title: Characterization of an epidemic carbapenem-resistant Pseudomonas aeruginosa producing SPM-1 metallo-beta-lactamase in a hospital located in Rio de Janeiro, Brazil.
abstract: Metallo-beta-lactamase production is emerging worldwide as an important mechanism of carbapenem resistance among nonfermentative Gram-negative isolates, and this mechanism is becoming frequently observed in Brazil. This study documents the occurrence and characteristics of an epidemic SPM-1-producing Pseudomonas aeruginosa strain in a teaching hospital located in Rio de Janeiro City, Brazil. The bla (SPM-1) gene and a class 1 integron were detected in 13 isolates, representing 20% of the 65 imipenem-resistant P. aeruginosa isolates obtained from January, 2000, to August, 2001. DNA sequencing revealed that this integron carries three gene cassettes that confer resistance to antimicrobials, aacA4, bla (OXA-56), and aadA7, and an orf1 encoding a putative transposase. All 13 SPM-producing P. aeruginosa isolates had closely related pulsed-field gel electrophoresis (PFGE) profiles, designated as clonal group A, suggesting nosocomial spread of the strain. This clonal group was the same as that observed in other SPM-1-producing P. aeruginosa isolates from distinct Brazilian states. The dissemination of this clone throughout Brazil could not be explained by transfer of infected patients and/or sharing of common health-care staff. It is likely that the spread of these strains occurred indirectly via the community.
authors.affiliation: Departamento de Microbiologia Médica, Instituto de Microbiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ 21941-590, Brazil. nipa@terra.com.br
authors.forename: Ana Paula D'Alincourt
authors.initials: AP
authors.lastname: Carvalho
authors.forename: Rodolpho Mattos
authors.initials: RM
authors.lastname: Albano
authors.forename: Denise Neves
authors.initials: DN
authors.lastname: de Oliveira
authors.forename: Daniela Anhel de Paula
authors.initials: DA
authors.lastname: Cidade
authors.forename: Lúcia Martins
authors.initials: LM
authors.lastname: Teixeira
authors.forename: Elizabeth de Andrade
authors.initials: Ede A
authors.lastname: Marques
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001483:Base Sequence; D001938:Brazil / Q000453:epidemiology; D015780:Carbapenems / Q000494:pharmacology*; D015169:Colony Count, Microbial; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D005798:Genes, Bacterial; D006784:Hospitals, Teaching; D006801:Humans; D032023:Integrons; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D011552:Pseudomonas Infections / Q000453:epidemiology / Q000382:microbiology*; D011550:Pseudomonas aeruginosa / Q000187:drug effects* / Q000201:enzymology / Q000302:isolation & purification; D001618:beta-Lactamases / Q000235:genetics*
chemical_list: D000900:Anti-Bacterial Agents; D015780:Carbapenems; C476155:beta-lactamase SPM-1, Pseudomonas aeruginosa; D001618:beta-Lactamases