class 1 integrons detected in 39 strains (23.8%) were associated with aminoglycosides (aadB, aadA1, aadA6, aacA4, aac(3)-I) and carbapenems resistance genes (blaVIM-2). The aac(3)-I?+?aadA1 and blaVIM-2 arrangements were the most prevalent ones. Thirty-one different PFGE patterns and 4 STs (ST175, ST235, ST253, ST973) were detected among the 39 intI1-positive isolates, being ST235 the most frequent. CRPA showed a great variety of alterations in oprD gene. The exoU+/exoS? genotype was detected in 82.6% of blaVIM-2-producing strains (ST235) and the exoU?/exoS+ in the remaining 17.4% (ST973). |
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