Molecular Epidemiology and Clinical Implications of Metallo-β- Lactamase-Producing Pseudomonas aeruginosa Isolated from Urine

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Domenic Oliver
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1 Acta Med. Okayama, Vol., No., pp. Molecular Epidemiology and Clinical Implications of Metallo-β- Lactamase-Producing Pseudomonas aeruginosa Isolated from Urine Shinichi Sako a, Reiko Kariyama a*, Ritsuko Mitsuhata a, Masumi Yamamoto a, Koichiro Wada a, Ayano Ishii a, Shinya Uehara a, Susumu Kokeguchi b, Nobuchika Kusano c, and Hiromi Kumon a a b c We conducted a study on molecular epidemiology and clinical implications of metallo ヘータ lactamase (MBL)producing Pseudomonas aeruginosa isolated from urine. Over a 10year period from 2001 through 2010, a total of 92 MBLproducing P. aeruginosa urine isolates were collected from patients (one isolate per patient) who were admitted to 5 hospitals in Okayama Prefecture, Japan. When cross infection was suspected in the hospital, pulsedfield gel electrophoresis was performed. In the resulting dendrogram of 79 MBLproducing P. aeruginosa urine isolates, no identical isolates and 7 pairs of isolates with 80 similarity were found. The biofilmforming capabilities of 92 MBLproducing P. aeruginosa urine isolates were significantly greater than those of 92 nonmblproducing urine isolates in a medium of modified artificial urine. The imipenem resistance transferred in 16 of 18 isolates tested, and these frequencies were in the range of 10 3 to All of 18 isolates tested belonged to internationally spread sequence type 235 and had 3 gene cassettes of antimicrobial resistance genes in the class 1 integron. The strong biofilmforming capabilities of MBLproducing P. aeruginosa urine isolates could be seriously implicated in nosocomial infections. To prevent spread of the organism and transferable genes, effective strategies to inhibit biofilm formation in medical settings are needed. Key words: P

2 Sako et al. Acta Med. Okayama Vol., No. Materials and Methods Clinical isolates. Polymerase chain reaction (PCR) analysis. Pulsedfield gel electrophoresis (PFGE). ʼ

3 April MetalloβLactamaseProducing P. aeruginosa Susceptibility testing. Biofilm formation assay. Conjugative transfer experiments. Multilocus sequence typing (MLST).

4 Sako et al. Acta Med. Okayama Vol., No. PCR amplification of variable regions of the bla IMP1 containing integrons. ʼ ʼ ʼ Results PFGE analysis. Fig ʼ

5 April MetalloβLactamaseProducing P. aeruginosa Table 1 5ʼ3ʼ

6 Sako et al. Acta Med. Okayama Vol., No. 80 Fig

7 April MetalloβLactamaseProducing P. aeruginosa Antimicrobial susceptibility and biofilm forming capabilities Fig Carbapenemresistance transfer. Multilocus sequence typing (MLST). Structure of the bla IMP1 containing integrons. ʼ Discussion

8 Sako et al. Acta Med. Okayama Vol., No. Table ʼ

9 April MetalloβLactamaseProducing P. aeruginosa ʼ

10 Sako et al. Acta Med. Okayama Vol., No References ʼ ʼ

11 April MetalloβLactamaseProducing P. aeruginosa ʼ

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