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Metallo-beta-lactamases among imipenem-resistant Pseudomonas aeruginosa in a Brazilian university hospital

Franco, Maria Renata Gomes; Caiaffa-Filho, Hélio Hehl; Burattini, Marcelo Nascimento; Rossi, Flávia

Clinics; v. 65 n. 9 (2010); 825-829

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo 2010-01-01

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  • Título:
    Metallo-beta-lactamases among imipenem-resistant Pseudomonas aeruginosa in a Brazilian university hospital
  • Autor: Franco, Maria Renata Gomes; Caiaffa-Filho, Hélio Hehl; Burattini, Marcelo Nascimento; Rossi, Flávia
  • Assuntos: Pseudomonas Aeruginosa; Imipenem Resistance; Mbl Detection; Spm-1
  • É parte de: Clinics; v. 65 n. 9 (2010); 825-829
  • Descrição: INTRODUCTION: Imipenem-resistant Pseudomonas aeruginosa resulting from metallo-β-lactamases has been reported to be an important cause of nosocomial infection and is a critical therapeutic problem worldwide, especially in the case of bacteremia. OBJECTIVES: To determine the frequency of metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa isolates and to compare methods of phenotypic and molecular detection. METHODS: During 2006, 69 imipenem-resistant Pseudomonas aeruginosa samples were isolated from blood and tested for metallo-β-lactamase production using both phenotypic methods. Minimal Inhibitory Concentratrions (MIC) (μg/mL) was determined with commercial microdilution panels. Pulsed Field Gel Electrophoresis (PFGE) was performed among metallo-β-lactamase producers. RESULTS: Of all the blood isolates, 34.5% were found to be imipenem-resistant Pseudomonas aeruginosa. Positive phenotypic tests for metallo-β-lactamases ranged from 28%-77%, and Polymerase Chain Reaction (PCR) were positive in 30% (of note, 81% of those samples were blaSPM-1 and 19% were blaVIM-2). Ethylenediamine tetracetic acid (EDTA) combinations for the detected enzymes had low kappa values; thus, care should be taken when use it as a phenotypic indicator of MBL. Despite a very resistant antibiogram, four isolates demonstrated the worrisome finding of a colistin MIC in the resistant range. PFGE showed a clonal pattern. CONCLUSION: Metallo-β-lactamases among imipenem-resistant Pseudomonas aeruginosa were detected in 30.4% of imipenem-resistant Pseudomonas aeruginosa isolates. This number might have been higher if other genes were included. SPM-1 was the predominant enzyme found. Phenotypic tests with low kappa values could be misleading when testing for metallo-β-lactamases. Polymerase Chain Reaction detection remains the gold standard.
  • Títulos relacionados: https://www.revistas.usp.br/clinics/article/view/18536/20599
  • Editor: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo
  • Data de criação/publicação: 2010-01-01
  • Formato: Adobe PDF
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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