Tags

Type your tag names separated by a space and hit enter

Detection of an IncA/C plasmid encoding VIM-4 and CMY-4 β-lactamases in Klebsiella oxytoca and Citrobacter koseri from an inpatient in a cardiac rehabilitation unit.
New Microbiol. 2015 Jul; 38(3):387-92.NM

Abstract

A 62-year-old patient was transferred to the cardiac rehabilitation unit of the I.R.C.C.S. Fondazione S. Maugeri after undergoing a heart transplantation at the Acute Care Hospital I.R.C.C.S. S. Matteo of Pavia. On 1 August 2013 and during hospitalization in the rehabilitation unit, Klebsiella oxytoca and Citrobacter koseri clinical isolates were simultaneously recovered from the patient's preputial swab. Both the K. oxytoca and C. koseri strains were carbapenem- resistant by MicroScan System (Beckman Coulter). Carbapenem-resistant K. pneumoniae had previously been reported in the same rehabilitation facility. The aim of the study was to identify the carbapenem resistance mechanisms among the enterobacterial species recovered. Phenotypic screening tests useful to detect the β-lactamases/carbapenemases were performed. Carbapenem MICs were obtained by Etest. AmpC and MBL encoding genes were identified by PCR and sequencing. Conjugation assays and plasmid characterization were performed. Both of the K. oxytoca and C. koseri isolates were multi drug resistant, showing resistance to amoxicillin-clavulanic acid, three generation cephalosporins, ertapenem (K. oxytoca MIC, >32 mg/L; C. koseri MIC, 4 mg/L), imipenem (K. oxytoca MIC, 4 mg/L; C. koseri MIC, 12 mg/L), thrimethoprim sulphamethoxazole and gentamicin. Susceptibility was retained to fluoroquinolones, colistin and tigecycline. Molecular characterization confirmed the co-presence of blaCMY-4 and blaVIM-4 determinants in a 150 Kb transferable plasmid of IncA/C group. This case is the first detection in Italy of the K. oxytoca and C. koseri clinical isolates co-producing the CMY-4 and VIM-4 enzymes.

Authors+Show Affiliations

Clinical-Surgical, Diagnostic and Pediatric Sciences Department, University of Pavia, Italy.Clinical-Surgical, Diagnostic and Pediatric Sciences Department, University of Pavia, Italy.Clinical-Surgical, Diagnostic and Pediatric Sciences Department, University of Pavia, Italy.Clinical-Surgical, Diagnostic and Pediatric Sciences Department, University of Pavia, Italy.Clinical-Surgical, Diagnostic and Pediatric Sciences Department, University of Pavia, Italy.I.R.C.C.S. Fondazione Salvatore Maugeri, Pavia, Italy.Clinical-Surgical, Diagnostic and Pediatric Sciences Department, University of Pavia, Italy.

Pub Type(s)

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

Language

eng

PubMed ID

26147151

Citation

Caltagirone, Mariasofia, et al. "Detection of an IncA/C Plasmid Encoding VIM-4 and CMY-4 Β-lactamases in Klebsiella Oxytoca and Citrobacter Koseri From an Inpatient in a Cardiac Rehabilitation Unit." The New Microbiologica, vol. 38, no. 3, 2015, pp. 387-92.
Caltagirone M, Bitar I, Piazza A, et al. Detection of an IncA/C plasmid encoding VIM-4 and CMY-4 β-lactamases in Klebsiella oxytoca and Citrobacter koseri from an inpatient in a cardiac rehabilitation unit. New Microbiol. 2015;38(3):387-92.
Caltagirone, M., Bitar, I., Piazza, A., Spalla, M., Nucleo, E., Navarra, A., & Migliavacca, R. (2015). Detection of an IncA/C plasmid encoding VIM-4 and CMY-4 β-lactamases in Klebsiella oxytoca and Citrobacter koseri from an inpatient in a cardiac rehabilitation unit. The New Microbiologica, 38(3), 387-92.
Caltagirone M, et al. Detection of an IncA/C Plasmid Encoding VIM-4 and CMY-4 Β-lactamases in Klebsiella Oxytoca and Citrobacter Koseri From an Inpatient in a Cardiac Rehabilitation Unit. New Microbiol. 2015;38(3):387-92. PubMed PMID: 26147151.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detection of an IncA/C plasmid encoding VIM-4 and CMY-4 β-lactamases in Klebsiella oxytoca and Citrobacter koseri from an inpatient in a cardiac rehabilitation unit. AU - Caltagirone,Mariasofia, AU - Bitar,Ibrahim, AU - Piazza,Aurora, AU - Spalla,Melissa, AU - Nucleo,Elisabetta, AU - Navarra,Antonella, AU - Migliavacca,Roberta, Y1 - 2015/07/06/ PY - 2015/01/29/received PY - 2015/05/21/accepted PY - 2015/7/7/entrez PY - 2015/7/7/pubmed PY - 2015/10/28/medline KW - Cephalosporinases KW - Metallo-β-lactamases KW - Multi-drug resistant Enterobacteriaceae KW - Rehabilitation unit SP - 387 EP - 92 JF - The new microbiologica JO - New Microbiol VL - 38 IS - 3 N2 - A 62-year-old patient was transferred to the cardiac rehabilitation unit of the I.R.C.C.S. Fondazione S. Maugeri after undergoing a heart transplantation at the Acute Care Hospital I.R.C.C.S. S. Matteo of Pavia. On 1 August 2013 and during hospitalization in the rehabilitation unit, Klebsiella oxytoca and Citrobacter koseri clinical isolates were simultaneously recovered from the patient's preputial swab. Both the K. oxytoca and C. koseri strains were carbapenem- resistant by MicroScan System (Beckman Coulter). Carbapenem-resistant K. pneumoniae had previously been reported in the same rehabilitation facility. The aim of the study was to identify the carbapenem resistance mechanisms among the enterobacterial species recovered. Phenotypic screening tests useful to detect the β-lactamases/carbapenemases were performed. Carbapenem MICs were obtained by Etest. AmpC and MBL encoding genes were identified by PCR and sequencing. Conjugation assays and plasmid characterization were performed. Both of the K. oxytoca and C. koseri isolates were multi drug resistant, showing resistance to amoxicillin-clavulanic acid, three generation cephalosporins, ertapenem (K. oxytoca MIC, >32 mg/L; C. koseri MIC, 4 mg/L), imipenem (K. oxytoca MIC, 4 mg/L; C. koseri MIC, 12 mg/L), thrimethoprim sulphamethoxazole and gentamicin. Susceptibility was retained to fluoroquinolones, colistin and tigecycline. Molecular characterization confirmed the co-presence of blaCMY-4 and blaVIM-4 determinants in a 150 Kb transferable plasmid of IncA/C group. This case is the first detection in Italy of the K. oxytoca and C. koseri clinical isolates co-producing the CMY-4 and VIM-4 enzymes. SN - 1121-7138 UR - https://www.unboundmedicine.com/medline/citation/26147151/Detection_of_an_IncA/C_plasmid_encoding_VIM_4_and_CMY_4_β_lactamases_in_Klebsiella_oxytoca_and_Citrobacter_koseri_from_an_inpatient_in_a_cardiac_rehabilitation_unit_ L2 - http://www.newmicrobiologica.org/PUB/allegati_pdf/2015/3/387.pdf DB - PRIME DP - Unbound Medicine ER -