RESUMEN
In order to analyze the presence of metallo-ß-lactamase in our country, we included in this study Pseudomonas aeruginosa isolates causing nosocomial infections in a hospital from Uruguay. The presence of a metallo-ß-lactamase VIM-2 in a class 1 integron and of an extended spectrum -lactamase CTX-M-2 was detected in one isolate. This is the first report of both genes, bla(CTX-M-2) and bla(VIM-2),in the same P. aeruginosa isolate. Although carbapenemases have been extensively documented in the world, this is the first report of an acquired metallo-ß-lactamase with carbapenemase activity in pathogenic bacteria in Uruguay.
Asunto(s)
Proteínas Bacterianas/genética , Farmacorresistencia Bacteriana Múltiple/genética , Genes Bacterianos , Integrones/genética , Infecciones por Pseudomonas/microbiología , Pseudomonas aeruginosa/genética , Resistencia betalactámica/genética , beta-Lactamasas/genética , Carbapenémicos/farmacología , Humanos , Infecciones por Pseudomonas/epidemiología , Pseudomonas aeruginosa/enzimología , Infecciones Urinarias/epidemiología , Infecciones Urinarias/microbiología , Uruguay/epidemiologíaRESUMEN
This study characterised the mechanisms of fluoroquinolone and oxyimino-cephalosporin resistance in human Salmonella enterica isolates in Uruguay. Salmonella enterica isolates were collected from 2011-2013 and were selected based on non-susceptibility to ciprofloxacin and/or oxyimino-cephalosporins. The disk diffusion assay was performed for various antibiotics, and the ciprofloxacin minimum inhibitory concentration (MIC) was determined following CLSI guidelines. Genetic relatedness was determined following PulseNet protocols. Extended-spectrum ß-lactamases, ampC alleles and plasmid-mediated quinolone resistance were characterised by PCR and sequencing. Plasmid analyses were carried out by conjugation or transformation assays, and plasmid-encoded genes were identified by PCR. Mutations in the quinolone resistance-determining region of gyrases were sought by PCR and sequencing. Among 579 isolates, 105 (18.4%) ciprofloxacin-non-susceptible (CIP-NS) isolates, 9 (1.6%) oxyimino-cephalosporin-resistant isolates and 2 (0.3%) isolates resistant to both antibiotic families were detected. Thirteen isolates carried qnrB alleles (twelve qnrB19 and one qnrB2), four carried blaCTX-M-8, two blaCTX-M-14, two blaSHV-2 and three blaCMY-2-like genes. No correlation was found between mutations in gyrases and ciprofloxacin MICs. Several co-circulating clones of S. enterica ssp. enterica serovar Typhimurium were detected; conversely, S. enterica ssp. enterica serovar Enteritidis corresponded mainly to a single circulating clone. Nine (75%) of twelve of CIP-NS extraintestinal isolates shared the same pulsotype with intestinal isolates. During the study period, the frequency of CIP-NS isolates increased, albeit with ciprofloxacin MICs of 0.125-0.5mg/L. Detection of the same quinolone-resistant clones recovered both from intestinal and extraintestinal samples highlights the significance of epidemiological surveillance of antibiotic susceptibility for every human Salmonella isolate.
Asunto(s)
Resistencia a las Cefalosporinas/genética , Salmonella enterica/genética , Antibacterianos/farmacología , Ciprofloxacina/farmacología , Humanos , Pruebas de Sensibilidad Microbiana , Plásmidos/genética , Quinolonas/farmacología , Infecciones por Salmonella , Salmonella enterica/efectos de los fármacos , UruguayRESUMEN
Con el fin de analizar la presencia de metalo-ß-lactamasas en nuestro medio, se incluyeron en este estudio aislamientos de Pseudomonas aeruginosa causantes de infecciones nosocomiales en un centro hospitalario del Uruguay, en el período comprendido entre abril y setiembre de 2008. En un aislamiento se detectó la presencia del gen codificante de la metalo-ß-lactamasa VIM-2 asociado a un integrón de clase 1 y del gen codificante de una ß-lactamasa de espectro extendido CTX-M-2. Esta es la primera comunicación de la presencia de los genes blaCTX-M-2 y blaVIM-2 en un mismo aislamiento de P. aeruginosa. A pesar de que las carbapenemasas ya han sido ampliamente documentadas en varias partes del mundo, esta es la primera comunicación de una metalo-ß-lactamasa adquirida con actividad carbapenemasa en bacterias patógenas encontradas en el Uruguay.
VIM-2 metallo-ß-lactamase gen detection in a class 1 integron associated to blaCTX-M-2 in a Pseudomonas aeruginosa clinical isolate in Uruguay: first communication. In order to analyze the presence of metallo-ß-lactamase in our country, we included in this study Pseudomonas aeruginosa isolates causing nosocomial infections in a hospital from Uruguay. The presence of a metallo-ß-lactamase VIM-2 in a class 1 integron and of an extended spectrum -lactamase CTX-M-2 was detected in one isolate. This is the first report of both genes, blaCTX-M-2 and blaVIM-2,in the same P. aeruginosa isolate. Although carbapenemases have been extensively documented in the world, this is the first report of an acquired metallo-ß-lactamase with carbapenemase activity in pathogenic bacteria in Uruguay.