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Survey of metallo-β-lactamase-producing Enterobacteriaceae colonizing patients in European ICUs and rehabilitation units, 2008-11.
J Antimicrob Chemother. 2015 Jul; 70(7):1981-8.JA

Abstract

OBJECTIVES

The objective of this study was to perform a multinational survey of patients' colonization by metallo-β-lactamase (MBL)-producing Enterobacteriaceae, including their molecular characterization.

METHODS

Patients in 18 hospital units across Europe and Israel (n = 17 945) were screened between mid-2008 and mid-2011. MBL-producing isolates were typed by PFGE and MLST. MBL genes were amplified and sequenced within their integrons. Plasmids with MBL genes were analysed by nuclease S1 plus hybridization profiling, mating and transformation assays, and by PCR-based replicon typing.

RESULTS

Ninety-one patients in nine centres (six countries), including 62 patients in two Greek ICUs, carried 94 non-duplicate MBL-producing organisms. Klebsiella pneumoniae isolates from Greece dominated (n = 57) and belonged mainly to ST147, ST36 and ST383. All but one of the isolates expressed VIM-1-type MBLs. Isolates of Greek origins produced five enzymes, including new VIM-39, encoded by class 1 integrons of four types. In-e541-like elements prevailed, comprising six variants located on IncR, IncFIIK, IncR + FIIK, IncR + A/C or non-typeable plasmids. The other group were new In4873 and In4863, being the first In416-like elements identified in Greece, which were present on IncA/C or non-typeable plasmids. Isolates from other countries produced only VIM-1 and the major integron was In916, identified in 16 organisms from France, Italy and Spain. In916 was carried by four plasmid types, including IncA/C, IncFIIK and IncHI2. Other integrons included a new element, In3103, in Spain and In110 identified only in Latvia.

CONCLUSIONS

This study provided fully comparable data on the occurrence and molecular characteristics of VIM-producing Enterobacteriaceae in a group of hospital units across Europe, documenting recent changes in their epidemiology.

Authors+Show Affiliations

National Medicines Institute, Warsaw, Poland Faculty of Medicine in Plzeň, Charles University in Prague, Plzeň, Czech Republic.National Medicines Institute, Warsaw, Poland.National Medicines Institute, Warsaw, Poland.National Medicines Institute, Warsaw, Poland.National Medicines Institute, Warsaw, Poland.Faculty of Medicine in Plzeň, Charles University in Prague, Plzeň, Czech Republic.University Medical Center Utrecht, Utrecht, The Netherlands.University Medical Center Utrecht, Utrecht, The Netherlands.Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.University of Antwerp, Antwerp, Belgium.National Medicines Institute, Warsaw, Poland.INSERM, U957 & Université Paris-Est, Créteil, France.National Medicines Institute, Warsaw, Poland gniadkow@cls.edu.pl.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25759034

Citation

Papagiannitsis, C C., et al. "Survey of Metallo-β-lactamase-producing Enterobacteriaceae Colonizing Patients in European ICUs and Rehabilitation Units, 2008-11." The Journal of Antimicrobial Chemotherapy, vol. 70, no. 7, 2015, pp. 1981-8.
Papagiannitsis CC, Izdebski R, Baraniak A, et al. Survey of metallo-β-lactamase-producing Enterobacteriaceae colonizing patients in European ICUs and rehabilitation units, 2008-11. J Antimicrob Chemother. 2015;70(7):1981-8.
Papagiannitsis, C. C., Izdebski, R., Baraniak, A., Fiett, J., Herda, M., Hrabák, J., Derde, L. P., Bonten, M. J., Carmeli, Y., Goossens, H., Hryniewicz, W., Brun-Buisson, C., & Gniadkowski, M. (2015). Survey of metallo-β-lactamase-producing Enterobacteriaceae colonizing patients in European ICUs and rehabilitation units, 2008-11. The Journal of Antimicrobial Chemotherapy, 70(7), 1981-8. https://doi.org/10.1093/jac/dkv055
Papagiannitsis CC, et al. Survey of Metallo-β-lactamase-producing Enterobacteriaceae Colonizing Patients in European ICUs and Rehabilitation Units, 2008-11. J Antimicrob Chemother. 2015;70(7):1981-8. PubMed PMID: 25759034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survey of metallo-β-lactamase-producing Enterobacteriaceae colonizing patients in European ICUs and rehabilitation units, 2008-11. AU - Papagiannitsis,C C, AU - Izdebski,R, AU - Baraniak,A, AU - Fiett,J, AU - Herda,M, AU - Hrabák,J, AU - Derde,L P G, AU - Bonten,M J M, AU - Carmeli,Y, AU - Goossens,H, AU - Hryniewicz,W, AU - Brun-Buisson,C, AU - Gniadkowski,M, AU - ,, AU - ,, Y1 - 2015/03/10/ PY - 2014/12/19/received PY - 2015/02/07/accepted PY - 2015/3/12/entrez PY - 2015/3/12/pubmed PY - 2016/3/12/medline KW - MBLs KW - MLST KW - VIM KW - integrons KW - plasmids SP - 1981 EP - 8 JF - The Journal of antimicrobial chemotherapy JO - J. Antimicrob. Chemother. VL - 70 IS - 7 N2 - OBJECTIVES: The objective of this study was to perform a multinational survey of patients' colonization by metallo-β-lactamase (MBL)-producing Enterobacteriaceae, including their molecular characterization. METHODS: Patients in 18 hospital units across Europe and Israel (n = 17 945) were screened between mid-2008 and mid-2011. MBL-producing isolates were typed by PFGE and MLST. MBL genes were amplified and sequenced within their integrons. Plasmids with MBL genes were analysed by nuclease S1 plus hybridization profiling, mating and transformation assays, and by PCR-based replicon typing. RESULTS: Ninety-one patients in nine centres (six countries), including 62 patients in two Greek ICUs, carried 94 non-duplicate MBL-producing organisms. Klebsiella pneumoniae isolates from Greece dominated (n = 57) and belonged mainly to ST147, ST36 and ST383. All but one of the isolates expressed VIM-1-type MBLs. Isolates of Greek origins produced five enzymes, including new VIM-39, encoded by class 1 integrons of four types. In-e541-like elements prevailed, comprising six variants located on IncR, IncFIIK, IncR + FIIK, IncR + A/C or non-typeable plasmids. The other group were new In4873 and In4863, being the first In416-like elements identified in Greece, which were present on IncA/C or non-typeable plasmids. Isolates from other countries produced only VIM-1 and the major integron was In916, identified in 16 organisms from France, Italy and Spain. In916 was carried by four plasmid types, including IncA/C, IncFIIK and IncHI2. Other integrons included a new element, In3103, in Spain and In110 identified only in Latvia. CONCLUSIONS: This study provided fully comparable data on the occurrence and molecular characteristics of VIM-producing Enterobacteriaceae in a group of hospital units across Europe, documenting recent changes in their epidemiology. SN - 1460-2091 UR - https://www.unboundmedicine.com/medline/citation/25759034/Survey_of_metallo_β_lactamase_producing_Enterobacteriaceae_colonizing_patients_in_European_ICUs_and_rehabilitation_units_2008_11_ L2 - https://academic.oup.com/jac/article-lookup/doi/10.1093/jac/dkv055 DB - PRIME DP - Unbound Medicine ER -