title: Molecular characterization of imipenem-resistant, cfiA-positive Bacteroides fragilis isolates from the USA, Hungary and Kuwait.
abstract: Fifteen Bacteroides fragilis isolates from the USA, Hungary and Kuwait were examined for carbapenem resistance, for carbapenemase activity and, with the use of various PCR-based methods and nucleotide sequencing, for cfiA genes and activating insertion sequence (IS) elements. All the B. fragilis isolates were cfiA-positive, 10 of the cfiA genes being upregulated by IS elements that are already known. Of these 10, one was of a novel type (designated IS943) and two further ones (IS614B and IS614C) were suspected hybrids of IS612, IS614 and IS942. There were five cfiA-positive imipenem-resistant B. fragilis isolates with elevated imipenem MICs (minimal inhibitory concentration) that harboured no IS insertion upstream of the cfiA gene, but produced carbapenemase; these isolates might possess a novel activation mechanism. On the basis of the available phenotypic and genotypic evidence, the present data suggest that there are at least two cfiA activation mechanisms among B. fragilis isolates.
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: József
authors.initials: J
authors.lastname: Sóki
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: Eleonóra
authors.initials: E
authors.lastname: Fodor
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: David W
authors.initials: DW
authors.lastname: Hecht
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: Richard
authors.initials: R
authors.lastname: Edwards
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: Vincent O
authors.initials: VO
authors.lastname: Rotimi
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: Irén
authors.initials: I
authors.lastname: Kerekes
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: Edit
authors.initials: E
authors.lastname: Urbán
authors.affiliation: Institute of Clinical Microbiology, University of Szeged, Szeged, Hungary 2Department of Medicine, Microbiology and Immunology, Loyola University Chicago, Maywood, and Department of Medicine, VA Hospital, Hines, USA 3Division of Microbiology, University Hospital, Queen's Medical Centre, Nottingham, UK 4Department of Microbiology, Faculty of Medicine, University of Kuwait, Kuwait 5`Vitality' Laboratory, Biological Research Center of Hungarian Academy of Sciences, Szeged, Hungary.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Nagy
mesh_terms: D000595:Amino Acid Sequence; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics* / Q000378:metabolism; D001442:Bacteroides Infections / Q000382:microbiology; D001441:Bacteroides fragilis / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D001483:Base Sequence; D004251:DNA Transposable Elements; D024881:Drug Resistance, Bacterial; D006801:Humans; D006814:Hungary; D015378:Imipenem / Q000494:pharmacology*; D007730:Kuwait; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D017422:Sequence Analysis, DNA; D014481:United States; D001618:beta-Lactamases / Q000235:genetics* / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004251:DNA Transposable Elements; D015378:Imipenem; D001618:beta-Lactamases; C063912:carbapenemase