RESUMO
Sequence type 11 Klebsiella pneumoniae, coproducing NDM-1 and VIM-1 metallo-ß-lactamases, were isolated in a Greek hospital. blaNDM-1 was part of a Tn125 derivative, located on an ~90-kb plasmid similar to the NDM-1-encoding plasmid pB-3002cz. blaVIM-1 was located in an In-e541-like integron, carried on a multireplicon (IncA/C and IncR) plasmid of ~180kb.
Assuntos
Proteínas de Bactérias/genética , Carbapenêmicos/farmacologia , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/genética , beta-Lactamases/genética , Proteínas de Bactérias/metabolismo , Grécia , Hospitais , Humanos , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/isolamento & purificação , Testes de Sensibilidade Microbiana , beta-Lactamases/metabolismoRESUMO
OBJECTIVES: An Enterococcus faecium isolate (Efa-125) carrying both the vanA and vanB genes was recovered from a patient with bacteraemia treated in a Greek hospital. Since this is the first description in Europe of E. faecium carrying both vanA and vanB genes, the isolate was further studied. METHODS: Susceptibility to several antibiotics was determined using the VITEK®2 automated system. The isolate was typed by multilocus sequence typing (MLST). To define the genetic units of the vanA and vanB genes, the plasmid content of Efa-125 was analysed by pulsed-field gel electrophoresis (PFGE) of total DNA digested with S1 nuclease followed by hybridisation with digoxigenin-labelled vanA and vanB probes. In addition, plasmids and chromosomes were sequenced using the Illumina MiSeq platform. RESULTS: E. faecium Efa-125 belonged to ST117 and expressed resistance both to vancomycin and teicoplanin, with minimum inhibitory concentrations (MICs) for both of 256mg/L. The vanA gene was carried on a 29 320-bp plasmid exhibiting high similarity to pA6981 previously characterised from Enterococcus gallinarum A6981, whereas vanB was part of a Tn1549-like transposon integrated into the chromosome. Expression of the VanA phenotype was correlated with the presence of intact vanZ and vanS genes. CONCLUSIONS: This is the first detection in Greece of vanA-vanB genotype/VanA phenotype E. faecium and indicates an evolving epidemiology of vancomycin-resistant enterococci.
Assuntos
Proteínas de Bactérias/genética , Carbono-Oxigênio Ligases/genética , Enterococcus faecium/genética , Enterococcus faecium/isolamento & purificação , Epidemiologia Molecular , Antibacterianos/farmacologia , Bacteriemia/microbiologia , Elementos de DNA Transponíveis , Eletroforese em Gel de Campo Pulsado , Enterococcus faecium/efeitos dos fármacos , Enterococcus faecium/patogenicidade , Europa (Continente) , Regulação Bacteriana da Expressão Gênica , Genes Bacterianos/genética , Genótipo , Infecções por Bactérias Gram-Positivas/microbiologia , Grécia/epidemiologia , Hospitais , Humanos , Testes de Sensibilidade Microbiana , Tipagem de Sequências Multilocus , Fenótipo , Plasmídeos/genética , Proteínas Quinases/genética , Teicoplanina/farmacologia , Fatores de Transcrição/genética , Vancomicina/farmacologia , Resistência a Vancomicina , Enterococos Resistentes à Vancomicina/genéticaRESUMO
INTRODUCTION: The role played by Mycoplasma pneumoniae and Chlamydophila pneumoniae in the pathogenesis of chronic rhinosinusitis with nasal polyps has been the object of ongoing debate. We used real-time polymerase chain reaction to investigate the prevalence of both microorganisms in the nasal tissue samples of patients and controls. METHODS: We extracted DNA from nasal polyp samples obtained during functional endoscopic sinus surgery and the inferior turbinate samples of controls undergoing septoplasty. We used the highly sensitive real-time polymerase chain reaction to detect the presence of M pneumoniae and C pneumoniae DNA. RESULTS: Patients with chronic rhinosinusitis with nasal polyps consisted of 62 individuals (39 men; mean age 51 years); the control group consisted of 24 individuals (13 men; mean age 45 years). All samples from both groups were negative for M pneumoniae and C pneumoniae DNA. CONCLUSION: We have demonstrated that the likelihood of M pneumoniae and C pneumoniae acting as an ongoing inflammatory stimulus in chronic rhinosinusitis with nasal polyps is slim.